cssi/SciSciGPT-SciSciNet huggingface dataset:
Evaluation of Treatment Modalities for Thoracic Empyema: A Cost-Effectiveness Analysis

Abstract Background . Empyema thoracis is treated with a multitude of therapeutic options. Optimal therapy and cost-containment requires selection of the most appropriate initial intervention. Methods . A retrospective review of treatment modalities was performed on 77 patients diagnosed with empyema thoracis from 1990 to 1997 at one institution. Mean age was 59 years (range, 21 to 90 years); 52 were men and 25 were women. Results . Sixty-five percent (50/77) were parapneumonic and 68% (52/77) were multiloculated. Treatment modalities were as follows: group 1, antibiotics only (n = 4); group 2, primary intervention: image-directed catheter (n = 20) or tube thoracostomy (n = 24); and group 3, secondary intervention: decortication (n = 17), rib resection or muscle interposition (n = 12). Thirty-four percent (9/20 image-directed catheter and 8/24 tube thoracostomy) had failure of initial intervention. Patients undergoing decortication more often had multiloculated empyema thoracis (16 of 17) compared with those undergoing image-directed catheters (8 of 20) or tube thoracotomy (16 of 24). Length of stay was reduced for decortication patients (17 days) compared with those having image-directed catheters (21.8 days), failed image-directed catheters (29.7 days), or tube thoracostomies (19.6 days). Hospital charges per patient between decortication and image-directed catheter ($34,770.79 versus $37,869.41) were comparable, but charges were significantly decreased in decortication patients as compared with failed image-directed catheters ($55,609.32; p Conclusions . Our series revealed that early decortication has charges similar to those of primary intervention (image-directed catheter or tube thoracostomy) but is more cost-effective than failed image-directed catheter. We advocate the use of early surgical intervention as the most optimal and cost-effective initial modality for the treatment of empyema thoracis.
Ethanol impairs intestinal barrier defense by modulation of immunoglobulin A transport

Background. Increased epithelial permeability may contribute to septic complications after alcohol intoxication. Prior ethanol (EtOH) exposure leads to structural and functional effects on cytoskeletal components important in maintaining barrier integrity. The cytoskeleton is also important in the transcellular transport of proteins including the polymeric immunoglobulin receptor (pIgR) mediated transport of immunoglobulin A (IgA) to the luminal surface of mucosal tissues. We (1) investigated the effects of acute EtOH exposure on cell monolayer barrier integrity and IgA transport and (2) assessed the importance of microtubule function on these functions in vitro. Methods. Confluent Madin-Darby canine kidney (MDCK) epithelial cells transfected with pIgR cDNA were exposed to 1% or 5% EtOH, and transcytosis of dimeric IgA was measured. Paclitaxel was used to pretreat a subset of MDCK cells. Results. EtOH exposure resulted in a concentration and time dependent decrease in IgA transcytosis. This was associated with physical derangements in the integrity of the cell monolayer. Pretreatment with paclitaxel completely abrogated these effects. Conclusions. EtOH causes both physical and immune derangement of epithelial cell barrier function. Decreased secretory IgA at mucosal surfaces may initiate septic complications after EtOH intoxication. (Surgery 2002;132:573-81.)
Corticospinal Dysgenesis and Congenital Hemiplegia

A diffusion tensor imaging technique was compared with conventional MRI to measure and quantify corticospinal dysgenesis in 12 patients with congenital hemiplegia and 12 matched control subjects, in a study at Universite Catholique de Louvain, Brussels, Belgium.
Retrospective Review of Ocular Point-of-Care Ultrasound for Detection of Retinal Detachment.

Introduction: Retinal detachment is an ocular emergency that commonly presents to the emergency department (ED). Ophthalmologists are able to accurately make this diagnosis with a dilated fundoscopic exam, scleral depression or ophthalmic ultrasound when a view to the retina is obstructed. Emergency physicians (EPs) are not trained to examine the peripheral retina, and thus ophthalmic ultrasound can be used to aid in diagnosis. We assessed the accuracy of ocular point-of-care ultrasound (POCUS) in diagnosing retinal detachment. Methods: We retrospectively reviewed charts of ED patients with suspected retinal detachment who underwent ocular POCUS between July 2012 and May 2015. Charts were reviewed for patients presenting to the ED with ocular complaints and clinical concern for retinal detachment. We compared ocular POCUS performed by EPs against the criterion reference of the consulting ophthalmologist’s diagnosis. Results: We enrolled a total of 109 patients. Of the 34 patients diagnosed with retinal detachment by the ophthalmologists, 31 were correctly identified as having retinal detachment by the EP using ocular POCUS. Of the 75 patients who did not have retinal detachment, 72 were ruled out by ocular POCUS by the EP. This resulted in a POCUS sensitivity of 91% (95% CI [76-98]) and specificity of 96% (95% CI [89-99]). Conclusion: This retrospective study suggests that ocular POCUS performed by EPs can aid in the diagnosis of retinal detachment in ED.
Modeling of a Displacement Amplified Magnetostrictive Actuator for Active Mounts

