Increasing Doses of Intraoperative Hydromorphone Do Not Reduce Postoperative Pain

Introduction: • Intermediate and long acting opioids are given intraoperatively to reduce pain during emergence from anesthesia. • Recent evidence suggests that intraoperative opioids have inconsistent effects on nociception and pain in the immediate postoperative period. • Multiple potent, short-acting opioids such as remifentanil, sufentanil and fentanyl have been shown to produce dose-related increases in pain scores and opioid consumption in the immediate postoperative recovery period. • Intraoperative doses of longer acting opioids such as morphine and methadone6 have been shown to reduce pain scores and narcotic requirements in the immediate postoperative period. • Hydromorphone is an intermediate duration narcotic which is commonly used intraoperatively but has not been studied for its potential to reduce pain in the immediate postoperative period

Delimiting Cryptic Morphological Variation among Human Malaria Vector Species using Convolutional Neural Networks

Deep learning is a powerful approach for distinguishing classes of images, and there is a growing interest in applying these methods to delimit species, particularly in the identification of mosquito vectors. Visual identification of mosquito species is the foundation of mosquito-borne disease surveillance and management, but can be hindered by cryptic morphological variation in mosquito vector species complexes such as the malaria-transmitting Anopheles gambiaecomplex. We sought to apply Convolutional Neural Networks (CNNs) to images of mosquitoes as a proof-of-concept to determine the feasibility of automatic classification of mosquito sex, genus, species, and strains using whole-body, 2D images of mosquitoes. We introduce a library of 1, 709 images of adult mosquitoes collected from 16 colonies of mosquito vector species and strains originating from five geographic regions, with 4 cryptic species not readily distinguishable morphologically even by trained medical entomologists. We present a methodology for image processing, data augmentation, and training and validation of a CNN. Our best CNN configuration achieved high prediction accuracies of 96.96% for species identification and 98.48% for sex. Our results demonstrate that CNNs can delimit species with cryptic morphological variation, 2 strains of a single species, and specimens from a single colony stored using two different methods. We present visualizations of the CNN feature space and predictions for interpretation of our results, and we further discuss applications of our findings for future applications in malaria mosquito surveillance

An exposure prevention rating method for intervention needs assessment and effectiveness evaluation

This article describes a new method for (1) systematically prioritizing needs for intervention on hazardous substance exposures in manufacturing work sites, and (2) evaluating intervention effectiveness. We developed a checklist containing six unique sets of yes/no variables organized in a 2 × 3 matrix of exposure potential versus protection (two columns) at the levels of materials, processes, and human interface (three rows). The three levels correspond to a simplified hierarchy of controls. Each of the six sets of indicator variables was reduced to a high/moderate/low rating. Ratings from the matrix were then combined to generate a single overall exposure prevention rating for each area. Reflecting the hierarchy of controls, material factors were weighted highest, followed by process, and then human interface. The checklist was filled out by an industrial hygienist while conducting a walk-through inspection (N = 131 manufacturing processes/areas in 17 large work sites). One area or process per manufacturing department was assessed and rated. Based on the resulting Exposure Prevention ratings, we concluded that exposures were well controlled in the majority of areas assessed (64% with rating of 1 or 2 on a 6-point scale), that there is some room for improvement in 26 percent of areas (rating of 3 or 4), and that roughly 10 percent of the areas assessed are urgently in need of intervention (rated as 5 or 6). A second hygienist independently assessed a subset of areas to evaluate inter-rater reliability. The reliability of the overall exposure prevention ratings was excellent (weighted kappa = 0.84). The rating scheme has good discriminatory power and reliability and shows promise as a broadly applicable and inexpensive tool for intervention needs assessment and effectiveness evaluation. Validation studies are needed as a next step. This assessment method complements quantitative exposure assessment with an upstream prevention focus

Faculty and Student Perspectives on Open Education at Gettysburg College

Commercially available textbooks and course materials are often expensive for students and sometimes don’t cover topics in exactly the way you might prefer to teach. Freely available and completely adaptable open educational resources (OER) have risen in popularity in recent years, both nationwide and locally, as a way to address both issues. Join us to hear from Alice Brawley Newlin (Management), Tasha Gownaris (Environmental Studies), Chris Oechler (Spanish), and Ryan Nedrow ’22 to hear about their experiences with OER in the classroom. Panelists will talk honestly about the benefits, drawbacks, challenges, and successes associated with open course materials in order to give you a better sense of whether OER might be a good fit in your own context

Assessment of the Feasibility of Permeable Pavement for Sustainable Stormwater Management Using SWMM

