Glasses denser than the supercooled liquid.

When aged below the glass transition temperature, [Formula: see text], the density of a glass cannot exceed that of the metastable supercooled liquid (SCL) state, unless crystals are nucleated. The only exception is when another polyamorphic SCL state exists, with a density higher than that of the ordinary SCL. Experimentally, such polyamorphic states and their corresponding liquid-liquid phase transitions have only been observed in network-forming systems or those with polymorphic crystalline states. In otherwise simple liquids, such phase transitions have not been observed, either in aged or vapor-deposited stable glasses, even near the Kauzmann temperature. Here, we report that the density of thin vapor-deposited films of N,N'-bis(3-methylphenyl)-N,N'-diphenylbenzidine (TPD) can exceed their corresponding SCL density by as much as 3.5% and can even exceed the crystal density under certain deposition conditions. We identify a previously unidentified high-density supercooled liquid (HD-SCL) phase with a liquid-liquid phase transition temperature ([Formula: see text]) ∼35 K below the nominal glass transition temperature of the ordinary SCL. The HD-SCL state is observed in glasses deposited in the thickness range of 25 to 55 nm, where thin films of the ordinary SCL have exceptionally enhanced surface mobility with large mobility gradients. The enhanced mobility enables vapor-deposited thin films to overcome kinetic barriers for relaxation and access the HD-SCL state. The HD-SCL state is only thermodynamically favored in thin films and transforms rapidly to the ordinary SCL when the vapor deposition is continued to form films with thicknesses more than 60 nm.

Effects of an open lung extubation strategy compared with a conventional extubation strategy on postoperative pulmonary complications after general anesthesia: a single-centre pilot randomized controlled trial.

PURPOSE: Postoperative pulmonary complications (PPCs) are a common cause of morbidity. Postoperative atelectasis is thought to be a significant risk factor in their development. Recent imaging studies suggest that patients' extubation may result in similar postoperative atelectasis regardless of the intraoperative mechanical ventilation strategy used. In this pilot trial, we hypothesized that a study investigating the effects of an open lung extubation strategy compared with a conventional one on PPCs would be feasible. METHODS: We conducted a pilot, single-centre, double-blinded randomized controlled trial. Adult patients at moderate to high risk of PPCs and scheduled for elective surgery were eligible. Patients were randomized to an open lung extubation strategy (semirecumbent position, fraction of inspired oxygen [FIO2] 50%, pressure support ventilation, unchanged positive end-expiratory pressure) or to a conventional extubation strategy (dorsal decubitus position, FIO2 100%, manual bag ventilation). The primary feasibility outcome was global protocol adherence while the primary exploratory efficacy outcome was PPCs. RESULTS: We randomized 35 patients to the conventional extubation group and 34 to the open lung extubation group. We observed a global protocol adherence of 96% (95% confidence interval, 88 to 99), which was not different between groups. Eight PPCs occurred (two in the conventional extubation group vs six in the open lung extubation group). Less postoperative supplemental oxygen and better lung aeration were observed in the open lung extubation group. CONCLUSIONS: In this single-centre pilot trial, we observed excellent feasibility. A multicentre pilot trial comparing the effect of an open lung extubation strategy with that of a conventional extubation strategy on the occurrence of PPCs is feasible. STUDY REGISTRATION DATE: ClinicalTrials.gov (NCT04993001); registered 6 August 2021.

