Child hand contamination is associated with subsequent pediatric diarrhea in rural Democratic Republic of the Congo (REDUCE Program).

OBJECTIVE: The Reducing Enteropathy, Undernutrition, and Contamination in the Environment (REDUCE) program focuses on identifying exposure pathways to faecal pathogens for young children in the Democratic Republic of the Congo (DRC) and on developing scalable interventions to reduce faecal contamination from these pathways. METHODS: A prospective cohort study of 690 participants was conducted to investigate the association between hand, food, and environmental faecal contamination and diarrhoeal disease prevalence among young children in Walungu Territory, South Kivu, DRC. A total of 1923 hand rinse, soil, food, object, surface, stored water and water source samples were collected during unannounced spot checks after baseline enrolment and analysed for Escherichia coli. Caregiver reports of diarrhoea were obtained from children < 5 years at a 6-month follow-up. RESULTS: E.coli was detected in 73% of child and caregiver hand-rinse samples, 69% of soil samples from child play spaces, 54% of child food samples, 38% of objects and surfaces children were observed putting in their mouths, 74% of stored water samples, and 40% of source water samples. Children < 5 years with E. coli on their hands had significantly higher odds of diarrhoea at the 6-month follow-up (odds ratio: 2.03 (95% confidence interval: 1.05, 3.92)). CONCLUSION: The cohort study findings from the REDUCE program have shown that child hand contamination is associated with diarrhoeal disease in rural DRC, and that there is high faecal contamination in child plays spaces and food. These findings provide evidence demonstrating the urgent need to provide clean play spaces for young children and interventions targeting hand hygiene to reduce paediatric exposure to faecal pathogens.

OBJECTIF: L'étude REDUCE (Réduire l'Entéropathie, la Dénutrition et la Contamination à partir de l'Environnement) se concentre sur l'identification des voies d'exposition aux pathogènes fécaux pour les jeunes enfants en République Démocratique du Congo (RDC) et sur le développement d'interventions évolutives pour réduire la contamination fécale par ces voies. MÉTHODES: Une étude de cohorte prospective de 690 participants a été menée pour étudier l'association entre la contamination fécale des mains, des aliments et de l'environnement et la prévalence des maladies diarrhéiques chez les jeunes enfants dans le Territoire de Walungu, dans le Sud-Kivu, en RDC. Un total de 1.923 échantillons de rinçages des mains, de sol, d'aliments, d'objets, de surfaces, d'eau stockée et de sources d'eau ont été collectés lors de contrôles ponctuels inopinés après l'inscription de base et analysés pour Escherichia coli. Les rapports des soignants concernant la diarrhée ont été obtenus pour les enfants de moins de 5 ans à un suivi de 6 mois. RÉSULTATS: E. coli a été détecté dans 73% des échantillons de rinçage des mains des enfants et des soignants, 69% des échantillons de sol des aires de jeux pour enfants, 54% des échantillons d'aliments pour enfants, 38% des objets et des surfaces que les enfants mettaient en bouche, 74 % des échantillons d'eau stockée et 40% des échantillons de sources d'eau. Les enfants de moins de 5 ans avec E. coli sur leurs mains avaient un risque de diarrhée significativement plus élevé au suivi de 6 mois (rapport de cotes: 2,03 (intervalle de confiance à 95%: 1,05, 3,92)). CONCLUSION: Les résultats de l'étude de cohorte du programme REDUCE ont montré que la contamination des mains des enfants est associée aux maladies diarrhéiques dans les régions rurales de la RDC et à une forte contamination fécale dans les aires de jeux et les aliments pour enfants. Ces résultats fournissent des données démontrant le besoin urgent de fournir des espaces de jeu propres aux jeunes enfants et des interventions ciblant l'hygiène des mains pour réduire l'exposition pédiatrique aux pathogènes fécaux.

The impact of face masks on the recall of spoken sentences.