A hydraulically-amplified Terfenol-D actuator is developed to be used as a driver in active engine mounts. A measure of the actuator’s performance is obtained through electromechanical tests in mechanically-blocked and mechanically-free conditions. A nonlinear model for the actuator is presented. The Jiles-Atherton model is coupled with Maxwell’s equations in order to quantify the radial dependence of magnetization and associated dynamic losses. Magnetostriction, which is modeled as a single-valued function of magnetization, provides an input to the mechanical model describing the system vibrations. Friction at the elastomeric seals is modeled using the LuGre friction model for lubricated contacts. Results show that the model is able to accurately describe the dynamic behavior of the actuator up to 400 Hz. An order analysis on the data and modeled responses show that the model is capable of describing the higher harmonic content of the device with sufficient accuracy for control design.© 2009 ASME
Validity and Utility of the ADAS-L for Measurement of Cognitive and Functional Impairment in Geriatric Schizophrenic Inpatients

This study examined the usefulness of the Alzheimer's Disease Assessment Scale-Late Version (ADAS-L) for assessing cognitive and behavioral impairment in geriatric schizophrenic patients. Subjects were 339 geriatric schizophrenic inpatients. Discriminant function analyses compared the Mini-Mental State Examination (MMSE) with the ADAS-L as independent variables predicting the level of impairment on the criterion measure, the Clinical Dementia Rating. The ADAS-L surpassed the MMSE at correctly distinguishing severe to profound impairment; the MMSE was superior for identifying absent or questionable impairment. Findings provide evidence for the concurrent validity of the ADAS-L as an instrument for measuring impairment in geriatric schizophrenic inpatients.
Optimal Dispatching Schedule of Hybrid Pumped-storage Power Station

In view of the current situation of fast and large-scale wind power grid-connection in China,an extension to the hybrid pumped-storage power station is proposed.The significance to the power grid dispatching construction is analyzed and summarized.Meanwhile,a general model of multi-reservoirs optimization combined operation is developed according to the functions and features of the hybrid pumped-storage power station.The operation benefits of the hydropower stations of different grid demands are generalized.The algorithm of two-dimensional discrete differential dynamic programming(DDDP) is adopted in conjunction with the successive approximation algorithm(SAA) for solution.Verification by simulation is made for Baishan-Fengman cascade plant in Northeast China.The result shows that the model structure is rational and the algorithm is effective. This work is supported by State Grid Corporation of China.
The Speeches of Outsiders in Acts: The speeches of Claudius Lysias, Tertullus, and Festus

This is the final chapter in my exegetical investigation of the speeches of outsiders. In the previous three chapters I demonstrated that the following pattern emerged with respect to Luke's use of the speeches of outsiders: non-Christians, by means of their speech, were the instruments through which the spread of the word was facilitated. In addition, some of the non-Christian speeches served as the voice of the narrator in affirming the legitimacy of the Jesus movement. The outsiders, we observed, were not consciously performing these acts of gospel forwarding and legitimation. Rather, the narrator had introduced sufficient clues in the narrative to allow the reader to conclude that these characters did not realise the wider significance of their statements and actions. In other words, the speech-acts of the outsiders were saturated with dramatic irony. By exploiting this literary technique, Luke was able to accent his own theological/historiographic convictions through the unlikely channel of the speeches of outsiders. We shall explore in this chapter whether a similar ploy is used by Luke in the speeches of Lysias, Tertullus, and Festus. In this manner I bring to a close my exegetical discussion of the speeches of outsiders in Acts. Context The outsider speeches encountered in the previous two chapters occurred in the context of Paul's itinerant mission. Paul and his associates were able to move about freely in the eastern parts of the empire disseminating the message concerning Jesus.
Review of Clinical Databases

There are several open access health datasets that promote effective retrospective comparative effectiveness research.
Total Water Intake from Beverages and Foods Is Associated with Energy Intake and Eating Behaviors in Korean Adults.

Water is essential for the proper functioning of the body. Even though a recommendation exists for adequate water intake for Koreans, studies identifying actual water intake from all beverages and foods consumed daily in the Korean population are limited. Thus, we estimated total water intake from both beverages and foods and its association with energy intake and eating behaviors in Korean adults. We used a nationally representative sample of 25,122 Korean adults aged ≥19 years, from the Korean National Health and Nutrition Examination Survey 2008–2012. We performed multiple regression analyses, adjusting for sociodemographic and health-related variables to investigate the contribution of overall energy and dietary intakes and eating behaviors to total water intake. The mean total water intake excluding plain water was 1071 g (398 g from beverages and 673 g from foods) and the estimated plain water intake was 1.3 L. Among Korean adults, 82% consumed beverages (excluding plain water) and these beverages contributed to 10% of daily energy intake and 32% of total water intake from beverages and foods. For every 100 kcal/day in energy intake, water intake consumed through beverages and foods increased by 18 g and 31 g, respectively. Water intake from beverages and foods was positively associated with energy from fat and dietary calcium, but inversely associated with energy density and energy from carbohydrates. When there was a 5% increase in energy intake from snacks and eating outside the home, there was an increase in water intake from beverages of 13 g and 2 g, respectively. Increased daily energy intake, the number of eating episodes, and energy intake from snacks and eating outside the home predicted higher water intake from beverages and foods. Our results provide evidence suggesting that various factors, including sociodemographic status, dietary intakes, and eating behaviors, could be important contributors to the water intake of Korean adults. Findings from this cross-sectional analysis may provide insight into strategies for promoting adequate water intake among Koreans.
Carbamate Insecticides Target Human Melatonin Receptors.

