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This is the second volume of a series of mainly expository articles on the arithmetic theory of automorphic forms. It forms a sequel to On the Stabilization of the Trace Formula published in 2011. The books are intended primarily for two groups of readers: those interested in the structure of automorphic forms on reductive groups over number fields, and specifically in qualitative information on multiplicities of automorphic representations; and those interested in the classification of I-adic representations of Galois groups of number fields. Langlands' conjectures elaborate on the notion that these two problems overlap considerably. These volumes present convincing evidence supporting this, clearly and succinctly enough that readers can pass with minimal effort between the two points of view. Over a decade's worth of progress toward the stabilization of the Arthur-Selberg trace formula, culminating in Ngo Bau Chau's proof of the Fundamental Lemma, makes this series timely.
There is no single ultrasound probe available that allows visualization of all airway structures in children of all ages. In larger children above approximately 8 years of age, the linear medium-to-high frequency (5–14 MHz) transducer is suitable for imaging superficial airway structures (within 0–5 cm beneath the skin surface). The curved low-frequency transducer (~4.0 MHz) is most suitable for obtaining sagittal and parasagittal views of the tongue and structures in the submandibular and supraglottic regions, mainly because of its wider field of view. Linear transducers, which are used for assessment of the upper airways, provide excellent images of superficial structures, such as ribs and the pleura, but deeper structures can be difficult to assess. A micro-convex transducer (~8.0 MHz) is a good all-round transducer for focused ultrasonographic examination of the lungs, since most micro-convex transducers have an acceptable image quality of both superficial (pleura) and deeper structures (e.g., lung consolidation, atelectasis). Furthermore, micro-convex transducers are often small, which makes it easier to access the posterior thoracic wall, when the patient can only be examined in the supine position. An alternative to the micro-convex transducer for examination of the lungs is the curved low-frequency transducer (~4.0 MHz), which also has an acceptable image quality of both superficial and deeper structures. Since visualization of superficial and deep structures is needed, it is important to continuously optimize transducer frequency to obtain the best possible images. The presence or absence of artifacts are an important part of lung ultrasonography; hence, one should be mindful to deactivate any image optimization software that is inherently built into newer ultrasound machines as this would remove or diminish the presence of these useful artifacts when performing lung ultrasonography.
Healthcare-associated bloodstream infections (HABSIs) are a significant cause of mortality and morbidity in the neonatal intensive care unit (NICU) population. Our objectives were to review the epidemiology of HABSIs in our NICU and to examine the applicability of National Healthcare Safety Network (NHSN) definitions to the NICU population.
We performed a retrospective review of all neonates admitted to the 54-bed, level IV NICU at Yale-New Haven Children’s Hospital with a HABSI between January 1, 2013, and December 31, 2018. Clinical definitions per NICU team and NHSN site-specific definitions used for source identification were compared using the McNemar χ2 test.
We identified 86 HABSIs with an incidence rate of 0.80 per 1,000 patient days. Only 13% of these were CLABSIs. Both CLABSIs and non–catheter-related bloodstream infections occurred primarily in preterm neonates, but the latter were associated with a significantly higher incidence of comorbidities and the need for respiratory support. The NHSN definitions were less likely to identify a source compared to the clinical definitions agreed upon by our NICU treating team (P < .001). Furthermore, 50% of patients without an identified source of infection by NHSN definitions were bacteremic with a mucosal barrier injury organism, likely from gut translocation.
HABSIs occur primarily in premature infants with comorbidities, and CLABSIs account for a small proportion of these infections. With the increasing focus on HABSI prevention, there is a need for better NHSN site-specific definitions for the NICU population to prevent misclassification and direct prevention efforts.
Preparation of electron-transparent thin specimens can be costly in terms of time and is often challenging. Materials and products are becoming more complex, and device components are getting smaller each year. On the other hand, analysis and diagnostic methods become more exacting. Lack of time and high costs for diagnostics force companies to speed up, simplify, and customize the analysis process. Ultra-short-pulsed laser-based sample preparation can speed up the process and make possible new sample geometries. This article shows the advantages of this technology and how it can be used to prepare TEM lamellas (H-Bar) and multiple APT tips or pillars.
