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• To date no research has been conducted on the educational preparation of active-duty military corpsman and medics sitting for the licensed vocational nurse exam, National Council Licensure by Examination- Practical Nurse (NCLEX-PN). • This paper shares a nurse faculty led intervention to help military corpsman and medics study for and pass the NCLEX-PN. • Capitalizing on prior learning and military medical healthcare experience, this study shares the benefit of nurse faculty led interventions through a scaffolded learning approaching moving these students into civilian licensed vocational nursing positions or further advancement in their careers. This study explored the use of an intervention to increase test success of corpsmen in pursuit of the LVN license. Corpsmen who pursue California Licensed Vocational Nurse (LVN) licensure and sit for the National Council Licensure by Examination- Practical Nurse (NCLEX-PN) historically pass with a 50% rate. It is not understood how the combination of formalized test preparation and faculty facilitation of course impact test success. Using a quantitative design, we explored the effectiveness of the course and relationship between individual intervention outcomes for 12 military corpsmen. Student mean scores on the pretest were 58.0%, while comprehensive exam scores were 84.2%. This gain represents a 45% increase and comprehensive exam scores that could have likely satisfied 2021 NCLEX-PN passing scores. The findings suggest that a model with a nurse-led facilitation of NCLEX-PN test plan content shows promise in helping corpsmen close the theory to practice gap in passing the NCLEX-PN. [ABSTRACT FROM AUTHOR]

The concept of the 'bathroom' in space habitats has typically been applied with only the most fundamental human requirements in mind, resulting in unpleasant, uninspiring, or even brutal areas to perform tasks intrinsic to our physiological health and overall mortality. Bathrooms are one of the few zones crew are afforded visual privacy, and due to the demands surrounding grooming, bathing, and waste elimination, require the most sensitive and intimate hardware our bodies must directly interface with on any inhabited spacecraft. Many cultures on Earth have independently developed their own customs, social taboos, syntaxes, and hardware regarding their attitudes for an idealized performance of self-hygiene. Because of these drivers, how these spaces appeared, and the tools used within them, have varied wildly throughout human history. There already exist various concepts of bodily elimination and sanitation to inform what future hygiene stations and toilet closets can potentially adopt - less of a dreaded necessity and more of an integral and regenerative ritual of living in space. As the space industry pushes for a more permanent human presence outside Earth, examinations of how design implementations can simultaneously improve the sanitary and cultural considerations of these spaces should be contemplated. The focus of this paper examines our hygienic needs from these subsequent viewpoints: our essential physiological demands; the performative patterns and postures of carrying out these actions; methodologies for operating these fundamental activities; and prospective design applications to better facilitate these needs for future bathrooms in microgravity environments. These topics will be supported by schematic drawings and research from anthropometric and architectural sources designed for use both on and off Earth. • Squatting positions aren't considered in WCS design but are superior for gastrointestinal health. • Useful flexion muscles in the thighs and hips aren't activated in sitting positions. • Squatting positions make dual use (defecation and urination) easier to accomplish. • Architecturally integrated WCS design saves on crew cleaning time and is a more efficient use of volume. • Toilet seat lids should consider the ischial tuberosity to help crew align with the WCS. [ABSTRACT FROM AUTHOR]