Carbaryl (1-naphthyl methylcarbamate) and carbofuran (2,3-dihydro-2,2-dimethyl-7-benzofuranyl methylcarbamate) are among the most toxic insecticides, implicated in a variety of diseases including diabetes and cancer among others. Using an integrated pharmacoinformatics based screening approach, we have identified these insecticides to be structural mimics of the neurohormone melatonin and were able to bind to the putative melatonin binding sites in MT1 and MT2 melatonin receptors in silico. Carbaryl and carbofuran then were tested for competition with 2-[125I]-iodomelatonin (300 pM) binding to hMT1 or hMT2 receptors stably expressed in CHO cells. Carbaryl and carbofuran showed higher affinity for competition with 2-[125I]-iodomelatonin binding to the hMT2 compared to the hMT1 melatonin receptor (33 and 35-fold difference, respectively) as predicted by the molecular modeling. In the presence of GTP (100 μM), which decouples the G-protein linked receptors to modulate signaling, the apparent efficacy of carb...
Cross calibration of two dual-energy X-ray densitometers and comparison of visceral adipose tissue measurements by iDXA and MRI.

Objective Compare total percentage body fat (pfat) measurements between two densitometers and visceral adipose tissue (VAT) estimates between iDXA and magnetic resonance imaging (MRI) from the same defined abdominal region. Methods Participants [N = 93 (50 men, 43 women), BMI: 19.1–57.6 kg/m2] underwent dual-energy X-ray absorptiometry (DXA) scans on two DXA systems (GE Healthcare Lunar iDXA and Lunar Prodigy), and a subgroup underwent abdominal MRI imaging for quantification of VAT. Results Pfat correlated strongly between both machines (r2 = 0.98, P < 1.0E-14). Bland-Altman plots showed a bias with higher measured pfat on iDXA versus Prodigy in leaner subjects and the opposite in more overweight subjects. The R2 for regression of MRI on iDXA VAT values was 0.948. Bland-Altman bias was +104.1 cm3 with 95% limits of agreement of −681.9 to 890.0 cm3. For both DXA methods, and iDXA versus MRI determined VAT, comparison using rank regression demonstrated no order bias. Conclusions The total pfat measured by both machines was strongly and linearly associated, allowing for conversion (equations are provided) of iDXA for assessment of longitudinal body fat changes. Despite a bias of abdominal VAT measures of iDXA versus MRI, the high rank correlation makes iDXA a good alternative to the more complicated and time-consuming MRI for use in larger cross-sectional and longitudinal studies.
Bone Marrow‐Derived Mesenchymal Stem Cells‐Derived Exosomes Promote Survival of Retinal Ganglion Cells Through miRNA‐Dependent Mechanisms

The loss of retinal ganglion cells (RGC) and their axons is one of the leading causes of blindness and includes traumatic (optic neuropathy) and degenerative (glaucoma) eye diseases. Although no clinical therapies are in use, mesenchymal stem cells (MSC) have demonstrated significant neuroprotective and axogenic effects on RGC in both of the aforementioned models. Recent evidence has shown that MSC secrete exosomes, membrane enclosed vesicles (30-100 nm) containing proteins, mRNA and miRNA which can be delivered to nearby cells. The present study aimed to isolate exosomes from bone marrow-derived MSC (BMSC) and test them in a rat optic nerve crush (ONC) model. Treatment of primary retinal cultures with BMSC-exosomes demonstrated significant neuroprotective and neuritogenic effects. Twenty-one days after ONC and weekly intravitreal exosome injections; optical coherence tomography, electroretinography, and immunohistochemistry was performed. BMSC-derived exosomes promoted statistically significant survival of RGC and regeneration of their axons while partially preventing RGC axonal loss and RGC dysfunction. Exosomes successfully delivered their cargo into inner retinal layers and the effects were reliant on miRNA, demonstrated by the diminished therapeutic effects of exosomes derived from BMSC after knockdown of Argonaute-2, a key miRNA effector molecule. This study supports the use of BMSC-derived exosomes as a cell-free therapy for traumatic and degenerative ocular disease. Stem Cells Translational Medicine 2017;6:1273-1285.
The Religious Origins and Destinations of Individuals Identifying as a Sexual Minority

