2002-2017 anthropogenic emissions data for air quality modeling over the United States.

The United States Environmental Protection Agency (US EPA) has developed a set of annual North American emissions data for multiple air pollutants across 18 broad source categories for 2002 through 2017. The sixteen new annual emissions inventories were developed using consistent input data and methods across all years. When a consistent method or tool was not available for a source category, emissions were estimated by scaling data from the EPA's 2017 National Emissions Inventory with scaling factors based on activity data and/or emissions control information. The emissions datasets are designed to support regional air quality modeling for a wide variety of human health and ecological applications. The data were developed to support simulations of the EPA's Community Multiscale Air Quality model but can also be used by other regional scale air quality models. The emissions data are one component of EPA's Air Quality Time Series Project which also includes air quality modeling inputs (meteorology, initial conditions, boundary conditions) and outputs (e.g., ozone, PM2.5 and constituent species, wet and dry deposition) for the Conterminous US at a 12 km horizontal grid spacing.

Validation with single-step SNPBLUP shows that evaluations can continue using a single mean of genotyped individuals, even with multiple breeds.

BACKGROUND: In genomic prediction, it is common to centre the genotypes of single nucleotide polymorphisms based on the allele frequencies in the current population, rather than those in the base generation. The mean breeding value of non-genotyped animals is conditional on the mean performance of genotyped relatives, but can be corrected by fitting the mean performance of genotyped individuals as a fixed regression. The associated covariate vector has been referred to as a 'J-factor', which if fitted as a fixed effect can improve the accuracy and dispersion bias of sire genomic estimated breeding values (GEBV). To date, this has only been performed on populations with a single breed. Here, we investigated whether there was any benefit in fitting a separate J-factor for each breed in a three-way crossbred population, and in using pedigree-based expected or genome-based estimated breed fractions to define the J-factors. RESULTS: For body weight at 7 days, dispersion bias decreased when fitting multiple J-factors, but only with a low proportion of genotyped individuals with selective genotyping. On average, the mean regression coefficients of validation records on those of GEBV increased with one J-factor compared to none, and further increased with multiple J-factors. However, for body weight at 35 days this was not observed. The accuracy of GEBV remained unchanged regardless of the J-factor method used. Differences between the J-factor methods were limited with correlations approaching 1 for the estimated covariate vector, the estimated coefficients of the regression on the J-factors, and the GEBV. CONCLUSIONS: Based on our results and in the particular design analysed here, i.e. all the animals with phenotype are of the same type of crossbreds, fitting a single J-factor should be sufficient, to reduce dispersion bias. Fitting multiple J-factors may reduce dispersion bias further but this depends on the trait and genotyping rate. For the crossbred population analysed, fitting multiple J-factors has no adverse consequences and if this is done, it does not matter if the breed fractions used are based on the pedigree-expectation or the genomic estimates. Finally, when GEBV are estimated from crossbred data, any observed bias can potentially be reduced by including a straightforward regression on actual breed proportions.

Parenting a child with a chronic illness during a pandemic.

BACKGROUND: Nearly 20% of children in the United States experience one or more chronic health conditions. Parents of a child with a special healthcare need (CSHCN) experience increased stress caring for a child with chronic illness. PURPOSE: The purpose of this descriptive study is to describe stress in parents of a child with chronic illness during the COVID-19 pandemic. METHODS: Parents of CSHCN (n = 34) were asked to fill out the Pediatric Inventory for Parents (PIP) and answer two questions related to caring for their child during the COVID-19 pandemic. CONCLUSIONS: The means of the PIP-F (M = 146.6, SD = 20.5) and PIP-D (M = 141.9, SD = 23.9) were significantly higher than in previous studies. There is statistically significant positive correlation between parent stress and variables of age of the child and the length of time since diagnosis. In response to the questions about the impact of COVID, nearly all parents reported COVID increased their stress and reported their stress was related to isolation, lack of resources, and concern for the mental health of other children in the household. PRACTICE IMPLICATIONS: COVID-19 likely exacerbated feelings of stress for parents of children with chronic health conditions. Although unprecedented, COVID-19 shed light on the existing fragility and high stress of parents of CSHCN. Pediatric nurses not only care for children, but must be advocates for the mental health of their patient's parents.

