cssi/SciSciGPT-SciSciNet huggingface dataset:
Improving Outcomes of Reverse Total Shoulder Arthroplasty in Patients With Preoperative External Rotation Deficit: The Effect of Latissimus Dorsi Tendon Transfer Versus Lateral-Offset Glenosphere

Introduction: Reverse total shoulder arthroplasty (RTSA) has become an accepted surgical treatment for patients with severe deficiency of the rotator cuff. Despite the utility of RTSA in managing difficult shoulder problems, humeral rotation does not reliably improve and may even worsen following RTSA. Several approaches to increase active external rotation (aER) postoperatively have been proposed including the use of concomitant latissimus dorsi tendon transfer (LDTT) or the use of an increased lateral-offset glenosphere (LG). We hypothesized that clinical outcome and range of motion after RTSA with a +4 mm or +6 mm LG would be comparable to RTSA with LDTT in patients with a lack of aER preoperatively. Methods: An IRB-approved, prospective, single surgeon RTSA registry was reviewed for patients treated with LDTT or LG for preoperative aER deficiency with minimum 1-year follow-up. Patients qualified for aER deficiency if they had a positive ER lag sign or less than or equal to 10 degrees of aER preoperatively. Matched control groups with patients that did not have preoperative lack of aER and were not treated with LDTT or LG were included for comparison. Outcomes measures included Constant-Murley score (CMS), American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), ASES Activities of Daily Living (ADL) score, Visual Analogue pain Scale (VAS), active forward elevation (aFE), active internal rotation (aIR), and aER. An independent, institutional biostatistician performed statistical analyses. Results: The LDTT group had 21 patients (10 male, 11 female) and the LG group had 16 patients (5 male, 11 female). CMS, ASES, SSV, ADL, VAS, and aFE were significantly improved in case and control groups following RTSA ( P P > .05). aER was significantly improved in the LDTT and LG groups ( P P > .05) (Figure 1). The LDTT group had a significantly lower postoperative aER than its control group ( P = .001), whereas the LG group had similar postoperative aER to its control group ( P = .376) (Figure 1). The LG group had significantly greater aER preoperatively and postoperatively than the LDTT group ( P P = .013). There was no significant difference in degree of improvement of aER between the LDTT and LG groups ( P = .212). The LDTT group had a significantly lower postoperative aIR than its control group (P=.025), whereas the LG group had similar postoperative aIR to its control group ( P = .234). The LG group had significantly greater improvement in aIR than the LDTT group (P=.009). Conclusion: To our knowledge, this is the first series to compare outcomes of two common techniques used to improve aER following RTSA. In this series, we found overall similar improvements in outcomes between the groups. These results suggest that use of a LG may be preferable to LDTT given the relatively simplified surgical technique, similar improvement in aER, comparable clinical outcome scores, and the added benefit of improved aIR.
Delay Analysis of Unsaturated Heterogeneous Omnidirectional-Directional Small Cell Wireless Networks: The Case of RF-VLC Coexistence

The coexistence of omnidirectional small cells (OSCs), such as RF small cells, and directional small cells (DSCs), such as visible-light communication cells, is investigated. The delay of two cases of such heterogeneous networks is evaluated. In the first case, resource allocated OSCs, such as RF femtocells, are considered. In the second case, contention-based OSCs, such as WiFi access point, are studied. For each case, two configurations are evaluated. In the first configuration, the non-aggregated scenario, any request is either allocated to OSC or DSC. While in the second configuration, the aggregated scenario, each request is split into two pieces, one is forwarded to OSC and the other is forwarded to DSC. For the first case, under Poisson request arrival process and exponential distribution of request size, the optimal traffic allocation ratio is derived for the non-aggregated scenario and it is mathematically proved that the aggregated scenario provides lower minimum average system delay than that of the non-aggregated scenario. For the second case, the average system delay is derived for both non-aggregated and aggregated scenarios, and extensive simulation results imply that, under certain conditions, the non-aggregated scenario outperforms the aggregated scenario due to the overhead caused by contention.
PPARδ as a Metabolic Initiator of Mammary Neoplasia and Immune Tolerance

PPARδ is a ligand-activated nuclear receptor that regulates the transcription of genes associated with proliferation, metabolism, inflammation, and immunity. Within this transcription factor family, PPARδ is unique in that it initiates oncogenesis in a metabolic and tissue-specific context, especially in mammary epithelium, and can regulate autoimmunity in some tissues. This review discusses its role in these processes and how it ultimately impacts breast cancer.
Learning with Synaptic Nonlinearities in a Coupled Oscillator Model of Olfactory Cortex

A simple network model of olfactory cortex, which assumes only minimal coupling justified by known anatomy, can be analytically proven to function as an associative memory for oscillatory patterns. The network has explicit excitatory neural populations with local inhibitory interneu- ron feedback that forms a set of nonlinear oscillators coupled only by long range excitatory connections. Using a local Hebb-like learning rule for primary and higher order synapses at the ends of the long range connections, the system can learn to store the kinds of oscillation amplitude and phase patterns observed in olfactory and visual cortex. The network can be truely self-organizing because a synapse can modify itself according to it’s own pre and postsynaptic activity during stimulation by an input pattern to be learned. The neurons of the neuron pools modeled here can be viewed as operating in the linear region of the usual sigmoidal axonal non- linearity, and multiple memories are stored instead by the learned synaptic nonlinearities
Dual Identities: Organizational Negotiation in STEM-Focused Catholic Schools.

