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Anthropogenic carbon dioxide (CO2) emissions simultaneously increase ocean temperatures and reduce ocean surface pH, a process termed ocean acidification (OA). OA is expected to negatively affect the growth and physiology of many calcified organisms, but the response of non-calcified (fleshy) organisms is less well understood. Rising temperatures and pCO2 can enhance photosynthetic rates (within tolerance limits). Therefore, warming may interact with OA to alter biological responses of macroalgae in complicated ways. Beyond thresholds of physiological tolerance, however, rising temperatures could further exacerbate negative responses to OA. Many studies have investigated the effects of OA or warming independently of each other, but few studies have quantified the interactive effects of OA and warming on marine organisms. We conducted four short-term independent factorial CO2 enrichment and warming experiments on six common species of calcified and fleshy macroalgae from southern California to investigate the independent and interactive effects of CO2 and warming on growth, carbonic anhydrase (CA) enzyme activity, pigment concentrations, and photosynthetic efficiency. There was no effect of elevated pCO2 on CA activity, pigment concentration, and photosynthetic efficiency in the macroalgal species studies. However, we found that calcareous algae suffered reduced growth rates under high pCO2 conditions alone, although the magnitude of the effect varied by species. Fleshy algae had mixed responses of growth rates to high pCO2, indicating that the effects of pCO2 enrichment are inconsistent across species. The combined effects of elevated pCO2 and warming had a significantly negative impact on growth for both fleshy and calcareous algae; calcareous algae experienced five times more weight loss than specimens in ambient control conditions and fleshy growth was reduced by 76%. Our results demonstrate the need to study the interactive effects of multiple stressors associated with global change on marine communities. [ABSTRACT FROM AUTHOR]

In this paper, we present a novel localization scheme, location-aware ranging correction (LARC), to correct ranging estimates from ultra wideband (UWB) signals. Existing solutions to calculate ranging corrections rely solely on channel information features (e.g., signal energy, maximum amplitude, estimated range). We propose to incorporate a preliminary location estimate into a localization chain, such that location-based features can be calculated as inputs to a range-error prediction model. This way, we can add information to range-only measurements without relying on additional hardware such as an inertial measurement unit (IMU). This improves performance and reduces overfitting behavior. We demonstrate our LARC method using an open-access measurement dataset with distances up to 20 m, using a simple regression model that can run purely on the CPU in real-time. The inclusion of the proposed features for range-error mitigation decreases the ranging error 90th percentile (P90) by 58% to 15 cm (compared to the uncorrected range error), for an unseen trajectory. The 2D localization P90 error is improved by 21% to 18 cm. We show the robustness of our approach by comparing results to a changed environment, where metallic objects have been moved around the room. In this modified environment, we obtain a 56% better P90 ranging performance of 16 cm. The 2D localization P90 error improves as much as for the unchanged environment, by 17% to 18 cm, showing the robustness of our method. This method evolved from the first-ranking solution of the 2021 and 2022 International Conference on Indoor Position and Indoor Navigation (IPIN) Competition.

Background: Consensus guidelines for pain, agitation, and delirium (PAD) in mechanically ventilated patients recommend maintaining a light level of sedation., Local Problem: Consistent attainment of target PAD assessments in mechanically ventilated ICU patients is often challenging., Methods: This is a single-center, prospective study., Interventions: In the intervention group, a pharmacist provided weekly feedback to nurses on their success in achieving target PAD assessments compared with a historical cohort without feedback., Results: Overall, 478 patients and 205 nurses were included. The odds of having weekly Richmond Agitation-Sedation Scale (RASS) score, pain score goals, and Confusion Assessment Method for the ICU (CAM-ICU) negative assessments at goal between the intervention and control groups fluctuated over time without a discernible trend., Conclusion: The provision of weekly feedback to nurses on PAD nursing assessments by a pharmacist did not impact the achievement of PAD goals among critically ill mechanically ventilated patients., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

The flame retardant (FR) BLUEDGE polymeric flame retardant (PFR) has been in use since 2011 and was developed as a replacement FR for hexabromocyclododecane in polystyrene (PS)-based insulation foams. To better understand the degradation behavior of the PFR used within PS foams, we examined the degradation of PFR under application-relevant conditions. Thermo-oxidative and photolytic pathways represent the most relevant degradation pathways. Separately, both the thermal and oxidative degradations of PFR at ambient conditions were shown to be negligible based on kinetic models of thermogravimetric analysis data obtained at elevated temperatures; the models predict that it would take 100 years to degrade 1% of PFR at 50 °C and 1000 years at 20 °C. Photodegradation was shown to degrade PFR after accelerated ultraviolet (UV) aging/exposure. UV radiation did not significantly penetrate the foam insulation (<2000 μm); the degradation process took place primarily at the surface. The molecular weight of the polymer changed with degradation, but there was minimal loss of bromine from the foam with degradation. The data from the liquid chromatography-mass spectrometry analysis focused primarily on several small-molecule polar products formed, which included two brominated species. These species were predicted using computer-based modeling to be biodegradable, to not be persistent in the environment, and to exhibit a low toxicity to aquatic organisms.