The science of studying diamond inclusions for understanding Earth history has developed significantly over the past decades, with new instrumentation and techniques applied to diamond sample archives revealing the stories contained within diamond inclusions. This chapter reviews what diamonds can tell us about the deep carbon cycle over the course of Earth’s history. It reviews how the geochemistry of diamonds and their inclusions inform us about the deep carbon cycle, the origin of the diamonds in Earth’s mantle, and the evolution of diamonds through time.
In this paper, we present an experimental investigation of the turbulent saturation of the flow driven by the parametric resonance of inertial waves in a rotating fluid. In our set-up, a half-metre wide ellipsoid filled with water is brought to solid-body rotation, and then undergoes sustained harmonic modulation of its rotation rate. This triggers the exponential growth of a pair of inertial waves via a mechanism called the libration-driven elliptical instability. Once the saturation of this instability is reached, we observe a turbulent state for which energy is injected into the resonant inertial waves only. Depending on the amplitude of the rotation rate modulation, two different saturation states are observed. At large forcing amplitudes, the saturation flow mainly consists of a steady, geostrophic anticyclone. Its amplitude vanishes as the forcing amplitude is decreased while remaining above the threshold of the elliptical instability. Below this secondary transition, the saturation flow is a superposition of inertial waves which are in weakly nonlinear resonant interaction, a state that could asymptotically lead to inertial wave turbulence. In addition to being a first experimental observation of a wave-dominated saturation in unstable rotating flows, the present study is also an experimental confirmation of the model of Le Reun et al. (Phys. Rev. Lett., vol. 119 (3), 2017, 034502) who introduced the possibility of these two turbulent regimes. The transition between these two regimes and their relevance to geophysical applications are finally discussed.
Simulation plays an integral role in the Canadian healthcare system with applications in quality improvement, systems development, and medical education. High-quality, simulation-based research will ensure its effective use. This study sought to summarize simulation-based research activity and its facilitators and barriers, as well as establish priorities for simulation-based research in Canadian emergency medicine (EM).
Simulation-leads from Canadian departments or divisions of EM associated with a general FRCP-EM training program surveyed and documented active EM simulation-based research at their institutions and identified the perceived facilitators and barriers. Priorities for simulation-based research were generated by simulation-leads via a second survey; these were grouped into themes and finally endorsed by consensus during an in-person meeting of simulation leads. Priority themes were also reviewed by senior simulation educators.
Twenty simulation-leads representing all 14 invited institutions participated in the study between February and May, 2018. Sixty-two active, simulation-based research projects were identified (median per institution = 4.5, IQR 4), as well as six common facilitators and five barriers. Forty-nine priorities for simulation-based research were reported and summarized into eight themes: simulation in competency-based medical education, simulation for inter-professional learning, simulation for summative assessment, simulation for continuing professional development, national curricular development, best practices in simulation-based education, simulation-based education outcomes, and simulation as an investigative methodology.
This study summarized simulation-based research activity in EM in Canada, identified its perceived facilitators and barriers, and built national consensus on priority research themes. This represents the first step in the development of a simulation-based research agenda specific to Canadian EM.
To assess whether a community water service is associated with the frequency of sugar-sweetened beverages (SSB) consumption, obesity, or perceived health status in rural Alaska.
We examined the cross-sectional associations between community water access and frequency of SSB consumption, body mass index categories, and perceived health status using data from the 2013 and 2015 Alaska Behavioral Risk Factor Surveillance System (BRFSS). Participants were categorized by zip code to ‘in-home piped water service’ or ‘no in-home piped water service’ based on water utility data. We evaluated the univariable and multivariable (adjusting for age, household income and education) associations between water service and outcomes using log-linear survey-weighted generalized linear models.
Rural Alaska, USA.
Eight hundred and eighty-seven adults, aged 25 years and older.
In unadjusted models, participants without in-home water reported consuming SSB more often than participants with in-home water (1·46, 95 % CI: 1·06, 2·00). After adjustment for potential confounders, the effect decreased but remained borderline significant (1·29, 95 % CI: 1·00, 1·67). Obesity was not significantly associated with water service but self-reported poor health was higher in those communities without in-home water (1·63, 95 % CI: 1·05, 2·54).
Not having access to in-home piped water could affect behaviours surrounding SSB consumption and general perception of health in rural Alaska.
Metabolic syndrome (MetS) is associated with reduced life expectancy in patients with affective disorders, however, whether MetS also plays a role before the onset of affective disorder is unknown. We aimed to investigate whether MetS, inflammatory markers or oxidative stress act as risk factors for affective disorders, and whether MetS is associated with increased inflammation and oxidative stress.