RéSUMé: OBJECTIF: Les complications pulmonaires postopératoires (CPP) sont une cause fréquente de morbidité. L'atélectasie postopératoire est considérée comme un facteur de risque important de CPP. Des études d'imagerie récentes suggèrent que l'extubation des patient·es peut entraîner une atélectasie postopératoire semblable, quelle que soit la stratégie de ventilation mécanique peropératoire utilisée. Dans cet essai pilote, nous avons émis l'hypothèse qu'une étude examinant les effets sur les CPP d'une stratégie d'extubation à poumon ouvert par rapport à une stratégie d'extubation conventionnelle serait réalisable. MéTHODE: Nous avons mené une étude randomisée contrôlée pilote, monocentrique et à double insu. Les patient·es adultes présentant un risque modéré à élevé de CPP et devant bénéficier d'une chirurgie non urgente étaient éligibles. Les patient·es ont été randomisé·es à une prise en charge par une stratégie d'extubation à poumon ouvert (position semi-couchée, fraction d'oxygène inspiré [FIO2] 50 %, ventilation par aide inspiratoire, pression positive télé-expiratoire inchangée) ou à une stratégie d'extubation conventionnelle (décubitus dorsal, FIO2 100 %, ventilation manuelle par masque). Le principal critère de faisabilité était l'adhésion au protocole global, tandis que les CPP constituaient le principal critère d'efficacité exploratoire. RéSULTATS: Nous avons randomisé 35 patient·es dans le groupe d'extubation conventionnelle et 34 dans le groupe d'extubation à poumon ouvert. Nous avons observé une adhésion globale au protocole de 96 % (intervalle de confiance à 95 %, 88 à 99), qui n'était pas différente entre les groupes. Huit CPP sont survenues (deux dans le groupe d'extubation conventionnelle vs six dans le groupe d'extubation à poumon ouvert). Nous avons observé des besoins moins importants en oxygène supplémentaire postopératoire et une meilleure aération pulmonaire dans le groupe extubé à poumon ouvert. CONCLUSION: Dans cet essai pilote monocentrique, nous avons observé une excellente faisabilité. Une étude pilote multicentrique comparant l'effet d'une stratégie d'extubation à poumon ouvert à celui d'une stratégie d'extubation conventionnelle sur la survenue de CPP est réalisable. DATE D'ENREGISTREMENT DE L'éTUDE: ClinicalTrials.gov (NCT04993001); enregistrée le 6 août 2021.

Efficacy of a propofol bolus against placebo to prevent cough at emergence from general anesthesia with desflurane: a randomized controlled trial.

PURPOSE: Emergence from anesthesia is a critical period and cough can result in adverse effects. Propofol inhibits airway reflexes and when infused it reduces cough more than inhalation anesthesia does. We evaluated the effect of a propofol bolus given at emergence on the incidence of coughing following a desflurane-based anesthesia. METHODS: One hundred and fifty-four patients scheduled for elective surgery were prospectively randomized to propofol (0.5 mg·kg-1) or normal saline (NS) administered at the end of the surgery at 1 minimum alveolar concentration (MAC) of desflurane. A "no touch" emergence technique was used until extubation. The primary outcome was the incidence of cough at the discontinuation of desflurane (T0) and reaching a MAC adjusted for age (MACage) of 0.15. Secondary outcomes included incidence and severity of cough until five minutes postextubation (T0-T5), time to extubation, nausea and vomiting, sedation, hemodynamic variations, postoperative hypoventilation, hypoxemia, and sore throat. RESULTS: We could not draw inferences on the incidence of cough between T0 and MACage of 0.15 because only 27/68 (40%) patients in the NS group and 13/73 (18%) patients in the propofol group regained consciousness before reaching a MACage of 0.15. There were no significant differences between the groups in coughing incidence and severity between T0 and T5 (NS group, 57/68 [84%] vs propofol group, 70/73 [96%] ). The mean time to extubation in the propofol group was prolonged by 3 min 27 sec (95% confidence interval, 1 min 7 sec to 4 min 47 sec; P < 0.001) and more vasopressors were used at emergence (P = 0.02). The incidence of respiratory complications, nausea and vomiting, agitation, and sedation were not different between groups. CONCLUSION: In the present trial, a propofol bolus administered at emergence did not reduce the incidence of cough occurring between T0 and T5 following a desflurane-based general anesthesia compared with placebo. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02932397); registered 13 October 2016.