Depression not only creates enormous costs for treatment and lost work time, but also increases the risk for other costly chronic diseases such as cardiovascular disease and diabetes. The magnitude of these risks remains unclear, with existing prospective studies using small sample sizes with limited diversity and reliant on surveys. We use 2 billion prescription fill records to quantify depression by antidepressant fill records. We track each patient's prescriptions longitudinally and use Cox's time varying proportional hazard model to quantify the effect of taking antidepressants on the hazard rate of taking drugs associated with other chronic diseases quantified similarly by disease-relevant fill records. Controlling for socioeconomic variables, antidepressant use increased the hazard rate for drugs used for cardiovascular disease (1.59 fold), diabetes (1.30) and cancer (1.50). Antidepressant use also predicted substantially higher use of sedatives (3.06) and amphetamines (4.11). Antidepressant use, as a proxy for depression, is a significant risk factor for the most prevalent and costly chronic diseases, and should be treated as a disease with quantifiable and significant implications for individual health. • Antidepressant use, as proxy for depression, is a significant risk factor for the most prevalent and costly chronic diseases. • Depression should be treated as a disease with quantifiable physical and economic implications for individual health. • We use 2.4 billion longitudinal prescription fill records as a proxy to quantify depression by antidepressant fill records. • We track patients and quantify the effect of antidepressants on the hazard rate of taking drugs for other chronic diseases. • Antidepressants predict higher drug usage for cardiovascular disease (1.59 fold), diabetes (1.30), cancer (1.50). • Antidepressant use also predicted substantially higher use of sedatives (3.06) and amphetamines (4.11). [ABSTRACT FROM AUTHOR]

Single-axis solar trackers are currently the most commonly used racking system in utility scale solar photovoltaic (PV) plants. The last decade has seen significant advances in the understanding of single-axis tracker aerodynamics after significant failures have occurred due to aerodynamic instabilities. The current study focuses on the aeroelastic mechanisms causing these divergent instabilities. The analytical background as a function of static tilt angle is presented for the different instabilities. The role of aerodynamic stiffness and aerodynamic damping are examined through rigid sectional model testing and these results are used to perform numerical stability estimates using multiple theoretical approaches. These results are compared with aeroelastic model testing of a single-axis solar tracker over a wide range of static tilt angles. These analytical, numerical, and experimental approaches are used to assess the static tilt angles governed by stiffness-driven and damping-driven aerodynamic instabilities. The small size and light weight of single-axis trackers makes them more susceptible to turbulent gusts. This aspect has been addressed in the current study through the concept of the structurally averaged wind speed and the effective gust velocity factor. Comparison to the experimental results suggests that stiffness-driven torsional instability can respond quite rapidly to the passage of turbulent gusts. • Theoretical descriptions of the observed aeroelastic instabilities of single-axis solar PV trackers are provided. • Sectional and aeroelastic model tests are used to discern stiffness-driven from damping-driven instabilities. • A velocity gust factor approach is used to relate analytically determined wind speed to an appropriate averaging time. • Numerical simulations are performed using purely quasi-steady theory and a model based on aerodynamic derivatives. [ABSTRACT FROM AUTHOR]

We have reported that clinical variables such as episode duration, early partial response, previous antidepressant trials, age at onset, and baseline symptom severity can be used to guide whether an older person whose depression has not responded to pharmacotherapy should be switched to a different medication (Kim et al., in press). In this study, we assessed whether combining clinical variables, pharmacogenetics, and pharmacokinetic parameters would improve decision trees guiding early treatment decisions. We analyzed data from 218 older participants with major depressive disorder (MDD) who had not responded after four weeks of treatment with venlafaxine XR in the Incomplete Response in Late-Life Depression: Getting to Remission (IRL-Grey) study. Participants were treated up to 12 weeks, during which venlafaxine XR was titrated up to 300 mg/day or until remission was attained. Treatment response was defined as > 50% symptom improvement. Metabolizer status was derived from Cytochrome 2D6 (CYP) genotype using existing guidelines. Venlafaxine (VEN) and o-desemethylvenlafaxine (ODV) plasma levels collected at week 12 were used for population pharmacokinetic (PK) modeling using NONMEM to obtain VEN and ODV exposures. Active moiety (AM; VEN + ODV) exposure was also calculated. Using a receiver operating characteristic (ROC) model, clinical variables, CYP metabolizer status, VEN, ODV, and AM exposures were entered as potential predictors. One decision tree minimizing false identification of future responders (false positives) and another decision tree minimizing false identification of future non-responders were created (false negatives) with five-fold cross validation. Not having a partial response at week 4, a longer episode duration, and a higher AM exposure were identified as predictors of non-response at week 12. Test negative predictive values of the left most terminal node of the two trees were 78.3% and 77.2%, respectively, similar to the negative predictive values of the trees that did not include the pharmacogenetics and pharmacokinetic parameters. In conclusion, higher AM exposure was identified as a predictor of non-response. Our decision trees also included two previously identified clinical predictors of non-response: early non-response and longer episode duration. Addition of pharmacogenetics and pharmacokinetic parameters did not improve the predictive ability of decision trees using clinical variables to predict response to venlafaxine XR in older patients with MDD. The IRL-GRey study was supported primarily by the National Institute of Mental Health (R01 MH083660 and P30 MH90333 to University of Pittsburgh, R01 MH083648 to Washington University, and R01 MH083643 to University of Toronto). Additional funding was provided by the UPMC Endowment in Geriatric Psychiatry, the Taylor Family Institute for Innovative Psychiatric Research (at Washington University), the Washington University Institute of Clinical and Translational Sciences grant UL1 TR000448 from the National Center for Advancing Translational Sciences (NCATS), and the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto. Pfizer contributed venlafaxine extended-release capsules for this study and Bristol-Myers Squibb contributed aripiprazole and matching placebo tablets for the randomized phase of the study. [ABSTRACT FROM AUTHOR]

