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Purpose To compare corneal endothelial damage from longitudinal and torsional ultrasound during phacoemulsification. Setting John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Design Experimental Study. Methods Nine New Zealand white rabbits underwent bilateral surgery. After incision, the Intrepid Balanced tip of the Centurion (Alcon) Ozil handpiece was inserted into the anterior chamber and the following settings were used: 50 mL/minute flow, 70 mmHg intraocular pressure, 600 mmHg vacuum, and 60% longitudinal (one eye) or torsional (contralateral eye) ultrasound for 30 seconds. Cumulative dissipated energy (CDE) was noted. After euthanasia and enucleation, the corneas were removed, stained with trypan blue/alizarin red, and photographed (X400 photographs from 5 specific areas, and 1 overview photograph from each corneal button). The ImageJ program was used to evaluate cell damage and loss in the photographs obtained from each cornea. Results Cavitation bubbles around the phaco tip was generally observed in the longitudinal group. CDE was 17.4 +/- 0.58 and 6.93 +/- 0.15 in the longitudinal and torsional groups, respectively (P = 0.003). The percentage of intact cells was statistically higher in the torsional group, and the percentage of lost cells was statistically higher in the longitudinal group (P = 0.003). This was observed in the analysis of the X400 photographs, as well as the overview photographs. Conclusion This study suggests that torsional ultrasound was associated with significantly less corneal endothelial cell damage than classical longitudinal tip motion, providing further insight on mechanisms of corneal endothelial damage during phacoemulsification.

Side‐scan sonar and Compressed High Intensity Radar Pulse mapping of Great Salt Lake, Utah, linked to reprocessing of acoustic data from bathymetric surveys, has enabled the distribution of microbial bioherms to be assessed. Bioherms occupy an estimated area >700 km2 in the south arm and >300 km2 in the north arm. Distributions vary from statistically dispersed to clustered, and in this latter case, are predominantly located on metre‐scale, fault‐controlled topographic highs, with sediment infilling intervening lows between adjacent offsets. Individual bioherms are circular to oblate and range from centimetres to over 2 m in diameter. In some areas, bioherm heights were measured at more than 1.5 m above adjacent substrate. Sublittoral bioherms are made of aragonite, calcite and minor dolomite precipitated due to physico‐chemical, biologically induced and influenced carbonate mineralization processes in association with microbial mats. Bioherm fabrics vary at the millimetre to centimetre‐scale and consist of leiolitic and clotted peloidal micrite‐grade carbonate, sinuous threads of spherulitic fibrous aragonite crystals, laminated micrite boundstone and internal carbonate mud sediment with peloids and ooids. The identification of factors that influence microbial bioherm occurrence and spatial distribution in Great Salt Lake is limited to a set of collinear physical, chemical and biological variables that are confined to a localised closed system, such as salinity, water depth, wave energy, stable substrate and sediment accumulation. Anthropogenic modifications to Great Salt Lake resulting in increased salinity have exceeded the salinity range in which bioherm‐mediating microbial communities can survive, effectively defining an upper limit of salinity for bioherm microbial community viability. The better understanding of the distribution of microbial bioherms has significant implications for managing and protecting the lake ecosystem and may provide insights into the physical and chemical controls that existed during the formation of fossil microbialites in deep time.

Purpose A "dead bag syndrome" has been recently described, in which the capsular bag appears to be clear many years after surgery, becoming diaphanous and floppy, and unable to support the intraocular lens (IOL) within it. The aim of this study was to describe findings of this syndrome. Setting John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Design Case series with clinicopathological correlation. Methods Out of 10 cases suspected to be from dead bag syndrome, 8 IOLs/7 capsular bags were removed due to subluxation/dislocation. The seven capsular bags available for analysis were fixed in formalin and submitted to histopathological examination (hematoxylin/eosin and Masson's trichrome stains). The associated explanted IOLs in 5 cases were also examined microscopically. Results Histopathologic examination of the seven capsular bags showed capsular thinning and/or splitting. Lens epithelial cells (LECs) were completely absent on two specimens while the other five specimens had rare LECs on the inner surface of the capsule. Explanted IOLs were three-piece silicone lenses or single-piece hydrophobic acrylic lenses. One IOL optic showed a small amount of granular pigment deposition, but the optics of the other four lenses were unremarkable. Conclusions In this syndrome, there appears to be an absence of secondary proliferation of LECs, as well as fibrotic changes. The capsule shows some signs of degradation, such as thinning and/or splitting. Weakness of zonular attachments appears to be an associated finding, with subsequent in-the-bag IOL dislocation. Further studies are necessary to ascertain the etiology of this condition.

Outcomes and costs of coronavirus disease (COVID-19) contact tracing are limited. During March-May 2020, we constructed transmission chains from 184 index cases and 1,499 contacts in Salt Lake County, Utah, USA, to assess outcomes and estimate staff time and salaries. We estimated 1,102 staff hours and $29,234 spent investigating index cases and contacts. Among contacts, 374 (25%) had COVID-19; secondary case detection rate was ≈31% among first-generation contacts, ≈16% among second- and third-generation contacts, and ≈12% among fourth-, fifth-, and sixth-generation contacts. At initial interview, 51% (187/370) of contacts were COVID-19-positive; 35% (98/277) became positive during 14-day quarantine. Median time from symptom onset to investigation was 7 days for index cases and 4 days for first-generation contacts. Contact tracing reduced the number of cases between contact generations and time between symptom onset and investigation but required substantial resources. Our findings can help jurisdictions allocate resources for contact tracing.

Objective The 2 primary aims of this study were to identify ultrasonographic tendon abnormalities in asymptomatic runners and to examine the likelihood of developing pain in runners with ultrasound abnormalities compared with those without abnormalities. Design Longitudinal, prospective cohort study. Setting 2019 Salt Lake City Marathon. Participants Recreational half-marathon and full-marathon runners. Assessment of risk factors The Achilles and patellar tendons of asymptomatic runners were examined with ultrasound imaging before a running event. Runners were monitored for self-reported outcomes of pain in the examined tendons at 1, 3, 6, and 12 months after the event. Main outcome measures Development of pain based on the presence of asymptomatic tendon abnormalities. Results One hundred thirty-eight runners (36.2 ± 12.0 years, 49.3% men, and 31.2% full-marathon runners) were included. Ultrasound abnormalities of the Achilles and patellar tendons were identified in 24.6% and 39.1% of the runners before the race, respectively. Ultrasound abnormalities were significantly associated with approximately a 3-fold increase [hazard ratio (HR) = 2.55, P = 0.004] in the hazard of developing pain in the Achilles tendon and patellar tendon (HR = 1.67, P = 0.042) over the year after the race. Positive and negative predictive values of developing pain over the year were 34.1% and 87.2%, respectively, for abnormal findings in the Achilles tendon, and 22.9% and 85.0%, respectively, for the patellar tendon. Conclusions The presence of ultrasonographic abnormalities is associated with increased development of pain in the Achilles and patellar tendons within 1 year of a marathon or half marathon.