RéSUMé: OBJECTIF: L'émergence de l'anesthésie est une période critique et la toux peut entraîner des effets indésirables. Le propofol inhibe les réflexes des voies aériennes et, lorsqu'il est perfusé, il est plus efficace pour réduire la toux que l'anesthésie inhalée. Nous avons évalué l'effet d'un bolus de propofol administré à l'émergence sur l'incidence de toux après une anesthésie à base de desflurane. MéTHODE: Cent cinquante-quatre patients devant bénéficier d'une chirurgie non urgente ont été randomisés prospectivement à recevoir du propofol (0,5 mg·kg−1) ou une solution physiologique de sérum salé (NS) administrée à la fin de la chirurgie lorsque la concentration alvéolaire minimale (MAC) de desflurane était de 1. Une technique d'émergence « sans contact ¼ a été utilisée jusqu'à l'extubation. Le critère d'évaluation principal était l'incidence de toux à l'arrêt du desflurane (T0) et à l'atteinte d'une MAC ajustée en fonction de l'âge (MACâge) de 0,15. Les critères d'évaluation secondaires comprenaient l'incidence et la gravité de la toux jusqu'à cinq minutes après l'extubation (T0-T5), le délai d'extubation, les nausées et vomissements, la sédation, les variations hémodynamiques, l'hypoventilation postopératoire, l'hypoxémie et les maux de gorge. RéSULTATS: Nous n'avons pas pu tirer de conclusions sur l'incidence de toux entre T0 et à une MACâge de 0,15 parce que seulement 27/68 (40 %) patients du groupe NS et 13/73 (18 %) patients du groupe propofol ont repris conscience avant d'atteindre une MACâge de 0,15. Il n'y avait aucune différence significative entre les groupes dans l'incidence et la gravité de la toux entre T0 et T5 (groupe NS, 57/68 [84 %] vs groupe propofol, 70/73 [96 %]). Le temps moyen d'extubation dans le groupe propofol a été prolongé de 3 min 27 sec (intervalle de confiance à 95 %, 1 min 7 sec à 4 min 47 sec; P < 0,001) et une plus grande quantité de vasopresseurs a été utilisée à l'émergence (P = 0,02). L'incidence de complications respiratoires, de nausées et vomissements, d'agitation, et de sédation n'était pas différente entre les groupes. CONCLUSION: Dans la présente étude, un bolus de propofol administré à l'émergence n'a pas réduit l'incidence de toux survenant entre T0 et T5 après une anesthésie générale à base de desflurane par rapport au placebo. ENREGISTREMENT DE L'éTUDE: ClinicalTrials.gov (NCT02932397); enregistrée le 13 octobre 2016.

The role of intramolecular relaxations on the structure and stability of vapor-deposited glasses.

Stable glasses (SGs) are formed through surface-mediated equilibration (SME) during physical vapor deposition (PVD). Unlike intermolecular interactions, the role of intramolecular degrees of freedom in this process remains unexplored. Here, using experiments and coarse-grained molecular dynamics simulations, we demonstrate that varying dihedral rotation barriers of even a single bond, in otherwise isomeric molecules, can strongly influence the structure and stability of PVD glasses. These effects arise from variations in the degree of surface mobility, mobility gradients, and mobility anisotropy, at a given deposition temperature (Tdep). At high Tdep, flexible molecules have access to more configurations, which enhances the rate of SME, forming isotropic SGs. At low Tdep, stability is achieved by out of equilibrium aging of the surface layer. Here, the poor packing of rigid molecules enhances the rate of surface-mediated aging, producing stable glasses with layered structures in a broad range of Tdep. In contrast, the dynamics of flexible molecules couple more efficiently to the glass layers underneath, resulting in reduced mobility and weaker mobility gradients, producing unstable glasses. Independent of stability, the flattened shape of flexible molecules can also promote in-plane orientational order at low Tdep. These results indicate that small changes in intramolecular relaxation barriers can be used as an approach to independently tune the structure and mobility profiles of the surface layer and, thus, the stability and structure of PVD glasses.

