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OBJECTIVES Psychological comorbidities have been associated with asthma in adults and children, but have not been studied in a population of children with severe asthma. The aim of this study was to test the hypothesis that symptoms of anxiety or depression are highly prevalent in pediatric severe asthma and negatively effects asthma control. METHODS Longitudinal assessments of anxiety or depression symptoms (Patient Health Questionnaire-4 [PHQ-4]), asthma control (Asthma Control Test [ACT]), and lung function were performed in a single-center pediatric severe asthma clinic. Participant data were collected during routine clinical care. Primary outcomes were ACT and forced expiratory volume in 1 s per forced vital capacity (FEV1/FVC). RESULTS Among 43 subjects (with total 93 observations), 58.1% reported at least one anxious or depressive symptom and 18.6% had a PHQ-4 more than 2, the threshold for an abnormal test result. After adjusting for age, sex, race, and asthma medication step, there was a significant reduction in ACT for girls with PHQ-4 more than 2 (adjusted mean [SE] ACT for PHQ-4 > 2: 13.64 [0.59], ACT for PHQ-4 ≤ 2: 20.64 [1.25], p = .02) but not boys. Moreover, there was a significant differential effect of mental health impairment for girls than boys. ACT for girls with PHQ more than 2: 13.64 (0.59) compared with boys with PHQ-4 more than 2: 17.82 (0.95), adjusted mean difference ACT by sex = 4.18 points; 95% confidence interval, 0.63-7.73; p = .033. In adjusted models, there was no association between PHQ-4 more than 2 and FEV1/FVC. CONCLUSIONS Symptoms of anxiety and depression are common. In children with severe asthma, a PHQ-4 score more than 2 is associated with worse asthma symptom control in girls, but not boys.

The collision rate of particles suspended in turbulent flow is critical to particle agglomeration and droplet coalescence. The collision kernel can be evaluated by the radial distribution function (RDF) and radial relative velocity (RV) between particles at small separations $r$. Previously, the smallest $r$ was limited to roughly the Kolmogorov length $\eta$ due to particle position uncertainty and image overlap. We report a new approach to measure RDF and RV near contact ($r/a\: \approx$ 2.07, $a$ particle radius) overcoming these limitations. Three-dimensional particle tracking velocimetry using four-pulse Shake-the-Box algorithm recorded short particle tracks with the interpolated midpoints registered as particle positions to avoid image overlap. This strategy further allows removal of mismatched tracks using their characteristic false RV. We measured RDF and RV in a one-meter-diameter isotropic turbulence chamber with Taylor Reynolds number $Re_\lambda=324$ with particles of 12-16 $\mu$m radius and Stokes number $\approx$ 0.7. While at large $r$ the measured RV agrees with the literature, when $r\eta$, RDF scales as $r^{-0.39}$ reflecting RDF scaling for polydisperse particles in the literature , but when $r\lessapprox\eta$ RDF scales as $r^{-6}$, yielding 1000 times higher near-contact RDF than simulations. Such extreme clustering and relative velocity enhancement can be attributed to particle-particle interactions. Uncertainty analysis substantiates the observed trends. This first-ever simultaneous RDF and RV measurement at small separations provides a clear glimpse into the clustering and relative velocities of particles in turbulence near-contact., Comment: 16 pages, 5 figures, 1 table. Under review in the Journal of Fluid Mechanics

OBJECTIVE: Children with severe asthma are underrepresented in studies of the relationship of sleep-disordered breathing (SDB) and asthma and little is known about sex differences of these relationships. We sought to determine the relationship of SDB with asthma control and lung function among boys and girls within a pediatric severe asthma cohort. METHODS: Patients attending clinic visits at the Boston Children’s Hospital Pediatric Severe Asthma Program completed the Pediatric Sleep Questionnaire (PSQ), Asthma Control Test (ACT) and Spirometry. The prevalence of SDB was defined as a PSQ score >0.33. We analyzed the association between PSQ score and both ACT score and spirometry values in mixed effect models, testing interactions for age and sex. RESULTS: Among 37 subjects, mean age was 11.8 years (4.4) and 23 (62.2%) were male, the prevalence of SDB was 43.2% (16/37). Including all 80 observations, there was a moderate negative correlation between PSQ and ACT scores (r=−0.46, p