On-demand microtransit services are frequently seen as an important tool in supporting first and last mile operations surrounding fixed route high frequency transit facilities, but questions remain surrounding who will use these novel services and for what purposes. In November 2019, the Utah Transit Authority launched an on-demand microtransit service in south Salt Lake County in partnership with a private mobility operator. This paper reports the results of an expressed preferences survey of 130 transit riders in the microtransit service area that was collected before and immediately after the service launched. There is not a clear relationship between current transit access mode and expressed willingness to use microtransit, although some responses from new riders indicate the novel service competes most directly with commercial transportation network company operations. The survey responses also reveal younger passengers express a more than expected willingness to use microtransit, middle-aged passengers a less than expected willingness, and older passengers neutral or no expressed opinion. The results suggest additional relationships between household size and transit use frequency, but further research is necessary. The effect of other user characteristics, including income and automobile availability, is less statistically clear and requires further research.

Objective US-based descriptions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have focused on patients with severe disease. Our objective was to describe characteristics of a predominantly outpatient population tested for SARS-CoV-2 in an area receiving comprehensive testing. Methods We extracted data on demographic characteristics and clinical data for all patients (91% outpatient) tested for SARS-CoV-2 at University of Utah Health clinics in Salt Lake County, Utah, from March 10 through April 24, 2020. We manually extracted data on symptoms and exposures from a subset of patients, and we calculated the adjusted odds of receiving a positive test result by demographic characteristics and clinical risk factors. Results Of 17 662 people tested, 1006 (5.7%) received a positive test result for SARS-CoV-2. Hispanic/Latinx people were twice as likely as non-Hispanic White people to receive a positive test result (adjusted odds ratio [aOR] = 2.0; 95% CI, 1.3-3.1), although the severity at presentation did not explain this discrepancy. Young people aged 0-19 years had the lowest rates of receiving a positive test result for SARS-CoV-2 (Conclusions We found disparities by race/ethnicity and age in access to testing and in receiving a positive test result among outpatients tested for SARS-CoV-2. Further research and public health outreach on addressing racial/ethnic and age disparities will be needed to effectively combat the coronavirus disease 2019 pandemic in the United States.

PURPOSE The purpose of this study is to examine the following questions: 1) Do refugees and non-refugees differ in self-rated health? 2) Do refugees and non-refugees differ in cancer risk awareness? and 3) Are lifestyle factors such as diet, physical activity participation, and weight status risk or protective factors of cancer risk awareness? METHODS A self-administered or interviewer-administered survey were collected from adults with a refugee background from spring to fall in 2017 in Salt Lake County, Utah. Free clinic data (a non-refugee comparison group) were collected using a self-administered survey from May to June in 2017 from a free clinic in Salt Lake County, Utah. RESULTS Refugees reported better self-rated health and were less likely to be obese/overweight, have family history of cancer, and have healthy diet. Refugees reported lower levels of cancer risk awareness than free clinic non-refugee patients. Having a healthy diet was associated with higher levels of cancer risk awareness. CONCLUSION Future studies should examine cultural differences related to cancer risk awareness among refugee populations.

Dear Editor, BioFire® Filmarray® Pneumonia Panel (BFPP) (BioFire Diagnostics, LLC, Salt Lake City, UT) is a multiplex PCR system that rapidly identifies 33 different pathogens and resistance genes ...

Urban environments are characterized by pronounced spatiotemporal heterogeneity, which can present sampling challenges when utilizing conventional greenhouse gas (GHG) measurement systems. In Salt Lake City, Utah, a GHG instrument was deployed on a light rail train car that continuously traverses the Salt Lake Valley (SLV) through a range of urban typologies. CO2 measurements from a light rail train car were used within a Bayesian inverse modeling framework to constrain urban emissions across the SLV during the fall of 2015. The primary objectives of this study were to (1) evaluate whether ground-based mobile measurements could be used to constrain urban emissions using an inverse modeling framework and (2) quantify the information that mobile observations provided relative to conventional GHG monitoring networks. Preliminary results suggest that ingesting mobile measurements into an inverse modeling framework generated a posterior emission estimate that more closely aligned with observations, reduced posterior emission uncertainties, and extends the geographical extent of emission adjustments.

The existing condition of potable water in the city of Qom and its adjacent villages needs improvement, both for the quantity as well as the quality. On one side, the excess use of wells has decreased the level of underground water, resulting to Penetration of salty water from the neighboring salt lake into the underground water and therefore, lowering the quality of potable water, and on the other side, during the recent years the consumption of water has increased due to growth of the city population. Because of these factors, the improvement of quality and overcoming the shortage of drinkable water in the city of Qom and its adjacent villages, have turned to an urgent need. To respond to the above-mentioned needs, some studies have been carried out by a number of consultants during the past years. In addition, based on such studies, certain projects have been implemented to provide new sources of potable water for the city of Qom.this paper aims at investigating the existing condition of potable water in the city of Qom. The goal of this water treatment is to supply the drinkable water for agriculture and industry and producing the energy.

In 2017, a connected vehicle (CV) corridor utilizing dedicated short-range communication (DSRC) technology was built along Redwood Road, Salt Lake City, Utah. One main goal of this CV corridor is to implement transit signal priority (TSP) when the bus is behind its published schedule by a certain threshold. With the data generated by the transit vehicles, transmitted through the DSRC system, logged by traffic signal controller, and coupled with the Utah Transit Authority (UTA) data from transit operation system, some performance data of the TSP can be analyzed including TSP requested, TSP served, bus reliability, bus travel time, and bus running time. For providing better signal coordination to buses, the signal plan for this CV corridor underwent retiming in October 2018. This research aims to compare the TSP performance before and after the signal retiming. The field data of August, September, November, and December in 2018 were selected to perform this evaluation. Results show that the TSP served rate after signal retiming is 35.29%, which is higher than that of 33.12% before signal retiming. In addition, compared with the signal plan before October, bus reliability northbound and southbound on the CV corridor was improved by 2.4% and 1.47%, respectively; bus travel time and bus running time were reduced as well.

PURPOSE To evaluate longitudinal power settings for optimally efficient lens fragment removal, using the Centurion machine. SETTING John A. Moran Eye Center, University of Utah, Salt Lake City, USA. DESIGN Experimental study. METHODS Porcine lens nuclei were cut into 2.0 mm cubes. Experiments were conducted at 100% torsional power; vacuum set at 500 mm Hg, aspiration 50 mL/min, and intraocular pressure 110 mm Hg. A 20-degree tip with a 30-degree bevel was used. Longitudinal power was tested between 20% and 100%. Efficiency (time for fragment removal) and chatter (the number of times the fragment bounced from the tip) were measured. RESULTS A linear increase in efficiency was observed from 20% to 100% longitudinal power (R = 0.9281, slope = -0.0271). An efficiency slope change occurred at 60% power, with the largest incremental change in efficiency between 20% and 60% (R = 0.9756, slope = -0.0394) and a lesser change between 60% and 100% (R = 0.9827, slope = -0.0121). Chatter analysis showed minimal events at 20% to 60%, but a significant increase at >80% (P = .005). This increase appeared to be incremental (R = 0.8929). CONCLUSIONS Increasing longitudinal power, with all other settings constant, increased efficiency. Greatest efficiency gains were observed between 20% and 60%. At 80% and 100%, chatter events increased significantly. With a goal of recommending optimally efficient settings while minimizing excess energy and chatter, adding 60% of longitudinal power to 100% torsional power was shown to be the best setting to increase efficiency and avoid repulsion in these vacuum and aspiration settings.