Religion has been, and continues to be, a source of external hostility and internal struggle for many sexual minorities. This has potential implications for the observed religious origins and current religious affiliations of individuals identifying as a sexual minority. Regarding origins, self-identified sexual minorities might be less likely than heterosexuals to have come from religious traditions that have tended to be hostile to minority sexualities, as individuals raised within those traditions might be hesitant to identify as a sexual minority even if they have same-sex attractions. Regarding destinations, self-identified sexual minorities might be more likely than heterosexuals to switch away from religious traditions that have tended to be hostile to minority sexualities. We examine these expectations using nationally representative survey data from the 2008 to 2014 General Social Surveys. The analysis shows that sexual minorities do not significantly differ from heterosexuals by the religious traditions in which they were raised. Sexual minorities are, however, more likely than heterosexuals to move away from Christian traditions and towards disaffiliation or reaffiliation with “other” traditions that include Judaism, Buddhism, and liberal nontraditional religions such as Unitarian Universalism. For gay and lesbian individuals, these patterns of disaffiliation and reaffiliation can be attributed to higher on average education and lower likelihood of being married and having children; however, these sociodemographic factors do not explain the disaffiliation and reaffiliation of bisexual individuals. Further research should explore the different religious experiences of sexual minority sub-groups.
Elites and Stars of Modern Architecture

In the shift from aristocratic society to democracy professional and social elites still are lacking definite cultural norms and attitudes. Rapid change of tastes and political influence blurs common attitudes and values, intuitive and rational methods of decision making, moral and artistic values. Architectural schools trying to accommodate to those changes lose their professional permanency.
Black Rural Lives Matters: Ethnographic Research about an Anti-Racist Interfaith Organization in the U.S. South

The non-indictment of Michael Brown's killer in fall 2014, the castigation of Blacks during the Baltimore uprising following Freddie Gray's death in police custody, and the death of Sandra Bland in a Texas jail further solidified the notion of the expendability of Black life in the United States. But while larger urban areas like Cleveland, Ferguson, and Staten Island mobilized around anti-Black police brutality, African Americans in smaller rural towns struggled to manifest their opposition to anti-Black violence in ways that were meaningful to their communities. Many turned to the Black church, which emerged once again as a site of struggle and resistance. This essay charts the rise of an anti-racist, interfaith organization created to combat anti-Black racism in the South: Blount County United (BCU) organized by Reverend Dr. Willa Estell, head pastor of Saint Paul African Methodist Episcopal Zion Church in Maryville, Tennessee. Our focus on BCU renders problems that Blacks face in non-urban contexts visible and demonstrates the systemic nature of racism in the 21st century as it is articulated in rural contexts thereby highlighting the hidden transcripts of anti-Black violence.
Vocational Goals of the Graduate Student

TUDENTS in rural social sciences feel the full impact of problems encountered in graduate study when those problems become hindrances in the achievement of vocational goals. This is particularly true when such problems result in training deficiencies that limit the student's qualifications for a wide scope of job opportunities. The cumulative result of such shortcomings in academic preparation is brought to focus even more sharply when they prevent vocational advancement in whatever employment the student accepts at the end of his graduate training. Outstanding among the problems which handicap many graduate students in achieving their vocational goals are those which have been so ably described by the preceding discussants. Certainly it seems reasonable that some prospective employers might discriminate against applicants from a graduate center which has a reputation for institutional "inbreeding" of ideas. On the other hand, such applicants might be at a definite advantage when being considered by employers who are themselves inculcated with the one-mindedness of "inbreeding." Another equally handicapping circumstance is that of educational provincialism which results when a student's entire academic training, undergraduate and graduate, has been taken at the same institution. Acquaintance with only one state or region and training in only one intellectual approach definitely limit breadth of viewpoint. This situation is even more harmful in departments where the graduate student too often is looked upon as a building brick that may be broken or forced into place in order to contribute to the over-all program of an institution or an exploitative advisor. These inadequacies alone offer justification for ranking a student's eligibility for employment below that of applicants whose backgrounds include more than one intellectual climate.
A transformational study abroad process model for nursing educators consideration

Objective: Preparing nursing students within the college or university setting to make a positive difference in today’s global society increasingly includes opportunities to study abroad. Maximizing the transformational benefits of these experiences while minimizing the potential ill effects must be a focus of those who develop and implement these programs. This research was conducted to better understand the entire study abroad experience from the student point of view in order to develop a holistic model for nurse educators to utilize in the development of curricular and support programming. Methods: A descriptive, qualitative survey with 72 baccalaureate nursing and other art and science degree alumni from a mid-sized, private, Christian university in the United States who studied for a semester in a third world country was conducted. These participants provided essay answers to four questions regarding the impact, challenges, and opportunities appreciated throughout their study abroad experience, as well as recommendations for future study abroad programming. The responses were analyzed and the results compared with the theoretical framework upon which the study was based. Results and conclusion: Five major components of a transformative study abroad experience were exemplified. The first related to the characteristics of the sojourner, and the remaining four to a comprehensive patterned experiential process by which students moved through their study abroad experience towards transformation and action. The findings provide both a conceptual model and practical insights for nurse educators to consider as they prepare future nurses to engage their world for good through study abroad experiences.
Drug accessibility and availability tool: Case of Rwanda

Drug accessibility is a barrier to the timely treatment of patients and in some cases it contributes, to health complications and can lead to death. Drug availability is more important than drug accessibility as the drug has to be available first in order to be accessible. However, access to information about the price of the drug and the location of the pharmacy in which one can find the drug remains a challenge. In this paper, we present a web application solution that bridges the gap between accessibility and availability by providing real-time information about drug inventory, drug cost and pharmacies' address in Rwanda.
Etiology of Acute Coronary Syndrome after Noncardiac Surgery.