To aid in predicting and improving treatment outcome of endovascular coiling of intracranial aneurysms, simulation of patient-specific coil deployment should be both accurate and fast. We developed a fast virtual coiling algorithm called Pre-shape Path Planning (P3). It captures the mechanical propensity of a released coil to restore its pre-shape for bending energy minimization, producing coils without unrealistic kinks and bends. A coil is discretized into finite-length segments and extruded from the delivery catheter segment-by-segment following a generic coil pre-shape. With the release of each segment, coil-wall and coil-coil collisions are detected and resolved. Modeling of each case took seconds to minutes. To test the algorithm, we evaluated its output against the literature, experiments, and patient angiograms. The periphery-to-core ratio of coils deployed by P3 decreased with increasing coil packing density, consistent with observations in the literature. Coils deployed by P3 compared well with in vitro experiments, free from unphysical kinks and loops that arose from previous virtual coiling algorithms. Simulations of coiling in four patient-specific aneurysms agreed well with the patient angiograms. To test the influence of coil pre-shape on P3, we performed hemodynamic simulations in aneurysms with coils deployed by P3 using the generic pre-shape, P3 using a coil-specific pre-shape, and full finite-element-method simulation. We found that the generic pre-shape was sufficient to produce results comparable to virtual coiling by finite element modeling. Based on these findings, P3 can rapidly simulate coiling in patient-specific aneurysms with good accuracy and is thus a potential candidate for clinical treatment planning.

OBJECTIVES The coronavirus pandemic created significant, abrupt challenges to the delivery of ambulatory health care. Because tertiary medical centers limited elective in-person services, telehealth was rapidly enacted in settings with minimal previous experience to allow continued access to care. With this quality improvement (QI) initiative, we aimed to achieve a virtual visit volume of at least 75% of our prepandemic volume. We also describe patient and provider experience with telehealth services. METHODS Our QI team identified the primary drivers contributing to low telehealth volume and developed a telehealth scheduling protocol and data tracking system using QI-based strategies. Patients and providers were surveyed on their telehealth experience. RESULTS At the onset of the pandemic, weekly visit volume dropped by 65% (99 weekly visits; historical average of 281). Over the subsequent 3 weeks, using rapid Plan-Do-Study-Act cycles, we achieved our goal volume. In surveys, it was indicated that most participants had never before used telehealth (71% of patients; 82% of providers) yet reported high satisfaction (90% of patients; 81% of providers). Both groups expressed concern over the lack of in-person assessments. Most respondents were interested in future use of telehealth. CONCLUSIONS With a QI-based approach, we successfully maintained access to care via telehealth services for pediatric pulmonary patients during the coronavirus pandemic and found high rates of satisfaction among patients and providers. Telehealth will likely continue to be a part of our health care delivery platform, expanding the reach of our services. Further work is needed to understand the effects on clinical outcomes.

This chapter argues that books and videogames, frequently presented as rival media, have much to teach us about one another. It does so by analyzing representations of books in videogames, focusing on a pair of games, Myst and Gone Home, that present competing allegories. Myst has been read as allegorizing the printed book’s obsolescence and impending replacement by videogames, while Gone Home diminished its differences from printed forms, presenting itself in allegorical alliance with photocopied zines. Working through these allegories, this chapter argues that books and videogames resist these games’ attempts to collapse the two media into one or to position them as alternatives. Indeed, simulations of physical codices in videogames can help us to understand the differences between these two media as neither absolute nor trivial. By bringing into relief their respective materialities, in particular, these simulations reveal books and videogames as distinct but mutually illuminating.

The concept of remediation, as elaborated by Jay David Bolter and Richard Grusin in Remediation: Understanding New Media (1999), is premised on the notion that media are best understood in interaction rather than in isolation. Every artistic medium, they argue, orients itself in relation to another medium, whether respectfully—as in the case of an online literary database that seeks to provide easy access to faithful facsimiles of manuscripts—or competitively—as with a videogame that seeks to replace the linearity and passivity of print with open-ended interactivity. Bolter and Grusin describe individual media in turns of two basic impulses: immediacy, or the attempt to erase the mediating function and present the illusion of directly represented reality; and hypermediacy, or the attempt to foreground the mediating function, exposing the impossibility of direct representation. They employ the same vocabulary to describe the interaction of media. Every act of remediation—every representation of one medium in another—necessarily involves both immediacy and hypermediacy. A digital edition of a literary text grants access to the words of the original print artifact (immediacy), yet by including audio readings and video commentary draws attention to its digital-specific affordances (hypermediacy). A digital archive gathers together high-resolution, color-accurate reproductions of materials scattered in rare-book libraries around the world (immediacy), yet by granting free and instantaneous access to these precious, fragile objects, fundamentally transforms the experience of engaging with their analog originals (hypermediacy). Insisting that one approach media through interaction, Bolter and Grusin’s theory of remediation positions the movement of content from one medium to another as a form of translation—a transformative act in which much is lost as well as gained.

