Method and Meaning: Selections from the Gettysburg College Collection

What is art historical study and how it should be carried out are fundamental questions the exhibition Method and Meaning: Selections from the Gettysburg College Collection intends to answer. This student-curated exhibition is an exciting academic endeavor of seven students of art history majors and minors in the Art History Methods course. The seven student curators are Shannon Callahan, Ashlie Cantele, Maura D’Amico, Xiyang Duan, Devin Garnick, Allison Gross and Emily Zbehlik. As part of the class assignment, this exhibition allows the students to explore various art history methods on individual case studies. The selection of the works in the exhibition reflects a wide array of student research interests including an example of 18th century Chinese jade chime stone, jade and bronze replicas of ancient Chinese bronze vessels, a piece of early 20th century Chinese porcelain, oil paintings by Pennsylvania Impressionist painter Fern Coppedge, prints by Salvador Dalí and by German artist Käthe Kollwitz, and an early 20th century wood block print by Japanese artist Kawase Hasui. [excerpt]https://cupola.gettysburg.edu/artcatalogs/1014/thumbnail.jp

Nanophotonic design principles for ultrahigh efficiency photovoltaics

To date, solar-cell efficiencies have remained well below the thermodynamic limits. However new nanophotonic and microphotonic approaches to light management that systematically minimize thermodynamic losses can enable ultrahigh efficiencies previously considered to be out of reach

Extremely broadband ultralight thermally emissive metasurfaces

We report the design, fabrication and characterization of ultralight highly emissive metaphotonic structures with record-low mass/area that emit thermal radiation efficiently over a broad spectral (2 to 35 microns) and angular (0-60 degrees) range. The structures comprise one to three pairs of alternating nanometer-scale metallic and dielectric layers, and have measured effective 300 K hemispherical emissivities of 0.7 to 0.9. To our knowledge, these structures, which are all subwavelength in thickness are the lightest reported metasurfaces with comparable infrared emissivity. The superior optical properties, together with their mechanical flexibility, low outgassing, and low areal mass, suggest that these metasurfaces are candidates for thermal management in applications demanding of ultralight flexible structures, including aerospace applications, ultralight photovoltaics, lightweight flexible electronics, and textiles for thermal insulation

Validation of the Family Inpatient Communication Survey

CONTEXT: Although many family members who make surrogate decisions report problems with communication, there is no validated instrument to accurately measure surrogate/clinician communication for older adults in the acute hospital setting. OBJECTIVES: The objective of this study was to validate a survey of surrogate-rated communication quality in the hospital that would be useful to clinicians, researchers, and health systems. METHODS: After expert review and cognitive interviewing (n = 10 surrogates), we enrolled 350 surrogates (250 development sample and 100 validation sample) of hospitalized adults aged 65 years and older from three hospitals in one metropolitan area. The communication survey and a measure of decision quality were administered within hospital days 3 and 10. Mental health and satisfaction measures were administered six to eight weeks later. RESULTS: Factor analysis showed support for both one-factor (Total Communication) and two-factor models (Information and Emotional Support). Item reduction led to a final 30-item scale. For the validation sample, internal reliability (Cronbach's alpha) was 0.96 (total), 0.94 (Information), and 0.90 (Emotional Support). Confirmatory factor analysis fit statistics were adequate (one-factor model, comparative fit index = 0.981, root mean square error of approximation = 0.62, weighted root mean square residual = 1.011; two-factor model comparative fit index = 0.984, root mean square error of approximation = 0.055, weighted root mean square residual = 0.930). Total score and subscales showed significant associations with the Decision Conflict Scale (Pearson correlation -0.43, P < 0.001 for total score). Emotional Support was associated with improved mental health outcomes at six to eight weeks, such as anxiety (-0.19 P < 0.001), and Information was associated with satisfaction with the hospital stay (0.49, P < 0.001). CONCLUSION: The survey shows high reliability and validity in measuring communication experiences for hospital surrogates. The scale has promise for measurement of communication quality and is predictive of important outcomes, such as surrogate satisfaction and well-being

The Family Navigator: A pilot intervention to support intensive care unit family surrogates

Background Although communication problems between family surrogates and intensive care unit (ICU) clinicians have been documented, there are few effective interventions. Nurses have the potential to play an expanded role in ICU communication and decision making. Objectives To conduct a pilot randomized controlled trial of the Family Navigator (FN), a distinct nursing role to address family members’ unmet communication needs early in an ICU stay. Methods An inter-disciplinary team developed the FN protocol. A randomized controlled pilot intervention trial of the FN was performed in a tertiary referral hospital ICU to test the feasibility and acceptability of the intervention. The intervention addressed informational and emotional communication needs through daily contact using structured clinical updates, emotional and informational support modules, family meeting support and follow-up phone calls. Results Twenty-six surrogate/patient pairs (13 per study arm) were enrolled. Surrogates randomized to the intervention had contact with the FN 90% or more of eligible patient days. All surrogates agreed or strongly agreed that they would recommend the FN to other families. Open-ended comments from both surrogates and clinicians were uniformly positive. For both groups, 100% of baseline data collection interviews and 81% of 6–8 week follow-up interviews were completed. Conclusions A fully integrated nurse empowered to facilitate decision making is a feasible intervention in the ICU setting. It is well-received by ICU families and staff. A larger randomized controlled trial is needed to demonstrate an impact on important outcomes, such as surrogate well-being and decision quality