Pedestrian Dead Reckoning (PDR) uses inertial measurement units (IMUs) and combines velocity and orientation estimates to determine a position. The estimation of the velocity is still challenging, as the integration of noisy acceleration and angular speed signals over a long period of time causes large drifts. Classic approaches to estimate the velocity optimize for specific applications, sensor positions, and types of movement and require extensive parameter tuning. Our novel hybrid filter combines a convolutional neural network (CNN) and a bidirectional recurrent neural network (BLSTM) (that extract spatial features from the sensor signals and track their temporal relationships) with a linear Kalman filter (LKF) that improves the velocity estimates. Our experiments show the robustness against different movement states and changes in orientation, even in highly dynamic situations. We compare the new architecture with conventional, machine, and deep learning methods and show that from a single non-calibrated IMU, our novel architecture outperforms the state-of-the-art in terms of velocity (≤0.16 m/s) and traveled distance (≤3 m/km). It also generalizes well to different and varying movement speeds and provides accurate and precise velocity estimates.

Radio signal-based positioning in environments with complex propagation paths is a challenging task for classical positioning methods. For example, in a typical industrial environment, objects such as machines and workpieces cause reflections, diffractions, and absorptions, which are not taken into account by classical lateration methods and may lead to erroneous positions. Only a few data-driven methods developed in recent years can deal with these irregularities in the propagation paths or use them as additional information for positioning. These methods exploit the channel impulse responses (CIR) that are detected by ultra-wideband radio systems for positioning. These CIRs embed the signal properties of the underlying propagation paths that represent the environment. This article describes a feature-based localization approach that exploits machine-learning to derive characteristic information of the CIR signal for positioning. The approach is complete without highly time-synchronized receiver or arrival times. Various features were investigated based on signal propagation models for complex environments. These features were then assessed qualitatively based on their spatial relationship to objects and their contribution to a more accurate position estimation. Three datasets collected in environments of varying degrees of complexity were analyzed. The evaluation of the experiments showed that a clear relationship between the features and the environment indicates that features in complex propagation environments improve positional accuracy. A quantitative assessment of the features was made based on a hierarchical classification of stratified regions within the environment. Classification accuracies of over 90% could be achieved for region sizes of about 0.1 m 2 . An application-driven evaluation was made to distinguish between different screwing processes on a car door based on CIR measures. While in a static environment, even with a single infrastructure tag, nearly error-free classification could be achieved, the accuracy of changes in the environment decreases rapidly. To adapt to changes in the environment, the models were retrained with a small amount of CIR data. This increased performance considerably. The proposed approach results in highly accurate classification, even with a reduced infrastructure of one or two tags, and is easily adaptable to new environments. In addition, the approach does not require calibration or synchronization of the positioning system or the installation of a reference system.

Background: Vasopressin is commonly used as an adjunct vasopressor in shock. However, response to vasopressin varies among critically ill patients., Objective: To identify patient-specific factors that are associated with vasopressin responsiveness in critically ill adults., Methods: This retrospective, multicenter study included adult patients who were admitted to an intensive care unit (ICU) and received vasopressin for shock. Patients were excluded if they received vasopressin for less than 30 minutes, if vasopressin was initiated prior to ICU arrival, or if an additional vasopressor was initiated within 30 minutes of starting vasopressin. Responsiveness was defined as an increase in mean arterial pressure of ≥10 mm Hg or the ability to taper a concurrent catecholamine vasopressor. Patient-specific factors evaluated in a multivariate analysis included age, gender, ethnicity, body mass index, type of shock, serum pH, Sequential Organ Failure Assessment (SOFA) score, and use of stress-dose steroids. These variables were also evaluated in a subgroup analysis of patients with septic shock., Results: Of 1619 patients screened, 400 patients were included, with 231 identified as vasopressin responsive and 169 as nonresponsive. Vasopressin used as an adjunct vasopressor, as opposed to first line, during shock was the only variable associated with vasopressin responsiveness (odds ratio [OR] = 1.71; 95% CI = 1.10 to 2.65). Among the subgroup of patients with septic shock, female patients had a higher odds of responding than male patients (OR = 2.10; 95% CI = 1.12 to 3.95)., Conclusions: Vasopressin initiated as an adjunct vasopressor, as opposed to first-line therapy, was associated with response.