We propose a simple noninvasive technique called holographic deflection imaging (HDI) to measure electric charge on individual aerosol particles. Particles in many flows such as atmospheric turbulence can carry electric charges, which add forces that compete with turbulence and affect particle dynamics. To measure particle charges, we devised a novel technique for polydispersed particles with bipolar charge distributions. The technique uses common optical hardware and a novel particle sizing algorithm for polydispersed size distributions. A charged particle sample is introduced into a vertical channel air flow and a horizontal electric field. For each particle, In-line digital holography is used to simultaneously track particle positions over successive holograms and decode size information from hologram interference fringes. This enables measurement of the electric-force-induced horizontal component of terminal velocity and the particle size. From velocity and size, particle charge is calculated using a force balance, assuming Stokes drag on spherical particles. Two experiments were conducted, one to validate HDI measurements of a bipolarly charged particle sample against an electrometer, and the other to demonstrate particle size effect on triboelectric charging of aerosols in a fan-driven isotropic turbulence chamber. The HDI setup was configured for each experiment, and measurement uncertainty was estimated. Experiment 1 found good agreement (

This chapter argues that literary studies is returning to the concerns of the modernist period and interests of Woolf. Hammond draws on complexity theory to present Woolf as a model builder: she understood that the form was interactive and so provides impressions rather than telling reader what exists.

Born Herbert Marshall McLuhan in Edmonton, Alberta, Canada, Marshall McLuhan was a literary critic, communications theorist, public intellectual, and the father of modern media studies. McLuhan rose to international fame as a ‘media guru’ in the 1960s when works like The Gutenberg Galaxy (1962), Understanding Media (1964), and The Medium is the Massage (1967) became best sellers. His dictum, ‘the medium is the message’ — which packages McLuhan’s notion that humans and human society are more profoundly affected by the formal properties of the media through which they communicate than by the specific content transmitted — became widely known, if not widely understood, during this period. Though his public and academic influence waned in the last decade of his life, interest in McLuhan’s ideas was revived with the expansion and popularization of the internet. Among the many thinkers he has influenced are Neil Postman, Jean Beaudrillard, and Friedrich Kittler.

The effects of Reynolds number and Stokes number on particle-pair relative velocity (RV) were investigated systematically using a recently developed planar four-frame particle tracking technique in a novel homogeneous and isotropic turbulence chamber., Accepted for publishing on Journal of Fluid Mechanics

In Macroanalysis (2013), Matthew Jockers provocatively declares that large digitized collections of literary texts have rendered close reading “totally inappropriate as a method of studying literary history.” Hammond, Brooke and Hirst respond by demonstrating the productive interpretive interplay that results when close reading is placed in a “feedback loop” with the insights available at the scale of big data. Using cutting-edge techniques in computational stylistics, including their own six-dimensional approach to quantifying literary style, Hammond, Brooke and Hirst argue that analytic techniques trained on large datasets can prompt new close readings and, in particular, provide new insight into the dialogism or multi-voicedness of three important modernist texts: T. S. Eliot’s The Waste Land, Virginia Woolf’s To the Lighthouse and James Joyce’s “The Dead.”

