Digital Commons Network^™

The Non-Communicable Disease E-Cohort For Hypertension In Latin America: Concept, Survey Development And Study Protocol, Patricia J Garcia, Laura Espinoza-Pajuelo, Hannah H Leslie, Margaret E Kruk, Catherine Arsenault, Agustina Mazzoni, Jesus Medina-Ranilla, Javier Roberti, Marina Guglielmino, Ezequiel Garcia-Elorrio

2020-Current year OA Pubs

Non-communicable diseases like hypertension cause substantial morbidity and mortality in low- and middle-income countries, where limited access to high-quality care contributes to millions of preventable deaths annually. Traditional assessments of health system performance often rely on structural indicators and cross-sectional, overlooking patient experiences and care processes. In Latin America, amid rising cardiovascular disease, longitudinal tools are needed to guide improvements in healthcare delivery models, particularly for chronic diseases such as hypertension. The NCD e-Cohort is a prospective, longitudinal, mixed-mode (in-person and phone) survey designed to assess health system quality in Latin America. Developed by the QuEST Network, it integrates validated …

Buprenorphine Treatment During The Extended Postpartum Period: A Survey Of Patient Experiences, Bridget Galati, Heather Jacobsen, Melissa Krauss, Melissa Mills, Brittaney Vaughn, Sam Williams, Michael Wenzinger, Cynthia Rogers, Nandini Raghuraman, Jeannie Kelly

2020-Current year OA Pubs

OBJECTIVE: The late postpartum period, defined as greater than 6 weeks to 12 months, is a high-risk time for individuals with opioid use disorder (OUD). Discontinuation rates of buprenorphine treatment for OUD during this period are high. Little is known about patients' subjective experience with buprenorphine treatment during this time. We sought to assess patient treatment experience, goals, facilitators and barriers to continued buprenorphine treatment throughout the extended postpartum period.

METHODS: We performed a cross-sectional survey of postpartum patients who received buprenorphine treatment, including sublingual and long-acting injectable formulations, in an interdisciplinary, wrap-around clinic for maternal OUD between February 2022 …

Long-Term Illness In Adults Hospitalized For Respiratory Syncytial Virus Disease, United States, February 2022-September 2023, Aleda M Leis, Jennie H Kwon, Et Al.

2020-Current year OA Pubs

Respiratory syncytial virus (RSV) can cause severe illness, but little is known about long-term consequences in hospitalized adults. We surveyed adults (>18 years of age) who survived hospitalization for RSV or COVID-19 during February 2022-September 2023 about physical functioning and quality of life; surveys were conducted 6-12 months after hospitalization. We compared outcomes after RSV hospitalization by age (< 60 vs. >60 years) and to those hospitalized for COVID-19 by using multivariable regression models. Among 146 adults hospitalized with RSV, 27.4% reported severe breathlessness and 21.9% poor quality of life at follow-up. Few differences were seen in posthospital illness by age. …

Adverse Experiences, Protective Factors, And Obesity In Latinx And Hispanic Youths, Victoria Goldman, Sevan Esaian, Miguel Ángel Rivas Fernández, Jonatan Ottino Gonzalez, Nicole Karcher, Jeffrey I Gold, Alaina P Vidmar, Shana Adise

2020-Current year OA Pubs

IMPORTANCE: Pediatric obesity rates are rising, and adverse childhood experiences (ACEs) may contribute by promoting stress-induced weight gain. Few studies have examined the association of ACEs with body mass index (BMI) and youth-reported protective factors, particularly among Latinx and Hispanic youths, who face higher rates of ACEs and obesity.

OBJECTIVE: To evaluate the association of ACEs with BMI in a population-based cohort and determine whether youth-reported protective factors (eg, self-coping skills, caregiver or friend support, or overall support) moderate this association, with a focus on Latinx and Hispanic youths.

DESIGN, SETTING, AND PARTICIPANTS: This large, cross-sectional study of youths aged …

Genetic Predisposition To Persistent Fatigue After A Diagnosis Of Colorectal Cancer, Elham Kazemian, Adetunji T Toriola, Et Al.

2020-Current year OA Pubs

BACKGROUND: Cancer-related fatigue (fatigue) is a common and persistent symptom after cancer treatment, yet the role of genetic susceptibility remains unclear.