Peak plasma concentration of total and free bupivacaine after erector spinae plane and pectointercostal fascial plane blocks.

PURPOSE: Erector spinae plane blocks (ESPB) and pectointercostal fascial (PIFB) plane blocks are novel interfascial blocks for which local anesthetic (LA) doses and concentrations necessary to achieve safe and effective analgesia are unknown. The goal of this prospective observational study was to provide the timing (Tmax) and concentration (Cmax) of maximum total and free plasma bupivacaine after ESPB in breast surgery and after PIFB in cardiac surgery patients. METHODS: Erector spinae plane blocks or PIFBs (18 patients per block; total, 36 patients) were performed with 2 mg⋅kg-1 of bupivacaine with epinephrine 5 µg⋅mL-1. Our principal outcomes were the mean or median Cmax of total and free plasma bupivacaine measured 10, 20, 30, 45, 60, 90, 180, and 240 min after LA injection using liquid chromatography with tandem mass spectrometry. RESULTS: For ESPB, the mean (standard deviation [SD]) total bupivacaine Cmax was 0.37 (0.12) µg⋅mL-1 (range, 0.19 to 0.64), and the median [interquartile range (IQR)] Tmax was 30 [50] min (range, 10-180). For ESPB, the mean (SD) free bupivacaine Cmax was 0.015 (0.017) µg⋅mL-1 (range, 0.003-0.067), and the median [IQR] Tmax was 30 [20] min (range, 10-120). After PIFB, mean plasma concentrations plateaued at 60-240 min. For PIFB, the mean (SD) total bupivacaine Cmax was 0.32 (0.21) µg⋅mL-1 (range, 0.14-0.95), with a median [IQR] Tmax of 120 [150] min (range, 30-240). For PIFB, the mean (SD) free bupivacaine Cmax was 0.019 (0.010) µg⋅mL-1 (range, 0.005-0.048), and the median [IQR] Tmax was 180 [120] min (range, 30-240). For both ESPB and PIFB, we observed no correlations between pharmacokinetic and demographic parameters. CONCLUSION: Total and free bupivacaine Cmax observed after ESPB and PIFB with 2 mg⋅kg-1 of bupivacaine with epinephrine 5 µg⋅mL-1 were five to twenty times lower than levels considered toxic in the literature.

RéSUMé: OBJECTIF: Les blocs des muscles érecteurs du rachis (ESP) et les blocs des plans fasciaux pecto-intercostaux (PIFB) sont de nouveaux blocs interfasciaux pour lesquels les doses et les concentrations d'anesthésique local (AL) nécessaires à obtenir une analgésie sécuritaire et efficace sont inconnues. L'objectif de cette étude observationnelle prospective était de déterminer le moment d'administration (Tmax) et la concentration (Cmax) de bupivacaïne plasmatique totale et plasmatique libre maximale après un bloc ESP pour chirurgie mammaire et après un PIFB chez les patients en chirurgie cardiaque. MéTHODE: Des blocs ESP ou PIFB (18 patients par bloc; total, 36 patients) ont été réalisés avec 2 mg⋅kg-1 de bupivacaïne et 5 µg⋅mL-1 d'épinéphrine. Nos principaux critères d'évaluation étaient la Cmax moyenne ou médiane de bupivacaïne plasmatique totale et libre mesurée 10, 20, 30, 45, 60, 90, 180 et 240 min après l'injection d'AL par chromatographie liquide avec spectrométrie de masse en tandem. RéSULTATS: Pour le bloc ESP, la Cmax de bupivacaïne totale moyenne (écart type [ET]) était de 0,37 (0,12) µg⋅mL-1 (plage, 0,19 à 0,64), et le Tmax médian [écart interquartile (ÉIQ)] était de 30 [50] min (intervalle, 10­180). Pour le bloc ESP, la Cmax de bupivacaïne libre moyenne (ET) était de 0,015 (0,017) µg⋅mL-1 (plage, 0,003­0,067), et le Tmax médian [ÉIQ] était de 30 [20] min (intervalle, 10­120). Après un PIFB, les concentrations plasmatiques moyennes ont plafonné à 60­240 min. Pour le bloc PIFB, la Cmax de bupivacaïne totale moyenne (ET) était de 0,32 (0,21) µg⋅mL-1 (plage, 0,14­0,95), et le Tmax médian [ÉIQ] était de 120 [150] min (intervalle, 30­240). Pour le bloc PIFB, la Cmax de bupivacaïne libre moyenne (ET) était de 0,019 (0,010) µg⋅mL-1 (plage, 0,005­0,048), et le Tmax médian [ÉIQ] était de 180 [120] min (intervalle, 30­240). Pour le bloc ESP et le PIFB, nous n'avons observé aucune corrélation entre les paramètres pharmacocinétiques et démographiques. CONCLUSION:  : Les Cmax de bupivacaïne totale et libre observées après un bloc ESP et PIFB avec 2 mg⋅kg-1 de bupivacaïne avec 5 µg⋅mL-1 d'épinéphrine étaient cinq à vingt fois plus faibles que les niveaux considérés comme toxiques dans la littérature.

