cssi/SciSciGPT-SciSciNet huggingface dataset:
Worries in expectant parents: Its relation with perinatal well‐being and relationship satisfaction

Although much has been written about the impact of pregnancy on expectant parents, less is known about the worries couples experience during pregnancy. Sex differences in worries and the link between self and coparent worries on perinatal well-being and relationship satisfaction in 104 primiparous couples were examined. It was found not only do expectant mothers and fathers worry about different things, but also type of worry is related to different outcomes. Moreover, using structural equation modeling, childbirth worries and worry frequency indirectly predict lower relationship satisfaction through worse well-being. However, coparent’s worries did not significantly relate to their partner’s perinatal well-being or relationship satisfaction. This study suggests the importance of examining perinatal worries in parents, as well as the dyadic interaction between coparents.
Artificial-rearing technique: its usefulness in nutrition research.

The rat model has been useful in deter mining the role of nutrients in such mammalian develop mental processes as maturation of the brain and gastro intestinal tract and metabolic adaptation in the liver. The suckling period, a critical time in early development, has been intractable to classical nutritional studies because of the necessity of the maternal involvement in rearing the pups. In this article, we review a promising technique in which rat pups are artificiallyreared through the use of an intragastric cannula connected to an automated pump that delivers a milk-substitute formula. We present relevant details of this technique, highlighting some of its advantages and limitations. Three metabolic processes in different organs are presented as examples of the usefulness of the artificial-rearingtechnique. This technique has high potential for a wider range of applica tions in nutritional assessment of macro- and micronutrients and in metabolic regulation in rats during the early postnatal period. J. Nutr. 122:412-419, 1992.
Effects of treatment differences on psychosocial predictors of exercise and improved eating in obese, middle-age adults.

Background: Behavioral interventions for weight-loss have been largely unsuccessful. Exercise is the strongest predictor of maintained weight loss and much of its effects may be from associated changes in psychosocial factors. Methods: Middle-aged, formerly sedentary adults with severe obesity were randomly selected to 6-month treatments of cognitive-behavioral exercise support paired with either standard nutrition education (n = 99) or nutrition change supported by cognitive-behavioral means with an emphasis on self-regulation (n = 101). Results: Overall improvements in self-efficacy and self-regulation for both exercise and managed eating, and mood, were found, with significantly greater improvements associated with the cognitive-behavioral nutrition condition in self-regulation for eating and mood. Change scores trended toward being stronger predictors of increased exercise and fruit and vegetable intake than scores at treatment end. Multiple regression analyses indicated that significant portions of t...
Evaluation and Treatment of Patients With Constipation

Constipation occurs in approximately 12% to 19% of the population1 and increases with age, especially after 60 years. Constipation is a common problem in outpatient practices and a frequent reason for admission to the hospital2 and thus is associated with significant adverse effects on quality of life and health care expenditures. Chronic constipation is defined as presence for more than 3 to 6 months of 2 or more of the following symptoms: decreased stool frequency, straining, hard stools, sensation of incomplete emptying or anorectal blockage, requirement for manual maneuvers to pass stool, and rare loose stools in the absence of laxative use.3 Unlike chronic constipation, constipation-predominant irritable bowel syndrome (IBS-C) presents as recurrent abdominal pain or discomfort associated with hard or infrequent stools or relieved by defecation. There are 3 categories of chronic constipation: disorders of defecation (dyssynergy), STC, and NTC. Defecatory disorders can occur with either STC or NTC. Most patients can be treated without extensive testing. Systemic conditions and medications that aggravate constipation should be addressed.4 Diet, fluids, nonprescription medications, fiber supplements, osmotic agents, and stimulant cathartics can be effective but may challenge adherence. Refractory cases require specific testing and specialist referral. New drugs with novel mechanisms of action have shown promise.5,6 Biofeedback typically is recommended for defecatory disorders. Colorectal surgery is a last resort.
Fine structure of far infrared spectrum of ethanol in the lowest OH-torsional vibrational trans-state (e 0 ) of ethanol

Abstract In this report the spectroscopic results for far infrared Fourier transform spectrum corresponding to the b-type transitions within the lowest lying trans-substrate (e 0 ) have been presented. The calculated matrix elements connecting various K -levels suggest that Δ K = 1 transitions within the trans- subs-state should be quite strong but the transitions between the trans state to the gauche states would quite week (practically non-existent). This was also concluded by previous studies using microwave and millimeter wave regions (Pearson et al., 1982; Millar, 1995). The assignments were confirmed by direct observations at the spectrum and the agreement between the observed and calculated spectrum using precise energy levels reported by Pearson et al. (1982). All the strong R R and some R Q branch lines starting from K = 10 ← 9 through K = 24 ← 23 have been identified. State dependent expansion parameters for all the 15 sub-bands have been presented. These parameters can reproduce the experimental wave numbers within experimental uncertainty. An atlas for about 450 transition lines corresponding to transitions within the e 0 torsional–vibrational species has been prepared. To our knowledge this is the first time the high resolution far infra-red spectral region study for ethanol have been performed.
Suppression of four hardwood defoliators by helicopter application of concentrate and dilute chemical and biological sprays.