Maneuvering the Institutional Review Board Process: A Guide for Critical Care Nurses and Researchers.

Institutional review boards (IRBs) exist to protect the rights and welfare of research participants. Critical care nurses and researchers may interface with IRBs directly or indirectly. Having an understanding of how the IRB process works will help nurses advocate for patients who may also be research participants and will help researchers facilitate approval of their research studies.

"Finding My Own Way": The lived experience of undergraduate nursing students learning psychomotor skills during COVID-19.

BACKGROUND: Little is known about how nursing students learned psychomotor skills during the COVID-19 pandemic. AIMS: What is the lived experience of undergraduate nursing students learning psychomotor skills during the COVID-19 pandemic? METHODS: Using a phenomenological approach, eight undergraduate nursing students were interviewed about their experiences learning psychomotor skills during the pandemic. RESULTS: Thematic analysis revealed three main themes. "Finding My Own Way" described adapting learning styles and advocacy for learning. Sub-themes included perseverance and comradery. "Learning the Skills" described modifications to skills learning. Sub-themes included grace by professors, smaller group sizes, less practice, and "my brain is split in half," describing the challenges of giving dual attention to COVID-19 and skills learning. "Stress of the Pandemic" described the stress of quarantine, isolation and online learning. DISCUSSION: Findings of this study may help nurse educators understand the challenges of learning skills during the pandemic. Implications are discussed.

Chemical Emissions From Heated Vitamin E Acetate-Insights to Respiratory Risks From Electronic Cigarette Liquid Oil Diluents Used in the Aerosolization of Δ9-THC-Containing Products.

As of February 18, 2020, the e-cigarette, or vaping, product use associated lung injury (EVALI) outbreak caused the hospitalization of a total of 2,807 patients and claimed 68 lives in the United States. Though investigations have reported a strong association with vitamin E acetate (VEA), evidence from reported EVALI cases is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC or non-THC products. This study characterized chemicals evolved when diluent oils were heated to temperatures that mimic e-cigarette, or vaping, products (EVPs) to investigate production of potentially toxic chemicals that might have caused lung injury. VEA, vitamin E, coconut, and medium chain triglyceride (MCT) oil were each diluted with ethanol and then tested for constituents and impurities using a gas chromatograph mass spectrometer (GC/MS). Undiluted oils were heated at 25°C (control), 150°C, and 250°C in an inert chamber to mimic a range of temperatures indicative of aerosolization from EVPs. Volatilized chemicals were collected using thermal desorption tubes, analyzed using a GC/MS, and identified. Presence of identified chemicals was confirmed using retention time and ion spectra matching with analytic standards. Direct analysis of oils, as received, revealed that VEA and vitamin E were the main constituents of their oils, and coconut and MCT oils were nearly identical having two main constituents: glycerol tricaprylate and 2-(decanoyloxy) propane-1,3-diyl dioctanoate. More chemicals were measured and with greater intensities when diluent oils were heated at 250°C compared to 150°C and 25°C. Vitamin E and coconut/MCT oils produced different chemical emissions. The presence of some identified chemicals is of potential health consequence because many are known respiratory irritants and acute respiratory toxins. Exposure to a mixture of hazardous chemicals may be relevant to the development or exacerbation of EVALI, especially when in concert with physical damage caused by lung deposition of aerosols produced by aerosolizing diluent oils.

Assessment of a regulatory measurement system for the determination of the non-volatile particulate matter emissions from commercial aircraft engines.