To summarize research on optimal emergency department (ED) care practices for persons living with dementia (PLWDs) and develop research priorities. Systematic scoping review. PLWDs in the ED. The following Patient-Intervention-Comparison-Outcome (PICO) questions were developed: PICO 1, What components of emergency department care improve patient-centered outcomes for persons with dementia? PICO 2, How do emergency care needs for persons with dementia differ from other patients in the emergency department? A scoping review was conducted following PRISMA-ScR guidelines and presented to the Geriatric Emergency care Applied Research 2.0 Advancing Dementia Care network to inform research priorities. From the 6348 publications identified, 23 were abstracted for PICO 1 and 26 were abstracted for PICO 2. Emergency care considerations for PLWDs included functional dependence, behavioral and psychological symptoms of dementia, and identification of and management of pain. Concerns regarding ED care processes, the ED environment, and meeting a PWLD's basic needs were described. A comprehensive geriatric assessment and dedicated ED unit, a home hospital program, and a low-stimulation bed shade and contact-free monitor all showed improvement in patient-centered or health care use outcomes. However, all were single-site studies evaluating different outcomes. These results informed the following research priorities: (1) training and dementia care competencies; (2) patient-centric and care partner–centric evaluation interventions; (3) the impact of community- and identity-based factors on ED care for PLWDs; (4) economic or other implementation science measures to address viability; and (5) environmental, operational, personnel, system, or policy changes to improve ED care for PLWDs. A wide range of components of both ED care practices and ED care needs for PLWDs have been studied. Although many interventions show positive results, the lack of depth and reproducible results prevent specific recommendations on best practices in ED care for PLWDs. [ABSTRACT FROM AUTHOR]

Novel antifungals are in high demand as there is a growing resistance to antifungals currently in use. In particular, opportunistic fungal infections caused by Candida spp. are on the rise with infections by this genus accounting for the most severe fungal infections following chemotherapy, implantation procedures, and in patients with HIV/AIDS. A series of simple aurone analogs were synthesized and screened for antifungal activity versus Candida spp. Several compounds displayed activity at 100 μM, with two having IC 50 values below 20 μM for three species of Candida . One of the compounds tested here also exhibits anti-biofilm activity for mid-maturation growth. [ABSTRACT FROM AUTHOR]

Measurements have been performed in a large scale wind tunnel on an elongated bluff body with a chord-to-thickness ratio of 7 over the Reynolds number range Re=4.0–7.5×104. Six different leading edge separation angles were created by altering the leading edge geometry. Time-resolved, synchronized, surface pressure and Particle Image Velocimetry data allow for detailed characterization of the flow around the body and in the recirculation region. The results show a linear decrease in the shedding frequency of nearly 40% as the leading edge separation angle is increased from 0°–90°. The PIV data are phase averaged in the recirculation region and the convection speed of the vortices is characterized. From the phase averaged data, the velocity outside of the recirculation region is observed to decrease markedly as the leading edge separation angle is increased, which is suggested to be responsible for the observed changes in the shedding frequency. [ABSTRACT FROM AUTHOR]