The effect of face covering masks on listeners' recall of spoken sentences was investigated. Thirty-two German native listeners watched video recordings of a native speaker producing German sentences with and without a face mask, and then completed a cued-recall task. Listeners recalled significantly fewer words when the sentences had been spoken with a face mask. This might suggest that face masks increase processing demands, which in turn leaves fewer resources for encoding speech in memory. The result is also informative for policy-makers during the COVID-19 pandemic, regarding the impact of face masks on oral communication.

Context and Literality in Idiom Processing: Evidence from Self-Paced Reading.

In a self-paced reading study, we investigated how effects of biasing contexts in idiom processing interact with effects of idiom literality. Specifically, we tested if idioms with a high potential for literal interpretation (e.g., break the ice) are processed differently in figuratively and literally biasing contexts than idioms with a low potential (e.g., lose one's cool). Participants read sentences that biased towards a figurative or literal reading of idioms and continued with resolutions that were congruent or incongruent with these biases (e.g., [The new schoolboy/the chilly Eskimo] just wanted to break the ice [with his peers/on the lake]…). While interpretations of high-literality idioms were strengthened by supporting contexts and showed costs for incongruent resolutions, low-literality idioms did not show this effect. Rather, interpreting low-literality idioms in a literal manner showed a cost regardless of context. We conclude that biasing contexts are used in a flexible process of real-time idiom processing and meaning constitution, but this effect is mediated by idiom literality.

Wavelength-Dependent Damage to Adenoviral Proteins Across the Germicidal UV Spectrum.

Adenovirus, a waterborne pathogen responsible for causing bronchitis, pneumonia, and gastrointestinal infections, is highly resistant to UV disinfection and therefore drives the virus disinfection regulations set by the U.S. Environmental Protection Agency. Polychromatic UV irradiation has been shown to be more effective at inactivating adenovirus and other viruses than traditional monochromatic irradiation emitted at 254 nm; the enhanced efficacy has been attributed to UV-induced damage to viral proteins. This research shows UV-induced damage to adenoviral proteins across the germicidal UV spectrum at wavelength intervals between 200 and 300 nm. A deuterium lamp with bandpass filters and UV light-emitting diodes (UV LEDs) isolated wavelengths in approximate 10 nm intervals. Sodium dodecyl sulfate polyacrylamide gel electrophoresis and image densitometry were used to detect signatures for the hexon, penton, fiber, minor capsid, and core proteins. The greatest loss of protein signature, indicating damage to viral proteins, occurred below 240 nm. Hexon and penton proteins exposed to a dose of 28 mJ/cm2 emitted at 214 nm were approximately 4 times as sensitive and fiber proteins approximately 3 times as sensitive as those exposed to a dose of 50 mJ/cm2 emitted at 254 nm. At 220 nm, a dose of 38 mJ/cm2 reduced the hexon and penton protein quantities to approximately 33% and 31% of the original amounts, respectively. In contrast, a much higher dose of 400 mJ/cm2 emitted at 261 and 278 nm reduced the original protein quantity to between 66-89% and 80-93%, respectively. No significant damage was seen with a dose of 400 mJ/cm2 at 254 nm. This research directly correlates enhanced inactivation at low wavelengths with adenoviral protein damage at those wavelengths, adding fundamental insight into the mechanisms of inactivation of polychromatic germicidal UV irradiation for improving UV water disinfection.

Preliminary validation of the Claudication Symptom Instrument (CSI).

This article describes the development of the Claudication Symptom Instrument (CSI) and its measurement properties for evaluating the symptom experience of patients diagnosed with intermittent claudication (IC). We conducted semi-structured qualitative interviews with IC patients for item development and cognitive interviews in which patient comprehension of items was tested. We evaluated measurement properties using data collected and analyzed in the context of an observational comparative effectiveness study of IC treatments. Items measuring five symptom important to patients were developed and cognitively tested: Pain, Numbness, Heaviness, Cramping, and Tingling. Item means (higher means worse) ranged from 1.1 (Tingling) to 2.3 (Pain) (range: 0 'none' to 4 'extreme'). Rasch analysis yielded support for an overall score (χ2=26.5, df=20, p=0.15). The total CSI score differed by clinician-rated severity of mild versus moderate ( p<0.05), but not moderate versus severe. Re-administration of the CSI 5-10 days after baseline yielded an intra-class correlation coefficient of 0.86. Changes in CSI total score and VASCUQOL total score between baseline and 6 months post-treatment were correlated at -0.52 ( p<0.05). The CSI preliminarily meets accepted measurement standards for content validity, internal consistency and test-retest reliability, construct validity, and sensitivity for detecting change. Because of its high test-retest reliability, it may also be useful in clinical care with individual patients. It takes approximately 3 minutes to complete.