METHODS: We used data from a prospective cohort study called the ColoCare Study, conducted over 5 US sites and Germany. Fatigue was assessed at 5 time points using the European Organisation for the Research and Treatment of Cancer Core Quality of Life Questionnaire fatigue subscale and analyzed as (1) a binary summary measure of the trajectory from diagnosis into survivorship (defined as severe: yes/no), (2) a mean score across all time points, and (3) the highest (ie, worst) score …

Single Cell Viral Tagging Of Faecalibacterium Prausnitzii Reveals Rare Bacteriophages Omitted By Other Techniques, Danielle E Campbell, Xiaofen Wu, Lindsey R Hall, Dylan Lawrence, Jerome M Molleston, Lawrence A Schriefer, Lindsay Droit, James S Weagley, Benjamin S Olson, Joanna Rimmer, Miles Parkes, Scott A Handley, Megan T Baldridge

2020-Current year OA Pubs

The associations of the gut microbiome and virome with human health and disease are increasingly numerous and clear. The mechanistic roles of bacteriophages (phages) in the microbiome, however, are especially unclear, as their cultivation is exceedingly difficult and their diversity so immense. We use viral tagging (VT), a technique wherein fluorescently stained uncultivated viruses are allowed to adsorb to host cells and then host cells are singly sorted. This method identifies interacting phage-bacteria pairs to better sample and characterize the phages in human stool samples from healthy and inflammatory bowel disease (IBD)-affected patients. First, we apply VT to uncultivated bacteria …

Meniscal Repair In The Setting Of Revision Anterior Cruciate Ligament Reconstruction: 6-Year Follow-Up Results From The Mars Cohort, Mars Group, Amanda K Haas, Robert H Brophy, Matthew J Matava, Matthew V Smith, Et Al.

2020-Current year OA Pubs

BACKGROUND: Meniscal preservation has been demonstrated to contribute to long-term knee health and has been a successful intervention in isolation and in patients with anterior cruciate ligament reconstruction (ACLR). The long-term results of meniscal repair in the setting of revision ACLR have yet to be documented.

PURPOSE: To report the incidence of meniscal repair failures at the 6-year follow-up in a cohort of patients who underwent concurrent revision ACLR and primary meniscal repair.

STUDY DESIGN: Prospective cohort study; Level of evidence, 2.

METHODS: All revision ACLRs with concomitant primary meniscal repair cases from a multicenter group between 2006 and 2011 …

Phenotypic Variability And Paternal Inheritance Of A Chd8 Variant Causing Intellectual Developmental Disorder With Autism And Macrocephaly Confirmed By Epigenetic And Structural Analyses, Yutaka Furuta, Jonathan H Sheehan, Et Al.

2020-Current year OA Pubs

BACKGROUND: Intellectual developmental disorder with autism and macrocephaly (IDDAM, OMIM #615032) is an autosomal dominant neurodevelopmental disorder characterized primarily by intellectual disability, autism spectrum disorder, macrocephaly, tall stature, gastrointestinal symptoms, and variable neurological manifestations. Most cases result from de novo pathogenic variants in CHD8.

METHODS: We conducted genome sequencing through the Undiagnosed Diseases Network (UDN) in a female proband harboring a CHD8 variant of uncertain significance (VUS), whose clinical presentation was consistent with IDDAM but included atypical features such as ptosis and hearing loss. Variant pathogenicity was further evaluated using EpiSign DNA methylation analysis and structural biology modeling.

RESULTS: Genome …

A Roadmap To Scale Up Person-Centred Care In The Hiv Response: Recommendations From A Global Consensus-Building Process, Lina Golob, Elvin H Geng, Et Al.

2020-Current year OA Pubs

INTRODUCTION: World Health Organization global normative guidance recommends person-centred care (PCC) approaches to reduce HIV-related mortality and morbidity and to improve health-related quality of life (HrQoL). However, consensus on the priority PCC elements and guidance on how different stakeholders can realize PCC principles at the health systems, service delivery and individual client-healthcare worker (HCW) levels are lacking. We conducted a global consensus-building process to define core PCC elements and develop recommendations for implementation at scale.