In the last decade, STEM-focused schools have opened their doors nationally in the hope of meeting students’ contemporary educational needs. Despite the growth of these STEM-focused institutions, minimal research exists that follows how schools make a transition toward a STEM focus and what organizational structures are most conducive to a successful transition. The adoption of a STEM focus has clear implications for a school’s organizational identity. For Catholic schools, the negotiation of a new STEM focus is especially complex, as Catholic schools have been shown to generally possess a distinct religious and cultural organizational identity. The adoption of a second, STEM-focused identity raises questions about whether and how these identities can coexist. Framed by perspectives on organizational identity and existing conceptualizations of the cultural and religious hallmarks of Catholic schools, this study utilizes a multiple-case study design to explore the organizational transition of four Catholic K-8 institutions to Catholic STEM-focused schools. These cases demonstrate the particular challenges of negotiating multiple organizational identities. While variation existed in how the four schools accommodated these identities, the most promising environments for successful transition drew upon an aggregative model of identity negotiation, that is, when schools attended to both identities, but ensured that the original Catholic identity of the school remained foundational to all decisions. The least successful identity negotiations occurred when there was a lack of common understanding about what comprised a STEM-focused school, leading to minimal buy-in from stakeholders or when a school sought to make the transition for recruitment or marketing rather than mission-driven reasons. Discussion of the more successful identity aggregation provides a framework for schools within and beyond the religious sector that desire to adopt an additional STEM-focused identity.
Affective reactivity to cry sounds predicts young women's reactivity and behavior in a simulated caregiving task.

Abstract Different populations of adults (experienced vs. inexperienced caregivers, men vs. women, abusive vs. nonabusive parents, etc.) have been reported to differ in their affective reactions to the sounds of infant crying. These differences are thought to impact caregiving behavior and, in some instances, to affect long-term outcomes for infants. There can be great intra-group variation, however, even when group differences are significant; modeling developmental process will require a finer grained approach. We have undertaken a pair of studies intended to validate the Negative Affect Scale (NA) from the PANAS as a measure of individuals’ affective reactivity to cry sounds. In Study 1, 306 young women who were not yet mothers listened either to infant crying or to birdsong. The results supported the NA as a measure of reactivity to crying. In Study 2, a new sample of 301 young women listened to crying in a screening task; a group of “high reactors” (n = 21) and a group of “low reactors” (n = 22) then participated in a simulated caregiving situation. Individuals’ affective reactivity to the caregiving simulation mirrored their affective reactivity in the screening task, and rates and overall organization of caregiving behavior differed between the groups. Changes in negative affect, then, appear to be both a result of infant crying and a determinant of some aspects of caregiving behavior. Further studies will extend these laboratory results to real infants and their caregivers, and further validate the NA as a measure of individual differences in reactivity to cry sounds.
Rationalizing Promiscuity Cliffs

Compound promiscuity can be viewed in different ways. We distinguish "bad" promiscuity resulting from chemical liabilities, non-specific binding, or assay artifacts from "good" promiscuity representing true multi-target activities. Investigating multi-target activities of small molecules is scientifically stimulating and therapeutically relevant. To better understand the molecular basis of multi-target activities, structure-promiscuity relationships (SPRs) are explored. For this purpose, "promiscuity cliffs" (PCs) have been introduced, which can be rationalized as an extension of the activity cliff (AC) concept. A PC is defined as a pair of structural analogs that are active against different numbers of targets (given a difference threshold). As discussed herein. PCs frequently capture surprising SPRs and encode many experimentally testable hypotheses.
The NES Child Rearing Scale: A Detailed Empirical Examination of Its Measurement Properties

The objective of this paper is to provide a more accurate assessment of the measurement properties of the NES child rearing scale. In the literature so far, the usual go-to evaluation procedures, Cronbach’s alpha and confirmatory factor analysis, have been used. It is argued in the paper that these procedures yield misleading results of the measurement properties of the scale because the nature of the scores yielded by an application of the child rearing scale are not suited to an application of these procedures. Another objective is to arrive at a more valid characterization of the meaning of the scores yielded by the child rearing scale. It is argued that deeming the scores as representing authoritarianism is not supported. Rather it is argued that a more meaningful characterization is “inner-directed autonomy” versus “outer-directed conformity”. These ideas are then applied to a reinterpretation of the differences of the scores on the child rearing scale between whites and racial and ethnic minorities. The methods employed are simple measures of association and a straight-forward scaling analysis. The results suggest that Cronbach’s alpha underestimates the reliability of the scores yielded by the child rearing scale and that confirmatory factor analysis is not an appropriate procedure for assessing the homogeneity of the items on the scale. Also, a detailed analysis of the scores points to the conclusion that the considerate/well-behaved item needs to be rethought. Huge differences in the scores between whites and racial and ethnic minorities are observed. Instead of basing an explanation of these differences on authoritarianism, an explanation is based on the survival value of conformity for members of ethnic and racial minorities that are the object of discrimination. The conclusion is that the child rearing scale is a worthy addition to the armamentarium of social science measurement procedures with a wide range of potential applications. The data analyzed here were gathered by the ANES at the University of Michigan in their 2016 National Election Study. The author bears all responsibility for the uses and interpretations of these data.
Study of the impact of longitudinal variations in ambient conditions on transmission line voltage stability margin