Helicopter application of concentrate and dilute chemicals and biological sprays was used to suppress 4 lepidopterous hardwood defoliators. Evaluations were based upon larval catches on three 10×10 ft polyethylene tarps within treatment blocks. A 1% pyrethrin mist-blower spray was applied I week following treatment to the tree canopy above the tarps to detect surviving larvae and other organisms. Trichlorfon concentrate and trichlorfon and carbaryl dilute sprays reduced survival of 2nd-stage fall canker worm and spring canker worm to less than 0.5%. Carbaryl-oil concentrate spray had the highest larval survival percentage of any treatment, because of clogging of nozzles by the formulation. One year following applications, a 1% pyrethrin mist-blower evaluation of treated and untreated blocks showed little population change. After 2 years, the entire population collapsed. The decline was not attributed to the impact of chemical sprays but to natural factors which caused a similar collapse throughout Michigan. Second instars of the forest tent caterpillar were limited to 1% survival with 1 application of carbaryl-oil concentrate Dilute sprays of either carbaryl plus pinolene or Bacillus thuringiensis var. thuringiensis (Berliner) gave acceptable suppression in spite of ¼ inch of rain 10 hours after application. Trichlorfon concentrate and dilute sprays showed activity but failed to give larval reductions comparable to other treatments. Less than 0.25 of 3rd instars of the saddled prominent, Heteracampa guttavilla (Walker), survived a carbaryl 4-oil concentrate spray. Trichlorfon-oil concentrate caused larval reductions comparable to the carbaryl-oil, but sig. nificantly fewer survivors than a dilute spray of either trichlorfon or carbaryl. Dilute sprays of B. thuringiensis var. thuringiensis and B. thuringiensis var. kurstaki De-Dajac gave unacceptable larval reductions. Adults of predatory beetles Calasoma scrutator F. and C. calidum F. were affected adversely by the dilute carbaryl spray. whereas other treatments, including carbaryl-oil concentrate, showed no effect. No treatment had any apparent effect upon a predatory erythraeid mite Leptus sp . which attacks the saddled prominent.
Metastatic Bone Disease: Pelvis

Metastatic disease to the pelvis can lead to structural instability and debilitating pain. Lesions are often quite large at the time of diagnosis, as the size of the pelvis and elastic nature of the peri-pelvic organs often result in few symptoms of mass effect for smaller lesions. Lesions are classified by biologic subtype and location based on the system of Enneking—iliac (Type I), periacetabular (Type II), rami (Type III), and sacrum (Type IV) [1]. Advanced 3-dimensional imaging of the lesion is essential to adequately assess the anatomy and structural stability of the pelvis. Only posterior column Type I and Type II lesions typically lead to issues with structural stability. The majority of cases of pelvic metastatic disease can be managed nonoperatively with pain management and radiation therapy, as most are at least moderately sensitive to radiation. Occasionally, however, due to intractable pain, compromised pelvic stability, or (rarely) for the reduction of oncologic disease burden, surgical intervention is indicated. These interventions are divided into intralesional procedures such as curettage with or without adjuvant therapies and possible cemented reconstruction; and wide, extralesional procedures including internal and external hemipelvectomies. The extended ilioinguinal approach can be used for most lesions, in addition to the anterolateral or posterior approaches to the hip for periacetabular lesions. As most Type I, III, and IV lesions do not compromise the structural integrity or weight-bearing capacity of the patient, intralesional and extralesional resections are typically followed with no attempt at reconstruction. Conversely, there has been much debate over reconstruction methods after resection of Type II lesions and many options exist, ranging from custom arthroplasty implants to allograft reconstructions to cement-rebar constructs to simply leaving a flail hip. Type IV lesions that require resection of greater than 50 % of the sacroiliac joint compromise pelvic stability and therefore often require hardware to prevent dissociation and limb length discrepancy. In all cases, wound closure with adequate soft tissue coverage is critical, as complications such as dehiscence, infection and herniation can be devastating. If the wound cannot be closed without significant tension, a flap should be used. While morbidity for these surgeries is significant, treatment of these lesions has been shown to improve patient quality of life. The benefits of surgery should always be weighed against the risks and life expectancy of the patient prior to proceeding with surgery. As medical advances have increased patient survival for many types of metastatic cancer, orthopedic oncologists must now evaluate and hone our resection and reconstruction techniques to achieve longer lasting, commensurate results.
Abstract B31: Sulindac inhibition of tumor cell transformation