We conducted a high-risk study including 204 monozygotic (MZ) twins with unipolar or bipolar disorder in remission or partial remission (affected), their unaffected co-twins (high-risk) and twins with no personal or family history of affective disorder (low-risk). Metabolic Syndrome was ascertained according to the International Diabetes Federation (IDF) criteria. Inflammatory markers and markers of oxidative stress were analyzed from fasting blood and urine samples, respectively.
The affected and the high-risk group had a significantly higher prevalence of MetS compared to the low-risk group (20% v. 15% v. 2.5%, p = 0.0006), even after adjusting for sex, age, smoking and alcohol consumption. No differences in inflammatory and oxidative markers were seen between the three groups. Further, MetS was associated with alterations in inflammatory markers, and oxidative stress was modestly correlated with inflammation.
Metabolic syndrome is associated with low-grade inflammation and may act as a risk factor and a trait marker for affective disorders. If confirmed in longitudinal studies, this suggests the importance of early intervention and preventive approaches targeted towards unhealthy lifestyle factors that may contribute to later psychopathology.
The aggregation of neurocognitive deficits among the non-psychotic first-degree relatives of adult- and childhood-onset schizophrenia patients suggests that there may be a common etiology for these deficits in childhood- and adult-onset illness. However, there is considerable heterogeneity in the presentation of neurobiological abnormalities, and whether there are differences in the extent of familial transmission for specific domains of cognitive function has not been systematically addressed.
We employed variance components analysis, as implemented in SOLAR-Eclipse, to evaluate the evidence of familial transmission for empirically derived composite scores representing attention, working memory, verbal learning, verbal retention, and memory for faces. We contrast estimates for adult- and childhood-onset schizophrenia families and matched community control pedigrees, and compare our findings to previous reports based on analogous neurocognitive assessments.
We observed varying degrees of familial transmission; attention and working memory yielded comparable, significant estimates for adult-onset and community control pedigrees; verbal learning was significant for childhood-onset and community control pedigrees; and facial memory demonstrated significant familial transmission only for childhood-onset schizophrenia. Model-fitting analyses indicated significant differences in familiality between adult- and childhood-onset schizophrenia for attention, working memory, and verbal learning.
By comprehensively assessing a wide range of neurocognitive domains in adult- and childhood-onset schizophrenia families, we provide additional support for specific neurocognitive domains as schizophrenia endophenotypes. Whereas comparable estimates of familial transmission for certain dimensions of cognitive functioning support a shared etiology of adult- and childhood-onset neurocognitive function, observed differences may be taken as preliminary evidence of partially divergent multifactorial architectures.
Public support is usually a precondition for the adoption and successful implementation of costly policies. We argue that such support is easier to achieve with policy-packages that incorporate primary and ancillary measures. We specifically distinguish command-and-control and market-based measures as primary measures and argue that the former will usually garner more public support than the latter given the low-visibility tendency of costs associated with command-and-control measures. Nevertheless, if included in a policy-package, ancillary measures are likely to increase public support by reducing negative effects of primary measures. Based on a choice experiment with a representative sample of 2,034 Swiss citizens, we assessed these arguments with respect to political efforts to reduce vehicle emissions. The empirical analysis supported the argument that policy-packaging affects public support positively, particularly generating more support when ancillary measures are added. Lastly, we ultimately observe that command-and-control measures obtain more public support than market-based instruments.
Cognitive deficits in depressed adults may reflect impaired decision-making. To investigate this possibility, we analyzed data from unmedicated adults with Major Depressive Disorder (MDD) and healthy controls as they performed a probabilistic reward task. The Hierarchical Drift Diffusion Model (HDDM) was used to quantify decision-making mechanisms recruited by the task, to determine if any such mechanism was disrupted by depression.
Data came from two samples (Study 1: 258 MDD, 36 controls; Study 2: 23 MDD, 25 controls). On each trial, participants indicated which of two similar stimuli was presented; correct identifications were rewarded. Quantile-probability plots and the HDDM quantified the impact of MDD on response times (RT), speed of evidence accumulation (drift rate), and the width of decision thresholds, among other parameters.
RTs were more positively skewed in depressed v. healthy adults, and the HDDM revealed that drift rates were reduced—and decision thresholds were wider—in the MDD groups. This pattern suggests that depressed adults accumulated the evidence needed to make decisions more slowly than controls did.