The SAE International has published Aerospace Information Report (AIR) 6241 which outlined the design and operation of a standardized measurement system for measuring non-volatile particulate matter (nvPM) mass and number emissions from commercial aircraft engines. Prior to this research, evaluation of this system by various investigators revealed differences in nvPM mass emissions measurement on the order of 15-30% both within a single sampling system and between two systems operating in parallel and measuring nvPM mass emissions from the same source. To investigate this issue, the U. S. Environmental Protection Agency in collaboration with the U. S. Air Force's Arnold Engineering Development Complex initiated the VAriable Response In Aircraft nvPM Testing (VARIAnT) research program to compare nvPM measurements within and between AIR-compliant sampling systems used for measuring combustion aerosols generated both by a 5201 Mini-CAST soot generator and a J85-GE-5 turbojet engine burning multiple fuels. The VARIAnT research program has conducted four test campaigns to date. The first campaign (VARIAnT 1) compared two essentially identical commercial versions of the sampling system while the second campaign (VARIAnT 2) compared a commercial system to the custom-designed Missouri University of Science and Technology's North American Reference System (NARS) built to the same specifications. Comparisons of nvPM particle mass (i.e., black carbon), number, and size were conducted in both campaigns. Additionally, the sensitivity to variation in system operational parameters was evaluated in VARIAnT 1. Results from both campaigns revealed agreement of about 12% between the two sampling systems, irrespective of manufacturer, in all aspects except for black carbon determination. The major source of measurement differences (20-70%) was due to low BC mass measurements made by the Artium Technologies LII-300 as compared to the AVL 483 Micro-Soot Sensor, the Aerodyne Cavity Attenuated Phase Shift (CAPS PMSSA) monitor, and the thermal-optical reference method for elemental carbon (EC) determination, which was used as the BC reference.

Variance estimates are similar using pedigree or genomic relationships with or without the use of metafounders or the algorithm for proven and young animals1.

With an increase in the number of animals genotyped there has been a shift from using pedigree relationship matrices (A) to genomic ones. As the use of genomic relationship matrices (G) has increased, new methods to build or approximate G have developed. We investigated whether the way variance components are estimated should reflect these changes. We estimated variance components for maternal sow traits by solving with restricted maximum likelihood, with four methods of calculating the inverse of the relationship matrix. These methods included using just the inverse of A (A-1), combining A-1 and the direct inverse of G (HDIRECT-1), including metafounders (HMETA-1), or combining A-1 with an approximated inverse of G using the algorithm for proven and young animals (HAPY-1). There was a tendency for higher additive genetic variances and lower permanent environmental variances estimated with A-1 compared with the three H-1 methods, which supports that G-1 is better than A-1 at separating genetic and permanent environmental components, due to a better definition of the actual relationships between animals. There were limited or no differences in variance estimates between HDIRECT-1, HMETA-1, and HAPY-1. Importantly, there was limited differences in variance components, repeatability or heritability estimates between methods. Heritabilities ranged between <0.01 to 0.04 for stayability after second cycle, and farrowing rate, between 0.08 and 0.15 for litter weight variation, maximum cycle number, total number born, total number still born, and prolonged interval between weaning and first insemination, and between 0.39 and 0.44 for litter birth weight and gestation length. The limited differences in heritabilities suggest that there would be very limited changes to estimated breeding values or ranking of animals across models using the different sets of variance components. It is suggested that variance estimates continue to be made using A-1, however including G-1 is possibly more appropriate if refining the model, for traits that fit a permanent environmental effect.

Teaching Nursing Students the Care of a Patient with End Stage Renal Disease in a Pediatric Nursing Theory Course: A Comparison of Two Instructional Methods.

Effective methodologies for teaching nursing students how to care for pediatric patients with end stage renal disease (ESRD) are not well described. Two teaching methodologies were compared using a mixed-methods approach: an at-home simulation group (three days simulating having ESRD: taking medications, eating a renal diet, nightly peritoneal dialysis), and a video group (children with ESRD and their families sharing their experiences). Data were collected via an anonymous online survey at course completion. Knowledge acquisition was assessed using psychometrically reliable multiple-choice questions; no statistically significant differences between the two groups were found, indicating both learned the material. Qualitative analysis found that both groups valued the assigned teaching method and that it deepened their learning. Students identified challenges that children with ESRD and their families are known to experience. Combining both teaching methods may ultimately be the most effective approach.