Cell transformation is the process in which normal cells acquire the properties of cancer. Sulindac Sulfide (SS) is one of non-steroidal anti-inflammatory drugs (NSAIDs), and its anticancer activity in prevention of tumor occurrence and progression has been documented in various human cancers. In this study, we observed the anti-transformative activity of SS in NIH/3T3 cells by using a two-stage transformation assay induced by the carcinogens, 3-methylcholanthrene (MCA) and 2-O-tetradecanoylphorbol-13-acetate (TPA) in which foci formation is used to characterize the transformed cells. We found that SS could inhibit foci formation by attenuation of TPA9s promotive effect. K-Ras was upregulated in the transformed cells, while SS treatment could selectively inhibit the growth of transformed cell in which K-Ras was suppressed significantly. Loss-of-function study demonstrated that knockdown of K-Ras in NIH/3T3 cells could significantly reduce foci formation, which support that K-Ras might be one of the key targets involved in SS inhibiting tumor cell transformation. When studying the mechanism by which SS regulates K-Ras, we triggered two tumor suppressor miRNAs, let-7b and let-7g, which were previously reported to target K-Ras and repress its expression through the post-transcriptional or translational modulation. We found that let-7b and let-7g could be upregulated in the transformed cells by SS treatment. However, the inhibitory effect of SS on foci formation was significantly attenuated when let-7b and let-7g were knocked down by CRISPR/cas9. In parallel, K-Ras maintained static expression in the transformed cells, regardless of SS treatment. These results suggest that upregulation of let-7b and let-7g is the key step for SS to inhibit tumor transformation. In addition, we demonstrated that SS could suppress the expression of Lin28 that interacts with let-7 through a documented feedback loop. Given our previous studies reporting that SS was able to inhibit the transcriptional activity of NF-kappaB that is involved in regulation of Lin28 expression, our study demonstrates that the NF-kappaB/Lin28/Let-7/K-Ras axis addresses a new mechanism responsible for anti-transformative activity of SS. These results will provide novel insights into understanding the mechanisms involved in tumorigenesis and benefiting identification of new targets for drug development in prevention of tumor progression. This study is supported by the NIH/NCI R01 Grant (1R01CA192395) and the American Cancer Society Research Scholar Grant (RSG-13-265-01-RMC). Citation Format: Zhipin Liang, Xiangling Feng, Hong Chang, Bin Yi, Ruixia Ma, Yaguang Xi. Sulindac inhibition of tumor cell transformation. [abstract]. In: Proceedings of the AACR Precision Medicine Series: Cancer Cell Cycle - Tumor Progression and Therapeutic Response; Feb 28-Mar 2, 2016; Orlando, FL. Philadelphia (PA): AACR; Mol Cancer Res 2016;14(11_Suppl):Abstract nr B31.
Technical note: A new surgical technique for ovariohysterectomy during early pregnancy in beef heifers

We hypothesized that a standing flank ovariohysterectomy procedure could be developed in beef heifers that would provide high quality tissues for addressing critical questions during early pregnancy, while concomitantly keeping livestock stewardship a high priority. To test the hypothesis, we: 1) developed a standing flank ovariohysterectomy procedure for use in beef heifers, and 2) implemented this procedure in a cohort of heifers up to d 50 of pregnancy for tissue collections, documentation of post-surgical recovery, and assessment of feedlot finishing performance. Ovariectomy and cesarean section protocols are well established in research and veterinary medicine and were used as starting points for procedural development. Crossbred Angus heifers ( = 46; ∼ 15 mo of age; BW = 362.3 ± 34.7 kg) were used to develop this new surgical tissue collection technique. Heifers were subjected to the 5-d CO-Synch + CIDR estrous synchronization protocol so ovariohysterectomy occurred at d 16, 22, 28, 34, 40, and 50 of gestation. Key aspects of the standing flank ovariohysterectomy technique included 1) use of local anesthetic for a standing flank incision, 2) locate the uterine and ovarian arteries via blind palpation and ligate them through the broad ligament via an improved clinch knot, 3) cut the ovaries and uterus free from the broad ligament, 4) ligate the cervix and uterine branch of the vaginal artery, and 5) cut through the cervix and remove the reproductive tract. Surgical times, from skin incision to placement of the last suture, were influenced ( = 0.04) by stage of gestation. In pregnant heifers, time decreased from d 22 (120.0 ± 12.0 min) of gestation to d 40 (79.5 ± 12.0 min) of gestation; then increased at d 50 (90.5 ± 14.7 min) of gestation. Using this procedure, we obtained uterine, placental, and embryo/fetal tissues that had experienced limited hypoxia, little or no trauma, and thus were excellent quality for scientific study. All heifers recovered from surgery quickly and were moved to a finishing period. During the finishing period, ovariohysterectomized heifers had a DMI of 13.8 kg, gained 1.99 ± 0.35 kg/d, and had a G:F of 0.145 over 132-d. The standing flank ovariohysterectomy technique represents a new and viable model to economically obtain high quality tissues for investigating critical biological mechanisms during early pregnancy in beef heifers.
Facilitating Global Art Conversations: Availability of Art Scholarship in Latin America