Abstract: Archeological and paleoenvironmental records from southern Central America attribute population collapse to the Spanish Conquest about 500 years ago. Paleoclimate records from the circum-Caribbean have shown evidence of severe, regional droughts that contributed to the collapse of the Mayan Civilization, but there are few records of these droughts in southern Central America and no records of their effects on prehistoric populations in the region. Here we present a high-resolution lake sediment record of prehistoric agricultural activities using bulk sediment stable carbon isotopes from Laguna Zoncho, Costa Rica. We find isotopic evidence that agriculture was nearly absent from the watershed approximately 220 years prior to the Spanish arrival in Costa Rica and identify two distinct periods of agricultural decline, 1150–970 and 860–640 cal yr BP, which correspond to severe droughts in central Mexico. We attribute decreases in agriculture to a weakened Central American monsoon, which would have shortened the growing season at Laguna Zoncho, reduced crop yields, and negatively affected prehistoric populations. [Copyright &y& Elsevier]

Abstract: Although the aerodynamic cause of the collapse of the Tacoma Narrows Bridge is known to be flutter, there is still little known about the fluid mechanics of this phenomenon. Wind tunnel testing ensures that other bridges should not fail due to this instability, but flow field measurements, other than point measurements, are rare. Recent hypotheses have attributed the cause of the instability to the timing of vortices moving around the deck; however, there is minimal flow data to support this notion. In the current work, measurements were performed using the section model technique on a rectangular cross-section (chord/thickness=7) at different points during the build-up of flutter. These measurements include displacement measurements and high-speed PIV measurements. Experiments were also performed on a static body. The results confirm that the shedding frequency and frequency of the body motion are indeed distinct and both can be observed throughout the build-up of flutter. Moreover, it is shown that the vortex shedding activity changes minimally from that of a static body to one that is experiencing bluff body flutter. These results indicate that the timing of leading edge vortices cannot be the cause of the flutter instability. [Copyright &y& Elsevier]

Objective: A recent randomized trial suggested nitinol self-expanding stents (SES) were associated with reduced restenosis rates compared with simple percutaneous transluminal angioplasty (PTA). We evaluated our results with superficial femoral artery (SFA) SES to determine whether TransAtlantic InterSociety Consensus (TASC) classification, indication for intervention, patient risk factors, or Society of Vascular Surgery (SVS) runoff score correlated with patency and clinical outcome, and to evaluate if bare nitinol stents or expanded polytetrafluoroethylene (ePTFE) covered stent placement adversely impacts the tibial artery runoff. Methods: A total of 109 consecutive SFA stenting procedures (95 patients) at two university-affiliated hospitals from 2003 to 2006 were identified. Medical records, angiographic, and noninvasive studies were reviewed in detail. Patient demographics and risk factors were recorded. Procedural angiograms were classified according to TASC Criteria (I-2000 and II-2007 versions) and SVS runoff scores were determined in every patient; primary, primary-assisted, secondary patency, and limb salvage rates were calculated. Cox proportional hazard model was used to determine if indication, TASC classification, runoff score, and comorbidities affected outcome. Results: Seventy-one patients (65%) underwent SES for claudication and 38 patients (35%) for critical limb ischemia (CLI). Average treatment length was 15.7 cm, average runoff score was 4.6. Overall 36-month primary, primary-assisted, and secondary rates were 52%, 64%, and 59%, respectively. Limb salvage was 75% in CLI patients. No limbs were lost following interventions in claudicants (mean follow-up 16 months). In 24 patients with stent occlusion, 15 underwent endovascular revision, only five (33%) ultimately remained patent (15.8 months after reintervention). In contrast, all nine reinterventions for in-stent stenosis remained patent (17.8 months). Of 24 patients who underwent 37 endovascular revisions for either occlusion or stenosis, eight (35%) had worsening of their runoff score (4.1 to 6.4). By Cox proportional hazards analysis, hypertension (hazard ratio [HR] 0.35), TASC D lesions (HR 5.5), and runoff score > 5 (HR 2.6) significantly affected primary patency. Conclusions: Self-expanding stents produce acceptable outcomes for treatment of SFA disease. Poorer patency rates are associated with TASC D lesions and poor initial runoff score; HTN was associated with improved patency rates. Stent occlusion and in-stent stenosis were not entirely benign; one-third of patients had deterioration of their tibial artery runoff. Future studies of SFA interventions need to stratify TASC classification and runoff score. Further evaluation of the long-term effects of SFA stenting on tibial runoff is needed. [Copyright &y& Elsevier]