Elements not Graded in the Cardiac Enhanced Recovery After Surgery Guidelines Might Improve Postoperative Outcome: A Comprehensive Narrative Review.

Enhanced Recovery Programs (ERPs) are protocols involving the whole patient surgical journey. These protocols are based on multimodal, multidisciplinary, evidence-based, and patient-centered approaches aimed at improving patient recovery after a surgical intervention. Such programs have shown striking positive results in different surgical specialties. However, only a few research groups have incorporated preoperative, intraoperative, and postoperative evidence-based interventions in bundles used to standardize care and build cardiac surgery ERPs. The Enhanced Recovery After Surgery Society recently published evidence-based recommendations for perioperative care in cardiac surgery. Their recommendations included 22 perioperative interventions that may be part of any cardiac ERP. However, various components integrated in already-published cardiac ERPs were neither graded nor reported in these recommendations. The goals of the current review are to present published cardiac ERPs and their effects on patient outcomes and reported components incorporated into these ERPs and to discuss the objectives and scope of cardiac ERPs.

Effects of microstructure formation on the stability of vapor-deposited glasses.

Glasses formed by physical vapor deposition (PVD) are an interesting new class of materials, exhibiting properties thought to be equivalent to those of glasses aged for thousands of years. Exerting control over the structure and properties of PVD glasses formed with different types of glass-forming molecules is now an emerging challenge. In this work, we study coarse-grained models of organic glass formers containing fluorocarbon tails of increasing length, corresponding to an increased tendency to form microstructures. We use simulated PVD to examine how the presence of the microphase-separated domains in the supercooled liquid influences the ability to form stable glasses. This model suggests that increasing molecule tail length results in decreased thermodynamic stability of the molecules in PVD films. The reduced stability is further linked to the reduced ability of these molecules to equilibrate at the free surface during PVD. We find that, as the tail length is increased, the relaxation times near the surface of the supercooled equilibrium liquid films of these molecules are slowed and become essentially bulk-like, due to the segregation of the fluorocarbon tails to the free surface. Surface diffusion is also markedly reduced due to clustering of the molecules at the surface. Based on these results, we propose a trapping mechanism where tails are unable to move between local phase-separated domains on the relevant deposition time scales.

Vitreoretinal interface abnormalities in patients treatedwith ranibizumab for diabetic macular oedema.