Great Salt Lake (GSL), Utah, lost 1.89 +/- 0.04 meters of water during the 2012 to 2016 drought. During this timeframe, data from the GRACE mission do not detect anomalous mass loss, but nearby Glo...

OBJECTIVES Host gene expression signatures discriminate bacterial and viral infection but have not been translated to a clinical test platform. This study enrolled an independent cohort of patients to describe and validate a first-in-class host response bacterial/viral test. DESIGN Subjects were recruited from 2006 to 2016. Enrollment blood samples were collected in an RNA preservative and banked for later testing. The reference standard was an expert panel clinical adjudication, which was blinded to gene expression and procalcitonin results. SETTING Four U.S. emergency departments. PATIENTS Six-hundred twenty-three subjects with acute respiratory illness or suspected sepsis. INTERVENTIONS Forty-five-transcript signature measured on the BioFire FilmArray System (BioFire Diagnostics, Salt Lake City, UT) in ~45 minutes. MEASUREMENTS AND MAIN RESULTS Host response bacterial/viral test performance characteristics were evaluated in 623 participants (mean age 46 yr; 45% male) with bacterial infection, viral infection, coinfection, or noninfectious illness. Performance of the host response bacterial/viral test was compared with procalcitonin. The test provided independent probabilities of bacterial and viral infection in ~45 minutes. In the 213-subject training cohort, the host response bacterial/viral test had an area under the curve for bacterial infection of 0.90 (95% CI, 0.84-0.94) and 0.92 (95% CI, 0.87-0.95) for viral infection. Independent validation in 209 subjects revealed similar performance with an area under the curve of 0.85 (95% CI, 0.78-0.90) for bacterial infection and 0.91 (95% CI, 0.85-0.94) for viral infection. The test had 80.1% (95% CI, 73.7-85.4%) average weighted accuracy for bacterial infection and 86.8% (95% CI, 81.8-90.8%) for viral infection in this validation cohort. This was significantly better than 68.7% (95% CI, 62.4-75.4%) observed for procalcitonin (p < 0.001). An additional cohort of 201 subjects with indeterminate phenotypes (coinfection or microbiology-negative infections) revealed similar performance. CONCLUSIONS The host response bacterial/viral measured using the BioFire System rapidly and accurately discriminated bacterial and viral infection better than procalcitonin, which can help support more appropriate antibiotic use.

Bosma PJ, Chowdhury JR, Bakker C, Gantla S, de Boer A, Oostra BA, et al. The genetic basis of the reduced expression of bilirubin UDP-glucuronosyltransferase 1 in Gilbert’s syndrome. N Engl J Med. 1995;333:1171–5. CAS Article Google Scholar Riera P, Salazar J, Virgili AC, Tobena M, Sebio A, Gallano P, et al. Relevance of CYP3A4*20, UGT1A1*37 and UGT1A1*28 variants in irinotecan-induced severe toxicity. Br J Clin Pharmacol. 2018;84:1389–92. CAS Article Google Scholar Kaplan M, Beutler E, Vreman HJ, Hammerman C, Levy-Lahad E, Renbaum P, et al. Neonatal hyperbilirubinemia in glucose-6-phosphate dehydrogenase-deficient heterozygotes. Pediatrics. 1999;104:68–74. CAS Article Google Scholar Zangen S, Kidron D, Gelbart T, Roy-Chowdhury N, Wang X, Kaplan M. Fatal kernicterus in a girl deficient in glucose-6-phosphate dehydrogenase: a paradigm of synergistic heterozygosity. J Pediatr. 2009;154:616–9. Article Google Scholar Roy-Chowdhury N, Deocharan B, Bejjanki HR, Roy-Chowdhury J, Koliopoulos C, Petmezaki S, et al. Presence of the genetic marker for Gilbert syndrome is associated with increased level and duration of neonatal jaundice. Acta Paediatr. 2002;91:100–2. CAS Article Google Scholar Bahr TM, Christensen RD, Agarwal AM, George TI, Bhutani VK. The neonatal acute bilirubin encephalopathy registry (NABER): background, aims, and protocol. Neonatology. 2019;115:242–6. CAS Article Google Scholar Rets A, Clayton AL, Christensen RD, Agarwal AM. Molecular diagnostic update in hereditary hemolytic anemia and neonatal hyperbilirubinemia. Int J Lab Hematol. 2019;41:95–101. Article Google Scholar 1000 Genomes Project Consortium, Auton A, Brooks LD, et al. A global reference for human genetic variation. Nature. 2015;526:68–74. Article Google Scholar Download references Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA Timothy M. Bahr & Robert D. Christensen Division of Hematopathology, Department of Pathology, University of Utah Health and ARUP Laboratories, Salt Lake City, UT, USA Archana M. Agarwal Division of Hematology/Oncology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA Robert D. Christensen You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar Correspondence to Timothy M. Bahr. The authors declare that they have no conflicts of interest. Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reprints and Permissions Bahr, T.M., Agarwal, A.M. & Christensen, R.D. Does heterozygosity for UGT1A1 *28 convey increased risk for severe neonatal jaundice?. J Perinatol (2020). https://doi.org/10.1038/s41372-020-00826-5 Download citation Received: 15 June 2020 Revised: 17 August 2020 Accepted: 11 September 2020 Published: 21 September 2020 DOI: https://doi.org/10.1038/s41372-020-00826-5

Purpose To measure the time to fragment removal and number of chatter events using various combinations of micropulse on times and off times (measured in milliseconds) of longitudinal ultrasound (US) using a venturi-based phacoemulsification system. Setting John A. Moran Eye Center, University of Utah, Salt Lake City, USA. Design Experimental study. Methods Pig lenses were hardened with formalin and cut into 2.0 mm cubes. The time to fragment removal (efficiency) and frequency of fragments bouncing off the tip (chatter) were measured with the venturi-based system. Micropulse longitudinal US was tested. Parameters were combinations of 5, 6, and 7 milliseconds on, with 5, 6, and 7 milliseconds off. Twenty runs each of 9 combinations were completed. Results There was a statistically significant difference between on/off duty cycle combinations. The 6 on/7 off group had higher efficiency than the 5 on/6 off and 7 on/7 off groups. Six on/5 off was more efficient than 5 on/6 off. When data were pooled and on times alone were used, 6 milliseconds on time was more efficient than 5 or 7 milliseconds. No efficiency differences in off times were found. No significant chatter differences were observed. Conclusions Using micropulse longitudinal US in venturi vacuum mode, 6 milliseconds on was the most efficient on time. Five, 6, and 7 milliseconds off times had similar efficiency. These data suggest that the most efficient setting with lowest US energy use is 6 milliseconds on and 7 milliseconds off.

