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Background: Resources to improve antimicrobial stewardship (AS) are limited, but a telestewardship platform can enable capacity building and scalability. The Alberta Telestewardship Network (ATeleNet) was designed to focus on outreach across the province of Alberta, Canada, and facilitate AS activities. Methods: Outreach occurred virtually between pharmacists and physicians in hospital and long-term care settings throughout Alberta via secure, enterprise video conferencing software on both desktop and mobile devices. We used a quantitative questionnaire adapted from the telehealth usability questionnaire to capture the health provider’s experience during each session. The questionnaire consisted of 39 questions, and a 5-point Likert scale was used to assess the degree of agreement and collate responses into a descriptive analysis. Results: A total of 33 pilot consultations were completed between July 6, 2020 and December 15, 2021. The majority (22, 85%) of respondents agreed that video conference-based virtual sessions are an acceptable means to provide health care and that they were able to express themselves effectively to other health care professionals (23, 88%). Respondents agreed the system was simple to use (23, 96%), and that they could become productive quickly using the system (23, 88%). Overall, 24 (92%) respondents were satisfied or very satisfied with the virtual care platform. Conclusions: We implemented and evaluated a telehealth consultation and collaborative care service between AS providers at multiple centres. AHS has since prioritized similar workflows, including access to specialists in acute care, as part of their virtual health strategy. Evaluation results will be shared with provincial stakeholders for further strategic planning and deployment.

Nontyphoidal Salmonella enterica is one of the leading pathogens for foodborne outbreaks in a multitude of food commodities, including alfalfa sprouts, which are commonly consumed raw. The food industry has commonly used chlorinated washes, but such methods may not be perceived as natural; this can be a detriment as a large portion of sprouts are designated for the organic market. A natural and affordable antimicrobial method that has been acquiring popularity is the use of bacteriophages. This study compared the efficacy of repeated daily applications and a single application of two separate bacteriophage cocktails (SE14, SE20, SF6 and SE14, SF5, SF6) against four Salmonella enterica (S. enterica) strains on germinating alfalfa sprout seeds from days 0 to 7. The results show S. Enteritidis to be the most susceptible to both cocktails with ~2.5 log CFU/mL decrease on day 0 with cocktail SE14, SF5, and SF6. S. enterica populations on all strains continued to grow even with repeated daily bacteriophage applications but in a significantly decreased rate (p < 0.05) compared with a single bacteriophage application. The extent of the reduction was dependent on the S. enterica strain, but the results do show benefits to using repeated bacteriophage applications during sprout germination to reduce S. enterica populations compared with a single bacteriophage application.

The Watershed Function Scientific Focus Area (WFSFA) is a U.S. Department of Energy research project that seeks to determine how mountainous watersheds retain and release water, carbon, nutrients, and metals. The WFSFA maintains a community field observatory at its primary field site in the East River, Colorado. The WFSFA collects diverse environmental data and has developed a “Field-Data” workflow that standardizes data management across the project, from field collection to laboratory analysis to publication. This workflow enables the WFSFA to address data quality and management challenges that environmental observatories face. Through this workflow, the WFSFA has increased the use of the data curated from the project by (1) providing detailed metadata with unique identifiers for samples, locations, and sensors, (2) streamlining the data sharing and publication process through early sharing of data internally within the team and publication of data on the ESS-DIVE repository following curation, and (3) adopting machine-readable and FAIR community data standards (Findability, Accessibility, Interoperability, Reusability). We describe an example application of this workflow for geochemical data, which utilizes a community geochemical data standard for water-soil-sediment chemistry (https://github.com/ess-dive-community/essdive-water-soil-sed-chem) developed by Environmental Systems Science Data Infrastructure for a Virtual Ecosystem (ESS-DIVE). This data standard is designed to standardize geochemical data, metadata, and file-level metadata, and was applied to WFSFA geochemical data, including ICP-MS, Isotope, Ammonia-N, Anion, DIC/NPOC/TDN datasets. This ensures important metadata is contained within the data file, such as precision of data analysis, storage and sample processing information, detailed sample names, material information, and unique identifiers associated with the samples (IGSNs). This metadata is essential to understand and reuse data products, as well as enable machine-readability for future model applications. Detailed examples of the standardized geochemical data types were created and are now being used as templates by WFSFA researchers to standardize their geochemical data. The adoption of this community geochemical data standard and more broadly the Field-Data workflow will improve the findability and reusability of WFSFA datasets.

