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As scholars from the fields of history, anthropology and animal studies, as well as landscape planning and management, we discuss various forms of urban and urbanising infrastructures and their political entanglements. Questioning and illuminating how various actors and their practices build and shape urban environments, we address topics ranging from the black soldier fly - used as biotechnological infrastructure to manage waste - to other nonhumans, like macaques -developing and negotiating their own urbanisms; from plants and community gardens - used as green infrastructures to provide shade and food, and social infrastructures to endure and resist - to the transportation infrastructures that humans have built to both segregate and divide, as well as to live and unite. In case studies situated across the world, we present different conceptualisations of infrastructures as complex human-nonhuman co-productions that shape the modern city.

Home dialysis modalities (home hemodialysis [HD] and peritoneal dialysis [PD]) are associated with greater patient autonomy and treatment satisfaction compared with in-center modalities, yet the level of home-dialysis use worldwide is low. Reasons for limited utilization are context-dependent, informed by local resources, dialysis costs, access to healthcare, health system policies, provider bias or preferences, cultural beliefs, individual lifestyle concerns, potential care-partner time, and financial burdens. In May 2021, KDIGO (Kidney Disease: Improving Global Outcomes) convened a controversies conference on home dialysis, focusing on how modality choice and distribution are determined and strategies to expand home-dialysis use. Participants recognized that expanding use of home dialysis within a given health system requires alignment of policy, fiscal resources, organizational structure, provider incentives, and accountability. Clinical outcomes across all dialysis modalities are largely similar, but for specific clinical measures, one modality may have advantages over another. Therefore, choice among available modalities is preference-sensitive, with consideration of quality of life, life goals, clinical characteristics, family or care-partner support, and living environment. Ideally, individuals, their care-partners, and their healthcare teams will employ shared decision-making in assessing initial and subsequent kidney failure treatment options. To meet this goal, iterative, high-quality education and support for healthcare professionals, patients, and care-partners are priorities. Everyone who faces dialysis should have access to home therapy. Facilitating universal access to home dialysis and expanding utilization requires alignment of policy considerations and resources at the dialysis-center level, with clear leadership from informed and motivated clinical teams.

Adrienne Malik,1 Olga Dewald,2 John Gallien,3 Mark Favot,3 Adam Kasten,5 Brian Reed,6 Robert Wells,5 Robert R Ehrman4 1Department of Emergency Medicine, University of Kansas Medical Center, Kansas City, MO, 66160, USA; 2Department of Emergency Medicine, Sparrow Hospital, Lansing, MI, 48912, USA; 3Department of Emergency Medicine, DMC Detroit Receiving Hospital, Detroit, MI, 48201, USA; 4Department of Emergency Medicine, DMC Sinai Grace Hospital, Detroit, MI, 48235, USA; 5Department of Emergency Medicine, DMC Harper Hospital, Detroit, MI, 48201, USA; 6Department of Emergency Medicine, Wayne State University, Detroit, MI, 48201, USACorrespondence: Adrienne Malik, Department of Emergency Medicine, University of Kansas Medical Center, 4000 Cambridge St, Kansas City, MO, 66160, USA, Email amalik3@kumc.edu; adriennemalikmd@gmail.comBackground: Patients with difficult peripheral intravenous (IV) access are common in emergency departments (EDs). Ultrasound-guided peripheral intravenous catheters (USIVs) are frequently used in this population; however, information regarding the effect of patient and IV characteristics on the dwell time (DT) and survival probability (SP) of USIVs is limited.Objective: Our study aimed to evaluate for associations between patient or IV characteristics and the DT and SP of USIVs.Methods: Retrospective analysis was performed on a database from an ED nurse (RN) USIV training program at an urban, academic hospital. Patients over 18 years with an USIV placed during the study period were included. Subject demographics, history, IV characteristics, insertion, and removal times were collected. Data were analyzed using descriptive statistics and univariable and multivariable Cox regression. USIV survival times for variates of interest were estimated using Kaplan–Meier curves for three censoring points.Results: The final analysis cohort was 388 patients. Mean age was 56.6 years, 66.5% were female, mean BMI was 29.9 kg/m2, and 42.5% were obese (BMI ≥ 30). Median DT was 40.3 hours in admitted patients (N=340). SP for USIVs at 96 hours was 87.8%. A total of 21 of 340 (6.2%) USIVs failed. USIV location conferred a difference on DT in obese patients when dichotomized into upper arm versus antecubital fossa and forearm together (38.6 hours vs 44.6 hours, p=0.03). No factors were associated with a difference in USIV SP.Conclusion: Median USIV DT of 40.3 hours for admitted patients was higher than in previous studies. Only 7% of USIVs in our study failed. Overall, catheters survived longer than expected.Keywords: ultrasound, peripheral IV, retrospective, emergency medicine, vascular access