// Connor Willis 1 , Michelle Fiander 1 , Dao Tran 2 , Beata Korytowsky 3 , John-Michael Thomas 3 , Florencio Calderon 3 , Teresa M. Zyczynski 3 , Diana Brixner 1 and David D. Stenehjem 1 , 2 1 Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA 2 Department of Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota, Duluth, MN, USA 3 Bristol-Myers Squibb Company, Lawrenceville, NJ, USA Correspondence to: David Stenehjem, email: stene032@d.umn.edu Keywords: biomarkers; chemotherapy; immunotherapy; lung cancer; PD-L1 Received: June 14, 2019 Accepted: September 16, 2019 Published: November 12, 2019 ABSTRACT Purpose: To assess the association of tumor mutational burden (TMB) with clinical outcomes, other biomarkers and patient/disease characteristics in patients receiving therapy for lung cancer. Results: In total, 4,303 publications were identified; 81 publications were included. The majority of publications assessing clinical efficacy of immunotherapy reported an association with high TMB, particularly when assessing progression-free survival and objective response rate. High TMB was consistently associated with TP53 alterations, and negatively associated with EGFR mutations. High TMB was also associated with smoking, squamous cell non-small cell lung carcinoma, and being male. Methods: A systematic literature review based upon an a priori protocol was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane methodologies. Searches were conducted in EMBASE, SCOPUS, Ovid MEDLINE ® , and Emcare (from January 2012 until April 2018) and in two clinical trial registries. Conference abstracts were identified in EMBASE, and in targeted searches of recent major conference proceedings (from January 2016 until April 2018). Publications reporting data in patients receiving therapy for lung cancer that reported TMB and its association with clinical efficacy, or with other biomarkers or patient/disease characteristics, were included. Results are presented descriptively. Conclusion: This systematic literature review identified several clinical outcomes, biomarkers, and patient/disease characteristics associated with high TMB, and highlights the need for standardized definitions and testing practices. Further studies using standardized methodology are required to inform treatment decisions.

Due to the abundant reserves and increasing demand, the extraction and separation of lithium from salt-lake brines have attracted great interest worldwide. This review aims to summarize the major developments in lithium recovery from brines, starting from an overview of lithium demand and consumption, available resources and processing methods, and challenges of processing brines, followed with the advancements in solvent extraction, ion-sieve adsorption, electrochemical approaches, and membrane technology, successively. The paper focuses on the principles, mechanisms, operations, and comparison of the various approaches. Other promising techniques, such as the modification of ion-sieves, rocking-chair batteries, and liquid-membrane electrodialysis, also are discussed in the depth of mechanisms. These processes present excellent performance in the separation of Li+/Mg2+ or Li+/Na+. Finally, insights into the directions and prospects of lithium extraction from brines are presented. It can be concluded that only by integrating the advantages of various recent technologies will it be possible to develop an efficient, low cost, environmentally sustainable, and scalable process for lithium extraction from brines.

En 1970, l’artiste américain Robert Smithson construit, au fin fond du Grand Lac Salé, une œuvre devenue emblématique du Land art: la Spiral Jetty. En survolant la Spiral Jetty en hélicoptère dans son film éponyme, l’artiste saisi un rapport d’échelle qui désoriente le spectateur de même qu’il empêche l’œuvre d’être fixée à son sort muséal de manière définitive. Dans Casting a glance, l’artiste américain James Benning développe une réflexion sur le regard qui fait œuvre à l’heure du contemporain. Son film relate, de façon fragmentaire, ses séjours répétés au Grand Lac Salé pour y voir la Spiral Jetty. Enfin, la plasticienne Tacita Dean repart elle aussi sur les traces de la Spiral Jetty dans le film qu’elle consacre à l’auteur de science-fiction J. G. Ballard et en particulier son oeuvre Les Voix du temps. L’auteur y construit dans un futur où plane la menace d’une disparition de l’espèce, un immense mandala dans le désert. Devant ces trois exemples, il conviendra de s’interroger sur cette expérience esthétique étonnante d’une œuvre qui fait œuvre au-delà d’elle-même. Dans un renversement épistémologique de sa propre ontologie, le Land art retrouve par l’enregistrement cinématographique une place en des lieux hétérodoxes à l’art et la nature comme entité indissociable (la salle de cinéma, la galerie d’exposition...). À partir des différentes modalités filmiques citées en exemple, je questionnerai l’aporie d’une telle démarche.

// Elgilda Musi 1 , Gary K. Schwartz 1 , 2 , Jae Hyuk Yoo 3 , Shannon J. Odelberg 3 , 4 , 6 , Dean Y. Li 3 , 5 , 6 , 7 , Michael Y. Bonner 8 , Ponniah Selvakumar 9 , Shikha Rao 8 , Linda C. Gilbert 8 , 10 , Justin Elsey 8 and Jack L. Arbiser 8 , 10 1 Department of Medicine, Columbia University Medical Center, New York, New York, USA 2 Herbert Irving Comprehensive Cancer Center, Columbia University College of Medicine, New York, New York, USA 3 Department of Medicine, Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, USA 4 Department of Neurobiology and Anatomy, University of Utah, Salt Lake City, Utah, USA 5 Department of Human Genetics, University of Utah, Salt Lake City, Utah, USA 6 Department of Internal Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah, USA 7 Department of Oncological Sciences, University of Utah, Salt Lake City, Utah, USA 8 Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA 9 Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada 10 Veterans Affairs Medical Center, Decatur, Georgia, USA Correspondence to: Jack L. Arbiser, email: jarbise@emory.edu Keywords: melanoma; chemotherapy Received: April 09, 2019 Accepted: June 05, 2019 Published: July 09, 2019 ABSTRACT Uveal melanoma is a rare but often lethal malignancy and is the leading cause of death due to an ophthalmic condition. Uveal melanoma is often diagnosed at a late stage and has a strong propensity to hepatic metastasis. Recently, the most common driver mutations in uveal melanoma have been identified, predominantly in the G-proteins GNAQ. This pattern differs from that of cutaneous melanoma in which Braf and Nras predominate. There are no current clinically used agents that target GNAQ mutations, unlike the use of Braf inhibitors in cutaneous melanoma. We tested the novel agent Tris DBA palladium and found that it was markedly more effective against GNAQ mutant melanomas than wild type uveal melanomas. Given that ARF6 has recently been discovered as a node in GNAQ mutations, we evaluated the efficacy of Tris DBA palladium on ARF6 signaling and found that it was effective in inhibiting ARF6 activation. Finally, Tris DBA palladium was orally effective against GNAQ mutant melanoma in vivo . Tris DBA Palladium deserves further evaluation as a systemic agent for uveal melanoma.

A vehicle-to-infrastructure (V2I) connected vehicle system was installed along Redwood Road in Salt Lake City, Utah, United States, in November 2017 using dedicated short-range communication (DSRC) radios to connect transit buses to traffic signals. One of the goals of this system was to improve the schedule reliability of the bus by providing signal priority at traffic signals when the bus is behind its published schedule by a certain threshold. Data for the analysis were obtained from the DSRC communications, the Automated Traffic Signal Performance Measures (ATSPM) system, and the transit operations system. The robust data available from these three systems allow for detailed analysis of priority requests made, requests served, and bus on-time performance in a way that is not possible without these data sets. By comparing actual schedules of the four DSRC-equipped buses over a 4-month period from April to July 2018 with buses which do not have the ability to request signal priority, it has been determined that the equipped buses meet their published schedule about 2% to 6% more frequently, depending on direction and time of day, with the most significant improvement of 6% in the southbound PM peak.