The advancement of urbanization in the Philippines changed natural lands into impervious surfaces and aided the contamination of surface runoff and nearby water bodies. Low Impact Development (LID) technologies were introduced as an alternative to conventional drainage systems, specifically permeable pavements. Such technology is beneficial for stormwater runoff reduction, ground infiltration enablement, and stormwater treatment. This research was conducted to investigate the feasibility of permeable pavement for sustainable stormwater management in a university setting, particularly in De La Salle University – Laguna Campus. The Storm Water Management Model (SWMM) was utilized to simulate different rainfall scenarios on selected little to no vegetation regions with increasing permeable pavement area coverage. The findings showed that the LID surface area to subcatchment area (SA/CA) ratio is inversely proportional to the total runoff reduction observed in all rainfall scenarios. The total runoff reached zero when the SA/CA ratio was at least 50%. The permeable pavement was concluded to be effective in surface runoff infiltration, reduction, and storage which is beneficial for long-term stormwater management and flood prevention strategies. The study can be used in future investigations and applications of similar LID technologies

Microbial diversity and activity in the Nematostella vectensis holobiont: insights from 16S rRNA gene sequencing, isolate genomes, and a pilot-scale survey of gene expression

We have characterized the molecular and genomic diversity of the microbiota of the starlet sea anemone Nematostella vectensis, a cnidarian model for comparative developmental and functional biology and a year-round inhabitant of temperate salt marshes. Molecular phylogenetic analysis of 16S rRNA gene clone libraries revealed four ribotypes associated with N. vectensis at multiple locations and times. These associates include two novel ribotypes within the ε-Proteobacterial order Campylobacterales and the Spirochetes, respectively, each sharing 99% 16S rRNA identity with Endozoicomonas elysicola and Pseudomonas oleovorans, respectively. Species-specific PCR revealed that these populations persisted in N. vectensis asexually propagated under laboratory conditions. cDNA indicated expression of the Campylobacterales and Endozoicomonas 16S rRNA in anemones from Sippewissett Marsh, MA. A collection of bacteria from laboratory raised N. vectensis was dominated by isolates from P. oleovorans and Rhizobium radiobacter. Isolates from field-collected anemones revealed an association with Limnobacter and Stappia isolates. Genomic DNA sequencing was carried out on 10 cultured bacterial isolates representing field- and laboratory-associates, i.e., Limnobacter spp., Stappia spp., P. oleovorans and R. radiobacter. Genomes contained multiple genes identified as virulence (host-association) factors while S. stellulata and L. thiooxidans genomes revealed pathways for mixotrophic sulfur oxidation. A pilot metatranscriptome of laboratory-raised N. vectensis was compared to the isolate genomes and indicated expression of ORFs from L. thiooxidans with predicted functions of motility, nutrient scavenging (Fe and P), polyhydroxyalkanoate synthesis for carbon storage, and selective permeability (porins). We hypothesize that such activities may mediate acclimation and persistence of bacteria in a N. vectensis holobiont defined by both internal and external gradients of chemicals and nutrients in a dynamic coastal habitat.Massachusetts Institute of Technology. Department of Civil and Environmental EngineeringNational Science Foundation (U.S.). Graduate Research FellowshipNational Research Foundation of Korea (Fellowship

Reduced hypoglycemia risk in type 2 diabetes patients switched to/initiating insulin glargine 300 vs 100 U/ml: A european real-world study

Introduction: Randomized controlled trials and real-world data from the USA have shown similar glycemic control with insulin glargine 300 U/ml (Gla-300) and insulin glargine 100 U/ml (Gla-100) and reduced hypoglycemia risk with Gla-300. This real-world study describes the efficacy and safety of Gla-300 and Gla-100 in patients with type 2 diabetes (T2D) in France, Spain, and Germany. Methods: This retrospective chart review analysis used anonymized data for adults with T2D switching basal insulin analog (BIA) therapy to Gla-300 or Gla-100, or insulin-naïve patients initiating Gla-300 or Gla-100. Outcomes included change from baseline to 6-month follow-up in glycated hemoglobin A1c (A1C), total and severe hypoglycemia incidences and events, insulin dose, and reasons for BIA choice. Results: Six hundred sixty-five physicians (33.8% Spain, 31.7% France, 34.4% Germany) provided chart data for patients switching to Gla-300 (n = 679) or Gla-100 (n = 429) or initiating Gla-300 (n = 719) or Gla-100 (n = 711). After adjustment for baseline characteristics, A1C reductions from baseline were similar for patients switching to Gla-300 or Gla-100 (- 0.87% vs. - 0.93%; p = 0.326) while those switched to Gla-300 vs. Gla-100 had a significantly greater mean reduction in hypoglycemic events (- 1.29 vs. - 0.81 events during 6 months; p = 0.012). Mean insulin doses after titration were 0.43 ± 0.36 and 0.40 ± 0.28 U/kg in Gla-300 and Gla-100 switchers, respectively. Factors that significantly influenced BIA choice included a lower risk of hypoglycemia (for Gla-300) and physician familiarity (for Gla-100). Outcomes for insulin-naïve patients were broadly similar to those of switchers. Conclusions: In this real-world European study, patients with T2D who switched therapy to Gla-300 or Gla-100 had improved glycemic control and reduced hypoglycemia at 6 months, with significant hypoglycemia advantages with Gla-300