METHODS: We used a multi-phase process to build consensus and prioritize recommendations, consisting of a literature review, five stakeholder consultations (34-43 participants each) between July …

A Guide For Initiating And Managing Chimeric Antigen Receptor T Cell Therapy Clinical Trials In Autoimmune Rheumatic Diseases, Roberto Caricchio, Stacie Bell, Sasha Bernatsky, Maria Dall'era, David Goddard, Kenneth Kalunian, Alfred H J Kim, Fotios Koumpouras, Jose Rubio, Amit Saxena, Saira Sheikh, Lupus Clinical Investigators Network

2020-Current year OA Pubs

Chimeric antigen receptor (CAR) T-cell therapy, long transformative in oncology, is now rapidly emerging as a frontier in autoimmune rheumatic diseases, particularly systemic lupus erythematosus (SLE), driven by accumulating evidence of deep B-cell depletion, immune "resetting," and durable drug-free remission in early studies, yet its translation into rheumatology demands mastery of formidable logistical, regulatory, clinical, and ethical complexities that span institutional readiness, multidisciplinary team formation, stringent regulatory compliance, sophisticated operational workflows, comprehensive patient selection and education, meticulous clinical management of both classical toxicities (CRS, ICANS, ICAHT) and autoimmune-specific reactions such as LICATS, robust financial and resource planning, and long-term follow-up …

Bilateral Breast Treatment In A Single Arc Using Rapidarc Dynamic: A Planning Comparison With Conventional Volumetric Modulated Arc Therapy, Taoran Li, Luca Cozzi, Lesley Rosa, Ryan Clark, Priyanka Agarwal, Yin Gao, Yun Yang, Boon-Keng Kevin Teo, Anthony Magliari, Himank Kalra, Francisco Reynoso, Patrick Kupelian, Sushil Beriwal

2020-Current year OA Pubs

PURPOSE: Synchronous bilateral breast cancer (SBBC) presents significant radiotherapy planning challenges due to complex target volumes near critical organs. This study evaluated RapidArc Dynamic (RAD), a novel technique integrating dynamic arcs with static angle modulated ports (STAMPs) via simultaneous GPU-accelerated optimization, against conventional volumetric modulated arc therapy (VMAT) for SBBC treatment planning and delivery efficiency.

METHODS: Ten retrospective SBBC cases involving comprehensive nodal irradiation were planned using both multi-arc VMAT (six arcs) and RAD (one arc plus six STAMPs) in Eclipse (v18.1) with AcurosXB. A prescription dose of 40.05 Gy in 15 fractions was normalized to PTV D95% = 95%. …

Muc15 Ectodomain Architecture Regulates Integrin Clustering To Control Cancer Metastasis, Simei Zhang, Guy M Genin, Et Al.

2020-Current year OA Pubs

Cancer metastasis is governed by physical cues at the cell-matrix interface, with matrix stiffness, ligand density, and topography established as key determinants. Here, a fourth critical factor in cancer metastasis, the architecture of the cell-surface glycocalyx is identified. Using MUC15 as a representative small glycoprotein, mathematical modeling and domain truncation experiments are combined to show that glycoprotein size distribution governs integrin adhesion states and metastatic outcomes. MUC15 localizes to focal adhesions and interact with integrins, while larger glycoproteins such as MUC1 are sterically excluded. These physical effects, rather than intracellular signaling, dictate adhesion state transitions: removing MUC15's ectodomain eliminated its …

Fast And Accurate Measurement Of Small Field Dosimetry Using A Novel Scintillation Detector, Yiding Han, Jingzhu Xu, Yao Hao, Baozhou Sun

2020-Current year OA Pubs

BACKGROUND: The most used instruments for small-field dosimetry have notable limitations, including the need for correction of output factors, limited scanning speeds, and challenges in alignment for percentage depth dose (PDD) measurements, particularly for extremely small fields. However, plastic scintillation detectors (PSDs) are an attractive alternative for small-field dosimetry due to their correction-free nature, linear dose response, and fast response time.