In this study, the Sentinel-1A and Landsat 8 OLI images were taken as the basic data in Qarhan Salt Lake area. Combined with the field survey samples, the maximum likelihood classification method and support vector machine method were used to classify the two kinds of images, and the accuracy of the classification results was evaluated. The results show that: (1) The overall accuracy of both maximum likelihood classification and SVM classification is more than 75%. For the same image, the classification accuracy of SVM is higher than that of maximum likelihood classification. (2) The classification accuracy of Landsat 8 OLI data is higher than that of original Sentinel-1A data, but the classification accuracy of Sentinel-1A image based on H/α/Alpha target decomposition is higher than that of Landsat 8 OLI. (3) The classification results of Sentinel-1A images by H/α/Alpha polarization decomposition were verified by actual points. The classification accuracy of salt field and salt lake was 80.00% and 77.78%, respectively. The accuracy of swamp and other unused land was 57.14% and 63.63%, respectively, lower than that of the other four types of land features in the study area.

The coronavirus disease 2019 (COVID-19) pandemic has taken an unprecedented toll on clinical diagnostic testing, and the need for PCR-based testing remains to be met. Nucleic acid amplification testing (NAAT) is the recommended method for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to the inherent advantages in sensitivity and specificity. In this study, we evaluated the performance of the MatMaCorp COVID-19 2SF test, a reverse transcription-PCR (RT-PCR) assay for the qualitative detection of SARS-CoV-2 from nasopharyngeal (NP) swabs, run on the Solas 8 instrument (MatMaCorp, Lincoln, NE). The Solas 8 device is portable, and the kit is a lab-in-a-box design which provides reagents in a shelf-stable lyophilized powder format. A total of 78 remnant clinical specimens were used to evaluate the COVID-19 2SF test. Sixty-two clinical specimens originally tested by the Xpert Xpress SARS-CoV-2 assay (Cepheid, Inc., Sunnyvale, CA) were used to evaluate the clinical accuracy of the COVID-19 2SF test. The negative percent agreement (NPA) was 100% (95% confidence interval [CI], 83.9% to 100%), and the positive percent agreement (PPA) was 85.4% (95% CI, 70.8% to 94.4%). Sixteen remnant specimens positive for other common respiratory pathogens (FilmArray respiratory panel 2.0; BioFire, Salt Lake City, UT) were assayed on the Solas 8 device to evaluate specificity. No cross-reactivity with other respiratory pathogens was identified. The unique lab-in-a-box design and shelf-stable reagents of the MatMaCorp COVID-19 2SF test offer laboratories a rapid option for a diagnostic NAAT for SARS-CoV-2 that can help meet diagnostic needs. IMPORTANCE The demand for molecular testing for COVID-19 remains to be met. This study of the MatMaCorp Solas 8 device and COVID-19 test provides the first evaluation of this platform.

Pritam Banerjee1, 2, Kathryn A. Stewart3, Caterina M. Antognazza4, Ingrid V. Bunholi5, Kristy Deiner6, Matthew A. Barnes7, Santanu Saha8, Heloise Verdier9, Hideyuki Doi10, Jyoti Prakash Maity2, Michael W.Y. Chan1, Chien Yen Chen2*1Department of Biomedical Sciences, Graduate Institute of Molecular Biology, National Chung Cheng University, 168 University Road, Ming-Shung, Chiayi County 62102, Taiwan2Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Ming-Shung, Chiayi County 62102, Taiwan.3 Institute of Environmental Science, Leiden University, 2333 CC Leiden, The Netherlands4 Department of Theoretical and Applied Science, University of Insubria, Via J.H. Dunant, 3, 21100, Varese, Italy5 Department of Biology, Indiana State University, Terre Haute, IN 47809, USA6 Department of Environmental Systems Science, ETH Zurich, Universitatstrasse 16, CH-8092 Zurich, Switzerland7 Department of Natural Resources Management, Texas Tech University, Lubbock, TX USA8Post Graduate Department of Botany, Bidhannagar College, Salt Lake City, Kolkata 700064, India9Univ Lyon, Universite Claude Bernard Lyon 1, CNRS, ENTPE, UMR 5023 LEHNA, Villeurbanne, France10Graduate School of Information Science, University of Hyogo, 7-1-28 Minatojima-minamimachi, Chuo-ku, Kobe, 650-0047, JapanAbstract Plant-animal interactions (PAI) represent major channels of energy transfer through ecosystems, where both positive and negative relationships simultaneously contribute to ecosystem functioning. Extinction of a single plant species may have deleterious effects on associated animals and vice-versa, and loss of interactions may occur prior to species-extinction. Monitoring species-interactions is therefore directly related to environmental health and functioning, and studying complex interactions through accurate, cost-effective sampling can aid in the management of detrimental anthropogenic impacts. Conventional PAI monitoring methods (e.g., camera, malaise, and pitfall traps) are potentially invasive, time-consuming, and often unable to achieve species-specific detection. While DNA barcoding of gut contents or bulk samples provides species-specific detection, saves time, and enables simultaneous detection of many taxa, these methods remain potentially invasive and may require the sacrifice of study organisms. Alternatively, non-invasive environmental DNA (eDNA)-based monitoring provides accessible collection of biological signatures from the environment (air, water, soil) that can elucidate PAI. Environmental DNA methods have accurately detected plant-pollinator, plant-herbivore, and even some mutualistic relationships, from single-interacting species to the whole interacting community. In addition, a time-series of ecological interactions can be facilitated with eDNA methods. Although PAI studies using eDNA methods remain in their infancy, to date they have identified higher numbers of taxa in several direct comparisons to DNA-based gut/bulk sampling and conventional survey methods. Therefore, research into the influencing factors of eDNA detection involved in PAI (e.g., sources and types, methodological standardization, database limitations, validation with conventional surveys, and existing ecological models) will benefit the growth of this application. Involvement of environmental RNA (eRNA) can further strengthen eDNA-based methods, provide a better understanding of complex species-interactions, and help to avoid false positive results. Thus, implementation of eDNA methods to study PAI can particularly benefit environmental biomonitoring surveys that are imperative for biodiversity health assessments.

This study examined primary data on the energy use (electricity and natural gas) of nine surface water treatment plants in and around Salt Lake City, Utah, and how their energy use relates ...

* Abbreviations: COVID-19 — : coronavirus disease 2019 NICS — : National Instant Criminal Background Check System In this issue of Pediatrics, Cohen et al1 address the epidemic of pediatric firearm injuries through the lens of the coronavirus disease 2019 (COVID-19) pandemic. The authors used the National Instant Criminal Background Check System (NICS) to identify new gun purchases and the Gun Violence Archive to identify firearm injuries in children

Climate change and population growth serve as fundamental problems in assessing potential impacts on future surface water quality. In addition to uncertainties in climate depicted in various representative concentration pathway (RCP) scenarios, futuristic population growth mimicking historical conditions is subject to uncertainties related to changing development patterns. The combination of climate change and population characteristics exacerbates concerns regarding the future water quality performance of river systems. Previous studies have established linkages among future climate, population impacts and watershed water quality performance. However, these linkages have not been specifically incorporated into water quality trading programs. Rather than temporally-variant adjustment factors, WQT programs use constant margins of safety for pollutant reduction credits resulting in trade ratios that do not explicitly account for futuristic climate and population uncertainties. Hence, this study proposes a conceptual framework for water quality trading establishing adjustment factors as margins of safety on trade ratios for pollutant reduction credits examining climate and population characteristics separately followed by evaluating them combined. This new framework is demonstrated using a programming script that calculates the margins of safety based on simulation results conducted through a water quality model of the Jordan River in Salt Lake City, UT, USA over a 3-year timeframe. With margins of safety over magnitudes of ±2 over the Jordan River simulations, this research introduces the framework as a foundation for developing adjustment factors for addressing climatic and population characteristics upon river systems.