Simultaneous atrazine degradation and E. coli inactivation by simulated solar photo-Fenton-like process using persulfate.

This work evaluated the feasibility of a photo-Fenton-like process using persulfate (PS) and ferrous iron (Fe2+) under simulated solar radiation for degrading the herbicide atrazine (ATZ, 6-Chloro-N-ethyl-N'-isopropyl-1,3,5-triazine-2,4-diamine) and inactivating E. coli. Milli Q water, lake water, and diluted wastewater effluents were spiked both simultaneously and separately with ATZ (4 mg/L) and E. coli (105 CFU/mL), and exposed to treatment. A method for determining the average irradiance throughout the water media in the UV(A+B) range of the Xe lamp emission was developed for bench-scale experiments. These values were used to calculate the UV(A+B) fluences and the solar UV(A+B) energy doses per unit of volume (QUV(A+B), kJ/L). The obtained kinetic data were presented versus energy dose. Treatment of lake water at near-neutral pH was ineffective via the photo-Fenton-like process, attaining only 20% ATZ removal and 1-log reduction of E. coli. In Milli Q water and wastewater, the complete degradation of ATZ in the absence of bacteria was observed at an average energy dose of 1.5 kJ/L (60 min), while in the presence of cells the degradation efficiency was ∼60%. When ATZ was present, E. coli inactivation was also affected in Milli Q water, with 1.4-log reduction (93%) at a dose of 1.6 kJ/L (60 min), whereas in wastewater complete inactivation was achieved at a lower dose of 1.3 kJ/L (45 min). The energy requirements on a QUV(A+B) basis for simultaneous 90% ATZ removal and 99.99% E. coli inactivation in Milli Q water and wastewater were shown to be less than 10 kJ/L. This suggests the solar/PS/Fe2+ system is promising for simultaneous treatment and disinfection of wastewater effluents.

Ketorolac Use and Postoperative Complications in Gastrointestinal Surgery.

OBJECTIVE: To study the association between ketorolac use and postoperative complications. BACKGROUND: Nonsteroidal anti-inflammatory drugs may impair wound healing and increase the risk of anastomotic leak in colon surgery. Studies to date have been limited by sample size, inability to identify confounding, and a focus limited to colon surgery. METHODS: Ketorolac use, reinterventions, emergency department (ED) visits, and readmissions in adults (≥ 18 years) undergoing gastrointestinal (GI) operations was assessed in a nationwide cohort using the MarketScan Database (2008-2012). RESULTS: Among 398,752 patients (median age 52, 45% male), 55% underwent colorectal surgery, whereas 45% had noncolorectal GI surgery. Five percent of patients received ketorolac. Adjusting for demographic characteristics, comorbidities, surgery type/indication, and preoperative medications, patients receiving ketorolac had higher odds of reintervention (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.08-1.32), ED visit (OR 1.44, 95% CI 1.37-1.51), and readmission within 30 days (OR 1.11, 95% CI 1.05-1.18) compared to those who did not receive ketorolac. Ketorolac use was associated with readmissions related to anastomotic complications (OR 1.20, 95% CI 1.06-1.36). Evaluating only admissions with ≤ 3 days duration to exclude cases where ketorolac might have been used for complication-related pain relief, the odds of complications associated with ketorolac were even greater. CONCLUSIONS: Use of intravenous ketorolac was associated with greater odds of reintervention, ED visit, and readmission in both colorectal and noncolorectal GI surgery. Given this confirmatory evaluation of other reports of a negative association and the large size of this cohort, clinicians should exercise caution when using ketorolac in patients undergoing GI surgery.