Electric power transmission lines span through wide geographical areas, experiencing different ambient conditions. Varying weather conditions along the length of the line introduce changing conductor temperatures and hence non-uniform distribution of line electrical parameters along its length. This non-uniform distribution of electrical parameters is expected to impact line power handling capabilities. In order to investigate the impact of longitudinal variations in weather conditions on line voltage stability margins, a line model segmentation approach is used in this work. This line modeling approach, which accounts for non-uniformities in line parameters, divides the line model into multiple lumped parameter segments based on the degree of change in weather conditions. The multi-segment line model and a simple weighted average approach, in which a single segment with parameters calculated at the weighted average conductor temperature along the line is employed, are used in this paper to study the impact on line voltage stability margin. Simulation results are compared with the static line rating approach, in which a set of predefined weather conditions is used for line modeling. Noticeable differences were found in line voltage stability margins when longitudinal changes in ambient conditions were taken into account.
Characteristics of Bus Transit Vehicles in the United States: A 30-Year National Trend Analysis

In 2015, transit agencies in the United States spent over 60% of their bus transit capital funds on their revenue vehicles. Using 30 years of data from the National Transit Database (NTD), this pap...
Is Dick Cheney Unconstitutional

During a recent policy kerfuffle, Vice President Dick Cheney's office briefly argued that the Vice President is really a legislative official, and hence not subject to some obligations of the Executive branch. Though Cheney's office quickly shifted its argument to less controversial statutory grounds, it turns out that the Vice Presidency's legislative character is, in fact, quite significant. To the extent that the Vice President is a legislative official, however, it is likely that extensive delegation of Presidential authority to the Vice President, of the sort that Vice President Cheney has enjoyed, is probably unconstitutional and certainly unwise.
The peroxisome biogenesis disorder group 4 gene, PXAAA1, encodes a cytoplasmic ATPase required for stability of the PTS1 receptor.

Abstract In humans, defects in peroxisome assembly result in the peroxisome biogenesis disorders (PBDs), a group of genetically heterogeneous, lethal recessive diseases. We have identified the human gene PXAAA1 based upon its similarity to PpPAS5, a gene required for peroxisome assembly in the yeast Pichia pastoris. Expression of PXAAA1 restored peroxisomal protein import in fibroblasts from 16 unrelated members of complementation group 4 (CG4) of the PBD. Consistent with this observation, CG4 patients carry mutations in PXAAA1. The product of this gene, Pxaaa1p, belongs to the AAA family of ATPases and appears to be a predominantly cytoplasmic protein. Substitution of an arginine for the conserved lysine residue in the ATPase domain of Pxaaa1p abolished its biological activity, suggesting that Pxaaa1p is an ATPase. Furthermore, Pxaaa1p is required for stability of the predominantly cytoplasmic PTS1 receptor, Pxr1p. We conclude that Pxaaa1p plays a direct role in peroxisomal protein import and is required for PTS1 receptor activity.
Collaboration to Meet a Therapeutic Need: The Development of Nelarabine

The development of nelarabine as a therapeutic agent to treat various forms of hematologic malignancies spans more than 40 years. From the bench top to the bedside, basic scientists and clinical scientists in the pharmaceutical industry and academia collaborated with regulatory agencies to bring this drug to the market. Studies have demonstrated efficacy in treating T-cell leukemia and lymphoma and further work is ongoing as new dosing schedules of nelarabine and combinations with other chemotherapeutic agents are explored. This work is aimed at maximizing the therapeutic outcome while minimizing the potential neurotoxicity that has been identified with nelarabine. This brief review provides some of the “milestones” of development and presents a summary of the efforts of the pharmaceutical industry, academia, and government. Nelarabine, synthesized in the late 1970’s as a prodrug of 9-β-D-arabinofuranosylguanine (ara-G), is still undergoing rigorous clinical evaluations in an effort to identify its optimal use.
Serum NfL (Neurofilament Light Chain) Levels and Incident Stroke in Adults With Diabetes Mellitus