Objective – As art history becomes an increasingly global discipline, the question of geographically equitable access to the scholarly knowledge produced at universities in Europe and North America remains unexamined. This study aims to begin to answer that question by investigating the availability of art scholarship in Latin America. Methods – Sixty university libraries in Latin America were checked for various kinds of access to two major art history journals. Results – The study found that access rates were low, and that the types of access available were suboptimal. Conclusion – The results suggest that the current level of access is insufficient to support global scholarly conversations in art history and that current modes of dissemination of scholarship are not reaching key audiences.
Cover glass behavior in handheld device drop: modeling; validation and design evaluation

Cover glass reliability performance in a drop test is critical for handheld electronic devices. Handheld device drop test has limitations in measuring dynamic response on the device components which complicates the test control and data analysis. To supplement, design and improve the drop test we developed a full-scale modeling approach of a representative handheld device drop test. The device model includes all the major components such as: display, cover glass, rear cover, battery, printed circuit board/bracket, screws, adhesives, etc. The developed model explicitly simulates the device drop test, allowing us to measure mechanical parameters as function of process time for each of the device components. The numerical model was validated with the device drop test. In the current report we are focused on cover glass reliability. The cover glass performance was studied with respect to effects of adhesive materials on the rear side of the cover glass and the overall device rigidity. Using the model, we evaluated effects of each device component for the cover glass during drop. It was shown that significant cover glass reliability improvement in the device resistance against sharp indentation can be achieved if the glass is supported from the back side with a soft adhesive material. Key observations from these extensive modeling efforts have been discussed and the conclusions from the current study can serve as a general guideline to improve cover glass’s reliability of a handheld device.
Predicting Sensory Data and Extending Battery Life for Wearable Devices

Telepath is a framework that supports communication-free offloading for wearable devices. With offline training, activity recognition tasks can be offloaded from the wearable to the user's phone, without transferring raw sensing data. The key observation is that when the user is carrying both devices, the sensing streams on the two devices are highly correlated. By exploiting the correlation, the phone can estimate the wearable's sensing data and emulate the watch. Our evaluations shows that with Telepath, the phone performs accurately on activity recognition tasks that are designed for smart watches, achieving on average 87% of the watch's accuracy while extending the watch's battery life by 2.1x.
Immediate Post-operative Management After Heart Transplantation

Ultimately, the purpose of cardiac transplantation is to provide a means to high quality long-term survival in patients with end-stage heart disease. The immediate post-operative period is crucial in determining the probability of this outcome. Heart transplant clinicians should be familiar with and be comfortable treating multiple simultaneous medical and transplant-specific issues in patients that have often been critically ill prior to transplant. This chapter aims to provide an overview of the post-transplant hospitalization period, including perioperative management strategies, frequently encountered early morbidities, and short-term outcomes. Although induction and immunosuppression agents are discussed in depth in Chap. 9, their initiation, which is crucial in the perioperative period to prevent graft rejection, will also be covered briefly.
Pre-treatment Near-Infrared Spectral Tomography (NIRST) to predict pathologic complete response to neoadjuvant chemotherapy (NAC) in women with locally advanced breast cancer (LABC).

1047 Background: NIRST has a potential role for easily integrated monitoring and prediction of therapeutic response in women with LABC undergoing NAC. It captures biophysical changes in tissue occu...
Deciphering the use and predictive value of "emergency medical services provider judgment" in out-of-hospital trauma triage: a multisite, mixed methods assessment.