School closures affected more than 55 million students across the United States when implemented as a strategy to prevent the transmission of SARS-CoV-2, the virus that causes COVID-19 (1). Reopening schools requires balancing the risks for SARS-CoV-2 infection to students and staff members against the benefits of in-person learning (2). During December 3, 2020-January 31, 2021, CDC investigated SARS-CoV-2 transmission in 20 elementary schools (kindergarten through grade 6) that had reopened in Salt Lake County, Utah. The 7-day cumulative number of new COVID-19 cases in Salt Lake County during this time ranged from 290 to 670 cases per 100,000 persons.† Susceptible§ school contacts¶ (students and staff members exposed to SARS-CoV-2 in school) of 51 index patients** (40 students and 11 staff members) were offered SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) testing. Among 1,041 susceptible school contacts, 735 (70.6%) were tested, and five of 12 cases identified were classified as school-associated; the secondary attack rate among tested susceptible school contacts was 0.7%. Mask use among students was high (86%), and the median distance between students' seats in classrooms was 3 ft. Despite high community incidence and an inability to maintain ≥6 ft of distance between students at all times, SARS-CoV-2 transmission was low in these elementary schools. The results from this investigation add to the increasing evidence that in-person learning can be achieved with minimal SARS-CoV-2 transmission risk when multiple measures to prevent transmission are implemented (3,4).

Few large, longitudinal studies document multiple contraceptive methods' effects on sexual functioning, satisfaction, and well-being. We leveraged data from the HER Salt Lake Contraceptive Initiative, a prospective cohort study with patient surveys at baseline, one month, and three months. Surveys assessed bleeding changes, contraceptive-related side effects, sexual functioning and satisfaction, and perceptions of methods' impact on sexual well-being. Individuals in the final sample (N = 2,157) initiated either combined oral contraceptives, levonorgestrel intrauterine devices (IUDs), copper IUDs, implants, injectables, or vaginal rings. Across methods, participants exhibited minimal changes in sexual function (Female Sexual Function Index-6 scores) or satisfaction (New Scale of Sexual Satisfaction scores) over three months. However, many perceived contraception-related changes to sexual well-being. Half (51%) reported their new method had made their sex life better; 15% reported it had made their sex life worse. Sexual improvements were associated with decreased vaginal bleeding, fewer side effects, and IUD use. Negative sexual impacts were associated with physical side effects (e.g., bloating and breast tenderness), increased bleeding, and vaginal ring use. In conclusion, contraceptive users did not experience major changes in sexual functioning or satisfaction over three months, but they did report subjective sexual changes, mostly positive, due to their method.

Reflections from the Book of the Dead: Weighing the Impact of Epicardial Fat on Atrial Fibrillation Vulnerability T. Jared Bunch MDDepartment of Medicine, School of Medicine, University of Utah, Salt Lake City, UtahAddress for correspondence: T. Jared Bunch, M.D.University of Utah School of Medicine Department of Internal Medicine Division of Cardiovascular Medicine 30 North 1900 East, Room 4A100 Salt Lake City, UT 84132 Phone: 801-213-2387 E-mail: jared.bunch@hsc.utah.edu

In this chapter, the authors share lessons that Salt Lake Community College (SLCC), a two-year comprehensive community college located in the most urban area of the state, learned in implementing CBE. The story begins with an explanation of the organizational context for CBE reform at SLCC. As one of two 2-year colleges to join the initial group of higher education institutions in the Competency-Based Education Network (C-BEN), very quickly SLCC was thrust into the limelight as a potential leader in the newest national wave of CBE implementation. The story continues by describing full-scale implementation of CBE at SLCC funded by the United States Department of Labor Trade Adjustment Act Community College Career Training (TAACCCT) grant. Lastly, the authors highlight major lessons learned through SLCC's journey and implications for future CBE implementation that focuses on institution-wide scale up at SLCC and consider what other higher education institutions may be able to learn from SLCC's experience.

This chapter will describe the Salt Lake City Library main branch. “The City Library” is represented as “a dynamic civic resource that promotes free and open access to information, materials and services to all members of the community to advance knowledge, foster creativity, encourage the exchange of ideas, build community and enhance the quality of life” (The City Library website, https://about.slcpl.org/mission). The library was designed by Moshe Safdie with VCBO Architecture as the local firm and opened to the public in 2003. Its modern architecture has received great reception from the public and is a source of pride to the urban identity of Salt Lake City. This chapter will focus on a description of the Salt Lake City Public Library design and mission that contributes to a better understanding of the library’s role within Salt Lake City and its community-oriented programming.

Neurological manifestations are commonly reported in patients with celiac disease (CD). We aimed to characterize epilepsy features in a pediatric population with CD and the effect of a gluten-free diet (GFD) on seizure burden.A retrospective chart review was performed on pediatric patients treated at the University of Utah and Primary Children's Hospital in Salt Lake City, Utah, with both epilepsy and CD and compared with a control group with epilepsy only.We identified 56 patients with epilepsy and biopsy-confirmed CD (n = 36, 64%) or elevated tissue transglutaminase antibodies (tTG-Ab) without biopsy-confirmed CD (n = 20, 36%). Age- and gender-matched controls were selected from patients with epilepsy only (n = 168). Patients with biopsy-proven CD or positive tTG-Ab had high percentage of drug-resistant epilepsy (DRE) compared with the control group (P0.05). Age at seizure onset preceded the diagnosis of CD on average by 5.9 years for patients with DRE (P0.01) compared with 2.2 years for those with drug-responsive epilepsy. Adhering to a GFD reduced seizure frequency or resulted in weaning dosage or weaning off of one or more antiseizure medications in a majority of patients with DRE.DRE was more prevalent in pediatric patients with biopsy-confirmed CD and positive tTG-Ab compared with the control group (which included childhood epilepsy syndromes), but comparable with the prevalence of DRE in the general population. Adherence to a GFD in combination with antiseizure medications appears to reduce seizure burden for those with CD and DRE.