Background The objective of this investigation was to determine the etiology of perioperative acute coronary syndrome with a particular emphasis on thrombosis versus demand ischemia. Methods In this retrospective cohort study, adult patients were identified who underwent coronary angiography for acute coronary syndrome within 30 days of noncardiac surgery at a major tertiary hospital between January 2008 and July 2015. Angiograms were independently reviewed by two interventional cardiologists who were blinded to clinical data and outcomes. Acute coronary syndrome was classified as ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, or unstable angina; myocardial infarctions were adjudicated as type 1 (plaque rupture), type 2 (demand ischemia), or type 4b (stent thrombosis). Results Among 215,077 patients screened, 146 patients were identified who developed acute coronary syndrome: 117 were classified as non-ST-elevation myocardial infarction (80.1%); 21 (14.4%) were classified as ST-elevation myocardial infarction, and 8 (5.5%) were classified as unstable angina. After coronary angiography, most events were adjudicated as demand ischemia (type 2 myocardial infarction, n = 106, 72.6%) compared to acute coronary thrombosis (type 1 myocardial infarction, n = 37, 25.3%) and stent thrombosis (type 4B, n = 3, 2.1%). Absent or only mild, nonobstructive coronary artery disease was found in 39 patients (26.7%). In 14 patients (9.6%), acute coronary syndrome was likely due to stress-induced cardiomyopathy. Aggregate 30-day and 1-yr mortality rates were 7 and 14%, respectively. Conclusions The dominant mechanism of perioperative acute coronary syndrome in our cohort was demand ischemia. A subset of patients had no evidence of obstructive coronary artery disease, but findings were consistent with stress-induced cardiomyopathy.
Stride length: the impact on propulsion and bracing ground reaction force in overhand throwing

Propulsion and bracing ground reaction force (GRF) in overhand throwing are integral in propagating joint reaction kinetics and ball velocity, yet how stride length effects drive (hind) and stride (lead) leg GRF profiles remain unknown. Using a randomised crossover design, 19 pitchers (15 collegiate and 4 high school) were assigned to throw 2 simulated 80-pitch games at ±25% of their desired stride length. An integrated motion capture system with two force plates and radar gun tracked each throw. Vertical and anterior-posterior GRF was normalised then impulse was derived. Paired t-tests identified whether differences between conditions were significant. Late in single leg support, peak propulsion GRF was statistically greater for the drive leg with increased stride. Stride leg peak vertical GRF in braking occurred before acceleration with longer strides, but near ball release with shorter strides. Greater posterior shear GRF involving both legs demonstrated increased braking with longer strides. Conversely, decreased drive leg propulsion reduced both legs' braking effects with shorter strides. Results suggest an interconnection between normalised stride length and GRF application in propulsion and bracing. This work has shown stride length to be an important kinematic factor affecting the magnitude and timing of external forces acting upon the body.
Will aging voting machines cause more voters to experience long waits

Abstract As the majority of voting machines in use today approach or exceed their expected lifetime, an increased number of voting machine failures are expected in upcoming elections. This study examines and quantifies the impact of less reliable voting machines, due to age, on the number of voters waiting longer than 30-min. G/G/s queue approximation and discrete event simulation are used in the analysis. Results show that if reliability measures — mean time between failures, mean time to repair, and availability — are within certain interval ranges, no additional voting machines are needed to ensure that no more than 5% of voters wait for longer than 30 min. However, significantly more voters would have long waits if the reliability of voting machines is poor. Accordingly, less reliable voting machines do not necessarily cause more voters to experience long waits. The proposed closed-form approximation formula and the simulation model are practical tools for election officials to evaluate the impact of less reliable voting machines on voting lines.
Baseline multimodal information predicts future motor impairment in premanifest Huntington's disease

