Search Results (93)

Glaucoma is one of the most common causes of irreversible visual impairment world wide. Providing low vision rehabilitation (LVR) services is a primary mode of support for patients with permanent vision loss. This retrospective, cross-sectional study evaluated the rate at which patients with severe open-angle glaucoma (OAG) were referred for LVR services at an academic medical center. Patient demographics, glaucoma severity, appointment history, performance on visual field (VF) testing, presenting visual acuity (VA), and change in best-corrected visual acuity (BCVA) after low vision refraction were abstracted from the electronic record and summarized by using descriptive statistics. Logistic regression analysis was used to assess the relationship between study variables and the likelihood of referral for LVR evaluation. Out of 522 patients with severe OAG, 88% of whom qualified as having low vision, 14 were referred for an LVR evaluation (2.7%). Referrals were most strongly associated with VA (adjusted odds ratio [aOR], 7.20; 95% confidence interval [CI], 2.11–24.64, p = 0.001) but not glaucoma-associated VF loss (aOR, 0.90; 95% CI, 0.24–3.37, p = 0.876). Thirteen of 14 patients referred for LVR completed visits (93%). More than one-third of those patients improved in their better-seeing eye after a low vision refraction, gaining an average of −0.18 ± 0.24 logMAR (half gaining ≥2-lines of BCVA). Patients with severe OAG are at risk of progressive visual disability from their eye disease. We found, however, that the majority of these patients were not referred to LVR services, despite meeting eligibility criteria and growing evidence demonstrating their potential benefit. Full article

Urinary tract infections (UTIs) are linked to adverse pregnancy outcomes, yet epidemiological data on gestational UTIs in Kenya are limited. This study assessed diagnostic and management practices in Kisumu County to inform diagnostic and antimicrobial stewardship. A hospital-based retrospective study was conducted from February 2020 to February 2021 among 416 records of pregnant women at Chulaimbo and Nyahera Sub-County Hospitals. Socio-demographic, laboratory, and clinical history data were collected using structured forms and analysed in STATA 16.0. Statistical methods included chi-square, multivariate logistic regression, and Spearman’s rank correlation (p ≤ 0.05). Dipstick-based presumptive proportion of UTIs was 57.9% (241/416). Only 1.4% (6/416) had microbiological confirmation despite infections being recorded. The mean maternal age was 23.92 years, parity two, mean antenatal visits two, and mean haemoglobin 10.73 ± 1.8 g/dL. The first antenatal care attendance occurred at varying gestational ages in 56% (233/416). Antibiotics prescribed were 60% from WHO ‘Access’ group and 40% from ‘Watch’ group. Gestational UTI’s in Kisumu County were frequently managed without confirmatory diagnosis, increasing antimicrobial resistance risk. Strengthening management requires better laboratory capacity, sustained financial investment, improved antibiotic access, and adherence to WHO AWaRe guidelines to protect maternal and neonatal health. Full article

Azomethine ylides (AMYs) have a nitrogen–carbon double bond and an electron lone pair on the nitrogen atom. They are essential 1,3-dipoles for [3+2] cycloadditions in the synthesis of pyrrolidine-containing heterocycles. Significant progress in 1,3-diplolar cycloadditions has been made in the construction of novel heterocyclic scaffolds, with efforts to broaden substrate scope, enhance stereoselectivity, and integrate green chemistry principles. This article summarizes double cycloadditions of AMYs derived from amino esters and amino acids for the synthesis of novel polyheterocycles. The design of double cycloadditions through the pot, atom, and step economic (PASE) method to increase the reaction efficiency is discussed. The examples presented in this paper may be applied to the synthesis of biologically active molecules. Full article

This study examines intergenerational transmission of Russian within the U.S. Russophone diaspora in the wake of Russia’s 2022 full-scale invasion of Ukraine. It addresses: (1) parents’ motivations and practices surrounding intergenerational language transmission; and (2) challenges faced by Russian-speaking families in today’s shifting sociopolitical landscape. The study draws on semi-structured Zoom interviews with 16 Russian-speaking parents in the United States, each raising children aged 3–15 and representing four different immigration periods, from the early 1990s to 2022, following Russia’s invasion of Ukraine. Findings reveal that heritage language maintenance is shaped not only by linguistic choices, but also by political and ethical considerations. While all parents continue to view Russian as a source of identity, cultural capital, and familial cohesion, many also actively disassociate the language from its sociopolitical ties to the aggressor state. Shared aspirations for bilingualism are tempered by internal and external pressures, including children’s growing agency, family dynamics, challenges of immigrant life, and war-driven fractures within the diaspora. This study contributes to research on heritage language maintenance and family language policies by exploring how global geopolitical events are negotiated through intimate, everyday language practices in immigrant households. Full article