* Abbreviations: IMV — : invasive mechanical ventilation NIV — : noninvasive ventilation Noninvasive ventilation (NIV) is appealing for the treatment of severe asthma because it likely avoids the potential airway and lung trauma of intubation and invasive mechanical ventilation (IMV). In this issue of Pediatrics , Smith et al1 illustrate the compelling appeal of NIV in clinical use, showing that centers with high use of NIV in 2014 doubled their use of NIV in the next 4 years and that NIV is more common as a mode of respiratory support than IMV. … Address correspondence to Michael D. Johnson, MD, MS, Primary Children’s Hospital, 100 N Mario Capecchi Dr, Salt Lake City, UT 84108. E-mail: mike.johnson{at}hsc.utah.edu

Meighan Wetland and its surroundings have undergone many changes in recent years. This study aims to monitor and predict land use changes using the land change model (LCM) module in the Meighan wetland. Land Sat images of years 2000, 2007 and 2015 were used to produce digital land use maps. The images were classified into seven classes including; Salt lake, Agriculture, Rangeland, Manmade, Wastewater, Wetland and Mine areas. The LCM module in Idrisi GIS software was used to analyze the land use changes for predicting the land uses status in 2015, based on artificial neural network (ANN) and Markov Chain analysis. The ANN was trained with various influencing factors including; distance from road, distance from manmade areas, distance from land changed edge, distance from stream, elevation and slope. The results indicated that 1663.88 ha of the rangeland cover and 715.68 ha of the salt lake cover have been degraded during the 2000–2015 period. Furthermore, the wetland, mine, wastewater and manmade degradation are increased to 724 ha, 335 ha, 37 ha and 270 ha in comparison to initial land conditions. Also, the result shows that rangeland and salt lake areas will decrease in the year 2030 compare to 2015, while, wetland, mine and manmade land changes may increase. Keywords: LCM, Prediction, Meighan wetland, Land use changes, Artificial Neural Network

Objective Examine differences in skin carotenoid status (SCS) based on time, age, and sex of preschool-aged children enrolled in Head Start (HS) in North Carolina. Design Data were collected using surveys from participating families. preschool-aged children's SCS were measured 3 times over a 6-month period. Setting Three HS centers in North Carolina. Participants One hundred twelve children aged 3–5 years, enrolled in HS. Main Outcome Measure(s) Differences in SCS assessed using the Veggie Meter (Longevity Link, Salt Lake City, UT) based on time, sex, and age. Analysis One-way ANOVA to assess SCS at time 1 between sex and age (n = 112). Repeated measures ANOVA with a Greenhouse-Geisser correction for assessment of SCS over time (n = 45) using Bonferroni correction. Results On average, children were aged 4 years, African American (81.3%), male (57%), and had a mean SCS of 266 (SD = 82.9). Skin carotenoid status (Veggie Meter units) were significantly different over time (P Conclusions and Implications The Veggie Meter is a promising tool to assess fruit and vegetable intake but needs to be validated in preschool-aged children as it has been in adults. Sex and age are potential confounders which should be assessed in future studies using the Veggie Meter.

PURPOSE To evaluate the ease of replacement and capsular stability of a new fluid-filled, modular, accommodating intraocular lens (IOL) system composed of a monofocal base lens with a fluid lens clipped inside of it. SETTING John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. DESIGN Experimental study. METHODS Five New Zealand rabbits underwent bilateral phacoemulsification with implantation of the test lens (Juvene, LensGen, Inc.) in both eyes (4 rabbits), or a control IOL in 1 eye (AcrySof, Alcon Laboratories, Inc.) and the test IOL in the other (1 rabbit). At 2 weeks, the 4 rabbits with bilateral Juvene IOLs had the clipped-in fluid lens exchanged for a new fluid lens in 1 eye, and the base and fluid lenses exchanged for a control lens in the contralateral eye. Slitlamp examinations were performed weekly for 4 weeks. The globes were enucleated and evaluated with ultrasound biomicroscopy, grossly from the posterior Miyake-Apple view, and histopathologically. RESULTS Explantation/exchange of the fluid lens was considered straightforward by the surgeon. Explantation of the base lens (4) was also safely performed, albeit more demanding, without any signs of damage to the capsular bag under clinical, ultrasound biomicroscopy, and pathological examination in the exchanged eyes. Less capsular bag opacification was observed with the Juvene lens system. CONCLUSIONS Explantation/exchange of the fluid lens component, or both fluid and base lenses, of this new lens system can be safely accomplished if necessary, because of its modular design and the relative lack of postoperative capsular bag opacification associated with it.

Hypogonadism affects hepatic lipid metabolism and is expected to promote nonalcoholic fatty liver disease (NAFLD). The aims of this study were to determine (1) the prevalence of NAFLD in hypogonadal males and (2) the impact of correction of hypogonadism by LPCN 1144 (Lipocine, Inc., Salt Lake City, UT), an oral testosterone prodrug, on NAFLD in this population. Data were derived from a multicenter open‐label single‐arm trial of LPCN 1144 for hypogonadal males, in which a subset (n = 36) had serial magnetic resonance imaging–proton density fat fraction measurements (National Clinical Trial 03868059). NAFLD prevalence, defined by magnetic resonance imaging–proton density fat fraction ≥5%, was 66%. Eighty‐one percent of those with baseline liver fat (BL) ≥5% had improvement in liver fat content, and NAFLD resolved in 33% of subjects at 8 weeks (mean relative reduction: 45%) and 48% (mean relative reduction: 55%) after 16 weeks of LPCN 1144 therapy. The reduction in liver fat was greater in those with higher BL (BL ≥5%: 71%; BL ≥8%: 80%; and BL ≥10%: 75%). Normalization rate of alanine aminotransferase and gamma‐glutamyltransferase greater than the upper limit of normal range were 100% and 50% of treated patients, respectively. LPCN 1144 was not associated with major adverse events. Conclusion: Treatment with LPCN 1144 (oral T prodrug) in hypogonadal males with NAFLD resolved NAFLD in approximately half of the affected patients without any safety signals. Further studies are needed to validate its use in hypogonadal males with nonalcoholic steatohepatitis.

Objectives The Clinical Practice Guideline of the American Academy of Otolaryngology-Head & Neck Surgery (2014) stated that clinicians should not recommend dietary supplements for the treatment of tinnitus. The aim of this study is to characterize over-the-counter tinnitus remedies (OTCTR) on the U.S. market, describe the ingredients and prices, and characterize the methods of promoting these products. Methods OTCTR were identified via Web search and visits to retail establishments. Information was collected regarding OTCTR chemical composition, product labeling, advertisements and marketing, price, and customers reviews. Results A wide array of unproven OTCTR exist on today's market. All make unfounded claims of relief from ear ringing. Most of the products considered in this study consist of mixtures of inexpensive and common vitamins, minerals, and/or herbs sold at a premium compared to similar preparations not expressly advertised for tinnitus. Certain brands, most notably Arches Tinnitus Formula (Arches Natural Products Inc., Salt Lake City, UT) and Lipo-Flavonoid (Clarion Brands Inc., Solon, OH), target otolaryngologists by advertising in specialty journals and prominently featuring supposed endorsement by "Ear-Nose-and-Throat Doctors" in their marketing. Conclusion It is important for otolaryngologists who are caring for tinnitus sufferers to be aware that a robust and diverse market exists for unproven OTC tinnitus remedies. It is troubling that heavily advertised brands profess support by otolaryngologists. Responsible specialty organizations in the field should consider opposing such commercially motivated representations. Otolaryngology journals may wish to adopt a policy along the lines of The Journal of the American Medical Association publications to decline advertisements of dietary supplements that make unproven therapeutic claims. Level of evidence 5 Laryngoscope, 129:1898-1906, 2019.