Abstract In Huntington's disease (HD), accurate estimates of expected future motor impairments are key for clinical trials. Individual prognosis is only partially explained by genetics. However, studies so far have focused on predicting the time to clinical diagnosis based on fixed impairment levels, as opposed to predicting impairment in time windows comparable to the duration of a clinical trial. Here we evaluate an approach to both detect atrophy patterns associated with early degeneration and provide a prognosis of motor impairment within 3 years, using data from the TRACK-HD study on 80 premanifest HD (pre-HD) individuals and 85 age- and sex-matched healthy controls. We integrate anatomical MRI information from gray matter concentrations (estimated via voxel-based morphometry) together with baseline data from demographic, genetic and motor domains to distinguish individuals at high risk of developing pronounced future motor impairment from those at low risk. We evaluate the ability of models to distinguish between these two groups solely using baseline imaging data, as well as in combination with longitudinal imaging or non-imaging data. Our models show improved performance for motor prognosis through the incorporation of imaging features to non-imaging data, reaching 88% cross-validated accuracy when using baseline non-longitudinal information, and detect informative correlates in the caudate nucleus and the thalamus both for motor prognosis and early atrophy detection. These results show the plausibility of using baseline imaging and basic demographic/genetic measures for early detection of individuals at high risk of severe future motor impairment in relatively short timeframes.
Basic Rehabilitation Principles of Persons with Leg Length Discrepancy: An Overview

A sucessful rehabilitation program is built upon a thorough evaluation of the patient’s physical and emotional problems. A person with leg length discrepancy may have functional, cosmetic, or pain problems. Proper identification of these problems is imperative if the treatment is to bear desired results. It is necessary for the physician and therapists to work with the patient in a team approach from the very beginning. The team approach enables the proper priorities to be placed on the problem areas; to try to correct all problem areas at once would be futile. For some patients cosmesis is the overriding factor in their desire to have corrective measures performed. In others, function may be the most inportant factor. Some defects may be minor to the evaluators but major to the patient, or vice versa.
Chemical Risk Management: Introduction

The level of concern over the environmental and occupational risks from chemicals is often measured in terms of the vast number of chemicals in circulation, many of which are suspected of having adverse human health effects. The specific numbers often cited in connection with the volume of chemicals potentially in the environment are: the over 5.3 million chemicals listed in Chemical Abstracts, the 70,000 synthetic chemicals currently in circulation, and the average rate of over 1,000 chemicals per year introduced into the market place.1 The chemical industry, which did an estimated volume of sales of $162 billion in 1980, accounts for five percent of the gross national product.2 As a result of these concerns, the number of environmental laws that deal with chemical risks has grown exponentially over the past decade. Several hundred chemicals are closely monitored under these laws.
From General to Specific: Can Pseudomonas Primary Metabolism Be Exploited for Narrow-Spectrum Antibiotics?

The spread of antimicrobial resistance is a major threat to human health, and patients requiring prolonged antibiotic exposure are in desperate need of new therapeutic strategies. It has been hypothesized that tailoring our antibiotics to inhibit molecular targets specific to pathogens might stem the spread of resistance. A prime candidate for such a strategy is Pseudomonas aeruginosa, which can be found in the lungs of nearly all adult cystic fibrosis patients and, due to chronic exposure to antibiotics, has a high rate of multidrug-resistant strains. Although much research has been done on P. aeruginosa virulence factors as narrow-spectrum targets, less attention has been paid to primary carbon metabolism being leveraged for pathogen-specific mechanisms. However, early studies show that primary metabolic pathways, although shared amongst all organisms, contain intricacies specific to Pseudomonas species that have potential for antibiotic exploitation. Here we lay out some of this work in the hopes that it inspires researchers to continue developing a knowledge base for future antibiotic discovery to build upon and include a case study of a Pseudomonas primary metabolic pathway that has been targeted by small molecules in a species-specific manner.
Current and emerging radiotherapy strategies for pancreatic adenocarcinoma: Stereotactic, intensity modulated and particle radiotherapy

The role of radiotherapy for locally advanced pancreatic cancer (LAPC) is unclear based on studies that used conventional doses and fractionation schedules. Modern radiotherapy techniques have not been studied in depth, however. We reviewed the literature on emerging methods of delivering higher doses of conformal radiotherapy using stereotactic body radiation, intensity modulated radiation, and particle beam radiation, highlighting clinical outcomes and toxicities. The literature review suggests low rates of acute and late toxicities when higher doses of radiation are given with careful attention to normal tissue dose constraints, including for stereotactic body radiotherapy (SBRT), escalated doses with intensity modulated radiation therapy (IMRT), and particle-based therapy. Retrospective evidence suggests prolonged survival for patients who receive biological equivalent doses above 70 Gy. Prospective trials that evaluate modern radiotherapy techniques are warranted for LAPC.
Cost-based temporal reasoning

Abstract Reasoning about the behavior of real-world systems and processes faces problems such as repeating events or subprocesses , evolving component behaviors, and indefinite time horizons. To date, existing representations of time and uncertainty have been unable to fully address such requirements. They often tradeoff assumptions of available knowledge against richness of representing time and semantics for uncertainty. This has made representations either overly simplistic or cumbersome to model with, or both. In this paper, we present a new theoretical representation for reasoning about time and uncertainty extending our ability to better address real-world systems. Called cost-based temporal reasoning, we believe it is simple to understand, is rigorously defined, and allows for strong semantics of time and uncertainty. This paper formally details the definitions and proofs about the capabilities of cost-based temporal reasoning.
Structure of restriction endonuclease BamHI and its relationship to EcoRI.