Power models and average ship parameter effects on marine emissions inventories.

Maritime greenhouse gas emissions are projected to increase significantly by 2050, highlighting the need for reliable inventories as a first step in analyzing ship emission control policies. The impact of ship power models on marine emissions inventories has garnered little attention, with most inventories employing simple, load-factor-based models to estimate ship power consumption. The availability of more expansive ship activity data provides the opportunity to investigate the inventory impacts of adopting complex power models. Furthermore, ship parameter fields can be sparsely populated in ship registries, making gap-filling techniques and averaging processes necessary. Therefore, it is important to understand of the impact of averaged ship parameters on ship power and emission estimations. This paper examines power estimation differences between results from two complex, resistance-based and two simple, load-factor-based power models on a baseline inventory with unique ship parameters. These models are additionally analyzed according to their sensitivities toward average ship parameters. Automated Identification System (AIS) data from a fleet of commercial marine vessels operating over a 6-month period off the coast of the southwestern United States form the basis of the analysis. To assess the inventory impacts of using averaged ship parameters, fleet-level carbon dioxide (CO2) emissions are calculated using ship parameter data averaged across ship types and their subtype size classes. Each of the four ship power models are used to generate four CO2 emissions inventories, and results are compared with baseline estimates for the same sample fleet where no averaged values were used. The results suggest that a change in power model has a relatively high impact on emission estimates. They also indicate relatively little sensitivity, by all power models, to the use of ship characteristics averaged by ship and subtype. Implications: Commercial marine vessel emissions inventories were calculated using four different models for ship engine power. The calculations used 6 months of Automated Identification System (AIS) data from a sample of 248 vessels as input data. The results show that more detailed, resistance-based models tend to estimate a lower propulsive power, and thus lower emissions, for ships than traditional load-factor-based models. Additionally, it was observed that emission calculations using averaged values for physical ship parameters had a minimal impact on the resulting emissions inventories.

Nursing Students' Perceptions of Skills Learning: A Phenomenological Study.

BACKGROUND: Deliberate practice (DP) and cognitive load theory have renewed educators' interest in effective psychomotor skills teaching. PURPOSE: The purpose of this research was to explore how prelicensure nursing students learned psychomotor skills. METHODS: Nine senior nursing students participated in this phenomenological study to capture how they experienced learning nursing skills. Colaizzi's method was used to analyze in-depth interviews of open-ended questions. RESULTS: Six themes emerged: (a) the umbrella of emotion, (b) practice, (c) learning through technology, (d) fidelity affects learning, (e) teaching matters, and (f) importance of peers. Students found creative ways to learn nursing skills. Research findings contributed to a greater understanding of student experiences in gaining competency in nursing skills. CONCLUSIONS: Participants used aspects of DP, cognitive load theory, and technology to learn skills. These findings provide current information to nurse educators about skills learning and recommendations for effective skills teaching.

Carbon monoxide emission rates from roasted whole bean and ground coffee.

Carbon monoxide (CO) emitted from roasted coffee is a potential occupational respiratory exposure hazard to workers within the coffee industry. The current study objective was to estimate CO emission factors from commercially available roasted whole bean and ground coffee measured in loose form, not packaged, and to assess the utility of CO monitoring in nonventilated storage spaces such as within coffee roasting and packaging facilities, transport vessels, and cafés. Determinants affecting CO emissions from coffee were investigated, including form (whole bean vs. ground), roast level (light, medium, medium-dark, dark), and age (time since the package was opened). CO emission factors were estimated for roasted coffee samples from a variety of manufacturers purchased from local grocery stores and online. Emission tests were performed on 36 brands of coffee, some with more than one sample per brand and with various roast levels. Decaying source equations or smoothing functions were fitted to the CO concentration measurements. Maximum observed emission factors at the peak of the predicted concentration curve were adjusted by the time required to reach the maximum CO concentration and reported as emission factors (EFbuildup). Ground coffee had a significantly increased EFbuildup (P < 0.0001) compared with whole bean. Roast level did not significantly affect emissions for whole bean (P = 0.72) but did for ground (P < 0.001) coffee. For ground coffee, medium-dark and dark roasts had significantly higher emissions than medium and light roasts. Worst-case emission factors from commercially available whole bean and ground coffee measured in loose form, not packaged, showed that roasted coffee can rapidly emit CO. CO concentrations should be monitored in storage spaces in service and manufacturing facilities as well as transport vessels to ensure exposures do not exceed occupational exposure limits. Storage spaces may need to be ventilated to control CO concentrations to safe levels.Implications: Emission rates of carbon monoxide (CO) from roasted coffee showed that unventilated or underventilated storage spaces should be monitored and ventilated, if necessary, to control CO concentrations to safe levels.