Depressed adults responded slower than controls in both studies, and poorer performance led the MDD group to receive fewer rewards than controls in Study 1. These results did not reflect a sensorimotor deficit but were instead due to sluggish evidence accumulation. Thus, slowed decision-making—not slowed perception or response execution—caused the performance deficit in MDD. If these results generalize to other tasks, they may help explain the broad cognitive deficits seen in depression.
Objectives: To describe multivariate base rates (MBRs) of low scores and reliable change (decline) scores on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) in college athletes at baseline, as well as to assess MBR differences among demographic and medical history subpopulations. Methods: Data were reported on 15,909 participants (46.5% female) from the NCAA/DoD CARE Consortium. MBRs of ImPACT composite scores were derived using published CARE normative data and reliability metrics. MBRs of sex-corrected low scores were reported at <25th percentile (Low Average), <10th percentile (Borderline), and ≤2nd percentile (Impaired). MBRs of reliable decline scores were reported at the 75%, 90%, 95%, and 99% confidence intervals. We analyzed subgroups by sex, race, attention-deficit/hyperactivity disorder and/or learning disability (ADHD/LD), anxiety/depression, and concussion history using chi-square analyses. Results: Base rates of low scores and reliable decline scores on individual composites approximated the normative distribution. Athletes obtained ≥1 low score with frequencies of 63.4% (Low Average), 32.0% (Borderline), and 9.1% (Impaired). Athletes obtained ≥1 reliable decline score with frequencies of 66.8%, 32.2%, 18%, and 3.8%, respectively. Comparatively few athletes had low scores or reliable decline on ≥2 composite scores. Black/African American athletes and athletes with ADHD/LD had higher rates of low scores, while greater concussion history was associated with lower MBRs (p < .01). MBRs of reliable decline were not associated with demographic or medical factors. Conclusions: Clinical interpretation of low scores and reliable decline on ImPACT depends on the strictness of the low score cutoff, the reliable change criterion, and the number of scores exceeding these cutoffs. Race and ADHD influence the frequency of low scores at all cutoffs cross-sectionally.
Residual herbicides are routinely applied to control troublesome weeds in pumpkin production. Fluridone and acetochlor, Groups 12 and 15 herbicides, respectively, provide broad-spectrum PRE weed control. Field research was conducted in Virginia and New Jersey to evaluate pumpkin tolerance and weed control to PRE herbicides. Treatments consisted of fomesafen at two rates, ethalfluralin, clomazone, halosulfuron, fluridone, S-metolachlor, acetochlor emulsifiable concentrate (EC), acetochlor microencapsulated (ME), and no herbicide. At one site, fluridone, acetochlor EC, acetochlor ME, and halosulfuron injured pumpkin 81%, 39%, 34%, and 35%, respectively, at 14 d after planting (DAP); crop injury at the second site was 40%, 8%, 19%, and 33%, respectively. Differences in injury between the two sites may have been due to the amount and timing of rainfall after herbicides were applied. Fluridone provided 91% control of ivyleaf morningglory and 100% control of common ragweed at 28 DAP. Acetochlor EC controlled redroot pigweed 100%. Pumpkin treated with S-metolachlor produced the most yield (10,764 fruits ha–1) despite broadcasting over the planted row; labeling requires a directed application to row-middles. A separate study specifically evaluated fluridone applied PRE at 42, 84, 126, 168, 252, 336, and 672 g ai ha–1. Fluridone resulted in pumpkin injury ≥95% when applied at rates of ≥168 g ai ha–1; significant yield loss was noted when the herbicide was applied at rates >42 g ai ha–1. We concluded that fluridone and acetochlor formulations are unacceptable candidates for pumpkin production.
Today, information and knowledge as competitive factors influence the success of companies as much as traditional production factors like human resources or physical capital. However, the reuse of design knowledge still represents a major challenge for engineering organizations. That is, because barriers exist hindering a successful knowledge reuse. On the basis of a literature review, the research depicted in this paper analyses the relation between single information conveying design knowledge and barriers hindering a successful knowledge reuse. Developing a model-based approach, we propose a micro logic containing three steps and underlying methods enabling practitioners to identify situation-specific barriers within their organization. We illustrate the industrial application of the approach in a case study at a mining machinery OEM.