The effect of doping on low temperature growth of high quality GaAs nanowires on polycrystalline films.

The increasing demand for miniature autonomous sensors requires low cost integration methods, but to date, material limitations have prevented the direct growth of optically active III-V materials on CMOS devices. We report on the deposition of GaAs nanowires on polycrystalline conductive films to allow for direct integration of optoelectronic devices on dissimilar materials. Undoped, Si-doped, and Be-doped nanowires were grown at Ts  = 400 °C on oxide (indium tin oxide) and metallic (platinum and titanium) films. Be-doping is shown to significantly reduce the nanowire diameter and improve the nanowire aspect ratio to 50:1. Photoluminescence measurements of Be-doped nanowires are 1-2 orders of magnitude stronger than undoped and Si-doped nanowires and have a thermal activation energy of 14 meV, which is comparable to nanowires grown on crystalline substrates. Electrical measurements confirm that the metal-semiconductor junction is Ohmic. These results demonstrate the feasibility of integrating nanowire-based optoelectronic devices directly on CMOS chips.

Comparison of UV-Induced Inactivation and RNA Damage in MS2 Phage across the Germicidal UV Spectrum.

Polychromatic UV irradiation is a common method of pathogen inactivation in the water treatment industry. To improve its disinfection efficacy, more information on the mechanisms of UV inactivation on microorganisms at wavelengths throughout the germicidal UV spectrum, particularly at below 240 nm, is necessary. This work examined UV inactivation of bacteriophage MS2, a common surrogate for enteric pathogens, as a function of wavelength. The bacteriophage was exposed to monochromatic UV irradiation from a tunable laser at wavelengths of between 210 nm and 290 nm. To evaluate the mechanisms of UV inactivation throughout this wavelength range, RT-qPCR (reverse transcription-quantitative PCR) was performed to measure genomic damage for comparison with genomic damage at 253.7 nm. The results indicate that the rates of RNA damage closely mirror the loss of viral infectivity across the germicidal UV spectrum. This demonstrates that genomic damage is the dominant cause of MS2 inactivation from exposure to germicidal UV irradiation. These findings contrast those for adenovirus, for which MS2 is used as a viral surrogate for validating polychromatic UV reactors.

Wavelength dependent UV inactivation and DNA damage of adenovirus as measured by cell culture infectivity and long range quantitative PCR.

Adenovirus is regarded as the most resistant pathogen to ultraviolet (UV) disinfection due to its demonstrated resistance to monochromatic, low-pressure (LP) UV irradiation at 254 nm. This resistance has resulted in high UV dose requirements for all viruses in regulations set by the United States Environmental Protection Agency. Polychromatic, medium-pressure (MP) UV irradiation has been shown to be much more effective than 254 nm, although the mechanisms of polychromatic UV inactivation are not completely understood. This research analyzes the wavelength-specific effects of UV light on adenovirus type 2 by analyzing in parallel the reduction in viral infectivity and damage to the viral genome. A tunable laser from the National Institute of Standards and Technology was used to isolate single UV wavelengths. Cell culture infectivity and PCR were employed to quantify the adenoviral inactivation rates using narrow bands of irradiation (<1 nm) at 10 nm intervals between 210 and 290 nm. The inactivation rate corresponding to adenoviral genome damage matched the inactivation rate of adenovirus infectivity at 253.7 nm, 270 nm, 280 nm, and 290 nm, suggesting that damage to the viral DNA was primarily responsible for loss of infectivity at those wavelengths. At 260 nm, more damage to the nucleic acid was observed than reduction in viral infectivity. At 240 nm and below, the reduction of viral infectivity was significantly greater than the reduction of DNA amplification, suggesting that UV damage to a viral component other than DNA contributed to the loss of infectivity at those wavelengths. Inactivation rates were used to develop a detailed spectral sensitivity or action spectrum of adenovirus 2. This research has significant implications for the water treatment industry with regard to polychromatic inactivation of viruses and the development of novel wavelength-specific UV disinfection technologies.

Synergistic effect of UV-A and UV-C light is traced to UV-induced damage of the transfer RNA.