The Columbia, Missouri, Heat Island Experiment (COHIX) and the Influence of a Small City on the Local Climatology

The heat island effect is a well known feature in the microclimate of urban areas but only a few studies have addressed the effect for smaller urban areas. We examine here the impact of Columbia, Missouri and the University of Missouri campus on the microclimate (temperature and precipitation) of central Missouri. We purchased twenty Radio Shack® digital Max/Min thermometers and ten standard raised-edge rain gauges and these were given to students, staff, and faculty participants who were chosen for their reliability to provide daily data over the course of a year, site the instrument, and their location (in order to provide reasonable coverage locally). We also included information provided by automated and cooperative weather stations, and the weather station at the regional airport located 11 km (7 miles) southeast of Columbia. Our results indicate that the city has no discernable impact on the distribution of monthly precipitation totals. We found a distinct urban influence on the local surface temperatures, and the inner city region and the urbanized area of south Columbia were approximately 2 - 3 oF (1.0 - 1.5 oC) warmer in the mean than the surrounding environment. This difference grows to 3 - 6 oF (1.5 - 3.5 oC) when comparing the mean of the warmest station in the city to that of coolest station outside Columbia. We also observed a seasonal influence, as the heat island effect was more evident in the mean monthly maximum (minimum) temperatures during the warmest (coldest) months

A synthesis of European seahorse taxonomy, population structure, and habitat use as a basis for assessment, monitoring and conservation

Accurate taxonomy, population demography, and habitat descriptors inform species threat assessments and the design of effective conservation measures. Here we combine published studies with new genetic, morphological and habitat data that were collected from seahorse populations located along the European and North African coastlines to help inform management decisions for European seahorses. This study confirms the presence of only two native seahorse species (Hippocampus guttulatus and H. hippocampus) across Europe, with sporadic occurrence of non-native seahorse species in European waters. For the two native species, our findings demonstrate that highly variable morphological characteristics, such as size and presence or number of cirri, are unreliable for distinguishing species. Both species exhibit sex dimorphism with females being significantly larger. Across its range, H. guttulatus were larger and found at higher densities in cooler waters, and individuals in the Black Sea were significantly smaller than in other populations. H. hippocampus were significantly larger in Senegal. Hippocampus guttulatus tends to have higher density populations than H. hippocampus when they occur sympatrically. Although these species are often associated with seagrass beds, data show both species inhabit a wide variety of shallow habitats and use a mixture of holdfasts. We suggest an international mosaic of protected areas focused on multiple habitat types as the first step to successful assessment, monitoring and conservation management of these Data Deficient speciespublishersversionPeer reviewe

Roles of the Rlim-Rex1 axis during X chromosome inactivation in mice

In female mice, the gene dosage from X chromosomes is adjusted by a process called X chromosome inactivation (XCI) that occurs in two steps. An imprinted form of XCI (iXCI) that silences the paternally inherited X chromosome (Xp) is initiated at the 2-to 4-cell stages. As extraembryonic cells including trophoblasts keep the Xp silenced, epiblast cells that give rise to the embryo proper reactivate the Xp and undergo a random form of XCI (rXCI) around implantation. Both iXCI and rXCI require the lncRNA Xist, which is expressed from the X to be inactivated. The X-linked E3 ubiquitin ligase Rlim (Rnf12) in conjunction with its target protein Rex1 (Zfp42), a critical repressor of Xist, have emerged as major regulators of iXCI. However, their roles in rXCI remain controversial. Investigating early mouse development, we show that the Rlim-Rex1 axis is active in pre-implantation embryos. Upon implantation Rex1 levels are downregulated independently of Rlim specifically in epiblast cells. These results provide a conceptual framework of how the functional dynamics between Rlim and Rex1 ensures regulation of iXCI but not rXCI in female mice.</p