Background and Purpose- Effective stroke prevention depends on accurate stroke risk prediction. We determined the discriminative ability of NfL (neurofilament light chain) levels for distinguishing between adults with diabetes mellitus who develop incident stroke and those who remain stroke free during a 7-year follow-up period. Methods- We performed a case-control study of participants selected from the previously completed ACCORD trial (Action to Control Cardiovascular Risk in Diabetes). Cases were all ACCORD subjects who were stroke free at enrollment and developed incident stroke during follow-up (n=113). Control subjects (n=250) were randomly selected ACCORD subjects who had no stroke events either before or after randomization. NfL was measured in baseline samples using Single Molecule Array technology (Quanterix). Results- Baseline NfL levels were higher in stroke subjects, compared to controls, after adjusting for age, race, blood pressure, weight, and the Framingham Stroke Risk Score. Relative to the subjects in the lowest quintile of NfL levels, the hazard ratios of incident stroke for subjects in the second to fifth quintiles were 3.91 (1.45-10.53), 4.05 (1.52-10.79), 5.63 (2.16-14.66), and 9.75 (3.84-27.71), respectively, after adjusting for race and Framingham Stroke Risk Score. Incorporating NfL levels into a predictive score that already included race and Framingham Stroke Risk Score increased the score's C statistic from 0.71 (95% CI, 0.66-0.77) to 0.78 (95% CI, 0.73-0.83), P<0.001. Older age, nonwhite race, higher systolic blood pressure, glomerular filtration rate <60, and higher hemoglobin A1C were independent predictors of serum NfL in this cohort but diastolic blood pressure, durations of hypertension or diabetes mellitus, and lipid levels were not. In total, cardiovascular disease risk factors explained 19.2% of the variability in baseline NfL levels. Conclusions- Serum NfL levels predict incident stroke and add considerably to the discriminatory power of the Framingham Stroke Risk Score in a cohort of middle-aged and older adults with diabetes mellitus.
Is Health Care a Public Value

Achieving high value for each patient is a core tenet within the field of health care, yet health care remains a divisive issue for some countries. The importance of value within health care often ...
The Nonparametric Approach in Elementary Statistics

INTRODUCTORY statistics courses are taken each year by hundreds of thou sands of students across the country. These students come from many fields: the life sciences, humanities, education, agriculture, business, but above all from the social sciences. They rarely take sta tistics voluntarily. They sign up for the course because of departmental or grad uation requirements. The great majority has minimal preparation in mathematics, rarely more than they bring along from high school. They carry over into statis tics their prejudices of mathematics and quite often, justifiably so. Teachers of sta tistics courses should then ask themselves how they can make the introductory sta tistics course statistically meaningful and not simply an exercise in mathematics or, what may even be worse, a meaningless compendium of statistical techniques. A recent report, Introductory Statistics Without Calculus, by the Committee on the Undergraduate Program in Mathe matics (CUPM) addresses itself to this question. (Free copies of the report may be obtained by writing to CUPM, P.O. Box 1024, Berkeley, Calif. 94701.) The report strongly recommends courses whose main objectives are understanding of basic statistical concepts, rather than technical facility or the extensive study of the prob abilistic background of statistics. The report concerns itself in consider able detail with what it calls the conven tional approach, the approach taken by the large majority of present-day intro ductory statistics texts. Three other approaches, referred to as the decision theoretic, nonparametric, and problem oriented approaches, are discussed much more briefly. In this paper, we shall com pare the conventional and nonparametric approaches. The author has been using the nonpa rametric approach for quite a number of years and feels that it offers important advantages. These advantages stem from the fact that problems such as estimating the center of a population, comparing the observations in two samples, or measuring the strength of relationship in pairs of ob servations, which in the conventional ap proach are solved by methods appropriate for normally distributed populations, in the nonparametric approach are solved with the help of nonparametric procedures, that is with the help of procedures that are not tied to parametric population models like the normal model. Nonpara metric techniques not only require less preparatory work than normal-theory techniques, but are also conceptually much simpler than the latter as the paper will try to show. In connection with the first point, let us refer to descriptive statistics and the
Implementation of Temporal Parallelization for Rapid Quasi-Static Time-Series (QSTS) Simulations

Quasi-static time-series (QSTS) analysis of distribution systems can provide critical information about the potential impacts of high penetrations of distributed and renewable resources, like solar photovoltaic systems. However, running high-resolution yearlong QSTS simulations of large distribution feeders can be prohibitively burdensome due to long computation times. Temporal parallelization of QSTS simulations is one possible solution to overcome this obstacle. QSTS simulations can be divided into multiple sections, e.g. into four equal parts of the year, and solved simultaneously with parallel computing. The challenge is that each time the simulation is divided, error is introduced. This paper presents various initialization methods for reducing the error associated with temporal parallelization of QSTS simulations and characterizes performance across multiple distribution circuits and several different computers with varying architectures.
Mitigating Transformer Loss of Life and Reducing the Hazard of Failure by the Smart EV Charging