Purpose: Mucosal melanoma is a rare, aggressive form of melanoma with extremely high recurrence rates despite definitive surgical resection with curative intent. Currently there is no consensus on adjuvant therapy. Data on checkpoint inhibitors for adjuvant therapy are lacking. Patients and Methods: We performed a single-arm, multicenter clinical trial using “flip dose” ipilimumab (1 mg/kg q3w × 4 cycles), and nivolumab (3 mg/kg q3w × 4 cycles), then nivolumab 480 mg q4w × 11 cycles to complete a year of adjuvant therapy. Participants must have had R0/R1 resection ≤90 days before registration, no prior systemic therapy (adjuvant radiotherapy allowed), ECOG 0/1, and no uncontrolled autoimmune disease or other invasive cancer. Patients were recruited through the Midwest Melanoma Partnership/Hoosier Oncology Network. Results: From September 2017 to August 2021, 35 patients were enrolled. Of these, 29 (83%) had R0 resections, and 7 (20%) received adjuvant radiotherapy. Median age was 67 years, 21 (60.0%) female. Recurrence-free survival (RFS) rates at 1 and 2 years were 50% [95% confidence interval (CI), 31%–66%] and 37% (95% CI, 19%–55%), respectively. Overall survival rates at 1 and 2 years were 87% (95% CI, 68%–95%) and 68% (95% CI, 46%–83%), respectively. Median RFS was 10.3 months (95% CI, 5.7–25.8). Most common grade 3 toxicities were diarrhea (14%), hypertension (14%), and hyponatremia (11%), with no grade 4/5 toxicities. Conclusions: Flip-dose ipilimumab and nivolumab after resection of mucosal melanoma is associated with outcomes improved over that of surgical resection alone. Long-term follow-up, subgroup analyses and correlative studies are ongoing.

Despite its popularity in literature, there are few examples of machine learning (ML) being used for industrial nondestructive evaluation (NDE) applications. A significant barrier is the ‘black box’ nature of most ML algorithms. This paper aims to improve the interpretability and explainability of ML for ultrasonic NDE by presenting a novel dimensionality reduction method: Gaussian feature approximation (GFA). GFA involves fitting a 2D elliptical Gaussian function an ultrasonic image and storing the seven parameters that describe each Gaussian. These seven parameters can then be used as inputs to data analysis methods such as the defect sizing neural network presented in this paper. GFA is applied to ultrasonic defect sizing for inline pipe inspection as an example application. This approach is compared to sizing with the same neural network, and two other dimensionality reduction methods (the parameters of 6 dB drop boxes and principal component analysis), as well as a convolutional neural network applied to raw ultrasonic images. Of the dimensionality reduction methods tested, GFA features produce the closest sizing accuracy to sizing from the raw images, with only a 23% increase in RMSE, despite a 96.5% reduction in the dimensionality of the input data. Implementing ML with GFA is implicitly more interpretable than doing so with principal component analysis or raw images as inputs, and gives significantly more sizing accuracy than 6 dB drop boxes. Shapley additive explanations (SHAP) are used to calculate how each feature contributes to the prediction of an individual defect’s length. Analysis of SHAP values demonstrates that the GFA-based neural network proposed displays many of the same relationships between defect indications and their predicted size as occur in traditional NDE sizing methods.