This paper presents a concise method for determining the design wind loads for multi-row ground-mounted solar arrays, including both static and dynamic wind load coefficients compatible with the ASCE 7, based on a compilation of wind tunnel experiments conducted by RWDI using rigid pressure models. The proposed method addresses the well-established shortcomings of the ASCE 7–16 definition of 'rigid structure' based on the frequency of 1 ​Hz when applied to such arrays and the need identified in SEAOC PV2 (2017) that ground-mounted arrays with numerous repetitive structures shall consider vortex shedding and consequent dynamic resonant effects. Comparisons to other sources available in the technical literature have been made where possible, which are largely satisfactory, and an illustrative example is provided to assist practitioners in applying the proposed method. It is important to note that the method and data presented in this paper assume that wind-induced deflections are small, and thus, the structure is not flexible; flexible structures such as unrestrained single-axis trackers are also prone to aeroelastic effects and torsional instabilities, which are beyond the scope of this paper. Sources of uncertainty are discussed and, in an effort to minimize these uncertainties when predicting design wind loads, it is the authors' hope that the dataset presented herein be augmented by other contributors to form the basis for codification. • This paper presents a method to obtain design wind loads for ground-mounted solar arrays compatible with the ASCE 7. • The failings of the ASCE 7 'rigid structure' definition and the SEAOC PV2 need to include vortex shedding are addressed. • Flexible structures such as single-axis trackers are prone to torsional instabilities and beyond the scope of this paper. • It is the authors' hope that this dataset be augmented by other contributors to form the basis for codification. [ABSTRACT FROM AUTHOR]

Unrestrained single-axis solar trackers are uniquely flexible structures that can withstand more deflections than typical aeroelastic structures such as long-span bridges or aircraft wings. These distinctive features and the aerodynamics of multi-row arrays lead to the requirement of novel techniques for design wind loads. The present study presents a hybrid technique using two separate wind tunnel tests: (i) a pressure model at a relatively small scale, and (ii) a sectional model at a larger scale. The pressure model test is used to measure the buffeting forces acting on each row of the array and the sectional model study is used to extract the variation in aerodynamic stiffness and damping as a function of wind speed. The results of these separate studies are combined to numerically simulate the buffeting response of the tracker, which predicts significant inertial and self-excited forces. Comparisons between the proposed hybrid method and wind loads estimated using a dynamic amplification approach are performed. It is shown that at high wind speeds, the self-excited forces become significant and the peak design moments exceed those predicted using pressure data alone. The proposed methodology is expected to complement aeroelastic modeling as a convenient and efficient design tool. • Pressure model wind tunnel tests are performed on a solar array over a range of static tilt angles and wind directions. • Sectional model tests have been performed to understand the aerodynamic damping and stiffness variation with wind speed. • A novel buffeting response method is developed incorporating pressure data and measured aerodynamic damping and stiffness. [ABSTRACT FROM AUTHOR]

The combination of microwave heating and the deep eutectic solvent formed from choline chloride and urea has resulted in a new, essentially neutral, yet rapid method for the synthesis of a wide range of aurone derivatives. While isolated yields remain somewhat variable, in virtually every case, a significant increase in yield has been observed on going from conventional thermal heating to microwave heating. In addition, some compounds inaccessible using prior methods have become reproducibly available using this modification. Further application of the combination of DES and microwave heating is expected to be highly promising and of general utility. [ABSTRACT FROM AUTHOR]