UV light emitting diodes (LEDs) are considered the new frontier of UV water disinfection. As UV technologies continue to evolve, so does the need to understand disinfection mechanisms to ensure that UV treatment continues to adequately protect public health. In this research, two Escherichia coli (E. coli) strains (the wild type K12 MG1655 and K12 SP11 (ThiI E342K)) were irradiated with UV-C at 268 nm both independently and after exposure to UV-A (365 nm). A synergistic effect was found on the viability of the wild type E. coli K12 strain when UV-A irradiation was applied prior to UV-C. Sublethal UV-A doses, which had a negligible effect on cell viability alone, enhanced UV-C inactivation by several orders of magnitude. This indicated a specific cellular response mechanism to UV-A irradiation, which was traced to direct photolysis of the transfer RNA (tRNA), which are critical links in the translation of messenger RNA to proteins. The wild type K12 strain MG1655, containing tRNAs with a thiolated uridine, directly absorbs the UV-A light, which leads to a reduction in protein synthesis, making them more susceptible to UV-C induced damage. However, the K12 strain SP11 (ThiI E342K), with a point mutation in the thiI gene that prevents a post-transcriptional modification of tRNA, experienced less inactivation upon subsequent irradiation by UV-C. The growth rate of cells, which was inhibited by sublethal UV-A doses, was not inhibited in this mutant strain with the modified tRNA. Time-lapse microscopy with microfluidics showed that sub-lethal UV-A caused a transient, reversible, growth arrest in E. coli. However, once the growth resumed, the cell division time resembled that of unirradiated cells. Damage induced by UV-A impaired the recovery of damage induced by UV-C. Depending on the UV-A dose applied, the synergistic effect remained even when there was a time delay of several hours between UV-A and UV-C exposures. The effect of sublethal UV-A was reversible over time; therefore, the synergistic effect was strongest when UV-C was applied immediately after UV-A. Combining UV-A and UV-C irradiation may serve as a practical tool to increase UV disinfection efficacy, which could potentially reduce costs while still adequately protecting public health.

Optimizing energy efficiency in brackish water reverse osmosis (BWRO): A comprehensive study on prioritizing critical operating parameters for specific energy consumption minimization.

Reverse osmosis (RO) systems offer a viable solution for treating brackish water (BW), a common but underutilized water resource. However, the energy-intensive nature of brackish water reverse osmosis (BWRO) systems poses affordability challenges to water supply, necessitating a focus on minimizing their energy consumption to support SDG6's goal of providing safe and affordable drinking water for all. This study addresses the critical need to minimize the specific energy consumption (SEC) of a typical BWRO system, defined as the energy consumed per unit of water recovered, mathematically and experimentally. Empirical models were developed proving there is a global minimum SEC while adjusting the operating conditions. Furthermore, we identified the key operating factors influencing SEC and their priority levels, along with their interactive effects. Notably, no prior study has discussed the significance and interaction of these operating factors (e.g., feed water salinity, temperature, pressure, flowrate and membrane permeability) on SEC of a BWRO system. Employing a full factorial experimental design with mixed levels of operating parameters, the study developed regression models that elucidate the mechanistic interaction between these parameters and system performance. Moreover, the models were validated experimentally, with a new dataset demonstrating their accuracy and reliability. ANOVA statistical analysis identified feed salinity, pressure, flow rate, feed flow rate×pressure, salinity×pressure, and temperature as influential operating parameters in reducing SEC, in descending order of importance. Operating within the determined optimum range resulted in a 36 % decrease in SEC and a more than fourfold increase in water recovery. The study's systematic approach and findings can be extrapolated to optimize the performance of other desalination technologies and diverse feed water types, contributing significantly to global water sustainability efforts.

Evaluation of disinfection efficacy of single UV-C, and UV-A followed by UV-C LED irradiation on Escherichia coli, B. spizizenii and MS2 bacteriophage, in water.