At the time of his death in 1980, Marshall McLuhan was principally famous for two things: for having said, “The medium is the message” and for having deeply confused an entire generation by doing so. When I was growing up in Ontario in the 1980s, I remember watching a government-sponsored commemorative TV advertisement about McLuhan, part of a series of sixty-second celebrations of eminent Canadians. In the ad, an actor portrays a tweedy, mustachioed McLuhan leading a seminar at the University of Toronto. Suddenly he has his Eureka moment: “No, no…The medium is not more important than the message it carries.…It – it's obvious. The medium is the message.” Students leave the class, excited by the power of the gnomic phrase, yet also utterly perplexed by it. Back in the classroom, the fictionalized McLuhan paces about, ranting madly in solitude. Unable to fit his rambling theories into the minute allotted, the advertisement cuts him off mid-sentence. McLuhan had undoubtedly come up with something important, the advertisement implied – but exactly what it was remained entirely unclear. Today, McLuhan has come into focus. In part this is because the things he said about electronic media like radio and television turned out to be more applicable to digital media such as networked computers and smartphones. As Wired magazine recognized when it posthumously named McLuhan its “Patron Saint” in 1993, his theories only really began to make sense with the arrival of the internet. Since then, as the digital medium has extended further and further into our daily lives, we have come increasingly to feel the truth of McLuhan's statement, “The medium is the message.” So much of what we consume online is just the old media fed to us in new ways: Netflix is mostly made up of old TV shows and movies; YouTube is replete with MTV-style music videos and commercials; the most popular podcasts are radio shows. As McLuhan said, “The content of the medium is never the message because the content is always the old medium.” The real change comes from the new medium itself, which “creates a new situation for human association and human perception.”

In August 2013, I traveled to Brighton for the annual gathering of the Modernist Studies Association (MSA), the biggest academic conference in my field. I had been to the MSA conference many times before, but this time there was a twist: I was going to participate in the conference's first-ever “poster session.” Humanities conferences normally consist of oral presentations and seminars, and the MSA's decision to include a poster session – a common model in the sciences – was meant to recognize the growing prominence of Digital Humanities (DH), the area of humanities research concerned with and conducted with the aid of digital technology. Much of my work in the preceding years had focused on developing computational methods of tracking multi-voicedness in modernist writers such as T. S. Eliot and Virginia Woolf, and I was glad for an opportunity to present this digital work to my fellow modernists. After a long intercontinental flight with an unwieldy poster tube and several computers in tow, I arrived brimming with enthusiasm. However well intentioned, the poster session was a disaster. In an effort to attract maximum traffic, the conference organizers had set us up in the refreshments area. My booth – I sat behind a table with a large poster to my left and a laptop in front of me to “demo” my work – was directly across from the coffee station. On the first day of the conference, I was asked many questions (“Where is the toilet?”; “Which way to room 312?”; “What time is the plenary?”), but none pertaining to my research. In the visual vocabulary of the humanities conference, a person seated behind a desk, in the vicinity of a laptop, was staff – not someone with something to say about literature. On the second day of the conference, in a novel if somewhat desperate effort to attract attention to our work, the conference organizers suggested we set up during the wine and cheese reception, always a popular event. It was indeed packed – though no one, it seemed, was in the mood to discuss natural-language processing. One conference goer, gesticulating wildly in the course of a lively conversation with a colleague, knocked my poster off the wall. My booth was quickly identified as a convenient place to discard empty wine glasses and dirty napkins.

Literature in a Digital Age: An Introduction guides readers through the most salient theoretical, interpretive, and creative possibilities opened up by the shift to digital literary forms such as e-books, digital archives, and electronic literature. While Digital Humanities (DH) has been hailed as the 'next big thing' in literary studies, many students and scholars remain perplexed as to what a DH approach to literature entails, and skeptical observers continue to see literature and the digital world as fundamentally incompatible. In its argument that digital and traditional scholarship should be placed in dialogue with each other, this book contextualizes the advent of the digital in literary theory, explores the new questions readers can ask of texts when they become digitized, and investigates the challenges that fresh forms of born-digital fiction pose to existing models of literary analysis.

T. S. Eliot’s poem The Waste Land is a notoriously challenging example of modernist poetry, mixing the independent viewpoints of over ten distinct characters without any clear demarcation of which voice is speaking when. In this work, we apply unsupervised techniques in computational stylistics to distinguish the particular styles of these voices, offering a computer’s perspective on longstanding debates in literary analysis. Our work includes a model for stylistic segmentation that looks for points of maximum stylistic variation, a k-means clustering model for detecting non-contiguous speech from the same voice, and a stylistic profiling approach which makes use of lexical resources built from a much larger collection of literary texts. Evaluating using an expert interpretation, we show clear progress in distinguishing the voices of The Waste Land as compared to appropriate baselines, and we also offer quantitative evidence both for and against that particular interpretation.