Patients without colonoscopic follow-up after abnormal fecal immunochemical tests are often unaware of the abnormal result and report several barriers to colonoscopy.

BackgroundThe fecal immunochemical test (FIT) is the second most commonly used colorectal cancer (CRC) screening modality in the United States; yet, follow-up of abnormal FIT results with diagnostic colonoscopy is underutilized. Our objective was to determine patient-reported barriers to diagnostic colonoscopy following abnormal FIT in an academic healthcare setting.MethodsWe included patients age 50-75 with an abnormal FIT result between 1/1/2015 and 10/31/2017 and no documented follow-up diagnostic colonoscopy. We abstracted demographic data from the electronic health record (EHR). Study personnel conducted telephone surveys with patients to confirm colonoscopy completion and elicit data on notification of FIT results and barriers to colonoscopy. We also provided brief verbal education about diagnostic colonoscopy. We calculated frequencies of demographic data and survey responses and compared survey responses by interest in colonoscopy after education.ResultsWe surveyed 67 patients. Fifty-one were aware of the abnormal FIT result, and a majority learned of the abnormal FIT result by direct communication with providers (19, 37.3%) or EHR messaging (11, 21.6%). Overall, fifty-three patients (79.1%) confirmed lack of colonoscopy, citing provider-related (19, 35.8%), patient-related (16, 30.2%), system-related (1, 1.9%), or multifactorial (17, 32.1%) reasons. Lack of knowledge of FIT result (14, 26.4%) was most common. After brief education, 20 (37.7%) patients requested colonoscopy.ConclusionPatients with an abnormal FIT reported various multi-level barriers to diagnostic colonoscopy after abnormal FIT, including knowledge of FIT results. When provided with brief education, participants expressed interest in diagnostic colonoscopy. Future efforts will evaluate interventions to improve colonoscopy follow-up

Carballido: promotor de la Nueva Dramaturgia

El trabajo de Emilio Carballido como promotor de la dramaturgia nacional a finales de los años setenta impulsó a una generación entera de jóvenes escritores. El presente artículo hace una revisión de dicha labor, en un autor que, además de ser reconocido por su prolífica obra, mantuvo una preocupación constante por difundir y defender los espacios de producción de la dramaturgia hecha por los jóvenes.Emilio Carballido’s worked as a promoter of national dramaturgy at the end of the 1970s stimulated an entire generation of young writers. This article reviews this work, in a writer who, in addition to being recognized for his prolific work, maintained a constant concern to disseminate and defend the spaces for the production of dramaturgy made by young people

Identification of an alternative G{alpha}q-dependent chemokine receptor signal transduction pathway in dendritic cells and granulocytes

CD38 controls the chemotaxis of leukocytes to some, but not all, chemokines, suggesting that chemokine receptor signaling in leukocytes is more diverse than previously appreciated. To determine the basis for this signaling heterogeneity, we examined the chemokine receptors that signal in a CD38-dependent manner and identified a novel "alternative" chemokine receptor signaling pathway. Similar to the "classical" signaling pathway, the alternative chemokine receptor pathway is activated by G{alpha}i2-containing Gi proteins. However, unlike the classical pathway, the alternative pathway is also dependent on the Gq class of G proteins. We show that G{alpha}q-deficient neutrophils and dendritic cells (DCs) make defective calcium and chemotactic responses upon stimulation with N-formyl methionyl leucyl phenylalanine and CC chemokine ligand (CCL) 3 (neutrophils), or upon stimulation with CCL2, CCL19, CCL21, and CXC chemokine ligand (CXCL) 12 (DCs). In contrast, G{alpha}q-deficient T cell responses to CXCL12 and CCL19 remain intact. Thus, the alternative chemokine receptor pathway controls the migration of only a subset of cells. Regardless, the novel alternative chemokine receptor signaling pathway appears to be critically important for the initiation of inflammatory responses, as G{alpha}q is required for the migration of DCs from the skin to draining lymph nodes after fluorescein isothiocyanate sensitization and the emigration of monocytes from the bone marrow into inflamed skin after contact sensitization

Een archeologische evaluatie en waardering van het slagveld van Oudenaarde 1708 (Oudenaarde, provincie Oost-Vlaanderen)

Het Ename Expertisecentrum voor Erfgoedontsluiting (EEC) heeft in 2011 en 2012 in opdracht van het agentschap Onroerend Erfgoed en in functie van de mogelijke opmaak van een beschermingsdossier een archeologische evaluatie en waardering uitgevoerd van het slagveld van Oudenaarde 1708. Een eerdere survey uit 2007 onder leiding van de Britse Battlefields Trust had via metaaldetectie het archeologisch potentieel van dit slagveld aangetoond en een doorgedreven onderzoek van het slagveld mogelijk en wenselijk gemaakt. Het veldwerk werd uitgevoerd van 12 september tot 31 oktober 2011. De studie maakte een aanzienlijke vooruitgang in het begrijpen van de veldslag en in het plaatsen van de actie op het terrein, en liet toe om de aard, de toestand en de verspreiding van de archeologische zone te bepalen en de problemen die dit oplevert. Terzelfdertijd heeft dit werk inzicht gegeven in de praktische problemen op het veld, en een strategie opgeleverd voor verder onderzoek. De belangrijkste primaire bronnen van de veldslag werden samengebracht en vertaald en de grafische en geschreven bronnen werden in een redelijk accurate weergave van het landschap geplaatst zoals het er ten tijde van de veldslag moet hebben uitgezien. Oudenaarde bleek een ongewoon complexe veldslag met een opmerkelijke wisselwerking tussen het terrein en de acties. Door de goede staat van bewaring van het merendeel van het slagveld kan Oudenaarde van aanzienlijk belang zijn bij de verdere ontwikkeling van slagveldarcheologie. De kogels zijn weliswaar relatief slecht bewaard, maar toch nog voldoende goed om een adequate analyse van de inslagschade te bekomen. Het gebruik als akkerland sinds de late 18e eeuw had een ernstige destructief effect op slagveldartefacten. Het losmaken van de grond en diep ploegen is wellicht ook zeer destructief voor eventuele massagraven. Het permanent grasland op een beperkt deel van het terrein tempert wel de snelheid van verval van de artefacten, aangezien zowel verluchting van de grond als mechanische schade hierdoor vermeden wordt. De studie eindigt met aanbevelingen over de mogelijke begrenzing van de archeologische zone en stelt ook maatregelen voor naar beheer en behoud van de site