The impact of uncoordinated charging of electrical vehicles (EVs) under high penetration on distribution transformers is studied. It was shown that EV chagrining may cause prolonged transformer overload condition, that may in turn result in transformer loss of life and increased hazard of failure. To mitigate the impact, a fuzzy logic-based system for determining EV charging schedule is devised. It uses four main inputs: 1) EV battery state of charge; 2) required state of charge for the next trip; 3) estimated time of EV departure; and 4) customer comfort level. The resulting output is a performance index that the distribution system operators can utilize in a decision-making tool to determine whether to delay the charging of given EV and pay the incentive to the EV owner. The data for the city of College Station, Texas, USA including temperature, price of electricity and load profile are collected from various sources to simulate different use cases. The example illustrates how the proposed EV management approach could mitigate the impact of EV charging on the transformer loss of life and hazard of failure. The main advantage of the proposed approach is the low cost due to simple design implementation. The information that needs to be sent from the consumer to the distribution system operator is minimized, which helps in maintaining costumers’ privacy.
Chemical analysis of exhaled human breath using a novel sub-millimeter/terahertz spectroscopic approach

A novel technique that utilizes terahertz high resolution molecular spectra to quantitative chemical analysis of exhaled human breath is described. We successfully identified and quantified concentrations of acetone, methanol, ethanol, acetaldehyde and dimethyl sulfide in expired human breath samples collected from healthy donors.
Traveling and standing waves mediate pattern formation in cellular protrusions

The mechanisms regulating protrusions during amoeboid migration exhibit excitability. Theoretical studies have suggested the possible coexistence of traveling and standing waves in excitable systems. Here, we demonstrate the direct transformation of a traveling into a standing wave and establish conditions for the stability of this conversion. This theory combines excitable wave stopping and the emergence of a family of standing waves at zero velocity, without altering diffusion parameters. Experimentally, we show the existence of this phenomenon on the cell cortex of some Dictyostelium and mammalian mutant strains. We further predict a template that encompasses a spectrum of protrusive phenotypes, including pseudopodia and filopodia, through transitions between traveling and standing waves, allowing the cell to switch between excitability and bistability. Overall, this suggests that a previously-unidentified method of pattern formation, in which traveling waves spread, stop, and turn into standing waves that rearrange to form stable patterns, governs cell motility.
Evaluating videoconferencing systems for the quality of the educational experience

This study analyzed four widely used videoconferencing systems: Zoom, Skype, Microsoft Teams, and WhatsApp. Using experiential e-learning as the framework for analysis, this study examined the syst...
Effects of stress-related peptides on chloride secretion in the mouse proximal colon.

Background Stress increases intestinal secretion and exacerbates symptoms of irritable bowel syndrome (IBS). Peripherally derived corticotropin-releasing factor (CRF) is known to mediate stress-induced intestinal secretion, presumably by activation of CRF1 receptors in the gut. The present study aimed to ascertain the role of CRF2 activation in intestinal secretion by three other members of CRF peptide family, urocortin (UCN) 1-3, in wild type (WT) and CRF2 knockout (Crhr2-/- ) mice. Methods Mucosal/submucosal preparations from proximal colon of WT and Crhr2-/- mice of both sexes were mounted in Ussing chambers for measurement of short-circuit current (Isc ) as an indicator of ion secretion. Key results Male mice demonstrated a significantly higher baseline Isc than female in both WT and Crhr2-/- genotypes. CRF and UCN1-3 (1 μM) caused greater increases in colonic Isc (ΔIsc ) in male than female. Colonic Isc response to the selective CRF1 agonist, stressin1, was similar in both sexes. In male mice, the selective CRF2 agonists (UCN2 and UCN3) caused significantly greater ΔIsc than CRF and stressin1. UCN2- and UCN3-evoked ΔISC was significantly reduced in preparations pretreated with the selective CRF2 antagonist antisauvagine-30 and in Crhr2-/- mice. The prosecretory effects of urocortins were due to increases in Cl- secretion and involved enteric neurons and mast cells. Conclusions and inference The findings revealed sex differences in baseline colonic secretion and responses to stress-related peptides. CRF2 receptors play a more prominent role in colonic secretion in male mice. The greater baseline secretion and responses to UCNs may contribute to the higher prevalence of diarrhea-predominant IBS in males.
Skill retention with ultrasound curricula.

Background Implementation of a point of care ultrasound curricula is valuable, but optimal integration for internal medicine residency is unclear. The purpose of this study was to evaluate if a structured ultrasound curriculum vs. structured ultrasound curriculum plus supervised thoracic ultrasounds would improve internal medicine residents’ skill and retention 6 and 12 months from baseline. Methods We conducted a randomized controlled study evaluating internal medical residents’ skill retention of thoracic ultrasound using a structured curriculum (control, n = 14) vs. structured curriculum plus 20 supervised bedside thoracic ultrasounds (intervention, n = 14). We used a stratified randomization based on program year. All subjects attended a half-day course that included 5 lectures and hands-on sessions at baseline. Assessments included written and practical exams at baseline, immediately post-course and at 6 and 12 months. Scores are reported as a percentage for the number of correct responses/number of questions (range 0–100%). The Mann Whitney U and the Friedman tests were used for analyses. Results Twenty-eight residents were enrolled. Two subjects withdrew prior to the 6-month exams. Written exam scores for all subjects improved, baseline median (IQR) 60 (46.47 to 66.67) post-course 80 (65 to 86.67), 6-month 80 (66.67 to 86.67) and 12-month 86.67 (80 to 88.34), p = <0.001. All subjects practical exam scores median (IQR) significantly improved, baseline 18.18 (7.95 to 32.95), post-course 59.09 (45.45 to 70.45), 6 month 71.74 (60.87 to 82.61) and 12-month 76.09 (65.22 to 88.05), p = <0.001. Comparing the control group to the intervention group, there were statistically significant higher scores, median (IQR), in the intervention group on the practical exam at 6 months 63.05 (48.92 to 69.57) vs. 82.61(72.83 to89.13), p = <0.001. Conclusion In this cohort, internal medicine residents participating in a structured thoracic ultrasound course plus 20-supervised ultrasounds achieved higher practical exam scores long-term compared to controls.
Best practice for instructional labs