BACKGROUND:“Emergency medical services (EMS) provider judgment” was recently added as a field triage criterion to the national guidelines, yet its predictive value and real world application remain unclear. We examine the use and independent predictive value of EMS provider judgment in identifying s
Using Social Sensors for Detecting Emergency Events: A Case of Power Outages in the Electrical Utility Industry

This article presents a novel approach to detecting emergency events, such as power outages, that utilizes social media users as “social sensors” for virtual detection of such events. The proposed new method is based on the analysis of the Twitter data that leads to the detection of Twitter discussions about these emergency events. The method described in the article was implemented and deployed by one of the vendors in the context of detecting power outages as a part of their comprehensive social engagement platform. It was also field tested on Twitter users in an industrial setting and performed well during these tests.
Pseudo-arclength method convergence for continuous, piecewise-differentiable systems

Continuation algorithms such as the pseudo-arclength method are frequently used to analyze nonlinear dynamical systems and to solve optimal control problems. They require continuous differentiability of the equations to be solved and may stall if this assumption is violated. This paper analyzes the conditions under which the pseudo-arclength method succeeds or fails when applied to a system of equations that is continuous but only piecewise differentiable. A strategy to alleviate this problem is derived based on the insights gained.
Effects of load control for real-time energy balancing on distribution network constraints

This paper studies the effects that load control for balancing services has on the physical constraints of a distribution network. A simulation study is conducted across a range of scenarios and prototypical distribution networks. Network constraint violations, such as over-voltages and blown fuses, are recorded and compared to a no-control baseline simulation. Notably, the simulation results show that no instantaneous constraints are violated due to load control. We find that the mean aging rate of the transformers decreases in 24 of 25 simulations, though in 21 simulations a majority of transformers experience increased aging rates. Overall the results indicate that load control for balancing services is unlikely to cause emergency-level issues on a distribution network. However, longer term impacts, such as increased aging of certain transformers, may warrant a control design that manages particular network constraints.
Experimental demonstrations of unpinning domains in a saturated bismuth-substituted iron garnet

The utilization of a bismuth-substituted iron garnet as a magne-to-optic faraday rotator (MOFR) has been reported for all-optical networking purposes as well as for other applications [1 – 5]. When a significantly large magnetic field is applied to the MOFR, it will enter a saturated state. Once the material is saturated, the magnetic domains can become pinned into place [6]. In the past, unpinning the magnetic domains, and moving the MOFR material back into a desaturated state was a difficult task. This paper will present methods for unpinning the MOFR material, allowing the material to become desaturated.
Globalization and the Debt Crisis

Globalization has caused the nation state to lose control over its economy and has affected its ability to address the needs of its citizens. Meanwhile, the economic restructuring imposed on most indebted nations has caused states to lose a portion of their income. As a result, budget deficits have grown and poverty has increased; and that has created the need for more borrowing and caused interest payments and debts to rise and be placed on an unsustainable path. Dominique Strauss-Kahn, former International Monetary Fund (IMF) managing director, said, “Globalization has delivered a lot … but it also has a dark side: a large and growing chasm between the rich and the poor. Clearly we need a new form of globalization to prevent the ‘invisible hand’ of the loosely regulated markets from becoming ‘an invisible fist.’”
Treatment utilization and outcomes in elderly patients with locally advanced esophageal carcinoma: a review of the National Cancer Database

For elderly patients with locally advanced esophageal cancer, therapeutic approaches and outcomes in a modern cohort are not well characterized. Patients ≥70 years old with clinical stage II and III esophageal cancer diagnosed between 1998 and 2012 were identified from the National Cancer Database and stratified based on treatment type. Variables associated with treatment utilization were evaluated using logistic regression and survival evaluated using Cox proportional hazards analysis. Propensity matching (1:1) was performed to help account for selection bias. A total of 21,593 patients were identified. Median and maximum ages were 77 and 90, respectively. Treatment included palliative therapy (24.3%), chemoradiation (37.1%), trimodality therapy (10.0%), esophagectomy alone (5.6%), or no therapy (12.9%). Age ≥80 (OR 0.73), female gender (OR 0.81), Charlson-Deyo comorbidity score ≥2 (OR 0.82), and high-volume centers (OR 0.83) were associated with a decreased likelihood of palliative therapy versus no treatment. Age ≥80 (OR 0.79) and Clinical Stage III (OR 0.33) were associated with a decreased likelihood, while adenocarcinoma histology (OR 1.33) and nonacademic cancer centers (OR 3.9), an increased likelihood of esophagectomy alone compared to definitive chemoradiation. Age ≥80 (OR 0.15), female gender (OR 0.80), and non-Caucasian race (OR 0.63) were associated with a decreased likelihood, while adenocarcinoma histology (OR 2.10) and high-volume centers (OR 2.34), an increased likelihood of trimodality therapy compared to definitive chemoradiation. Each treatment type demonstrated improved survival compared to no therapy: palliative treatment (HR 0.49) to trimodality therapy (HR 0.25) with significance between all groups. Any therapy, including palliative care, was associated with improved survival; however, subsets of elderly patients with locally advanced esophageal cancer are less likely to receive aggressive therapy. Care should be taken to not unnecessarily deprive these individuals of treatment that may improve survival.
When and How to Stop Surveillance Colonoscopy in Older Adults: Five Rules of Thumb for Practitioners.