Urban pluvial waterlogging has become a major challenge for densely populated cities due to increasingly extreme rainfall events and the rapid expansion of impervious surfaces. In response to the growing demand for localized waterlogging risk assessments, an automated evaluation framework is proposed that integrates high-resolution digital elevation models (DEMs), rainfall scenarios, and classified building data within a GIS-based modeling system. The methodology consists of four modules: (i) design of rainfall scenarios and runoff estimation, (ii) waterlogging depth simulation based on volume-matching algorithms, (iii) construction of depth–damage curves for residential and commercial buildings, and (iv) building-level economic loss estimation though differentiated depth–damage functions for residential/commercial assets—a core innovation enabling sector-specific risk precision. A case study was conducted in the Lixia District, Jinan City, China, involving 15,317 buildings under a 50-year return period rainfall event. The total economic losses were shown to reach approximately USD 327.88 million, with residential buildings accounting for 88.6% of the total. The model achieved a mean absolute percentage error within 5% for both residential and commercial cases. The proposed framework supports high-precision, building-level urban waterlogging damage assessment and demonstrates scalability for use in other high-density urban areas. Note: all monetary values were converted from Chinese Yuan (CNY) to U.S. Dollars (USD) using an average exchange rate of 1 USD = 7.28 CNY. Full article

The increasing demand for effective flow control in supersonic boundary layers, particularly for mitigating shock-wave boundary-layer interactions, underscores the need to explore optimized micro-vortex generator (MVG) configurations. This study investigates the aerodynamic performance of two different MVG configurations: a two-MVG setup with a pair of close parallel-positioned MVGs and a three-MVG arrangement that includes an additional upstream unit. Both are examined within a Mach 2.5 flow regime, aiming to improve mixing and energize the boundary layer. Large Eddy Simulations (LES) were performed using high-order numerical schemes. A newly developed vortex identification method was utilized to characterize vortex structures, while turbulent kinetic energy (TKE) metrics were integrated to quantify turbulence. Findings reveal that the two-MVG configuration produces regular, symmetric vortex pairs with limited interaction. This results in a steady increase in TKE and a thickened momentum boundary layer—indicative of notable energy loss. In contrast, the three-MVG setup generates more intricate and interactive vortex formations that significantly elevate TKE levels, rapidly expand the turbulent region, and reduce energy loss downstream. The peak TKE occurs before tapering slightly. Instantaneous flow analysis further highlights chaotic, hairpin-dominated vortex structures in the three-MVG case, compared to the more orderly ones observed in the two-MVG case. Overall, the three-MVG configuration demonstrates superior mixing and boundary-layer energization potential, albeit with greater structural complexity. Full article

Scenario generation proves to be an effective approach for addressing uncertainties in stochastic programming for power systems with integrated renewable resources. In recent years, numerous studies have explored the application of deep generative models to scenario generation. Considering the challenge of characterizing renewable resource uncertainty, in this paper, we propose a novel two-stage generative architecture for renewable scenario generation using diffusion models. Specifically, in the first stage the temporal features of the renewable energy output are learned and encoded into the hidden space by means of a representational model with an encoder–decoder structure, which provides the inductive bias of the scenario for generation. In the second stage, the real distribution of vectors in the hidden space is learned based on the conditional diffusion model, and the generated scenario is obtained through decoder mapping. The case study demonstrates the effectiveness of this architecture in generating high-quality renewable scenarios. In comparison to advanced deep generative models, the proposed method exhibits superior performance in a comprehensive evaluation. Full article