BACKGROUND: Leading manufacturers of engines for trucks are constantly competing and trying to create engines with the best consumer characteristics, which at the same time meet modern environmental standards. One of the most important characteristics for long-haul tractors is fuel efficiency. As a way to improve this parameter, it was chosen to reduce the loss of mechanical energy to drive the oil pump. AIMS: To determine the current level of mechanical losses in the drive of the oil pump of the KAMAZ 6ChN13/15 engine, to form a set of solutions to reduce losses. METHODS: The current pattern of mechanical losses distribution for the 6ChN13/15 engine was obtained by engine motoring at the engine bench with sequential removal of engine components. A comparative diagram of the overpressure at the outlet of the uncontrolled and controlled pumps was obtained empirically during tests at the engine bench. The evaluation of the positive effect from the use of a controlled oil pump was determined analytically. RESULTS: As a result, by using a controlled oil pump, it became possible to reduce the excess pressure at the outlet of the pump at nominal rotational speed by 25%, which theoretically should reduce the relative mechanical losses of the engine by 3%. CONCLUSIONS: The practical value of the study lies in determining effective ways to reduce mechanical energy losses and improve the consumer qualities of modern diesel engines.

SUMMARY Salt structures are widely distributed in many basins worldwide and play an important role in understanding tectonic movements, offering underground storage and sealing hydrocarbon traps. In addition to the acknowledged difficulties in mapping complex salt structures through seismic methods, when an evaporitic layer, such as anhydrite, forms over salt, it can introduce strong multimode conversions that can couple with the primary compressional wavefields and generate artefacts in resulting acoustic images. From two well-log suites from the Gulf of Mexico, we identify thin evaporitic caprocks on top of their salt bodies and analyse their elastic properties. Through controlled experiments, including physical and numerical modelling with a vertical seismic profiling survey geometry, we observe significant shear-mode conversions at the top of the ultra-high-velocity caprock, which further result in a family of prominent S and P (converted from S wave) modes across the top of the salt region. Similarly, in a field survey, we identify evident converted S waves and a multimode P wave (converted S wave in the anhydrite layer, and P wave elsewhere) following the primary P transmission inside the salt body. While separating the converted Smodes at the receiver end is more unambiguous, the multimode P waves could behave very similarly to the primary Pmodes and are more difficult to suppress. Under the common acoustic assumption of seismic velocity model building and imaging, complex mode conversions on top of the salt are generally ignored. Through controlled experiments and a field survey, we analyse the pitfalls associated with this omission. We emphasize the importance of understanding the physics of wave partitioning in the presence of a thin ultra-high-velocity layer on the top of the salt.

Venus has a geologically young surface, but it is unknown whether it has ongoing active volcanism. From 1990 to 1992, the Magellan spacecraft imaged the planet’s surface, using synthetic aperture radar. We examined volcanic areas on Venus that were imaged two or three times by Magellan and identified an ~2.2-square-kilometer volcanic vent that changed shape in the 8-month interval between two radar images. Additional volcanic flows downhill from the vent are visible in the second-epoch images, although we cannot rule out that they were present but invisible in the first epoch because of differences in imaging geometry. We interpret these results as evidence of ongoing volcanic activity on Venus.

Background Dermatologists would benefit from an easy to use psoriasis severity assessment tool in the clinic. Objective To develop psoriasis assessment tools to predict PASI and Dermatology Life Quality Index (DLQI) using simple measures typically collected in clinical practice. Methods Data included 33 605 dermatology visits among plaque psoriasis patients enrolled in the CorEvitas Psoriasis Registry (4/15/15-7/11/20). Performance (adjusted coefficient of determination [R2adj], root mean square error [RMSE]) in predicting PASI and DLQI was assessed for 16 different linear regression models (specified a priori based on combinations of BSA, Investigator’s Global Assessment [IGA], itch, skin pain, patient global assessment, age, sex, BMI, comorbidity index, prior biologic use), and 2 stepwise selection models and 1 elastic net model based on 56 available variables. For each prediction model, concordance (sensitivity, specificity) of predicted PASI75, PASI90 and DLQI 0/1 with observed values was evaluated. Results Mean (SD) age, BSA, and PASI were 51 (14) years, 6 (11), and 4 (6), respectively; 46% were women, and 87% were biologic experienced. A model predicting PASI using BSA plus IGA performed best among a priori specified models (R2adj = .72, RMSE = 2.93) and only marginally worse than models including additional variables (R2adj range .64-.74, RMSE range 2.82-3.36). Models including IGA had the best concordance between predicted and observed PASI75 (sensitivity range 83-85%, specificity range 88-91%) and PASI90 (sensitivity range 76-82%, specificity range 94-98%). DLQI prediction was limited. Conclusion An assessment tool for psoriasis including BSA and IGA may be an ideal option to predict PASI in a clinic setting.