PURPOSE: Intravitreal anti-vascular endothelial growth factor (VEGF) agents are effective in the treatment of central involving diabetic macular oedema (DMO). Vitreoretinal interface abnormalities (VRIA) are common in patients with DMO, and the effect of these on the response to anti-VEGF treatment is unclear. Furthermore the effect of anti-VEGF agents on the VRIA itself is uncertain. METHOD: Prospective study of consecutive patients treated with ranibizumab (RZB) for DMO as part of routine clinical care in one eye unit over a 1-year period. Visual acuity (Va), central retinal thickness (CRT) and injection frequency data was recorded on an electronic database. Treatment was initiated with four monthly RZB injections and then a monthly PRN regime. All patients underwent high-density spectral-domain optical coherence tomography (SDOCT) at baseline and 12 months. The SDOCTs were graded by two observers masked to the outcome. RESULTS: One hundred and four eyes (77 patients) were included in the analysis. The mean age was 62 years, and 62% were male. The mean presenting vision was 62 letters and CRT 472 µm. Eighty eyes retained stable Va, and 17 had an improvement in Va. At baseline, 39 eyes had associated focal vitreomacular adhesion (VMA) and by 12 months this reduced to 30 (p = 0.04), with 12 releasing VMA and three developing it. Patients with VMA had significantly better final Va than those without VMA. Improvement in CRT was greatest in those where VMA released during the study. Forty-five eyes had some degree of foveal involving epiretinal membrane (ERM) at baseline, and 28 were considered to have clinically significant ERM. There was no clinically relevant change in ERM during the study. Patients with significant ERM at baseline had a lower final vision. Multivariate analysis showed that ERM and more severe retinopathy at baseline were predictive of less visual improvement (p < 0.01). Shorter intraretinal cyst length, ERM and the absence of VMA at baseline were predictive of a worsened anatomical response (p < 0.001). CONCLUSION: VRIA are related to outcome in patients treated with RZB. ERM was associated with a worsened visual and anatomic response, and VMA with an improved anatomical response particularly when spontaneous VMA release occurred during treatment. The presence and severity of ERM was not affected by RZB treatment.

Kindergartners' fluent processing of symbolic numerical magnitude is predicted by their cardinal knowledge and implicit understanding of arithmetic 2years earlier.

Fluency in first graders' processing of the magnitudes associated with Arabic numerals, collections of objects, and mixtures of objects and numerals predicts current and future mathematics achievement. The quantitative competencies that support the development of fluent processing of magnitude, however, are not fully understood. At the beginning and end of preschool (M=3years 9months at first assessment, range=3years 3months to 4years 3months), 112 children (51 boys) completed tasks measuring numeral recognition and comparison, acuity of the approximate number system, and knowledge of counting principles, cardinality, and implicit arithmetic and also completed a magnitude processing task (number sets test) in kindergarten. Use of Bayesian and linear regression techniques revealed that two measures of preschoolers' cardinal knowledge and their competence at implicit arithmetic predicted later fluency of magnitude processing, controlling domain-general factors, preliteracy skills, and parental education. The results help to narrow the search for the early foundation of children's emerging competence with symbolic mathematics and provide direction for early interventions.

I-gel Versus LMA-Fastrach Supraglottic Airway for Flexible Bronchoscope-Guided Tracheal Intubation Using a Parker (GlideRite) Endotracheal Tube: A Randomized Controlled Trial.