A 79-year-old obese man with obstructive sleep apnea, who ambulates with assistance comes to you to discuss post-polypectomy surveillance colonoscopy. His last colonoscopy was performed 5 years ago, during which two small adenomas were removed.
Nephronectin Regulates Mesangial Cell Adhesion and Behavior in Glomeruli

A critical aspect of kidney function occurs at the glomerulus, the capillary network that filters the blood. The glomerular basement membrane (GBM) is a key component of filtration, yet our understanding of GBM interactions with mesangial cells, specialized pericytes that provide structural stability to glomeruli, is limited. We investigated the role of nephronectin (Npnt), a GBM component and known ligand of α8β1 integrin. Immunolocalization and in situ hybridization studies in kidneys of adult mice revealed that nephronectin is produced by podocytes and deposited into the GBM. Conditional deletion of Npnt from nephron progenitors caused a pronounced increase in mesangial cell number and mesangial sclerosis. Nephronectin colocalized with α8β1 integrin to novel, specialized adhesion structures that occurred at sites of mesangial cell protrusion at the base of the capillary loops. Absence of nephronectin disrupted these adhesion structures, leading to mislocalization of α8β1. Podocyte-specific deletion of Npnt also led to mesangial sclerosis in mice. These results demonstrate a novel role for nephronectin and α8β1 integrin in a newly described adhesion complex and begin to uncover the molecular interactions between the GBM and mesangial cells, which govern mesangial cell behavior and may have a role in pathologic states.
Barriers to Entry into 12-Step Mutual Help Groups among Justice-Involved Women with Alcohol Use Disorders

Although involvement in twelve step mutual help groups (TMGs) is an accessible and effective means of addressing alcohol problems, many justice-involved women do not attend. This study examined barriers to TMG attendance for 135 justice-involved women with alcohol use disorders. TMG attenders were more likely than non-attenders to say their past contacts with people in TMGs were not helpful (χ2 = 4.91, p =.027); non-attenders were more likely to report that they did not want to change (χ2 = 7.58, p= .006). Findings provide guidance on how to enhance interest in and attendance at TMGs among justice-involved women returning to the community.
Barriers and Pathways to Providing Long-Acting Reversible Contraceptives in Massachusetts Community Health Centers: A Qualitative Exploration.

Context Structural barriers to the provision of long-acting reversible contraceptive (LARC) methods at community health centers have been identified in quantitative research, but the processes and behaviors by which center staff respond to these barriers are poorly understood. Methods Focus group discussions were conducted with clinical, support and administrative staff at three Massachusetts community health centers between April 2014 and January 2015. The centers were purposively selected to constitute a sample with diverse characteristics. Overall, 57 individuals participated in seven focus groups. Data were analyzed inductively using a modified grounded theory approach, and typical pathways to obtaining LARC methods were identified. Results Community health center staff provided contradictory descriptions of their facilities' protocols and practices. Patients' pathways to obtaining LARC methods were idiosyncratic and clinician-dependent, and resulted in patients' waiting between one week and three months to receive their preferred method. Providers' individual comfort with and perceived competence in contraceptive counseling often shaped patients' pathways to care. Overall, staff did not consider same-day insertion of LARC methods a feasible goal. Counseling protocols, insurance verification practices and logistical challenges in ordering and stocking devices were identified as major barriers to timely placement. Conclusions Efforts to improve LARC provision at community health centers should include the education of staff in how expeditious placement constitutes clinical best practice and the implementation of infrastructural changes to support staff in efficiently counseling patients, scheduling placements and procuring LARC devices regardless of patients' insurance coverage.
Enzyme–Enzyme Interactions and the Regulation of Metabolic Reaction Pathways

Publisher Summary This chapter focuses on enzyme-enzyme interactions and the regulation of metabolic reaction pathways. The existence of functional enzyme-enzyme interactions is most obvious in the case of multienzyme systems. The term “multienzyme system” is used to describe a variety of catalytically functional proteins, all of which have the property of association of more than one kind of functionally active enzyme within a specifically aggregated molecule. In general, evidence relevant to the function of enzyme-enzyme interactions comes from two sources: (1) the specific details of quaternary structural interactions between or among the enzyme subunits, and (2) kinetic studies, primarily involving the effectiveness of competition of a metabolic intermediate with the precursor metabolite for the formation of the final product. The individual protein concentrations in multienzyme systems are enormously high. For example, the individual enzyme site concentrations within the pyruvate dehydrogenase complex are approximately 10 mM. Many enzyme-enzyme interactions have been noted among soluble mitochondrial enzymes in in vitro experiments.
Sustainable Manufacturing Education Modules for Senior Undergraduate or Graduate Engineering Curriculum