Many young individuals at risk for eating disorders spend time on social media and frequently search for information related to their body image concerns. In a large randomized study, we demonstrated that a guided chat-based intervention could reduce weight and shape concerns and eating disorder pathology. The goal of the current study was to determine if a modified single session mini-course, derived from the aforementioned chat-based intervention, could reduce body image concerns among individuals using eating disorder related search terms on a social media platform. Over a two-month period of prompting individuals, 525 people followed the link to the web-based application where the intervention was hosted and subsequently completed the mini-course. This resulted in a significant improvement on the one-time body image satisfaction question pre-to post intervention (p .001) with a moderate effect size (Cohen's d = 0.54). Additionally, individuals completing the program showed significant improvement on motivation to change their body image (p .001) with a small effect size (Cohen's d = 0.28). Additionally, users reported that the program was enjoyable and easy to use. These results suggest that a single session micro-intervention, offered to individuals on social media, can help improve body image.

Osteocytes act as bone mechanosensors, regulators of osteoblast/osteoclast activity and mineral homeostasis, however, knowledge about their functional/morphological changes throughout life is limited. We used quantitative backscattered electron imaging (qBEI) to investigate osteocyte lacunae sections (OLS) as a 2D-surrogate characterizing the osteocytes. OLS characteristics, the density of mineralized osteocyte lacunae (i.e., micropetrotic osteocytes, md.OLS-Density in nb/mm

Impairing emotional outbursts, defined by extreme anger or distress in response to relatively ordinary frustrations and disappointments, impact all mental health care systems, emergency departments, schools, and juvenile justice programs. However, the prevalence, outcome, and impact of outbursts are difficult to quantify because they are transdiagnostic and not explicitly defined by current diagnostic nosology. Research variably addresses outbursts under the rubrics of tantrums, anger, irritability, aggression, rage attacks, or emotional and behavioral dysregulation. Consistent methods for identifying and assessing impairing emotional outbursts across development or systems of care are lacking.The American Academy of Child and Adolescent Psychiatry Presidential Task Force (2019-2021) conducted a narrative review addressing impairing emotional outbursts within the limitations of the existing literature and independent of diagnosis.Extrapolating from the existing literature, best estimates suggest that outbursts occur in 4%-10% of community children (preschoolers through adolescents). Impairing emotional outbursts may respond to successful treatment of the primary disorder, especially for some children with attention-deficit/hyperactivity disorder whose medications have been optimized. However, outbursts are generally multi-determined and often represent maladaptive or deficient coping strategies and responses.Evidence-based strategies are necessary to address factors that trigger, reinforce, or excuse the behaviors and to enhance problem-solving skills. Currently available interventions yield only modest effect sizes for treatment effect. More specific definitions and measures are needed to track and quantify outbursts and to design and assess the effectiveness of interventions. Better treatments are clearly needed.

Safe water and food are impactful public health measures that improved significantly during the past century in the United States. But waterborne and foodborne illnesses continue to cause significant morbidity and mortality despite existing public health control measures and regulations. It was estimated that each year in the United States, 31 pathogens caused 37.2 million illnesses, with 36.4 million domestically acquired. Of those, 9.4 million were foodborne: 59% were caused by viruses, 39% by bacteria, and 2% by parasites. The pathogens that caused the most foodborne illnesses were norovirus (58%), nontyphoidal Salmonella species (11%), Clostridium perfringens (10%), and Campylobacter species (9%). Unspecified agents caused an estimated 38.4 million episodes of domestically acquired foodborne gastroenteritis, 258,033 hospitalizations, and 3,574 deaths. The estimate for illnesses caused by waterborne transmission was 7.15 million. The diseases that caused the greatest number were otitis externa (n = 4.67 million), norovirus (n = 1.33 million), giardiasis (n = 415,000), and cryptosporidiosis (n = 322,000). An important aspect of management and prevention is health-care provider reporting of foodborne and waterborne illnesses. Health-care provider reporting of reportable diseases has been inconsistent, infrequent, and delayed. Education efforts concerning reporting need to be enhanced, and physicians should report suspected cases before laboratory confirmation to enhance the timeliness of outbreak investigation and possibly prevent subsequent cases.