PURPOSE: This study evaluates the robustness and accuracy of the dosimetric measurements using a new water-equivalent PSD in small-field dosimetry. The study also aims to report accurate measurements of output factors, profiles, and an indirect method for measuring PDD …

How Patients With Amyotrophic Lateral Sclerosis Perceive Respiratory Interventions: A Mixed-Methods Study To Inform Implementation Efforts, Jason Ackrivo, Danny Bracy, Lauren B. Elman, John Hansen-Flaschen, Zachary Simmons, Piera Pasinelli, Terry Heiman-Patterson, Steven M. Kawut, Meghan B. Lane-Fall

Department of Neuroscience Faculty Papers

BACKGROUND AND OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that commonly leads to respiratory failure. Early respiratory interventions that may improve symptoms and outcomes are underused when prescribed. We sought to characterize patient perspectives and preferences for respiratory care to enable identification of implementation strategies to improve the uptake of ALS respiratory interventions.

METHODS: A prospective multicenter mixed-methods observational study was conducted using semistructured interviews of participants recently diagnosed with ALS at 4 academic centers in the United States. Eligible patients were those with an ALS diagnosis in the previous 12 months, forced vital capacity < 80% predicted normal, or presence of dyspnea or orthopnea.

RESULTS: Twenty-four patients …

Array Of Mini-Graphene-Silicon Solar Cells Intermittently Recharges Storage Capacitors Powering A Temperature Sensor, Ashaduzzaman, Syed M. Rahman, Md R. Kabir, James M. Mangum, Hung Do, Gordon Carichner, David Blaauw, Paul M. Thibado

Physics Faculty Publications and Presentations

Developing autonomous sensor systems that draw power from the ambient environment is a critical step for creating the Internet of Things. In this study, the authors built dozens of graphene-based solar cells, wire bonded them into standard packages, and characterized the current-voltage characteristics of each under illumination. Next, solar cells were connected in series to increase the output voltage. Three different sets of solar cells were used to charge three storage capacitors to the voltage levels required by our temperature sensor. The storage capacitors require only a few minutes to charge, yet power the sensor system for more than 24 …

Case Presentation: Unilateral Neuroforaminal Widening/Expansion On Cervical Radiograph, Mya J. Reese

Aurora GME

No abstract provided.

Elucidating The Oxidation Mechanisms In Cr2alb2 Using Density Functional Theory And Thermodynamic Modeling, Ushan Asela Adhikarige

Theses and Dissertations

This thesis investigates the oxidation behavior of Cr2AlB2 surfaces using density functional theory calculations combined with thermodynamic modeling. Our analysis encompassed surface stability assessments, oxygen adsorption studies on various surfaces, and thermodynamic insights into oxidation mechanisms. Surface stability assessments reveal that the (010) surface terminated with an Al layer exhibits the lowest surface energy. Oxygen adsorption studies on the (010), (111), and (021) surfaces demonstrate strong dissociative adsorption with binding energies ranging from -4.72 to -4.22 eV depending on coverage. Thermodynamic analysis shows that elevated temperatures reduce oxidation favorability, while increased oxygen partial pressure enhances it. The study reveals that …

Integration Of Fluorescence Imaging And Advanced Analytical Techniques For Reliable Contamination Detection, Mahsa Aliee

Theses and Dissertations

Effective surface contamination detection in food processing and healthcare environments is hindered by the limitations of visual inspection and ATP bioluminescence testing, both of which struggle to identify thin, transparent, or spatially irregular organic residues. These constraints contribute to inconsistent hygiene verification and create a need for objective, scalable, and real-time detection methods capable of operating under variable environmental conditions.

This dissertation develops an integrated framework that combines UV-induced fluorescence imaging with advanced analytical techniques to improve contamination detection reliability. A UV/UVC fluorescence imaging system was engineered with synchronized pulsed excitation (275 nm, 365 nm, 405 nm), adaptive exposure control, …

A Stochastic Framework For Hosting Capacity Analysis Of Residential Distribution Systems With Solar Photovoltaic And Electric Vehicle Adoption, Sina Ibne Ahmed

Theses and Dissertations

The rise of distributed generation and the electrification of transportation are driving fundamental changes in the electric grid. The growing adoption of electric vehicles and solar rooftops introduces significant uncertainty in demand patterns, posing new challenges for the operation of distribution systems. Residential distribution systems are particularly vulnerable to the impacts of residential solar photovoltaics (PV) generation and electric vehicle charging, as they introduce significant variability and localized stress on the grid. To ensure reliable and efficient operation, utilities must account for the long-term growth of these technologies in their planning processes. While substantial progress has been made in assessing …

Control Strategy, Multi-Objective Optimization, And Economic Viability For Utility-Scale Wind-Solar-Based Hybrid Power Plant, Shree Om Bade