Abstract Sustainable manufacturing may be defined as the creation of manufactured products using non-polluting, energy and natural resources conserving, and economically sound and safe processes. Recently, there has been renewed interest in United States manufacturing and several industrial and governmental endeavours have been launched for sustainable manufacturing initiatives. To support such initiatives and to prepare the next generation of scientists and engineers, academic institutions have a responsibility to introduce educational programs and tools in the area of sustainable manufacturing. This work provides the engineering community with structured modules for introducing the topic of sustainable manufacturing in the curriculum. Working through an NSF funded SEES RCN program, the SMART CN project delivered 21 educational modules covering various aspects of engineering with the common theme of computer aided process design. This paper summarizes the concepts for module based learning, and a brief review of these educational modules for wider use and dissemination to the academic community.
Cone beam versus multi-detector computed tomography for detecting hearing loss

To determine whether the diagnostic value of cone-beam computed tomography (CBCT) is equivalent or superior to that of multi-detector computed tomography (MDCT) for the radiological assessment of conductive hearing loss with intact tympanic membrane in adults. Evaluation of inter- and intraobserver variability and measurement of the radiation dosimetry associated with each technique were secondary objectives. Prospective, single-center study. Ten adults were included from April to June 2013. All patients underwent MDCT and CBCT with reconstruction of temporal bones. Two radiologists with ENT experience reviewed the results twice. Diagnostic agreement between MDCT and CBCT and inter- and intraobserver agreement was evaluated with the kappa statistic. Comparisons of dosimetry were evaluated by calculating the ratio of the CT dose index (CTDI) between MDCT and CBCT. Diagnostic agreement between MDCT and CBCT was satisfactory (kappa = 0.69). Inter- and intraobserver agreement was also acceptable, and the average ratio of the CTDI of MDCT and CBCT was 4.01. CBCT is a reliable method that uses a low dose of radiation to investigate conductive hearing loss with intact tympanic membrane in adults. Its relevance and potential superiority to MDCT in diagnosing middle ear pathologies such as otosclerosis remain to be demonstrated, but the preliminary data are promising.
Professionalizing and Profiting: The Rise of Intermediaries in the Social Media Influencer Industry

This study examines the relationship between travel influencers (e.g., bloggers and social media personalities) and destination marketers within the changing travel and tourism industry. Through in...
Rapid sorting of aluminum alloys with handheld µLIBS analyzer

Abstract The most successful and best suited for rapid identification of alloys in field has been Handheld X-Ray Fluorescence (HHXRF). However, the XRF has inherent difficulty in analysis of many important aluminum alloys as well as other alloys containing low atomic number elements such as lithium, beryllium, boron, silicon or magnesium. The common practice to overcome this deficiency has been use of Optical Emission Spectroscopy (OES) or – most recently – Laser Induced Breakdown Spectroscopy (LIBS). Both these techniques can analyze all alloys the XRF can and especially those the XRF cannot. Recent technological advancements made possible design of handheld analyzers based on LIBS which are especially well suited to analysis of aluminum alloys. In this paper we report on the design features of Rigaku’s KT-100, micro-LIBS handheld analyser and discuss its performance in analysis and sorting of aluminum alloys, especially those containing light alloying elements such as Si, Li, Be, Mg.
Clinical use of inhaled nitric oxide: Local and systemic applications

Upon the FDA approval for inhaled nitric oxide (iNO) in 1999 to treat persistent pulmonary hypertension in neonates, iNO has proven to be a beneficial therapeutic in multiple diseases. We aim to review applications of iNO that have modeled its protective and therapeutic attributes, as well as highlight preliminary studies that could allude to future avenues of use. Numerous publications have reported specific incidences where iNO therapy has proved advantageous, while some applications have potential after further validation. Establishing guidelines on dosing, duration, and defined clinical uses are crucial for the future of iNO. Delivery of iNO has been controlled by a sole distributor, and comes with high cost, and lack of portability. A shift in patents has allowed for new designs for iNO device synthesis, with many new developments of iNO medical devices that will likely change the future of iNO in a medical setting.
Schistosoma mansoni glyceraldehyde-3-phosphate dehydrogenase enhances formation of the blood-clot lysis protein plasmin.