Stress granules (SGs) form through phase separation of biomacromolecules to assist cells in resisting environmental stresses. Numbers of SG proteins contain Arg-Gly-Gly (RGG) motifs, indicating their RNA binding ability, and providing a substrate platform for asymmetric dimethylation of arginine (ADMA), whose roles in SG assembly remain unclear. Here, we demonstrated that Caprin1-mediated recruitment of PRMT1 asymmetrically dimethylates RGGs to provide multiple binding sites for TDRD3, a typical ADMA reader, which in turn bridges the multivalent interactions between RGG motifs and RNA to promote phase separation. This process was suppressed by a bivalent inhibitor of TDRD3, eventually inhibiting proliferation more effectively than arsenite treatment alone. Our work reveals the role of ADMA in SG assembly and the potential of targeting condensates for cancer therapy.

Microplastics (MPs) were characterized in surficial marine sediment (n = 36) and mussel (n = 29) samples collected along the British Columbia (BC) coast, Canada, using visual identification and Fourier Transform Infrared Spectrometry. MPs counts averaged 32.6 ± 5.3 particles per kg in sediment and 0.38 ± 0.04 particles per individual mussel (0.24 ± 0.04 /g of tissue). Victoria Harbour and the North Coast (Prince Rupert area) were MP hotspots, likely resulting from a combination of local sources and oceanographic conditions. Microfibers1000 μm dominated the pattern in both matrices (61.1 % in sediment; 65.4 % mussels) highlighting the suspected role of textiles in the widespread distribution of MPs in the marine environment. Overall, polyester was dominant in sediment and mussels (54.1 % and 63.5 %, respectively), followed by polyethylene (16.2 % and 11.5 %, respectively). This is the first report of MPs in sediment and mussels along the coast of BC using standardized methods.

We present a system for inductive program synthesis called DreamCoder, which inputs a corpus of synthesis problems each specified by one or a few examples, and automatically derives a library of program components and a neural search policy that can be used to efficiently solve other similar synthesis problems. The library and search policy bootstrap each other iteratively through a variant of "wake-sleep" approximate Bayesian learning. A new refactoring algorithm based on E-graph matching identifies common sub-components across synthesized programs, building a progressively deepening library of abstractions capturing the structure of the input domain. We evaluate on eight domains including classic program synthesis areas and AI tasks such as planning, inverse graphics, and equation discovery. We show that jointly learning the library and neural search policy leads to solving more problems, and solving them more quickly.

Purpose We sought to evaluate features of partial remission (PR) in children with type 1 diabetes mellitus (T1DM) using the insulin-dose adjusted A1c (IDAA1c) definition and to identify risk factors associated with nonremission. Methods Medical records of patients with newly diagnosed T1DM between January 1, 2008, and June 30, 2018, were retrospectively reviewed. Hemoglobin A1c (HbA1c) readings and insulin total daily doses (TDDs) of each patient at each follow-up visit were obtained with IDAA1c values calculated. PR was defined as an IDAA1c score of 9 points or less within 6 months of diagnosis. The trends of HbA1c and TDD within 2 years after diagnosis were compared between remitters and nonremitters. Factors that may predict the occurrence of PR were studied, with their relative risks of nonremission calculated. Results PR occurred in 26 patients (45.6%), including 8 girls and 18 boys, with a median duration of 8 months. The frequency of remission in male patients was significantly higher (P=0.002) and the relative risk of female sex with nonremission was 2.20 (95% confidence interval [CI], 1.24-3.91), which remained significant when adjusted by multivariate regression modeling. The initial HbA1c level at diagnosis was also significantly higher in the nonremission group (P=0.029), with a relative risk of 1.12 (95% CI, 1.01-1.25). Both HbA1c (P=0.012) and TDD (P=0.006) were significantly lower within 2 years after diagnosis among remitters than in nonremitters. TDD was significantly lower in male patients (P=0.029) during the same period, while there was no significant difference in HbA1c level between male and female patients (P=0.163). Conclusion Both the initial HbA1c level at diagnosis and sex were factors associated with the occurrence of PR. Female sex was an independent risk factor of nonremission, likely resulting from a higher insulin requirement in female T1DM patients.