Ultraviolet light-emitting diodes (UV LEDs) have shown ability to inactivate microorganisms and viruses in water. The unique characteristic of the UV-LEDs' diversity in wavelengths ranging from UV-C, UV-B, and UV-A, allows for wavelengths to be combined in different manners for polychromatic irradiation. Previous studies reported no synergy from simultaneous or sequential UV-C and UV-B as well as UV-C or UV-B followed by UV-A irradiation. However, synergy was reported for UV-A followed by UV-C or UV-B irradiation on various microorganisms. Nevertheless, no clear ground has been reached on whether to adopt single UV-C wavelengths or UV-A followed by UV-C LED, irradiation on inactivation of microorganisms and viruses in water. Therefore, this work evaluates the disinfection efficacy of single UV-C as well as UV-A followed by UV-C LED irradiation on Escherichia coli, Bacillus spizizenii spores and MS2 bacteriophage in water. The UV-C wavelengths were represented by 267 and 278 nm UV LEDs, and UV-A by 368 nm UV LEDs. In this study, E. coli was highly susceptible to UV radiation followed by B. spizizenii spores, and lastly MS2. Repair following UV inactivation was only observed in E. coli. The synergistic effect found in both E. coli, and B. spizizenii spores was attributed to the different inactivation mechanisms of the UV-C and UV-A wavelengths. In both single UV-C, and UV-A followed by UV-C LED irradiations, single 267 nm UV-C LED showed higher inactivation efficacy. Meanwhile, single 278 nm UV-C LED showed higher efficacy in terms of suppression of repair, and electrical energy consumption. Using single UV-C LEDs in a water disinfection system cuts down on related extra costs by avoiding combined wavelengths while still attaining better levels of microorganism inactivation, repair suppression and electrical energy consumption. These findings are applicable for the design and implementation of UV LED water disinfection systems.

Integrated parent-child music classes for preschoolers with and without autism: Parent expectations and experiences.

Integrated recreational programs designed to support neurodiverse children and their families are important vehicles for community participation. In this mixed-methods study, we investigated the mechanisms by which parent-child music classes for autistic and neurotypical children can support community participation. Parents of autistic (n = 33) and typically developing (TD; n = 28) preschoolers were interviewed about their expectations for and experiences of participating in a 12-week psychoeducational parent-child music program. Parents completed ratings of momentary affect and social connection, and researchers coded children's behavioral engagement during classes at multiple time points throughout the program. Primary motivations for enrolling in an integrated music class included children's interest in music and opportunities for child socialization. Parent-focused reasons were less frequently endorsed as primary motivations for participation. Yet, momentary ratings indicated that music classes supported parents' affect regulation and social connection with other parents at the level of individual classes and across the program. These in-class experiences were echoed by interviews following program completion, which additionally highlighted the use of new parenting strategies through the musical activities. Since parental emotional experiences of activities, supportive community relationships, and parenting confidence are all linked with increased community participation, integrated music classes may support participation and satisfaction with community experiences.

Fecal Contamination in Child Play Spaces and on Child Hands Are Associated with Subsequent Adverse Child Developmental Outcomes in Rural Democratic Republic of the Congo: REDUCE Prospective Cohort Study.

The objective of the Reducing Enteropathy, Undernutrition, and Contamination in the Environment (REDUCE) program is to identify exposure pathways to fecal pathogens that are significant contributors to morbidity among young children in the Democratic Republic of the Congo (DRC), and on developing and evaluating scalable interventions to reduce fecal contamination from these pathways. This prospective cohort study of 270 children under 5 years of age was conducted in rural South Kivu, DRC, to investigate the association between Escherichia coli in hand rinse, soil, food, object, surface, stored water, and water source samples and child developmental outcomes. Child developmental outcomes were assessed by communication, fine motor, gross motor, personal social, problem-solving, and combined scores measured by the Extended Ages and Stages Questionnaire (EASQ) at a 6-month follow-up. Children having E. coli present in the soil in their play spaces had significantly lower combined EASQ z scores (coefficient: -0.38 (95% CI: -0.73, -0.03)). E. coli on children's hands was associated with lower communication EASQ z scores (-0.37 (95% CI: -0.0.10, -0.01), and E. coli in stored drinking water was associated with lower gross motor EASQ z scores (-0.40 (95% CI: -0.68, -0.12). In the REDUCE cohort study, E. coli in child play spaces, on children's hands, and in stored drinking water was associated with lower developmental outcome scores (communication, gross motor, fine motor, and problem-solving skills). These results suggest the need for interventions to reduce fecal contamination in the household environment to protect the cognitive development of susceptible pediatric populations in rural DRC.

