Patients After the Fontan Insights From Computational Fluid Dynamics

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Chemical Evidence for Cell Wall Lignification and the Evolution of Tracheids in Early Devonian Plants

Anatomically preserved land plant fossils from the Lower Devonian Rhynie Chert contain conducting tissues with cells that range from dark-colored, elongated cells without secondary wall thickenings to tracheids similar to those of extant tracheophytes. A suite of tissue-specific microanalytical techniques was used to assess lignification in fossils of Aglaophyton, Rhynia, and Asteroxylon. Isotope ratio mass spectrometry provides millimeter-scale resolution of carbon isotopic abundances, whereas soft X-ray carbon (1s) spectromicroscopy provides micrometer-scale resolution of the preservation of organic molecular functionality. The isotopic and organic chemistry of Rhynie Chert plants indicates that the earliest vascular thickenings were probably unlignified and that cell wall lignification may have first appeared in the outer cortex. Only in more derived plants, it seems, was lignin deposited in conducting cells to produce the true tracheids seen today in vascular plants.Organismic and Evolutionary Biolog

Provider Perspectives Regarding the Health Care Needs of a Key Population: HIV-infected Prisoners After Incarceration

During incarceration, many HIV-infected prisoners receive care and are adherent to medication. However, following release, many have difficulty engaging in HIV care and remaining on antiretroviral therapy (ART). Community-based service providers for HIV-infected releasees have a deep understanding of the health needs and challenges these individuals face on community re-entry. We conducted in-depth qualitative interviews with 38 health care and service professionals in 2 U.S. southern states regarding the barriers releasees faced in meeting their health needs, including HIV care and treatment post-release. Individual, community, and organization-level barriers to HIV care and treatment adherence post-release were identified and offered unique insight into the ways that these multi-level obstacles affect HIV-infected former prisoners’ abilities to engage in care and access necessary social services. Provider perspectives should be considered when designing interventions to support HIV care after release

The Missing Link! A New Skeleton for Evolutionary Multi-agent Systems in Erlang

Evolutionary multi-agent systems (EMAS) play a critical role in many artificial intelligence applications that are in use today. In this paper, we present a new generic skeleton in Erlang for parallel EMAS computations. The skeleton enables us to capture a wide variety of concrete evolutionary computations that can exploit the same underlying parallel implementation. We demonstrate the use of our skeleton on two different evolutionary computing applications: (1) computing the minimum of the Rastrigin function; and (2) solving an urban traffic optimisation problem. We show that we can obtain very good speedups (up to 142.44 ×× the sequential performance) on a variety of different parallel hardware, while requiring very little parallelisation effort.Publisher PDFPeer reviewe

The Far-Ultraviolet "Continuum" in Protoplanetary Disk Systems II: CO Fourth Positive Emission and Absorption

We exploit the high sensitivity and moderate spectral resolution of the $HST$-Cosmic Origins Spectrograph to detect far-ultraviolet spectral features of carbon monoxide (CO) present in the inner regions of protoplanetary disks for the first time. We present spectra of the classical T Tauri stars HN Tau, RECX-11, and V4046 Sgr, representative of a range of CO radiative processes. HN Tau shows CO bands in absorption against the accretion continuum. We measure a CO column density and rotational excitation temperature of N(CO) = 2 +/- 1 $\times$ 10$^{17}$ cm$^{-2}$ and T_rot(CO) 500 +/- 200 K for the absorbing gas. We also detect CO A-X band emission in RECX-11 and V4046 Sgr, excited by ultraviolet line photons, predominantly HI LyA. All three objects show emission from CO bands at $\lambda$ $>$ 1560 \AA, which may be excited by a combination of UV photons and collisions with non-thermal electrons. In previous observations these emission processes were not accounted for due to blending with emission from the accretion shock, collisionally excited H$_{2}$, and photo-excited H2; all of which appeared as a "continuum" whose components could not be separated. The CO emission spectrum is strongly dependent upon the shape of the incident stellar LyA emission profile. We find CO parameters in the range: N(CO) 10$^{18-19}$ cm$^{-2}$, T_{rot}(CO) > 300 K for the LyA-pumped emission. We combine these results with recent work on photo- and collisionally-excited H$_{2}$ emission, concluding that the observations of ultraviolet-emitting CO and H2 are consistent with a common spatial origin. We suggest that the CO/H2 ratio in the inner disk is ~1, a transition between the much lower interstellar value and the higher value observed in solar system comets today, a result that will require future observational and theoretical study to confirm.Comment: 12 pages, 7 figures, 3 tables. ApJ - accepte

Inpatient Opioid Use Varies by Construct Length Among Laminoplasty Versus Laminectomy and Fusion Patients

BACKGROUND: Laminoplasty (LP) and laminectomy and fusion (LF) are utilized to achieve decompression in patients with symptomatic degenerative cervical myelopathy (DCM). Comparative analyses aimed at determining outcomes and clarifying indications between these procedures represent an area of active research. Accordingly, we sought to compare inpatient opioid use between LP and LF patients and to determine if opioid use correlated with length of stay. METHODS: Sociodemographic information, surgical and hospitalization data, and medication administration records were abstracted for patients \u3e18 years of age who underwent LP or LF for DCM in the Mass General Brigham (MGB) health system between 2017 and 2019. Specifically, morphine milligram equivalents (MME) of oral and parenteral pain medication given after arrival in the recovery area until discharge from the hospital were collected. Categorical variables were analyzed using chi-squared analysis or Fisher exact test when appropriate. Continuous variables were compared using Independent samples RESULTS: One hundred eight patients underwent LF, while 138 patients underwent LP. Total inpatient opioid use was significantly higher in the LF group (312 vs. 260 MME, p=.03); this difference was primarily driven by higher postoperative day 0 pain medication requirements. Furthermore, more LF patients required high dose (\u3e80 MME/day) regimens. While length of stay was significantly different between groups, with LF patients staying approximately 1 additional day, postoperative day 0 MME was not a significant predictor of this difference. When operative levels including C2, T1, and T2 were excluded, the differences in total opioid use and average length of stay lost significance. CONCLUSIONS: Inpatient opioid use and length of stay were significantly greater in LF patients compared to LP patients; however, when constructs including C2, T1, T2 were excluded from analysis, these differences lost significance. Such findings highlight the impact of operative extent between these procedures. Future studies incorporating patient reported outcomes and evaluating long-term pain needs will provide a more complete understanding of postoperative outcomes between these 2 procedures