Undergraduate labs are more effective and more positive for students if they encourage investigation and decision-making, not verification of textbook concepts.
Acute Myositis in Three Adult Men with Rapid Resolution (P4.9-040)

Objective: To describe a case-series of three adult men with rapid resolution of myositis. Background: Acute viral myositis is characterized by muscle pain, weakness and elevated serum creatinine kinase after a suspected viral illness. It is a known, but rare, entity that occurs more commonly in children than adults. Design/Methods: Not applicable. Results: Three men ranging in age from 37 to 41 years presented within a span of 18 days in late summer of 2018 with a similar clinical course. Each had a fever (ranging from 101 to 103 °F) and then developed significant muscle weakness (e.g. inability to pick up or open items, ambulate without falling or climb stairs) over the course of 1–4 days. On examination, one man had bilateral wrist/hand weakness and the other two had bilateral full arm and proximal leg weakness (weakness ranged from 3–4/5). Creatinine kinase (peak ranged from 957 to 2121 U/L), C - reactive protein (ranged from 13.7 to 25.3 mg/L), serum myoglobin (ranged from 158 to 250 mcg/L), serum aldolase (ranged from 9.7 to 11.3 U/L) was elevated in all three men. Two of the three men had elevated thyroid peroxidase antibodies (general population has elevation in 8 to 27%). One man had positive Coxsackie antibodies; the other two had negative respiratory viral panels. Electromyogram/nerve conduction study in all three revealed no definite abnormalities. Each patient was discharged from the hospital in 2–3 days with resolution or near-resolution of his weakness. Conclusions: A syndrome of acute myositis with rapid resolution in three middle-aged men is described. Although a viral etiology was suspected, the role of thyroid peroxidase antibodies in two is unexplained. Disclosure: Dr. Danielson has nothing to disclose. Dr. Ranasinghe has nothing to disclose. Dr. Sultan has nothing to disclose. Dr. Riggs has nothing to disclose.
Recasting paradigms of institutional analysis and stakeholder analysis in housing research

Abstract In response to the global challenge of low-income housing provision, research on understanding the housing provision mechanisms has gained a reputation among emerging scholars and practitioners in architecture, urban development, housing, and public policy. An effective provision system entails the institutions and stakeholders comprehending their interrelations within the housing market context, lacking conceptual clarity. Challenging roles of institutions and stakeholders within the domain of housing provision necessitates the groundwork to study the contextual positions and relations of stakeholders as an analogous component and the analysis of institutional frameworks. The paper provides the theoretical foundations within the metaphorical bases for integrating the respective analytical approaches, i.e., institutional analysis (IA) and stakeholder analysis (SA), drawing on critical theoretical constructs. By analytical comparison of empirical evidence of IA and SA in housing research against the prompting keywords, critical reflections offer the conceptual foundation of new research agenda through IA-SA integrated approach. The study thereby advances the theoretical understanding between the regulatory level (institutions) and engagement level (stakeholders). It proposes a multi-level analysis process that complements the IA-SA integration for examining the provision systems in the context of low-income housing.
In-hospital Morbidity and Mortality Following Modified Blalock-Taussig-Thomas Shunts.

Abstract Background The modified Blalock-Taussig-Thomas shunt (mBTTs) is a critically important palliation for patients with insufficient pulmonary blood flow associated with congenital heart disease. Following creation of a mBTTs, patients experience high rates of early postoperative morbidity and mortality. Methods This is a single-institution retrospective cohort study. A query of the Society of Thoracic Surgeons database identified relevant patients whose health records were manually queried for echocardiography and operative reports. Patients with ductal-dependent systemic circulation were excluded. Primary outcomes were early serious adverse events and in-hospital mortality. Secondary outcomes were time to primary outcomes and postoperative lengths of stay. We investigated the correlation of demographics, presence of competitive pulmonary blood flow, and surgical and anatomic factors on outcomes. Results After exclusions, our cohort resulted in 155 patients. 33 (21.3%) patients experienced an early serious adverse event, ten (6.5%) early shunt malfunction, and 11 (7.1%) in-hospital mortality. Smaller shunt size, smaller shunted pulmonary artery size, surgical approach, and site of proximal shunt anastomosis were independently associated with morbidity and mortality. Conclusions Anatomical elements imparting increased resistance along the mBTTs predispose to increased morbidity and mortality, particularly in the early postoperative period. Despite the significant heterogeneity of patients receiving such shunts, similar risk profiles are observed regardless of lesion or presence of competitive flow. Surgical approach via thoracotomy with shunt anastomosis to the subclavian artery, where feasible, results in the subclavian artery as the point of natural resistance allowing for placement of larger shunts, yielding lower morbidity and mortality.
The Century of Taste: The Philosophical Odyssey of Taste in the Eighteenth Century