192 Background: Sleep disturbance negatively impacts quality of life and recovery. Our objective was to evaluate the relationship between individual patient factors (demographic, surgical, pain, opioid use, and psychosocial factors) and greater sleep disturbance. Methods: In this prospective longitudinal study, patients completed validated measures regarding their sleep disturbance, pain, opioid use, and psychological symptoms preoperatively and then 2 weeks, 6 and 12 months postoperatively. Objective pain sensitivity measures were evaluated at baseline using quantitative sensory testing. Univariable and multivariable generalized estimating equations (GEE) evaluated demographic, surgical, pain, and psychological predictors of sleep disturbance during the first year after surgery for breast cancer. Results: Female patients (n = 259) reported varying degrees of sleep disturbance, which were longitudinally associated with pain, psychosocial factors such as anxiety, depression, and affect. While the mean degree of sleep disturbance did not change substantially over time, the link to pain severity appeared to strengthen over the first postoperative year. Independent preoperative predictors of worse sleep disturbance on multivariable longitudinal GEE included younger age (B = -.09, p =.006), opioid use (B = 3.09, p =.02), higher pain (B =.19, p =

The Atmospheric Carbon Observations from Space (ACOS) retrieval algorithm has been delivering operational column-averaged carbon dioxide dry-air mole fraction (XCO2​​​​​​​) data for the Orbiting Carbon Observatory (OCO) missions since 2014. The ACOS Level 2 Full Physics (L2FP) algorithm retrieves a number of parameters, including aerosol and surface properties, in addition to atmospheric CO2. Past analysis has shown that while the ACOS retrieval meets mission precision requirements of 0.1 %–0.5 % in XCO2, residual biases and some sources of error remain unaccounted for (Wunch et al., 2017; Worden et al., 2017; Torres et al., 2019). Forward model and other errors can lead to systematic biases in the retrieved XCO2, which are often correlated with these additional retrieved parameters. The characterization of such biases is particularly essential to urban- and local-scale emissions studies, where it is critical to accurately distinguish source signals relative to background concentrations (Nassar et al., 2017; Kiel et al., 2021). In this study we explore algorithm-induced biases through the use of simulated OCO-3 snapshot area mapping (SAM) mode observations, which offer a unique window into these biases with their wide range of viewing geometries over a given scene. We focus on a small percentage of SAMs in the OCO-3 vEarly product which contains artificially strong across-swath XCO2 biases spanning several parts per million, related to observation geometry. We investigate the causes of swath bias by using the timing and geometry of real OCO-3 SAMs to retrieve XCO2 from custom simulated Level 1b radiance spectra. By building relatively simple scenes and testing a variety of parameters, we find that aerosol is the primary driver of swath bias, with a complex combination of viewing geometry and aerosol optical properties contributing to the strength and pattern of the bias. Finally, we seek to understand successful mitigation of swath bias in the new OCO-3 version 10 data product. Results of this study may be useful in uncovering other remaining sources of XCO2 bias and may help minimize similar retrieval biases for both present missions (GOSAT, GOSAT-2, OCO-2, OCO-3, TanSat) and future missions (e.g., MicroCarb, GeoCarb, GOSAT-GW, CO2M).

Social media platforms continue to increase in popularity and number. Although many associations between social media and user health interactions have been explored, little to no research has investigated TikTok, a recently released social media platform, and its individual interactions with user mental and physical well-being variables. To address this gap, we administered an online questionnaire to a group of college students (n = 407) at Brigham Young University – Idaho about their social media use, mental, and physical well-being. We observed potential differences among TikTok account holders and non-TikTok users using a series of independent-samples t tests with Bonferroni correction. Although TikTok account holders reported higher negative mental well-being indicators than their nonuser counterparts in almost all measured areas, these relationships were only consistent among female TikTok account holders. Conversely, our findings of significantly higher reported consumption of sugary drinks across our entire sample, t(403) = 3.41, p = .001, d = 0.33, only maintained significance among male participants, t(141) = 3.04, p < .001, d = 0.50. As such, female TikTok account holders reported consistently worse mental health and well-being indicators than non-TikTok users. Building on our findings, we call for future research to better understand the nature of these relationships for both TikTok and other social media users’.