TYPE II restriction endonucleases are characterized by the remarkable specificity with which they cleave specific DNA sequences. Surprisingly, their protein sequences are in most cases unrelated, and no recurring structural motif has yet been identified1,2. We have determined the structure of restriction endonuclease BamHI at 1.95 A resolution. BamHI shows striking resemblance to the structure of endonuclease EcoRI (refs 3, 4), despite the lack of sequence similarity between them. We also observe some curious differences between the two structures, and propose an evolutionary scheme that may explain them. The active site of BamHI is structurally similar to the active sites of EcoRI and EcoRV (ref. 5), but the mechanism by which BamHI activates a water molecule for nucleophilic attack may be different.
Characterizing the gut microbiome of patients with triple-negative breast cancer.

e14186Background: The human microbiome has been postulated to play a role in carcinogenesis, and there is evidence that commensal intestinal bacteria are capable of promoting tumor immunosurveillan...
Customization of a Deep Learning Accelerator

Deep-learning algorithms require large and parallel multiplication and accumulation (MAC), which fits hardware accelerators consist of parallel processing elements (PEs) to speed up. As the PE number increases, how to distribute data in time becomes the key problem. Improving the accelerator performance needs to balance the computation power and the data communication bandwidth, which forms a roofline model of the throughput. In addition to hardware setup, the combination of neural network operators, layers, also causes the roofline curve to shift. Optimizing the performance, power, cost of the accelerators needs to link the neural network models to the physical hardware setup, which indicates custom and model-specific are essential. This presentation introduces an example of custom deep-learning accelerating system developed from open-source NVIDIA deep-learning accelerator (DLA). We supplement an environment for developing the system, from model quantization, model compilation, test generation, to driving tools. FPGA prototypes and test chips are designed, running an application of object detection, offering 70% MAC network utilization.
Teen Mom Student of the Month: Ethics of Care, School Structure, and Reconfiguring What It Means to be a Good Student:

Using portraiture methodology, this study features caring classroom experiences between Latina teen mothers and their teachers at an alternative school along the U.S./Mexico border. Classroom obser...
Democratic Peace Theory, Montesquieu, and Public Choice

Democratic peace theory has been losing favor, causing many scholars to look for other causes of the steady decrease in interstate war. According to proponents of “capitalist peace theory,” it is economic liberalization that leads to fewer conflicts. This question originally came to the fore during the early modern period, when European states dramatically expanded their commercial interactions. Proponents of this theory thought trade would decrease the attractiveness of war-making and could cause the decrease of conflict we see today. One of the foremost thinkers on the mechanisms for capitalist peace is Montesquieu. This chapter has two primary aims. First, it examines Montesquieu’s primary reasons for capitalist peace. Second, it connects Montesquieu’s reasoning to contemporary public choice theory. This connection highlights the ongoing relevance, as well as the limits, of Montesquieu’s work for international peace.
Role of a Specific P53 Binding Site in Limiting Tissue Overgrowth

The p53 protein is an important transcription factor known for maintaining tissue homeostasis by activating genes that have antiproliferative function, such as pro-apoptotic and cytostatic genes. Transcriptional activation of proapoptotic genes has displayed a fundamental role in mediating apoptosis during Drosophila development. Using ChIP-Seq and RNA-Seq methods, we have identified p53 binding sites potentially responsible for p53-mediated induction of pro-apoptotic genes following DNA damage. We have since generated fly lines with the p53 binding site deleted by CRISPR-Cas9-mediated genome editing. To study the effects of the p53 binding site knockout (p53BSKO) on tissue homeostasis, wings of the knockout fly line were dissected, mounted, and then compared against WT wings. Results show p53BSKO animals had an increase in wing size compared to that of the WT. FijiWings 2.2 macros software was used to measure wing hair (trichome) densities, which is directly proportional to cell numbers. This analysis showed that p53BSKO led to hyperplasia of the wing as compared to the WT. Our study indicated that this single P53BS is required for ensuring the right number of cells in a given tissue, likely through mediating overproliferation-induced apoptosis.
Method-of-Use Patents, Appropriability, and Antitrust Policy

When an inventor discovers a novel, useful, and non-obvious way to use a patent or unpatented product, the Patent Office may issue a method-of-use patent. Because the method-of-use is information, it suffers from the same appropriability and excludability problems that all information bears. This paper examines vertical integration, patent licensing, and bundled pricing as business strategies for extracting the surplus. It also evaluates potential antitrust challenges to bundled pricing.
Computational insights into the molecular mechanisms for chromium passivation of stainless-steel surfaces

Abstract First principles DFT calculations are used to gain insights into the molecular mechanism of Cr passivation of FeCr alloy surfaces. The systems studied represent early stages of oxidation of FeCr alloys when the oxide layers extend just a few atomic layers into the bulk. A Monte-Carlo atom-swapping algorithm was developed to efficiently explore possible atomic positions and identify the most promising structures that yield overall energy lowering. Analysis of the resulting low energy structures show that the surface oxide layer is rich in chromium while there is a reduction in chromium in the metallic phase near the alloy-oxide interface. Furthermore, there is an increased concentration of Fe near the oxide-air surface. Analysis of the molecular structure of the oxide layers found that oxidized Cr was predominantly in the Cr2O3 phase, while oxidized Fe was present as both FeO and Fe2O3. We propose that the oxidative variability of Fe facilitates O diffusion in the iron-rich phases because of the range of geometries available for accommodating the O atom. In contrast, O diffusion is less facile in Cr, which has little variability in oxidation state.
Security analysis for fixed-time traffic control systems