The Century of Taste offers an exposition and critical account of the central figures in the early development of the modern philosophy of art: Hutcheson, Gerard, Alison, Kant, and Hume. Dickie follows the development of the modern theory of taste from its origination by Hutcheson, to blind alleys followed by Gerard and Alison, its refinement and complete expression by Hume, and finally to its decline in the hands of Kant. In a straightforward and unpretentious style, Dickie offers sympathetic discussions of the theoretical aims of these philosophers, but does not shy from controversy - for instance, pointing out the obscurities and inconsistencies in Kant's aesthetics writings, which Dickie argues are overrated.
Progress on a steady-state tokamak magnetic field sensor: accurate for unlimited time durations for fusion reactors

A novel hybrid method for accurate magnetic field measurements in steady-state or long-pulse tokamaks, described in a 1995 publication and patented in 1998, has not yet been tested in a tokamak. Recent development progress is described herein.
Black women and stress: utilization of self-help groups for stress reduction

This study investigated the success of a Focused Support Group (FSG) model in maintaining black women in self-help groups and reducing stress over a six-month period. Respondents participated in a five week Focused Support Group led by professional staff. Six months later they were administered a questionnaire to determine the usefulness of that model in alleviating work related stresses and maintaining the participants in self-help groups. Questionnaires examined self-reported changes in stress, support networks and the influence of group leadership characteristics on group continuation. Results indicated that those black women who remained in self-help groups after six months reported a continued lowered level of stress, an increase in sources of emotional support and a general increase in the quality of interpersonal relationships. Respondents who did not continue in self-help groups were characterized by a desire for mental health services, involvement in relationships and saw time conflicts as the pr...
Controlling invariant density: an l/sup /spl infin// solution to the inverse Frobenius-Perron problem

In a previous paper we gave a new formalism to solve the inverse Frobenius-Perron problem (IFPP), to produce a dynamical system, uniformly nearby a given dynamical system, but with a drastically different and desirable invariant density. Our previous algorithm reduced the problem of producing the dynamical system G with desirable statistics /spl beta/(x), into a constrained optimization problem, which we solved in l/sup 2/. However, we pointed out that if this l/sup 2/ solution does not correspond to a useful solution, one could not conclude nonexistence. The l/sup /spl infin// solution to the same optimization problem allows for a sharp existence-nonexistence theorem. In this paper, we present for the first time an l/sup /spl infin// algorithm which produces solutions to our IFPP, and conclude our nonexistence theorem which is pertinent to this solution. Then we discuss applications in control of chaos, both by open-loop control strategies for maps, and we discuss future applications to feedback control of flows.
A general representation for orientational uncertainty using random unit quaternions

Previous work in representing transformational uncertainty used a linearized perturbed-transform method which assumes small angle errors. This paper presents an alternative representation using random unit quaternions that makes no strict small angle error assumption. The approach uses a novel family of probability density functions derived by placing a unit-length constraint upon some or all of the degrees of freedom of a Gaussian in Euclidean space. An important property of this representation is that it does not directly interrelate angles with spatial components. This paper discusses the properties of radially constrained Gaussians, presents specific cases of uncertain rotations, directions, orientations, 2D transformations, and 3D transformations, and then indicates their applications to robotics. >
Genetic Analysis of Regulation of the RecF Pathway of Recombination in Escherichia coli K-12

Genetic evidence is provided supporting the hypothesis that one or more genes of the RecF pathway of recombination other than recA are controlled by the lexA repressor. Using lexA, recA, and recA operator mutations, we also analyze the role of recA and sbcB in regulating the RecF pathway.
The Partisan Legacies of Preemptive Leadership: Assessing the Eisenhower Cohorts in the U.S. House

Interrogating one case of what Stephen Skowronek calls the “preemptive” Presidency, I examine Dwight D. Eisenhower's New Republican project as it manifested itself in House elections and lawmaking. To that end, I assess the ideological characteristics, electoral dynamics, and roll-call behavior of the four cohorts elected to the House between 1952 and 1958. Synthesizing qualitative accounts and quantitative evidence, I determine that the Eisenhower years reshuffled party commitments in the House by leaving more-moderate but numerically decimated Republicans to battle ideologically galvanized and numerically strengthened Democrats in the 1960s. In short, Eisenhower affected the party system in identifiable ways, but he struggled to leave the legacies he envisioned when he took office. Beyond the specifics of the Eisenhower case, the methodology developed here is broadly applicable across Presidencies.
Overexpression, Purification, and Characterization of a Barley α-Glucosidase Secreted by Pichia pastoris