Associations between single-leg postural control and drop-landing mechanics in healthy women.

CONTEXT: Impaired postural control in single-limb stance and aberrant drop-landing mechanics have been implicated separately as risk factors for noncontact anterior cruciate ligament (ACL) injury, but associations between these variables has not been reported. OBJECTIVE: To determine whether there are associations between single-limb postural control and drop-landing mechanics. SETTING: University motion-analysis laboratory. DESIGN: Single-leg-landing kinematic and kinetic data were collected after participants dropped from a hang bar. Postural-control variables COP excursion and velocity were assessed during single-leg barefoot standing on a force platform. PARTICIPANTS: A convenience sample of 24 healthy women. MAIN OUTCOME MEASURES: Pearson product-moment correlation coefficients. RESULTS: Strong associations were measured between maximal knee-abduction moment and COP excursion (r = .529, P = .003) and average COP velocity (r = .529, P = .003). Strong inverse associations were measured between minimum hip-flexion angle and COP excursion (r = -.521, P = .003) and average COP velocity (r = -.519, P = .003). CONCLUSIONS: Participants with decreased postural control had higher knee-abduction moments and a more extended hip on landing, which have been implicated separately as risk factors for ACL injury. A longitudinal prospective analysis is needed to determine whether force-platform postural-control measures can identify athletes at risk for ACL injury.

Phrasal Learning Is a Horse Apiece: No Recognition Memory Advantages for Idioms in L1 and L2 Adult Learners.

Native (L1) and to some extent non-native (L2) speakers have shown processing advantages for idioms compared to novel literal phrases, and there is limited evidence that this advantage also extends to memory in L1 children. This study investigated whether these advantages generalize to recognition memory in adults. It employed a learning paradigm to test whether there is a recognition memory advantage for idioms compared to literal phrases in adult L1 and L2 learners considering both form and meaning recognition. Additionally, we asked whether the presence of unfamiliar vocabulary interferes with phrasal learning by looking at recall of such unfamiliar words. When encountering new idioms, L2 learners often must cope with both figurative meaning and unfamiliar vocabulary. While single word meaning need not interfere with idiomatic meaning, it is a building block for the meaning of literal phrases. In Experiment 1, L2 learners showed equal recall for the form and meaning of literal and idiomatic phrases in which either all words were highly familiar, or one word was unfamiliar. However, unfamiliar words decreased overall recognition and were also remembered significantly better in literal compared to idiomatic phrases. In Experiment 2, L1 speakers also showed no recall differences between phrase types, but they displayed a trending increase in recognition in the presence of unfamiliar words. We conclude that there is no inherent recognition memory advantage for idioms based on figurativeness alone, and word- and phrasal meaning interact differently in learner groups.

Communication Training, Adverse Events, and Quality Measures: 2 Retrospective Database Analyses in Washington State Hospitals.