Creative Teaching Methods for Educators: A Compendium of Critical-Care Concepts.

In order to gain expertise, intensive care unit nurses must have a good understanding of the pathophysiology and complicated disease processes seen in their units. Nurse educators and critical-care preceptors must be able to explain these complex concepts to a wide variety of audiences including nursing students, graduate nurses, and experienced critical-care nurses. Many times, demonstrations, analogies, visual aids, games, and creative teaching methods can help communicate these complicated ideas. The purpose of this article is to provide ideas for nurse educators and preceptors to use when explaining concepts that may be encountered with patients in a critical-care setting. In addition, general tips for using creative ideas when teaching are discussed.

Keeping track of all ongoing colorectal cancer trials using a mobile application: Usability and satisfaction results of the Dutch Colorectal Cancer Group Trials application.

BACKGROUND AND AIM: Both the number and complexity of medical trials are increasing vastly. To facilitate easy access to concise trial information, a freely available mobile application including all ongoing clinical trials of the Dutch Colorectal Cancer Group (DCCG) was developed. The aim of this study was to investigate the use and user satisfaction over the first 2 years. METHODS: The application was launched in January 2015 on iOS and Android platforms. Google Analytics was used to monitor anonymous user data up to February 2017. In addition, an online survey regarding the use and satisfaction among health-care professionals and research affiliates active in the field of colorectal cancer in the Netherlands was conducted. RESULTS: A total of 6173 unique users were identified, of which 1822 (30%) were from the Netherlands, representing a total of 16,065 and 10,987 (68%) sessions, respectively. The median session duration per day was 01:47 min (IQR 0:51-03:03). The mobile application was mostly used on Monday, Tuesday, and Thursday, and the number of sessions was highest during the following time frames: 12-13 pm (9%), 17-18 pm (9%), and 13-14 pm (8%). Of 121 survey responses, most were medical doctors (47%), nurses (25%), or researchers (9%), working either in a teaching (40%), academic hospital (32%), or general hospital (19%). 83% of all respondents rated the application 4 or higher for satisfaction on a 5-point scale. Highest reported reasons of the use were urgent trial inquiry (57%) and usage during multi-disciplinary meetings (49%). CONCLUSION: The DCCG Trials application is frequently used, and the majority of users is highly satisfied. RELEVANCE FOR PATIENTS: Clustering trial information into one platform, such as DCCG trials app, has shown to be useful for medical professionals treating patients with colorectal carcinoma in the Netherlands.

Family Presence During Trauma Resuscitation: Family Members' Attitudes, Behaviors, and Experiences.

BACKGROUND: The paradigm is shifting from separating family members from their children during resuscitation to one of patient- and family-centered care. However, widespread acceptance is still lacking. OBJECTIVE: To measure attitudes, behaviors, and experiences of family members of pediatric patients during the resuscitation phase of trauma care, including family members who were present and those who were not. METHODS: An observational mixed-methods study using structured interviews and focus groups was conducted at 3 level 1 pediatric trauma centers. Family members of children who met trauma team activation criteria (N = 126; 99 present, 27 not present) were interviewed; 25 also participated in focus groups. RESULTS: Mean attitude scores indicated a positive attitude about being present during the resuscitation phase of trauma care (3.65; SD, 0.37) or wanting to be present (3.2; SD, 0.60). Families present reported providing emotional support (94%) for their child and health care information (92%) to the medical team. Being present allowed them to advocate for their child, understand their child's condition, and provide comfort. Families in both groups felt strongly that the choice was their right but was contingent upon their bedside behavior. CONCLUSIONS: Study findings demonstrated compelling family benefits for presence during pediatric trauma care. This study is one of the first to report on family members who were not present. The practice of family presence should be made a priority at pediatric trauma centers.