Abstract α-Glucosidases (EC 3.2.1.20) are recognized as important in starch degradation during cereal seed germination. A barley ( Hordeum vulgare ) α-glucosidase expressed in Pichia pastoris was cultured in flasks; however, the yield was low necessitating the use of multiple batches. Problems arose because of significant variation between batches. We solved these problems by switching to a fermentation system producing a sufficient quantity of a uniform sample. Here we present the expression and purification of a recombinant α-glucosidase grown under fermentation conditions. We also present the results of experiments to characterize the thermostability, pH optimum, and substrate specificity of the recombinant enzyme. The optimal pH for the hydrolysis of maltose by recombinant α-glucosidase is between 3.5 and 4.5. The thermostability of recombinant α-glucosidase was determined at pH 4, where activity is optimal, and at pH 5 and 6, which better mimic the conditions used to convert barley starch to fermentable sugars during industrial processing. The results indicate the enzyme is most thermolabile at pH 4. However, the enzyme is protected from heat inactivation at pH 4 by high concentrations of sucrose. The purified enzyme hydrolyzed maltose three times more rapidly than nigerose and 20 times more rapidly than trehalose and isomaltose. Concentrations of maltose greater than 20 mM inhibited maltose hydrolysis. This is the first report of substrate inhibition for any α-glucosidase. The results indicate that the only significant difference between the recombinant enzyme and the previously characterized barley isoforms was the V max for maltose hydrolysis.
Synthesis and characterization of fluorescent cobalamin (CobalaFluor) derivatives for imaging.

Fluorescent derivatives of cobalamin have been prepared by linking fluorophores to cobalamin through a propylamide spacer. Fluorescein, naphthofluorescein, and Oregon Green derivatives have been prepared in good yield by reaction of the fluorophore NHS-ester with β-(3-aminopropyl)cobalamin to form fluorescent cobalamin conjugates (CobalaFluors) that are potentially suitable for the in vitro and in vivo imaging of transcobalamin receptors on cancer cells.
Investigation of short cavity CRDS noise terms by optical correlation

Cavity Ring Down Spectroscopy (CRDS) has been identified as having significant potential for Department of Defense security and sensing applications. Significant factors in the development of new sensor architectures are portability, robustness and economy. A significant factor in new CRDS sensor architectures is cavity length. Prior publication has examined the role of cavity length in sensing modality both from the standpoint of the system’s design and the identification of potential difficulties presented by novel approaches. Two of interest here are new noise terms that have been designated turbulence-like and speckle-like in prior publication. In the prior publication the theoretical and some empirical data was presented. This presentation addresses the automation of the experimental apparatus, new data analysis, and implications regarding the significance of the two noise terms. This is accomplished through an Analog-to- Digital Conversion (ADC) from the output of a custom designed optical correlator. Details of the unique application of the developed instrument and implications for short cavity (portable) CRDS applications are presented.
Long range planning— An open systems view

Abstract Long range planning has been identified as a major managerial factor for many years. Unfortunately, some important factors have not been adequately incorporated into the planning process. These componets of open systems theory—the environment, goals, and strategy— are discussed and integrated into the long-range planning process. This procedure will make for a more successful and effective planning operation in organizations
Confessions of a used programming language salesman

For many years I had been fruitlessly trying to sell functional programming and Haskell to solve real world problems such as scripting and data-intensive three-tier distributed web applications. The lack of widespread adoption of Haskell is a real pity. Functional programming concepts are key to curing many of the headaches that plague the majority of programmers, who today are forced to use imperative languages. If the mountain won't come to Mohammed, Mohammed must go to the mountain, and so I left academia to join industry. Instead of trying to convince imperative programmers to forget everything they already know and learn something completely new, I decided to infuse existing imperative object-oriented programming languages with functional programming features. As a result, functional programming has finally reached the masses, except that it is called Visual Basic 9 instead of Haskell 98.
Paying for prevention: associations between pay for performance and cessation counseling in primary care practices.

Abstract Purpose. To examine associations between pay for performance (P4P) and recommended cessation counseling among primary care practices (PCPs). Design. Cross-sectional survey of 89 PCPs participating in a joint Robert Wood Johnson Foundation (RWJF)–Agency for Healthcare Research and Quality (AHRQ) health promotion initiative. Setting and Participants. 100% response rate from PCPs participating in the RWJF-AHRQ initiative. Measures. Survey data on cessation counseling, practice involvement with P4P, practice size, public reporting of performance, practice competition, linkages with community resources, integration of evidence-based guidelines, patient recommendations for cessation, and state-specific smoking rates. Analysis. Logistic regression was used to examine associations between practice involvement with P4P and cessation counseling offered by PCPs. Practice characteristics, including size and availability of other cessation services, were included in the analysis. Results. Practices that were ...