Inherent to sedimentary compound-specific isotopic proxies of paleoecological and paleoclimate change is the assumption that biomarkers are coeval with the surrounding sedimentary matrix. Compound-specific radiocarbon analyses of lake and nearshore marine sediments have indicated a potential offset between the ages of terrestrial biomarkers and their surrounding sediments that could confound efforts to establish strong chronological control for compound-specific isotopic data. We conducted high-resolution compound-specific δ 13 C analyses of n -alkanes (δ 13 C alkane ) in a well-studied sediment core from Laguna Castilla, Dominican Republic, and compared the results to bulk sedimentary δ 13 C (δ 13 C bulk ), fossil pollen, and sediment geochemistry to assess potential ‘pre-aging’ of alkanes in the terrestrial environment prior to deposition. We found significant positive correlations between δ 13 C bulk values and δ 13 C alkane values, indicating little or no temporal lag in the response of δ 13 C alkane values to vegetation change and thus little or no offset in the age of terrestrially-derived compounds and the organic fraction of the sedimentary matrix. While this study highlights the need for further research into the variables affecting age offsets between proxy data, we propose the comparison of δ 13 C bulk and δ 13 C alkane values as a method to assess potential age offsets between compound-specific and other proxy datasets, particularly in small watersheds with sediment records containing a high proportion of allochthonous organic matter. This method is more available to researchers than obtaining numerous compound-specific radiocarbon analyses, which are costly and not a routine service offered by radiocarbon facilities. [ABSTRACT FROM AUTHOR]

Prostaglandin E 2 (PGE 2 ) is a lipid mediator of inflammation and its inhibition has become a popular drug target due to its harmful physiological roles. Diarylheptanoids are one class of compounds that have shown successful inhibition of PGE 2 . This paper reports the synthesis and PGE 2 inhibitory activity of a series of analogues of a naturally occurring diarylheptanoid. The most efficacious compounds were examined for dose-dependent PGE 2 inhibition. Among several promising compounds, the lead candidate exhibited an IC 50 value of 0.56 ng/µL or 1.7 µM with no detectable toxicity at the highest dose of 10 ng/µL. [ABSTRACT FROM AUTHOR]

We present a laboratory experiment of the initial growth of a turbulent patch in a stably stratified fluid. The patch is created due to a localized source of turbulence, generated by a horizontally oriented and vertically oscillating grid much smaller than the tank size and far from solid boundaries. Synchronized and overlapping particle image velocimetry(PIV) and planar laser induced fluorescence (PLIF) measurements capture the evolution of the patch through its initial growth until it reached a maximum size. The simultaneous measurements of density and velocity fields allow for a direct quantification of the distribution of kinetic energy, buoyancy and degree of mixing within the patch. We can also relate the propagation speed of the turbulent/non-turbulent interface and its thickness to the properties of the turbulent fluid inside the evolving patch. The velocity measurements in this setup indicate significant transient effects inside the patch during its growth. A local analysis of the turbulent/non-turbulent interface provides direct measurements of the entrainment velocity w e as compared to the local vertical velocity and turbulent intensity at the proximity of the interface. The detailed information about the growth of localized sources of turbulence in stratified environment might be of use in stealth design of autonomous underwater vehicles. [ABSTRACT FROM AUTHOR]

Terahertz digital holography is a non-scanning and real time method for reconstructing the absorption and phase distributions of the wave-front diffracted by a given sample simultaneously in the terahertz region. A continuous-wave terahertz in-line digital holographic multi-plane imaging method is presented here for achieving a three-dimensional shape of a specific portion of a sample with the best possible focus. The three enhancement techniques of synthetic aperture, autofocusing and phase retrieval are applied to the single plane recordings for achieving a high resolution, good quality and optimally focused reconstructed image. Later, multi-plane reconstructed images are processed with the threshold mask and a three dimensional profile of the sample is obtained. Experimental verification confirms that the proposed method is a valid tool for acquiring multi-plane information of a target in the terahertz range. [ABSTRACT FROM AUTHOR]