Theses and Dissertations

Hybrid Power Plants (HPP) that combine wind power plants (WPP), solar power plants (SPP), and battery energy storage systems (BESS) have recently emerged to provide dispatchable renewable electricity, improve the stability of the power grid, maximize use of infrastructure assets, and minimize carbon releases. Nevertheless, regardless of their technical potential, the large-scale application of HPP still encounters many barriers, such as operational complexity, inadequate sizing, and financial viability. To mitigate these issues, this study incorporates three research questions. First, this study introduces a four-layer hierarchical control architecture for coordinating WPP, SPP, and BESS to ensure dispatchable power. Second, a multi-objective …

Seasonal Performance Of Mrms Qpe In Urban Hydrologic Modeling Using Epa-Swmm, Randall Kirk Bagwell

Theses and Dissertations

Accurate rainfall estimation is essential for effective hydrologic modeling, particularly in urban environments where infrastructure must withstand extreme precipitation. This study evaluates the EPA Storm Water Management Model (EPA-SWMM) using MRMS RadarOnly Quantitative Precipitation Estimation (QPE) 1-hour Accumulation as the primary rainfall input for a watershed in Little Rock, Arkansas. The region was selected due to its urban character and the limited availability of radar-based hydrologic studies in Arkansas. 21 storms were analyzed from 2022-2025: 10 in Winter, 7 in Spring, and 4 in Summer. Storms were selected due to their effect on flow. The model was calibrated using February …

Culture-Dependent Characterization Of Microbial Succession And Persistence In The Integrated Lunar/Martian Analog Habitat (Ilmah), Haley Olivia Boles

Theses and Dissertations

This study examines culture-dependent microbial monitoring in a closed lunar/Martian analog habitat, focusing on viable community dynamics relevant to long-duration missions. A standardized sampling and cultivation pipeline was implemented in ILMAH to track microbial succession and persistence under realistic operational conditions. Surface samples were collected across eight habitat zones at five mission timepoints (Days 0, 5, 10, 15, 20) during a 21-day crewed mission. Samples were concentrated post-collection and plated on chromogenic film media to quantify total aerobic bacteria (AC-R), fungi (YM-R), E. coli (EC), and S. aureus (SA). Plates were imaged and enumerated digitally; representative colonies were isolated and …

Thermal Desorption-Pyrolysis Gas Chromatography-Mass Spectrometry Method Development For The Determination Of Wood Preservatives, Nafisa Bala

Theses and Dissertations

A thermal desorption-pyrolysis gas chromatography with mass spectrometric detection (TD-Pyr-GC-MS) method was developed, enabling a comprehensive analysis of preservatives as well as native wood constituents in treated wood. The developed method is based on thermal desorption, i.e., extraction of wood preservatives, followed by pyrolysis to investigate changes in the occurrence of characteristic wood building blocks (e.g., guaiacol derivatives). We implemented a combined MS data acquisition (i.e., SITI) consisting of selected ion monitoring (SIM) and total ion current (TIC), allowing for low limits of detection of preservatives in SIM mode and TIC detection of any evolving species. The matrix detection limits …

Differential Photometric Analysis Of Exoplanet Candidates Toi-1362.01, Toi-2290.01, Toi-6010.01, And Toi-6324.01, Samantha Buck

Theses and Dissertations

To maximize the science return from the Transiting Exoplanet Survey Satellite (TESS), the TESS Follow-up Observing Program (TFOP) was created to network scientists and observatories to conduct follow-up observations of potential exoplanets. As members of TFOP-Subgroup 1, we observed four exoplanet candidates: TOI-1362.01, TOI-2290.01, TOI-6010.01, and TOI-6324.01 using the University of North Dakota Space Studies Observatory. The TOI observations were conducted from 31 October 2024 – 15 November, 2024 UTC. AstroImageJ software was used to perform differential photometry and, if a transit event was observed, determine orbital parameters and physical characteristics. Each of the target’s light curves was modeled and …

Spaceflight Safety Regulations: The Case For Implementing Safety Management Systems In The Developing U.S. Commercial Human Spaceflight Industry, Carly Davidson