Sesquiterpene scaffolds are the core backbones of many medicinally and industrially important natural products. A plethora of sesquiterpene synthases, widely present in bacteria, fungi, and plants, catalyze the formation of these intricate structures often with multiple stereocenters starting from linear farnesyl diphosphate substrates. Recent advances in next-generation sequencing and metabolomics technologies have greatly facilitated gene discovery for sesquiterpene synthases. However, a major bottleneck limits biochemical characterization of recombinant sesquiterpene synthases: the absolute structural elucidation of the derived sesquiterpene products. Here, we report the identification and biochemical characterization of LphTPS-A, a sesquiterpene synthase from the red macroalga Laurencia pacifica. Using the combination of transcriptomics, sesquiterpene synthase expression in yeast, and microgram-scale nuclear magnetic resonance-coupled crystalline sponge X-ray diffraction analysis, we resolved the absolute stereochemistry of prespatane, the major sesquiterpene product of LphTPS-A, and thereby functionally define LphTPS-A as the first bourbonane-producing sesquiterpene synthase and the first biochemically characterized sesquiterpene synthase from red algae. Our study showcases a workflow integrating multiomics approaches, synthetic biology, and the crystalline sponge method, which is generally applicable for uncovering new terpene chemistry and biochemistry from source-limited living organisms.

Purpose: Recently published practice guidelines and research reports on pharmacotherapy in critical care patient populations are summarized., Summary: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group is composed of over 50 experienced critical care pharmacists who evaluate 31 peer-reviewed journals monthly to identify literature pertaining to pharmacotherapy in critical care populations. Articles are chosen for summarization in a monthly CCPLU Group publication on the basis of applicability and relevance to clinical practice and strength of study design. From January to December 2015, a total of 121 articles were summarized; of these, 3 articles presenting clinical practice guidelines and 12 articles presenting original research findings were objectively selected for inclusion in this review based on their potential to change or reinforce current evidence-based practice. The reviewed guidelines address the management of intracranial hemorrhage (ICH), adult advanced cardiac life support (ACLS) and post-cardiac arrest care, and the management of supraventricular tachycardia (SVT). The reviewed research reports address topics such as nutrition in critically ill adults, administration of β-lactams for severe sepsis, anticoagulant selection in the context of continuous renal replacement therapy, early goal-directed therapy in septic shock, magnesium use for neuroprotection in acute stroke, and progesterone use in patients with traumatic brain injury., Conclusion: Important recent additions to the critical care pharmacy literature include updated joint clinical practice guidelines on the management of spontaneous ICH, ACLS, and SVT., (Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.)

Purpose: Nine recently published articles and one guideline with important implications for critical care pharmacy practice are summarized., Summary: The Critical Care Pharmacotherapy Literature Update (CCPLU) group includes more than 40 experienced critical care pharmacists across the United States. Group members monitor 29 peer-reviewed journals on an ongoing basis to identify literature relevant to pharmacy practice in the critical care setting. After evaluation by CCPLU group members, selected articles are chosen for summarization and distribution to group members nationwide based on applicability to practice, relevance, and study design and strength. Hundreds of relevant articles were evaluated by the group in 2014, of which 114 were summarized and disseminated to CCPLU group members. From among those 114 publications, 10 deemed to be of particularly high utility to the critical care practitioner were selected for inclusion in this review for their potential to change practice or reinforce current evidence-based practice. One of the selected articles presents updated recommendations on the management of patients with atrial fibrillation (AF); the other 9 address topics such as albumin replacement in patients with severe sepsis, use of enteral statins for acute respiratory distress syndrome, fibrinolysis for patients with intermediate-risk pulmonary embolism, the use of unfractionated heparin versus bivalirudin for primary percutaneous coronary intervention, and early protocol-based care for septic shock., Conclusion: There were many important additions to the critical care pharmacotherapy literature in 2014, including a joint guideline for the management of AF and reports of clinical trials., (Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.)

Pain is a complex phenomenon: a sensory experience originating in traumatized tissues; an emotional (affective) experience that signals danger in the internal (body) or external environment; and a "disposition to act" that results either in "action" that prioritizes escape or in "inhibition of action" to minimize injury or facilitate healing. Recent advances in our understanding of the affective components of pain have significant implications for the treatment of chronic pain in children and adolescents. This article describes a chronic pain clinic for children and adolescents developed by the pain service of a large pediatric teaching hospital. Pain is conceptualized and managed in terms of multiple, interrelating systems (the body level, the psychological level, and the social level). This model of care is illustrated with reference to the management of two cases of children with chronic pain and significant functional impairment. A brief overview of the care utilization of 62 children referred to the Chronic Pain Clinic is also provided, with the clinical characteristics of 40 children with somatoform pain disorder (SPD) being described in more detail. Of 28 children with SPD treated with our systems intervention, 82% reported significant reductions in pain intensity, 71% returned to school full time, and 29% part time. An advantage of this integrated, family-based assessment and treatment approach is the overarching emphasis on identifying the contribution of each system to the child's subjective experience of pain, thereby avoiding the deleterious polarization of the pain as either physical or psychogenic in origin.