Over the years, our research group developed dehydrodipeptides N-capped with aromatic moieties as protease-resistant efficacious hydrogelators, affording self-assembled hydrogels at low (critical) concentrations. Dehydrotripeptides, with different dipeptide sequences and (D,L) stereochemistry, open a wider chemical space for the development of self-assembled soft nanomaterials. In this work, a small library of N-succinylated dehydrotripeptides containing a C-terminal dehydrophenylalanine (∆Phe) residue and a scrambled dipeptide sequence with phenylalanine (Phe) and homophenylalanine (Hph) (L-Phe-L,D-Hph and L,D-Hph-L-Phe) was synthesized and characterized as a potential hydrogelator. Two pairs of diastereomeric tripeptides were synthesized, both as C-protected methyl esters and as deprotected dicarboxylic acids. Peptides with the sequence Hph-Phe-ΔPhe were obtained as a pair (D,L,Z)/(L,L,Z) of diastereomers. Their scrambled sequence analogues Phe-Hph-ΔPhe were obtained also as a diastereomeric (L,D,Z)/(L,L,Z) pair. The effect of stereochemistry (homo- vs. hetero-chirality) and sequence (Phe-∆Phe vs. Hph-∆Phe motif) on the self-assembly, biocompatibility, gelation and rheological properties of the hydrogels was studied in this work. Accessible, both as C-protected methyl esters and as dicarboxylic acids, N-succinylated dehydrotripeptides are interesting molecular architectures for the development of supramolecular nanomaterials. Interestingly, our results do not comply with the well-documented proposition that heterochiral peptides display much higher self-assembly propensity and gelation ability than their homochiral counterparts. Further studies will be necessary to fully understand the interplay between peptide sequence and homo- and hetero-chirality on peptide self-assembly and on the properties of their supramolecular materials. Full article

Background/Objectives: The opioid crisis has disproportionately impacted U.S. military veterans, who face heightened risks of opioid use disorder and overdose due to chronic pain and mental health conditions. The pharmaceutical industry’s role in misrepresenting opioid risks—leading to over USD 50 billion in legal settlements—has included targeted marketing to vulnerable populations. This study examines Janssen Pharmaceuticals’ “Imagine the Possibilities Pain Coalition” (IPPC), which aimed to increase opioid use among veterans with chronic non-cancer pain. Insights from this public health industry document analysis offer guidance for military medicine and healthcare policymaking. Methods: Using the Opioid Industry Document Archive (OIDA), housed at Johns Hopkins University and the University of California, San Francisco, researchers conducted retrospective content analysis. Documents referencing veterans were identified through keyword searches on Johns Hopkins’ SciServer portal and reviewed using CoCounsel, an AI-based legal document platform using a human-in-the-loop approach. Relevant documents were examined by the authors to extract material aligned with the research focus. Results: The IPPC employed strategies to influence opioid prescribing for veterans. These included educational materials that minimized addiction risks and exaggerated long-term benefits and empathy-driven narratives prioritizing immediate pain relief over potential harms. Ghostwriting ensured favorable perspectives on opioids in scientific literature, aligning with broader industry strategies to promote opioids for chronic pain. Conclusions: The targeted marketing of opioids to veterans has exacerbated the opioid crisis, as documented in government reports and litigation. Rigorous oversight of industry-funded coalitions and evidence-based practices are critical to insulating military healthcare from corporate influence and addressing the opioid crisis among veterans. Full article

ATLAS is currently preparing for the HL-LHC upgrade, with an all-silicon Inner Tracker (ITk) that will replace the current Inner Detector. The ITk will feature a pixel detector surrounded by a strip detector, with the strip system consisting of four barrel layers and 12 endcap disks. After successful completion of a large-scale prototyping program, final design reviews have been completed in key areas, such as sensors, modules, front-end electronics, and ASICs. We present an overview of the strip system and highlight the final design choices of sensors, modules, and ASICs. We summarize the results achieved during prototyping and the current status of production and pre-production on various detector components, with an emphasis on QA and QC procedures. Full article

Landscape-oriented approaches in archaeology have moved beyond site-based research to interpret how people have engaged with, modified, and constructed the environment and how the legacies of these activities continue to influence land use. In the Maya Lowlands, landscape archaeology is related to the analysis of settlement patterns, households, agricultural intensification, and water management. The increasing availability of LiDAR data has revolutionized the mapping of archaeological landscapes under vegetation, especially in tropical environments like the Maya Lowlands, but researchers still emphasize site-oriented settlement densities and infrastructure. Furthermore, the accessibility of drone-based LiDAR platforms has the potential to collect data across several seasons or years to facilitate change detection. In this paper, we compare three LiDAR datasets collected from 2018 to 2023, using both occupied and unoccupied airborne systems. The landscape surrounding the archaeological site of El Infiernito, Chiapas, Mexico near the Classic period (AD 250–800) dynastic capital of Piedras Negras, Guatemala was selected to compare these LiDAR datasets in the context of prior, extensive ground-based fieldwork. These data were used to interpret the built environment, land use, hydrology, landscapes of movement, and other infrastructure constructed and modified by several communities beginning in the Late Preclassic period (400 BC–AD 250) to the present. When used alongside systematic survey and ground verification, the combination of several LiDAR platforms to collect data across different seasons at El Infiernito enhanced the understanding of the spatial distribution of archaeological sites and features across the karst landscape. Full article