Carotid intima-media thickness and plaque assessment by trained medical residents: validation and preliminary testing of a training protocol.

BACKGROUND: Training of nonsonographer physicians or staff members is needed to implement carotid intima-media thickness (CIMT) and plaque screening by ultrasound for the assessment of subclinical atherosclerosis. The purpose of this study was to determine the effect of formal training on CIMT assessment and plaque detection by medical residents. METHODS: A medical resident (R1) was trained using an abbreviated American Society of Echocardiography CIMT protocol. CIMT and plaque assessment by R1 were compared against an expert scanner on 60 subjects using a portable US system. A second medical resident (R2) was then trained on the CIMT protocol focusing on plaque visualization after the results of the first phase of the study were analyzed, and the results were compared against an expert on an additional 10 subjects. RESULTS: In the first phase of the study, a total of 106 images (94% interpretable) were available for CIMT and plaque assessment by both R1 and the expert. CIMT measurements were bioequivalent within the limits of ultrasound resolution, with 88% agreement. Variability on plaque presence was high, with only 53% agreement. R2 and the expert each scanned 10 new subjects twice, from whom 40 images were available for interpretation. R2 demonstrated CIMT agreement (93%) comparable with that observed in phase 1 but with greatly improved plaque agreement (100%). Intraobserver variability during phase 2 for both R2 and the expert was extremely low. CONCLUSIONS: Medical residents can undergo rapid training for CIMT measurement and plaque visualization to detect subclinical atherosclerosis compared with an expert.

A personal reflection: the difficult decision to leave critical care nursing.

At some point in their careers, all critical care nurses will decide that it is time for them to leave critical care nursing. Whether this decision happens because of role change, retirement, or burnout, the decision can be a difficult one. This article explains my decision to leave the pediatric critical care unit and explores some of the reasons nurses leave critical care.

Polymeric structure and host Toll-like receptor 4 dictate immunogenicity of NY-ESO-1 antigen in vivo.

In search of intrinsic factors that contribute to the distinctively strong immunogenicity of a non-mutated cancer/testis antigen, we found that NY-ESO-1 forms polymeric structures through disulfide bonds. NY-ESO-1 binding to immature dendritic cells was dependent on its polymeric structure and involved Toll-like receptor-4 (TLR4) on the surface of immature dendritic cells in mouse and human. Gene gun-delivered plasmid encoding the wild-type NY-ESO-1 readily induced T cell-dependent antibody (Ab) responses in wild-type C57BL/10 mice but not TLR4-knock-out C57BL/10ScNJ mice. Disrupting polymeric structures of NY-ESO-1 by cysteine-to-serine (Cys-to-Ser) substitutions lead to diminished immunogenicity and altered TLR4-dependence in the induced Ab response. To demonstrate its adjuvant effect, NY-ESO-1 was fused with a major mugwort pollen allergen Art v 1 and a tumor-associated antigen, carbonic anhydrase 9. Plasmid DNA vaccines encoding the fusion genes generated robust immune responses against otherwise non-immunogenic targets in mice. Polymeric structure and TLR4 may play important roles in rendering NY-ESO-1 immunogenic and thus serve as a potent molecular adjuvant. NY-ESO-1 thus represents the first example of a cancer/testis antigen that is a also damage-associated molecular pattern.

Sliding away from PowerPoint: the interactive lecture.

Class participation can be difficult to obtain when lecturing to a large group of students. Interactive lecture methods can help bridge the gap between faculty and students as well as increase class participation and satisfaction among faculty and students. The authors discuss various methods that may be used to increase student interaction.