This article describes an innovative application of a social justice-infused pedagogy to an out-of-school program for urban high school students. Using an interdisciplinary framework, the program featured a coherent synthesis of science, technology, engineering, and math (STEM) education, highlighting environmental and food justice perspectives; social justice education; and career and college planning. We used qualitative content analysis to analyze two separate interviews with six female and three male students of color ranging in age from 15 to 18 with an average age of 16.1 (SD=1.26) across an approximately 10-month time span. Utilizing a model of critical consciousness development as our organizing framework, we explored the students’ understanding of environmental and food justice issues. Participants indicated that they were actively engaged in learning about food and environmental justice, exploring STEM careers, and investigating the various ways that social justice is manifested in their lives. Implications for social justice and STEM education interventions as well as broader public policies are discussed.

Background: Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents. Methods :A systematic review was conducted to pool available data on the longest available (> 3 years) weight loss and comorbidity resolution outcome in adolescent bariatric surgery. Results: A total of 14 studies reporting the result of bariatric surgery after 3 years in 950 morbidly obese adolescents were included. Preoperative age and BMI ranged from 12 to 19 years and from 26 to 91 kg/m(2), respectively. Females were the predominant gender (72.8%). Laparoscopic roux-en-Y gastric bypass (n = 453) and adjustable gastric banding (n = 265) were the most common bariatric procedure performed. The number of patients at the latest follow-up was 677 (range from 2 to 23 years). On average, patients lost 13.3 kg/m(2) of their BMI. Among comorbidities, only diabetes mellitus resolved or improved dramatically. Of 108 readmissions, 91 led to reoperation. There was a weight regain

Representation and computation are the best tools we have for explaining intelligent behavior. In our program, we explore the space of representations present in the mind by constraining them to explain data at multiple levels of analysis, from behavioral patterns to neural activity. We argue that this integrated program assuages Brette's worries about the study of the neural code.

Structural aluminum alloys are used in marine applications where light weight and increased speed are paramount. The 5xxx series alloys are the ideal choice, providing an optimum combination of as-welded strength and general corrosion resistance. A particular concern is sensitization in service. Aluminum is considered sensitized when a nearly continuous network of β phase forms along the grain boundaries. The β phase is anodic to the Al matrix, and, when exposed to sea water and sufficient loading, provides a clear pathway to stress corrosion cracking (SCC). The degree of β-phase precipitation is driven by a combination of time and elevated temperature. For over a decade, SCC of Al superstructures has plagued Navy ships. To address this issue, relevant technologies have been adopted, adapted, and developed to combat this issue. More specifically, the technology areas involve the detection of sensitization, the mitigation of SCC, and the replacement of corrupt materials. The technologies discussed herein a...

As high-strength thinner-steel implementation in ship designs increase, dimensional management becomes critical to control construction costs and schedule in ship production. In the U.S. shipbuilding industry, improvements to shipbuilding facilities and processing technology have not kept pace with the rate of change in ship design. Additionally, new designs using thinner steels are subject to legacy weld sizing criteria possibly leading to inappropriately sized welds on lightweight materials. These two factors result in widespread overwelding, causing severe plate deformation in naval vessels during construction and nonvalue added labor to correct as needed for fit-up tolerances. Historically, shear and fatigue strength data has been focused on the larger welds and thicker steel plates typical of the state of the practice when these legacy weld sizing criteria were developed. In order to optimize weld design and production in modern, lightweight naval surface vessels, there is a need to develop more accurate data about the performance of precision fillet welds for thin steels.