Theses and Dissertations

Accidents have historically accompanied the development of new transportation systems, often due to technical failures; but human factors – such as organizational culture and management decisions – are increasingly recognized as significant contributors. A strong safety culture, prioritizing safety at all organizational levels, effective management procedures, and open reporting of violations, is believed to improve outcomes by proactively reducing risk in highly technical organizations. These elements form the basis of Safety Management Systems (SMS), which include safety policy, risk management, assurance, and promotion. As commercial spaceflight expands public access to space, US regulators must develop flexible safety regulations that protect …

The Role Of Attitude Ambivalence In Extending The Theory Of Planned Behavior: A Mixed-Methods Study Of Factors Predicting Influenza Vaccine Uptake Intentions Among Active-Duty Military Parents For Themselves And Their Children, Walter Eugene Carroll

Theses and Dissertations

This dissertation is a mixed-methods study examining how U.S. military parents form intentions to vaccinate themselves and their children against influenza. The study applies the Theory of Planned Behavior (TPB) and the construct of ambivalence tounderstand how attitudes, social norms, and perceived behavioral control influence vaccination decisions within the unique institutional and cultural environment of military life. Quantitative data were collected from 341 military parents through an online survey distributed across more than 50 military-affiliated Facebook groups. Regression models tested TPB constructs, flu knowledge, and social media use as predictors of vaccination intention and ambivalence. Results showed that flu shot …

Evaluating Hail Spectrometer Data Quality And Uncertainty For Calculating Radar Reflectivity Factor, James Klinman

Theses and Dissertations

Reliable in situ measurements are essential for accurately forecasting and nowcasting hailstorms, as they provide insight into storm processes, improve predictions that protect public safety, and help assess potential damage to agriculture and infrastructure. This study evaluates the reliability of in situ hail measurements from the T-28 aircraft’s Hail Spectrometer and assesses their feasibility for radar reflectivity validation and parameterization. Data from 14 flights across five field campaigns were analyzed, focusing on comparisons between one-dimensional (1D) 1-Hz accumulated particle counts and two-dimensional (2D) particle images produced by the Hail Spectrometer. The 2D data were processed using the System for Optical …

Dynamic Wellbore-Integrity Framework For Post-Blowout Capping Of Offshore Wells, Abdelhakim Khouissat

Theses and Dissertations

In the aftermath of a blowout, a well undergoes a period of unrestricted fluid discharge (de facto primary recovery) followed by pressure buildup after its shut-in, which can adversely impact wellbore integrity. The quintessential example is Union Oil’s 1969 “A-21” well blowout in California’s Santa Barbara Channel, where seafloor-broaching incidents (oil “boilups”) kept taking place from the sides of the well following several failed well-capping attempts, until reservoir depletion eventually allowed a successful shut-in.Analytical and numerical reservoir depletion models are coupled with near-wellbore geomechanics to quantify yardsticks related to the post-blowout discharge utilized to indicate dangers for underground blowouts, in …

Toward An Anthropological Ecocriticism, Grant Mcmillan

Theses and Dissertations

Environmental storytelling has increasingly reckoned with concepts and assumptions about (N/a)ture inherited from the Western intellectual tradition. The late 2010s and early 2020s in particular have seen an explosion of fiction that interrogates the limits of these past ideas. Relatedly, ecocriticism of this period has entered a self-reflexive mode that has sought to deal with its own limitations while offering insights that may prove generative for a more general audience of environmentally minded readers. This project adds to ongoing ecocritical discourse by tracing a series of implicit affinities between the broad traditions of anthropology and environmental fiction through their shared …

Methane Infusion Improved Oil Recovery In The Bakken Formation, Demetrius Maxey

Theses and Dissertations

This research establishes methane infusion improved oil recovery (MI IOR) as a technically viable and economically attractive early-stage intervention for unconventional reservoirs. Integrated multi-scale investigations included quantum molecular theory, nanoscale characterization, NMR experimentation, and field scale reservoir simulation. FEG-SEM analysis of core samples enabled development of a peer-reviewed pore size classification system informing MI operational design parameters. Integrated well logging quantified petrophysical properties across the Bakken stratigraphy. NMR relaxometry identified the lab-scale pore-level sweep efficiency of MI at 3,750 psi in Bakken core samples. Mobilization of hydrocarbons from Np1, Np2, and Np3 pores yielded recovery factors of 45-60%. Field-scale reservoir …