Abstract Wireless communication is being used as an enabling technology with traditional fixed traffic control systems in this transitional era toward Intelligent Transportation Systems (ITS). Unfortunately, major security concerns have arisen with respect to ever-increasing complexity and interconnectivity, and a noticeable lack of attention for security in these systems. Addressing concerns is a colossal challenge as it requires thorough development and formal analysis of a system model with respect to security. To tackle this challenge, we present a novel formal attack modeling and impact analysis methodology based on the Link Queue Model (LQM) of traffic flow inside a double ring road network, which is equivalent to a grid network with homogeneous links. We develop attack models as functions of tampered traffic control settings (e.g., green time ratios, cycle length, retaining ratios) with outputs equivalent to mobility impacts on the traffic network (e.g., time until system reaches state convergence, asymptotic average network flow). Further, for a given attack model, we define and identify vulnerable states: states that are critical to protect because they lead to negative impacts under the given attack model. Using our methodology we found that for certain vulnerable states, after only a few cycles of tampered control settings an attacker could cause a real impact of 1.5x speed-up in gridlock state convergence or 37%-99% drop in the asymptotic average flow rate. These results imply potentially drastic financial costs for cities and all involved drivers if similar attacks were performed on a real traffic control system.
Evolution of the environmental microbiota of a new neonatal intensive care unit (NICU) and implications for infection prevention and control.

Objective: To describe changes in the environmental microbiota of a new neonatal intensive care unit (NICU) and potential implications for infection prevention and control (IPC) efforts. Design: Prospective observational study. Setting: A newly constructed level IV neonatal cardiac intensive care unit (NCICU) before and after patient introduction and the original NICU prior to patient transfer. Methods: Environmental samples were obtained from the original NICU prior to patient transfer to a new NCICU. Serial sampling of patient rooms and provider areas of the new NICU was conducted immediately prior to patient introduction and over an 11-month study period. Microbiota at each sampling point were characterized using Illumina sequencing of the V3/V4 region of the 16S rRNA gene. Microbiota characteristics (α and β diversity and differential abundance) were compared based on time, location, and clinical factors (room-level antibiotic use and patient turnover). Results: An immediate increase in the environmental differential abundance of gut anaerobes were seen after patient introduction. There was an increase in the relative abundance of Staphylococcus spp, Klebsiella spp, Pseudomonas spp, and Streptococcus spp over time. The new NCICU consistently showed more diverse microbiota and remained distinct from the original NICU. The microbiota of the provider areas of the NCICU eventually formed a cluster separate from the patient rooms. Patient turnover increased room-level microbiota diversity. Conclusion: Microbiota characteristics of the new NICU were distinct from the original ICU despite housing similar patients. Patient and provider areas developed distinct microbiota profiles. Non–culture-based methods may be a useful adjunct to current IPC practice.
Characterization of the Benefit of APS Flash Coatings in Improving TBC Lifetime

The addition of an air plasma sprayed (APS) “flash” layer on top of a high velocity oxygen fuel (HVOF) bond coating has been shown to extend the lifetime of thermal barrier coatings. A series of furnace cycle tests (FCTs) has been conducted at 1100 °C in air + 10% H2O to study the benefit of flash coatings on rod and disk alloy 247 specimens and provide a better mechanistic understanding of their benefit. Flash coatings of NiCoCrAlY and NiCoCrAlYHfSi both improved the FCT lifetime of rod specimens tested in 100-h cycles and disk specimens tested in 1-h cycles. In 1-h cycles, the NiCoCrAlY flash coating significantly outperformed an HVOF-only NiCoCrAlYHfSi bond coating and a NiCoCrAlYHfSi flash coating. Both flash coatings increased the bond coating roughness compared to HVOF. During exposure, the flash layer formed an intermixed alumina-metal layer that appeared to inhibit crack formation. Using a time series of observations, the lower Y + Hf content in the Y-only flash coating appeared to reduce Al consumption. The HVOF layer acted as a source of Al for the adjacent mixed zone. A second series of specimens included a fully APS bond coating where oxide had penetrated through the entire coating to the substrate after only 100, 1-h cycles and lifetime was similar to an HVOF-only bond coating. The inner HVOF layer with the outer APS flash coating prevented this complete penetration from occurring.
Effects of Exercise on Explicit Memory Function: Incidental and Intentional Encoding May Depend on Exercise Timing:

The present experiment evaluated the effects of self-reported exercise behavior and an acute bout of high-intensity exercise on explicit memory function. The memory tasks were encoded either incide...