OBJECTIVE: Washington State's HealthPact program was launched in 2011 as part of AHRQ's Patient Safety and Medical Liability Reform initiative. HealthPact delivered interdisciplinary communication training to health-care professionals with the goal of enhancing safety. We conducted 2 exploratory, retrospective database analyses to investigate training impact on the frequency of adverse events (AEs) and select quality measures across 3 time frames: pretraining (2009-2011), transition (2012), and posttraining (2013). METHODS: Using administrative data from Washington State's Comprehensive Hospital Abstract Reporting System (CHARS) and clinical registry data from the Surgical Care and Outcomes Assessment Program (SCOAP), we compared proportions of AEs and quality measures between HealthPact (n = 4) and non-HealthPact (n = 93-CHARS; n = 48-SCOAP) participating hospitals. Risk ratios enabled comparisons between the 2 groups. Multivariable logistic regression enabled investigation of the association between training and the frequency of AEs. RESULTS: Approximately 9.4% (CHARS) and 7.7% (SCOAP) of unique patients experienced 1 AE or greater. In CHARS, the odds of a patient experiencing an AE in a HealthPact hospital were initially (pretraining) higher than in a non-HealthPact hospital (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.10-1.17), lower in transition (OR, 0.80; 95% CI, 0.76-0.83) and posttraining (OR, 0.72; 95% CI, 0.69-0.75) periods. In SCOAP, ORs were consistently lower in HealthPact hospitals: pretraining (OR, 0.87; 95% CI, 0.80-0.95), transition (OR, 0.75; 95% CI, 0.70-0.81), and posttraining (OR, 0.63; 95% CI, 0.58-0.68). The proportion of at-risk patients that experienced each individual AE was low (<1%) throughout. Adherence to quality measures was high. CONCLUSIONS: Interprofessional communication training is an area of intense activity nationwide. A broad-based training initiative may play a role in mitigating AEs.

Parents, Peers, and Musical Play: Integrated Parent-Child Music Class Program Supports Community Participation and Well-Being for Families of Children With and Without Autism Spectrum Disorder.

Opportunities for meaningful community participation may influence the development and well-being of individuals with autism spectrum disorder (ASD) and their families as well as impact how community members perceive and understand ASD. In the current study, we aimed to understand how a parent-child integrated music class program could be used to promote community participation and family well-being. Caregivers of preschoolers (2-5 years of age) with ASD and those of peer children with typical development (TD) were interviewed about their participation in a parent-child integrated music class program. Thematic analysis of interviews revealed that all caregivers viewed program participation as positive. Caregivers emphasized increasing connections within families, such as through strengthening parent-child bonds, as well as connections across families, including increased understanding of ASD and sensitivity to the experience of parenting. Many caregivers perceived the class as supporting their parenting and impacting their children's behavior in meaningful ways. Interview themes were supported by measures of caregiver and child program receipt, including questionnaires about family music engagement throughout their time in the class program and behavioral coding of children's engagement during music classes. Findings suggest that integrated community experiences such as parent-child music classes may impact whole family well-being, highlighting the value of integrated community participation experiences at the level of the family system. Parent-child music classes may provide a productive and accessible context for supporting integrated community experiences.

Application of a novel, continuous-feeding ultraviolet light emitting diode (UV-LED) system to disinfect domestic wastewater for discharge or agricultural reuse.

In many low-income countries, the poor conditions of sanitation systems have been a significant cause of mortality since they accelerate waterborne disease transmission. Developing sanitation systems in these countries is a pressing concern in both the public and private sectors. This research investigated a decentralized domestic wastewater treatment system using ultraviolet light-emitting diodes (UV-LEDs). Although UV-LED disinfection has become more widespread in recent years, it is a novel approach for domestic wastewater treatment. Domestic wastewater was pretreated by a low-cost pretreatment system with an inclined settler and a sand filter prior to feeding a novel flow-through UV LED reactor. At an inlet flow rate of 30 L/h, the COD, TSS, and turbidity of the effluent were 17.7 mg/L, 3.0 mg/L, and 3.9 NTU, respectively. UV transmittance at 285 nm was enhanced from 29.1% to 70.4%, improving the influent quality for UV LED disinfection. The flow-through UV LED reactor was operated at various flow rates from 10 to 50 mL/min, resulting in applied UV doses of 69.4 to 47.8 mJ/cm2 respectively. These doses are sufficient for inactivating total coliforms in the wastewater to meet the water reuse guidelines for agriculture for both processed food crops and non-food crops. Fouling, which was observed starting at 2 d of operation, decreased the disinfection efficacy to 27% after 25 days of continuous operation. Of the fouling layer, 67% was attributed to organic matter, in contrast to previous fouling studies with mercury UV lamps in which the fouling layer consisted primarily of inorganic compounds. The fouling was reversed by off-line citric acid cleaning for 4 h after every 400 h of continuous operation.