BACKGROUND: The I-gel (IG) supraglottic airway device is a reliable way to establish an airway. Its large ventilation lumen allows for easy passage of an endotracheal tube. With the use of a flexible bronchoscope, the IG offers a good visualization of the laryngeal inlet. This prospective randomized study aims to compare the success rate of flexible bronchoscope-guided tracheal intubation using either the IG or the LMA-Fastrach (FT) laryngeal masks. METHODS: One hundred twenty patients requiring general anesthesia were randomized to 1 of the 2 study groups: IG or FT. After anesthesia induction, the assigned laryngeal mask was inserted to obtain adequate ventilation. We then proceeded to a flexible bronchoscope-guided intubation through the supraglottic device. Tracheal intubation and laryngeal mask insertion success rates were noted, as well as the time required for these manipulations. The view of the laryngeal inlet was graded for each intubation attempt. RESULTS: Sixty patients were assigned to each study group. The intubation success rates were similar between the IG and the FT groups (100 % vs 95.0 % at first attempt; P = 0.12). The times required for tracheal intubation were significantly lower in the IG group (30 ± 11 seconds vs 50 ± 21 seconds; P < 0.0001). Glottic visualization was better in the IG group, with a significantly higher percentage of grade 1 visualization (63.3% vs 3.3%; P < 0.0001) and a lower percentage of grade 3 visualization (1.7% vs 60.0%; P < 0.0001), than that in the FT group. CONCLUSIONS: The use of the IG supraglottic airway device as a conduit for flexible bronchoscope-guided tracheal intubation results in a success rate equivalent to the use of the LMA-FT. However, the IG allows for shorter intubation times and a better visualization of the glottic opening compared with the LMA-FT.

Children's mathematical performance: five cognitive tasks across five grades.

Children in elementary school, along with college adults, were tested on a battery of basic mathematical tasks, including digit naming, number comparison, dot enumeration, and simple addition or subtraction. Beyond cataloguing performance to these standard tasks in Grades 1 to 5, we also examined relationships among the tasks, including previously reported results on a number line estimation task. Accuracy and latency improved across grades for all tasks, and classic interaction patterns were found, for example, a speed-up of subitizing and counting, increasingly shallow slopes in number comparison, and progressive speeding of responses especially to larger addition and subtraction problems. Surprisingly, digit naming was faster than subitizing at all ages, arguing against a pre-attentive processing explanation for subitizing. Estimation accuracy and speed were strong predictors of children's addition and subtraction performance. Children who gave exponential responses on the number line estimation task were slower at counting in the dot enumeration task and had longer latencies on addition and subtraction problems. The results provided further support for the importance of estimation as an indicator of children's current and future mathematical expertise.

Teaching Through the Student Lens: Qualitative Exploration of Student Evaluations of Teaching.

OBJECTIVE: The purpose of this study is to use feedback from student evaluations of teaching (SETs) to define and describe themes associated with perceived teaching effectiveness. METHODS: We retrospectively analyzed SETs for instructors in required didactic courses from one academic year using qualitative content analysis. The analysis included student responses to the following questions: "Describe the strongest aspect of the instructor's teaching." and "What could the instructor do to improve his/her teaching effectiveness?" RESULTS: Five themes were developed from 4683 coded segments and are described with example quotations. These themes included clarity of instruction and learning activities, alignment of learning and assessment activities, examples that offer practice or demonstrate relevance, engaging learning environment, and concern for student learning and success. Aspects of each theme are described with example coded segments. CONCLUSION: These themes and supportive quotes offer a deeper understanding of the student perspective on similar ideas that are present throughout the teaching and learning literature and represent broad aspects of teaching, such as material design, in-class practices, and interpersonal characteristics. These themes can provide guidance for specific domains of faculty development in teaching.

Randomized trial of routine versus on-demand intraoperative extracorporeal membrane oxygenation in lung transplantation: A feasibility study.

In most centers, extracorporeal membrane oxygenation (ECMO) is the preferred means to provide cardiopulmonary support during lung transplantation. However, there is controversy about whether intraoperative venoarterial (VA) ECMO should be used routinely or selectively. A randomized controlled trial is the best way to address this controversy. In this publication, we describe a feasibility study to assess the practicality of a protocol comparing routine versus selective VA-ECMO during lung transplantation. This prospective, single-center, randomized controlled trial screened all patients undergoing lung transplantation. Exclusion criteria include retransplantation, multiorgan transplantation, and cases where ECMO is mandatory. We determined that the trial would be feasible if we could recruit 19 participants over 6 months with less than 10% protocol violations. Based on the completed feasibility study, we conclude that the protocol is feasible and safe, giving us the impetus to pursue a multicenter trial with little risk of failure due to low recruitment.