Fiber-based Raman spectroscopy in the context of in vivo biomedical application suffers from the presence of background fluorescence from the surrounding tissue that might mask the crucial but inherently weak Raman signatures. One method that has shown potential for suppressing the background to reveal the Raman spectra is shifted excitation Raman spectroscopy (SER). SER collects multiple emission spectra by shifting the excitation by small amounts and uses these spectra to computationally suppress the fluorescence background based on the principle that Raman spectrum shifts with excitation while fluorescence spectrum does not. We introduce a method that utilizes the spectral characteristics of the Raman and fluorescence spectra to estimate them more effectively, and compare this approach against existing methods on real world datasets.

There is, in the content of the Journal, an embarrassment of riches, and picking a "best" seems to demand a certain qualification: is the "best" the most interesting, most surprising, most educational, most important, most provocative, most enjoyable? How to choose? We are hardly unbiased and can admit to a special affection for the ones that we and the authors worked hardest on, hammering version after version into shape. Acknowledging these biases, here are the 2022 articles that we think deserve your attention or at least a second read.

In clinical trials, treatment with the interleukin-23 inhibitor guselkumab was associated with significantly improved disease severity and patient-reported outcome measures (PROMs) among patients with moderate-to-severe plaque psoriasis. However, limited information is available regarding the real-world effectiveness of guselkumab among patients with psoriasis of mild, moderate, and severe Investigator's Global Assessment (IGA) severities living in the USA and Canada.Patients participating in the CorEvitas Psoriasis Registry between 18 July 2017 and 10 July 2019 who met the following criteria were included: IGA ≥ 2 (mild or greater disease severity), initiated guselkumab at a registry (index) visit, and had a registry follow-up visit after persistent guselkumab treatment for 9 to 12 months. Data were collected for patient demographics, disease characteristics, treatment history, disease activity, and PROMs. At follow-up, outcome measure response rates and mean changes from the index visit were calculated.Among 130 patients, the mean age was 50.2 years, 39.2% were female, and 56.9% had a body mass index ≥ 30 kg/mIn this real-world study, patients with a baseline IGA score ≥ 2 experienced improvements in disease activity and PROMs after 9-12 months of persistent guselkumab treatment.

Persistent postmastectomy pain after breast surgery is variable in duration and severity across patients, due in part to interindividual variability in pain processing. The Rapid OPPERA Algorithm (ROPA) empirically identified 3 clusters of patients with different risk of chronic pain based on 4 key psychophysical and psychosocial characteristics. We aimed to test this type of group-based clustering within in a perioperative cohort undergoing breast surgery to investigate differences in postsurgical pain outcomes. Women (N = 228) scheduled for breast cancer surgery were prospectively enrolled in a longitudinal observational study. Pressure pain threshold (PPT), anxiety, depression, and somatization were assessed preoperatively. At 2-weeks, 3, 6, and 12-months after surgery, patients reported surgical area pain severity, impact of pain on cognitive/emotional and physical functioning, and pain catastrophizing. The ROPA clustering, which used patients' preoperative anxiety, depression, somatization, and PPT scores, assigned patients to 3 groups: Adaptive (low psychosocial scores, high PPT), Pain Sensitive (moderate psychosocial scores, low PPT), and Global Symptoms (high psychosocial scores, moderate PPT). The Global Symptoms cluster, compared to other clusters, reported significantly worse persistent pain outcomes following surgery. Findings suggest that patient characteristic-based clustering algorithms, like ROPA, may generalize across diverse diagnoses and clinical settings, indicating the importance of "person type" in understanding pain variability. PERSPECTIVE: This article presents the practical translation of a previously developed patient clustering solution, based within a chronic pain cohort, to a perioperative cohort of women undergoing breast cancer surgery. Such preoperative characterization could potentially help clinicians apply personalized interventions based on predictions concerning postsurgical pain.