Characterization of Burkholderia rhizoxinica and B. endofungorum Isolated from Clinical Specimens

Eight isolates submitted to CDC from 1989 to 2006 from clinical specimens were initially identified as members of the genus Burkholderia based on preliminary cellular fatty acid analysis and/or 16S rRNA gene sequencing. With the recent descriptions of the new species B. rhizoxinica and B. endofungorum, which are considered endosymbiotic bacteria in Rhizopus microsporus fungi, we now identify seven of these clinical isolates as B. rhizoxinica and one as B. endofungorum based on biochemical testing, 16s rRNA, and DNA-DNA hybridization results. We also further characterize these isolates by assessing toxin production and/or by multiple locus sequence typing

Comparative analysis of the effects of tantalum doping and annealing on atomic layer deposited (Ta2O5)(x)(Al2O3)(1-x) as potential gate dielectrics for GaN/AlxGa1-xN/GaN high electron mobility transistors

This paper describes a method to optimally combine wide band gap Al2O3 with high dielectric constant (high-κ) Ta2O5 for gate dielectric applications. (Ta2O5)x(Al2O3)1−x thin films deposited by thermal atomic layer deposition (ALD) on GaN-capped AlxGa1−xN/GaN high electron mobility transistor (HEMT) structures have been studied as a function of the Ta2O5 molar fraction. X-ray photoelectron spectroscopy shows that the bandgap of the oxide films linearly decreases from 6.5 eV for pure Al2O3 to 4.6 eV for pure Ta2O5. The dielectric constant calculated from capacitance-voltage measurements also increases linearly from 7.8 for Al2O3 up to 25.6 for Ta2O5. The effect of post-deposition annealing in N2 at 600 °C on the interfacial properties of undoped Al2O3 and Ta-doped (Ta2O5)0.12(Al2O3)0.88 films grown on GaN-HEMTs has been investigated. These conditions are analogous to the conditions used for source/drain contact formation in gate-first HEMT technology. A reduction of the Ga-O to Ga-N bond ratios at the oxide/HEMT interfaces is observed after annealing, which is attributed to a reduction of interstitial oxygen-related defects. As a result, the conduction band offsets (CBOs) of the Al2O3/GaN-HEMT and (Ta2O5)0.16(Al2O3)0.84/GaN-HEMT samples increased by ∼1.1 eV to 2.8 eV and 2.6 eV, respectively, which is advantageous for n-type HEMTs. The results demonstrate that ALD of Ta-doped Al2O3 can be used to control the properties of the gate dielectric, allowing the κ-value to be increased, while still maintaining a sufficient CBO to the GaN-HEMT structure for low leakage currents. VC 2016 AIP Publishing LL

A Two-Stage Stochastic Optimization for Robust Operation of Multipurpose Reservoirs

Robust reservoir operation has long been considered a promising solution for addressing water allocation problems in the absence of reliable hydroclimatic forecasts. This study aims to evaluate the performance of this solution using a novel two-stage stochastic optimization model. The model maximizes economic benefits from reservoir deliveries while integrating stochastic inflows into a water allocation system with multiple demands and various constraints. The outcome of the model is a robust set of monthly reservoir releases that perform well under a wide range of hydroclimatic conditions. The model has been applied to the case of the Big Bend Reach of the Rio Grande/Bravo, a transboundary river basin of high importance for Mexico and the United States. The performance of the robust operation policy was assessed by comparing its outcome to those obtained under observed historical operations and an operation policy derived from a deterministic version of the optimization model that assumes perfect hydroclimatic knowledge. The results of this study indicate that the set of robust releases developed here outperforms historical reservoir operations and performs similarly to operations under perfect knowledge. These results show the effectiveness of robust reservoir operation and the usefulness of the proposed optimization model for decision-making under increasing hydroclimatic uncertainty

Failure patterns of solder joints identified through lifetime vibration tests

A method for non-destructively tracking the integrity of flip chip solder joints through life is investigated in this paper. An industry standard double-sided PCB was designed and manufactured with 14 flip chips to assess the failure patterns of each flip chip and each solder joint in lifetime vibration tests. Two configurations of PCB finish were tested, Electro Nickel Immersion Gold (ENIG) and Hot Air Surface Levelled lead (Pb HASL) using automotive industry manufacturing processes and quality standards. A random vibration test over a frequency range 10 Hz to 1000 Hz was specified by automotive engineers to replicate vibrations typically found on road vehicles. This vibration profile was applied to test circuit board assemblies (CBA) for 4-minute intervals until failure of all chips. At each interval test boards were extensively scanned by an acoustic micro-imaging (AMI) microscope to non-destructively measure parameters of solder joints. This enabled tracking of mechanical joint connection through-life. Methods were developed to process the large number of acoustic images of each solder joint and form metrics to evaluate solder joint integrity. Results from AMI show that the solder joints exhibit three distinct zones as they age: crack initiation, crack propagation and then failure