Seen and not seen: How people judge ambiguous behavior during the COVID-19 pandemic.

How do we judge others' behavior when they are both seen and not seen-when we observe their behavior but not the underlying traits or history that moderate the perceived riskiness of their behavior? We investigate this question in the context of the COVID-19 pandemic: How people make sense of, and judge, vaccination-contingent behaviors-behaviors, such as going to the gym or a bar, which are considered to be more or less risky and appropriate, depending on the target's vaccination status. While decision theoretic models suggest that these judgments should depend on the probability that the target is vaccinated (e.g., the positivity of judgments should increase linearly with the probability of vaccination), in a large-scale pre-registered experiment (N = 936) we find that both riskiness and appropriateness judgments deviate substantially from such normative benchmarks. Specifically, when participants judge a stranger's behavior, without being asked to think about the stranger's vaccination status, they tend to judge these behaviors similarly positively to behaviors of others who are known to be fully vaccinated. By contrast, when participants are explicitly prompted to think about the vaccination status of others, they do so, leading them to view others more disparagingly, at times even more negatively than what a normative benchmark would imply. More broadly, these results suggest new directions for research on how people respond to risk and ambiguity. We demonstrate that even subtle cues can fundamentally alter what information is "top of mind," that is, what information is included or excluded when making judgments. Supplementary Information: The online version contains supplementary material available at 10.1007/s11166-022-09396-7.

Feasibility of using intermittent active monitoring of vital signs by smartphone users to predict SARS-CoV-2 PCR positivity.

Early detection of highly infectious respiratory diseases, such as COVID-19, can help curb their transmission. Consequently, there is demand for easy-to-use population-based screening tools, such as mobile health applications. Here, we describe a proof-of-concept development of a machine learning classifier for the prediction of a symptomatic respiratory disease, such as COVID-19, using smartphone-collected vital sign measurements. The Fenland App study followed 2199 UK participants that provided measurements of blood oxygen saturation, body temperature, and resting heart rate. Total of 77 positive and 6339 negative SARS-CoV-2 PCR tests were recorded. An optimal classifier to identify these positive cases was selected using an automated hyperparameter optimisation. The optimised model achieved an ROC AUC of 0.695 ± 0.045. The data collection window for determining each participant's vital sign baseline was increased from 4 to 8 or 12 weeks with no significant difference in model performance (F(2) = 0.80, p = 0.472). We demonstrate that 4 weeks of intermittently collected vital sign measurements could be used to predict SARS-CoV-2 PCR positivity, with applicability to other diseases causing similar vital sign changes. This is the first example of an accessible, smartphone-based remote monitoring tool deployable in a public health setting to screen for potential infections.

Championing inclusive terminology in ecology and evolution.

Amid a growing disciplinary commitment to inclusion in ecology and evolutionary biology (EEB), it is critical to consider how the use of scientific language can harm members of our research community. Here, we outline a path for identifying and revising harmful terminology to foster inclusion in EEB.

Cognitive processes of numerical estimation in children.

We tested children in Grades 1 to 5, as well as college students, on a number line estimation task and examined latencies and errors to explore the cognitive processes involved in estimation. The developmental trends in estimation were more consistent with the hypothesized shift from logarithmic to linear representation than with an account based on a proportional judgment application of a power function model; increased linear responding across ages, as predicted by the log-to-lin shift position, yielded reasonable developmental patterns, whereas values derived from the cyclical power model were difficult to reconcile with expected developmental patterns. Neither theoretical position predicted the marked "M-shaped" pattern that was observed, beginning in third graders' errors and fourth graders' latencies. This pattern suggests that estimation comes to rely on a midpoint strategy based on children's growing number knowledge (i.e., knowledge that 50 is half of 100). As found elsewhere, strength of linear responding correlated significantly with children's performance on standardized math tests.