Purpose To examine the role of high vacuum and aspiration settings on efficiency using a transversal ultrasound (US) machine. Setting John A. Moran Eye Center Laboratory, University of Utah, Salt Lake City, Utah, USA. Design Experimental study. Methods Porcine lens nuclei were incubated in formalin for 2 hours and then cut into 2.0 mm cubes. Phacoemulsification was performed using the Whitestar Signature machine. Settings were bottle height 50 cm, on-time 6 milliseconds, and off-time 6 milliseconds. One hundred percent power was used for all 240 runs. Tested parameters were aspiration of 50 mL/min and 60 mL/min and vacuum of 500, mm Hg, 600 mm Hg, and 650 mm Hg. Results With continuous US, increasing aspiration from 50 mL/min to 60 mL/min significantly increased efficiency (23%). Increasing vacuum from 500 mm Hg to 650 mm Hg and from 600 mm Hg to 650 mm Hg significantly increased efficiency (20.2% and 13.6%, respectively). Higher vacuum and aspiration parameters did not influence the incidence of chatter events. In the micropulse US group, there was no significant efficiency increase with increasing vacuum or aspiration levels. There was a significant efficiency increase of continuous over micropulse US at an aspiration setting of 60 mL/min and vacuum settings of 600 mm Hg and 650 mm Hg. Conclusions As aspiration and vacuum increased, efficiency increased under continuous transverse US. No significant efficiency improvement occurred at high aspiration and vacuum settings under micropulse US. At 60 mL/min aspiration and more than 600 mm Hg vacuum, continuous power was significantly more efficient than micropulse transverse US.

Purpose To evaluate the optimum on-time setting for the most efficient removal of lens fragments using micropulse ultrasound (US) and Ellips FX transversal US in the Whitestar Signature Pro phacoemulsification machine. Setting John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, USA. Design Experimental study. Methods Porcine lens nuclei were soaked in formalin for 2 hours and cut into 2.0 mm cubes. The US machine was used with a bent 0.9 mm phaco tip and a 30-degree bevel. The off time was set to 6 milliseconds (ms) and the on time varied from 4 to 10 ms in 1 ms increments. Efficiency (time for fragment removal) and chatter (number of times the fragment bounced from the tip) were measured. Results A linear incremental increase in efficiency was observed between 4 ms and 6 ms. The most statistically significant efficiency was achieved with an on time of 6 ms. On times shorter than 6 ms were significantly less efficient (P = .05). Greater on times (7 to 10 ms) did not result in a significant difference in efficiency (P = .72), but did appear to have more chatter events when comparing on-time settings of 7 to 10 ms with 4 to 6 ms (P = .02). Conclusions With micropulse transversal US, 6 ms of on time was as efficient as longer on times. To maximize phacoemulsification efficiency and minimize chatter events, an on time of 6 ms is recommended.

Sabbaticals have long been part of the research culture in American higher education and academic libraries. A review of the scholarly literature shows that sabbaticals serve a number of purposes for librarians. By providing time for reviewing best practices at other libraries, working at other libraries within and outside the United States, or pursuing post-graduate degrees, sabbaticals have allowed those in academic libraries to improve their skill sets and knowledge base to improve themselves and their libraries. A successful sabbatical takes planning and focus; the author of the article will use his sabbatical, which took place between July and December 2015 in Salt Lake City, Utah, and St. Stephen's House, an Anglican Theological College and Permanent Private Hall at Oxford University, as model for this primer on having a successful sabbatical.

Certification labels have become a ubiquitous feature on food products across grocery store shelves. Although it is widely acknowledged that certified products often garner higher prices than their noncertified competition, less is known regarding what those price differences are based on, and what the personal, political, or ethical implications are for consumers. This research note argues for greater attention to the implications of certified food prices—which we conceptualize as the “consumer costs” of food certification. The paper discusses the theoretical linkages between food certifications and prices, and outlines the resulting consumer costs of which we are concerned. Through a pilot study in Salt Lake City, Utah, we investigate prices found on certified grocery store rice, and consider the causes and implications of the consumer costs of food certification.

The 2013 federal Colorado River Basin Water Supply and Demand Study projected the water imbalance between future supply and demand to increase. The Colorado water supply (WS) exemplifies a pronounced quasi-decadal oscillation (QDO) of 10–20 years throughout its historical record; however, this QDO feature is unaccounted for in the climate models used to project the future WS. Adjacent to the Colorado River, the large watershed of the Great Salt Lake (GSL) in Utah records the hydrologic QDO signal in its water surface, leading previous studies to explore the cause of decadal fluctuations in the lake elevation and assess predictability. This study reports a remarkable coherence between the Colorado WS and the GSL elevation at the 10–20-yr time scale. Analysis of precipitation and terrestrial water storage anomalies suggests a cross-basin connection in the climate and hydrometeorological variations of the Colorado WS and the GSL. The 160-yr-long and well-kept GSL elevation record makes it an effective indicator for the Colorado WS.

To evaluate long-term capsular clarity with a modified disk-shaped 1-piece hydrophilic acrylic monofocal intraocular lens (IOL) (Zephyr) suspended between 2 complete haptic rings connected by a pillar of the haptic material.John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.Experimental study.Study and control (1-piece hydrophobic acrylic) IOLs were implanted into the right and left eyes, respectively, of 8 New Zealand rabbits. Eyes were examined at the slitlamp at set intervals for 6 months. At the end of the clinical follow-up, the globes were enucleated and capsular clarity was scored from the posterior view (Miyake-Apple technique). Then, all the eyes were processed for a complete histopathological evaluation.At 6 months, the slitlamp evaluation showed a posterior capsule opacification score of 0.28 ± 0.26 (SD) in the study group and 4 ± 0 in the control (P .0001, paired t test). The anterior capsule was generally clear in the study group. This parameter was difficult to analyze in the control group because of synechiae formation and poor pupil dilation.The degree of capsular bag clarity observed at 6 months postoperatively in the study eyes in this rabbit model was exceptional. It was likely because of the IOL design, keeping the capsular bag open and expanded, and minimizing contact between the IOL and the anterior capsule.

PURPOSE To examine capsular tension ring (CTR) implantation to establish whether there are predictable movements of the CTR during deployment, indicating complicated vs uneventful implantation. SETTING Intermountain Ocular Research Center, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah. DESIGN Experimental study. METHODS Nine cadaver eyes were prepared using standard Miyake-Apple protocol with digital video recording. A 4 o'clock-hour zonular dialysis was created, followed by a capsulorhexis and hydrodissection. In 4 eyes, a suture-guided CTR (SGCTR) injector and 8-0 nylon suture through the leading eyelet served as a visible tracer for the CTR. In 5 eyes, a standard CTR was used. The movements of the CTR during implantation were observed. RESULTS In all eyes, SGCTR and CTR movements were predictable during implantation. All CTRs displayed cardinal movements within the injector, initially adjacent to the side of the inner diameter of the CTR. As the CTR made contact with lens or capsule, it shifted first to the center and then to the opposite side of the injector lumen. The appearance of an S-curve in the surgeon's view coincided with an obstruction of the leading eyelet and stress on the zonular fibers, as viewed with Miyake-Apple analysis. CONCLUSIONS Traumatic CTR implantation might be avoided by understanding the characteristics of uneventful insertion vs an insertion complicated by entrapment or entanglement of the CTR. By recognizing the abnormal movements of the CTR associated with an obstruction, a surgeon might avoid iatrogenic complications.