This economic evaluation study examines the authors’ experience of prescribing tafamidis in terms of their cost and the insurance status of patients.

Simulation is an important alternative to evaluate cricothyrotomy, a rare life-saving procedure. This crossover study aimed to determine whether contextualization of a crisis scenario would impact the performance of a cricothyrotomy procedural task. Sixty-five anesthesia assistants and emergency medicine and anesthesia residents underwent a teaching session in surgical cricothyrotomy using one of two sets of cricothyrotomy kits: the Portex 6.0 and Melker 3.5 (n = 32) or the Portex 6.0 and Melker 5.0 (n = 33). Within six weeks following the session, the participants performed cricothyrotomies on a full-body patient mannequin simulator coupled with a porcine larynx (tissue-mannequin simulator) using the assigned two kits in a “cannot intubate, cannot ventilate” (CICV) contextualized scenario (CS) and in a CICV verbalized non-contextualized scenario (NCS). Each participant performed a total of four cricothyrotomies using the two kits in the two scenarios. The primary outcome measure was insertion time, and secondary outcome measures were severity of injuries and failure rate. Outcome measures were compared between scenarios for each kit. Mean (SD) insertion time for a successful cricothyrotomy was not significantly different between NCS and CS for the Melker 3.5 [83.0 (45.0) sec vs 63.3 (36.1) sec, respectively; P = 0.96; mean difference (MD), 19.7 sec; 95% confidence interval (CI), −1.9 to 41.3], the Melker 5.0 [86.5 (36.8) sec vs 107.1 (55.6) sec, respectively; P = 0.11; MD, −20.6 sec; 95% CI, −44.9 to 3.7], and the Portex 6.0 [59.5 (35.5) sec vs 59.0 (35.0) sec, respectively; P = 0.95; MD, 0.5 sec; 95% CI, −13.2 to 14.2]. Failure rate and severity of injuries, measured as mean average injury score for each kit, were also similar between scenarios. Contextualization of a crisis scenario did not affect the performance of a cricothyrotomy procedural task on a tissue-mannequin simulator. These findings may have implications when considering the feasibility and cost-effectiveness for assessing the performance of cricothyrotomy procedural tasks.

As high-strength thin-steel use in ship design increases, dimensional management becomes critical to control construction costs and schedule in ship production. In the U.S. shipbuilding industry, improvements to shipbuilding facilities and processing technology have not kept pace with the rate of change in ship design. Additionally, new designs using thinner steels are subject to legacy weld-sizing criteria, which may inappropriately size welds on lightweight materials. These two factors result in widespread overwelding, causing severe plate buckling in naval vessels during construction. The problem of overwelding has two distinct sources:the weld-sizing methods developed in the 1980s are still used in most shipbuilding specifications regardless of ship class. This prevents the incentive of application of latest technologies that can make strong, precision fillet welds for modern lightweight thin steel naval surface combatants; andshipyard welders tend to make welds even larger than design requirements to satisfy naval production specifications, which do not allow for any undersized welds. On average, production welds are 3 mm larger than design, which can more than double the heat input and distortion caused by welding. The approach to the solution of this overwelding problem will be described in detail in this article:develop appropriate weld-sizing criteria for thin plate structures; this can be facilitated by numerical modeling to ensure adequate static shear, tensile, bending, fatigue, and dynamic impact capacity of structural welds; andperform a robust designed experiment to establish confidence that small weld sizes can provide necessary performance and strength to meet the design service life of the vessel and provide data to NAVSEA technical warrant holders to support the implementation of an underweld tolerance for ship production to prevent overwelding.