In recent years, unmanned aerial vehicles (UAVs) vision systems based on deep neural networks (DNNs) have made remarkable advancements, demonstrating impressive performance. However, due to the inherent characteristics of DNNs, these systems have become increasingly vulnerable to adversarial attacks. Traditional black-box attack methods typically require a large number of queries to generate adversarial samples successfully. In this paper, we propose a novel adversarial attack technique designed to achieve efficient black-box attacks with a minimal number of queries. We define a perturbation generator that first decomposes the image into four frequency bands using wavelet decomposition and then searches for adversarial perturbations across these bands by minimizing a weighted loss function on a set of fixed surrogate models. For the target victim model, the perturbation images generated by the perturbation generator are used to query and update the weights in the loss function, as well as the weights for different frequency bands. Experimental results show that, compared to state-of-the-art methods on various image classifiers trained on ImageNet (such as VGG-19, DenseNet-121, and ResNext-50), our method achieves a success rate over 98% for targeted attacks and nearly a 100% success rate for non-targeted attacks with only 1–2 queries per image. Full article

YqeK is a bacterial HD-domain metalloprotein that hydrolyzes the putative second messenger diadenosine tetraphosphate (Ap4A). Elevated Ap4A levels are primarily observed upon exposure of bacteria to factors such as heat or oxidative stress and cause pleiotropic effects, including antibiotic sensitivity and disrupted biofilm formation. Ap4A thus plays a central role in bacterial physiology and metabolism, and its hydrolysis by YqeK is intimately linked to the ability of these microbes to cope with stress. Although YqeK is reported to hydrolyze Ap4A under aerobic conditions, all four existing crystal structures reveal an active site that consists of a diiron center, portraying a cryptic chemical nature for the active metallocofactor. This study examines two YqeK proteins from two ecologically diverse parent organisms: the obligate anaerobe Clostridium acetobutylicum and the facultative aerobe Bacillus halodurans. Both enzymes utilize Fe-based cofactors for catalysis, while under ambient or oxidative conditions, Bh YqeK hydrolyzes Ap4A more efficiently compared to Ca YqeK. This redox-dependent activity difference stems from the following two molecular mechanisms: the incorporation of mixed-metal, Fe-based bimetallic cofactors, in which the second metal is redox inert (i.e., Fe–Zn) and the upshift of the Fe–Fe cofactor reduction potentials. In addition, three strictly conserved, positively charged residues vicinal to the active site are critical for tuning Ap4A hydrolysis. In conclusion, YqeK is an Fe-dependent phosphohydrolase that appears to have evolved to permit Ap4A hydrolysis under different environmental niches (aerobic vs. anaerobic) by expanding its cofactor configuration and O₂ tolerance. Full article

This paper analyzes the work of chaplaincy and spiritual care from the perspective of care recipients. Chaplains call their work a “ministry of presence,” a term of art that is often unclear to many who are not chaplains. How else might we conceptualize “presence” in order to ground it in the social science literature? Using sociological theory, we show that care recipients may experience a chaplain’s work as emotional labor, specifically “other-focused emotional labor.” Based on in-depth interviews with a sample of 38 care recipients, we find recipients feeling reassured by the chaplain; being offered support and help by the chaplain; and not feeling judged by the chaplain. These findings enlarge sociological concepts about spiritual care to include what recipients experience as emotional labor and call for a broader engagement between sociologists of religion and emotions. Full article

Background: Fragile X Syndrome (FXS) is the leading monogenetic cause of autism spectrum disorder (ASD) and is associated with seizures. We examined the impact of repeated seizures on the behavioral and molecular changes in male Fmr1 knockout (KO) mice and wild-type (WT) mice. Methods: Seizures were induced by administering three flurothyl seizures per day across postnatal days (PD) 7–11, for a total of 15 seizures. In adulthood, mice were tested in a battery of behavioral tasks to assess long-term behavioral deficits. Results: The two-hit impact of a Fmr1 knockout and seizures resulted in decreased anxiety-like behavior in the elevated plus maze test and a longer latency to their first nose poke (repetitive behavior). Seizures resulted in decreased activity, decreased repetitive behavior (grooming and rearings), and decreased social behavior, while they also increased habituation to auditory stimuli and increased freezing in delayed fear conditioning in both KO and control mice. KO mice displayed increased repetitive behavior in the open field task (clockwise revolutions) and repeated nose pokes, and decreased anxiety in the open field test. No differences in mTOR signaling were found. Conclusions: These findings further illuminate the long-term effects of synergistic impact of two hits on the developing brain. Full article