Extremely broadband ultralight thermally emissive metasurfaces

We report the design, fabrication and characterization of ultralight highly emissive metaphotonic structures with record-low mass/area that emit thermal radiation efficiently over a broad spectral (2 to 35 microns) and angular (0–60°) range. The structures comprise one to three pairs of alternating nanometer-scale metallic and dielectric layers, and have measured effective 300 K hemispherical emissivities of 0.7 to 0.9. To our knowledge, these structures, which are all subwavelength in thickness are the lightest reported metasurfaces with comparable infrared emissivity. The superior optical properties, together with their mechanical flexibility, low outgassing, and low areal mass, suggest that these metasurfaces are candidates for thermal management in applications demanding of ultralight flexible structures, including aerospace applications, ultralight photovoltaics, lightweight flexible electronics, and textiles for thermal insulation

NSAID use and clinical outcomes in COVID-19 patients: a 38-center retrospective cohort study.

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain, fever, and inflammation but have been associated with complications in community-acquired pneumonia. Observations shortly after the start of the COVID-19 pandemic in 2020 suggested that ibuprofen was associated with an increased risk of adverse events in COVID-19 patients, but subsequent observational studies failed to demonstrate increased risk and in one case showed reduced risk associated with NSAID use. METHODS: A 38-center retrospective cohort study was performed that leveraged the harmonized, high-granularity electronic health record data of the National COVID Cohort Collaborative. A propensity-matched cohort of 19,746 COVID-19 inpatients was constructed by matching cases (treated with NSAIDs at the time of admission) and 19,746 controls (not treated) from 857,061 patients with COVID-19 available for analysis. The primary outcome of interest was COVID-19 severity in hospitalized patients, which was classified as: moderate, severe, or mortality/hospice. Secondary outcomes were acute kidney injury (AKI), extracorporeal membrane oxygenation (ECMO), invasive ventilation, and all-cause mortality at any time following COVID-19 diagnosis. RESULTS: Logistic regression showed that NSAID use was not associated with increased COVID-19 severity (OR: 0.57 95% CI: 0.53-0.61). Analysis of secondary outcomes using logistic regression showed that NSAID use was not associated with increased risk of all-cause mortality (OR 0.51 95% CI: 0.47-0.56), invasive ventilation (OR: 0.59 95% CI: 0.55-0.64), AKI (OR: 0.67 95% CI: 0.63-0.72), or ECMO (OR: 0.51 95% CI: 0.36-0.7). In contrast, the odds ratios indicate reduced risk of these outcomes, but our quantitative bias analysis showed E-values of between 1.9 and 3.3 for these associations, indicating that comparatively weak or moderate confounder associations could explain away the observed associations. CONCLUSIONS: Study interpretation is limited by the observational design. Recording of NSAID use may have been incomplete. Our study demonstrates that NSAID use is not associated with increased COVID-19 severity, all-cause mortality, invasive ventilation, AKI, or ECMO in COVID-19 inpatients. A conservative interpretation in light of the quantitative bias analysis is that there is no evidence that NSAID use is associated with risk of increased severity or the other measured outcomes. Our results confirm and extend analogous findings in previous observational studies using a large cohort of patients drawn from 38 centers in a nationally representative multicenter database

Extremely broadband ultralight thermally-emissive optical coatings

We report the design, fabrication, and characterization of ultralight highly emissive structures with a record-low mass per area that emit thermal radiation efficiently over a broad spectral (2 to 30 microns) and angular (0–60°) range. The structures comprise one to three pairs of alternating metallic and dielectric thin films and have measured effective 300 K hemispherical emissivity of 0.7 to 0.9 (inferred from angular measurements which cover a bandwidth corresponding to 88% of 300K blackbody power). To our knowledge, these micron-scale-thickness structures, are the lightest reported optical coatings with comparable infrared emissivity. The superior optical properties, together with their mechanical flexibility, low outgassing, and low areal mass, suggest that these coatings are candidates for thermal management in applications demanding of ultralight flexible structures, including aerospace applications, ultralight photovoltaics, lightweight flexible electronics, and textiles for thermal insulation

Semantic integration of clinical laboratory tests from electronic health records for deep phenotyping and biomarker discovery.

Electronic Health Record (EHR) systems typically define laboratory test results using the Laboratory Observation Identifier Names and Codes (LOINC) and can transmit them using Fast Healthcare Interoperability Resource (FHIR) standards. LOINC has not yet been semantically integrated with computational resources for phenotype analysis. Here, we provide a method for mapping LOINC-encoded laboratory test results transmitted in FHIR standards to Human Phenotype Ontology (HPO) terms. We annotated the medical implications of 2923 commonly used laboratory tests with HPO terms. Using these annotations, our software assesses laboratory test results and converts each result into an HPO term. We validated our approach with EHR data from 15,681 patients with respiratory complaints and identified known biomarkers for asthma. Finally, we provide a freely available SMART on FHIR application that can be used within EHR systems. Our approach allows readily available laboratory tests in EHR to be reused for deep phenotyping and exploits the hierarchical structure of HPO to integrate distinct tests that have comparable medical interpretations for association studies