Schistosomes are intravascular blood flukes that cause the parasitic disease schistosomiasis. In agreement with Schistosoma mansoni (Sm) proteomic analysis, we show here that the normally intracellular glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is also found at the parasite surface; live worms from all intravascular life stages display GAPDH activity. Suppressing GAPDH gene expression using RNAi significantly lowers this live worm surface activity. Medium in which the worms are cultured overnight displays essentially no activity, showing that the enzyme is not shed or excreted but remains associated with the worm surface. Immunolocalization experiments confirm that the enzyme is highly expressed in the parasite tegument (skin). Surface activity in schistosomula amounts to about 8% of that displayed by equivalent parasite lysates. To address the functional role of SmGAPDH, we purified the protein following its expression in E. coli strain DS113. The recombinant protein displays optimal enzymatic activity at pH 9.2, shows robust activity at the temperature of the parasite9s hosts, and has a Km for GAP of 1.4 mM±0.24. We show that recombinant SmGAPDH binds plasminogen (PLMG) and promotes PLMG conversion to its active form (plasmin) in a dose response in the presence of tissue plasminogen activator. Since plasmin is a key mediator of thrombolysis, our results support the hypothesis that SmGAPDH, a host-interactive tegumental protein that can enhance PLMG activation, could help degrade blood clots around the worms in the vascular microenvironment and thus promote parasite survival in vivo.
Analyzing Link Dynamics in Student Collaboration Networks using Canvas-A Student-Centered Learning Perspective

A variety of cyberlearning environments and online student collaboration techniques are used in Science, Technology, Engineering and Math (STEM) courses to analyze and enhance academic performance. However, only a few research studies in the past have investigated the need for better modeling techniques of the unstructured discussion forums to enable measuring the influence of interactions in ’dynamically evolving’ student collaboration networks as the course progresses. This paper focuses on discussing both current collaborative learning techniques and analyzing the need for developing an innovative network model involving more structured/goal-oriented discussion forums that portray active collaborative learning techniques. Such a structured collaborative network model can be used to investigate the impact that student collaborations have on knowledge acquisition, persistence and course outcomes. The research objective leads to the research question this study addresses on the potential of the unstructured and dynamically evolving discussion boards to measure the ability of the learners to communicate technical information effectively as the course progresses. The experimental analysis of the weighted and undirected temporal (time-varying or dynamic) student discussion network data and the inferences drawn from such an exploratory analysis have revealed the pedagogical need for and the utility of schema-based structured discussion boards. These structured discussions would enable a pragmatic study to analyze the changes in student collaboration patterns and belongingness.
A retrospective analysis of associations between BMI and days spent on mechanical ventilation in a level 1 trauma facility

Abstract Objective To examine whether BMI impacts the outcomes of mechanically ventilated patients. Methods Data was collected retrospectively among patients involved in motor vehicle accidents in intensive care at a major trauma center in Atlanta, GA. Patients were categorized into five BMI groups: underweight (BMI 40). Results Among all patients (n=2,802), 3% of patients were underweight, 34% were of normal weight, 30% were overweight, 27% were obese, and 6% were morbidly obese. The mean number of ventilator days for normal weight patients was 4.6, whereas the mean number of ventilator days for underweight and morbidly obese patients were higher (10.3 and 7.4, respectively). Conclusions Underweight and morbidly obese populations may require additional interventions during their ICU stays to address the challenges presented by having an unhealthy BMI.
Reducing Outpatient Infant Blood Draws with Transcutaneous Measurement of Bilirubin.

Introduction Newborn jaundice is a common outpatient problem. Transcutaneous bilirubin (TcB) measurements correlate well with total serum bilirubin (SB) measurements below 15 mg/dl and are efficient and noninvasive. Some concern exists that TcB measurement may subsequently lead to an increase in the number of SB measurements performed in the outpatient setting. We aimed to implement the use of a TcB device in an outpatient clinic. By doing so, we sought to increase the number of newborns screened solely by TcB as opposed to SB, by 30%, within 12 months. Methods We conducted plan-do-study-act cycles with targeted interventions to promote the use of TcB in an outpatient clinic for eligible newborns older than 35 weeks gestational age, aged 1-20 days, and without a history of transfusion, phototherapy, extensive bruising, or risk of hemolysis. We used statistical process control methods to measure proportions of newborns evaluated with TcB (run chart) and patients-between SB measurements (G-chart) over time in the outpatient clinic. Results We collected preintervention data for 18-months and intervention data for 12 months. For newborns attending the outpatient clinic, the proportion of TcB measurements increased after implementation of the use of TcB measurement. There was an increase in patients-between SB measurements. At project inception, SB was drawn for every 8 eligible patients. By the end of the project, there were 98 eligible newborns between instances of SB testing. Conclusion Implementation of a quality-improvement initiative to measure TcB in the outpatient clinic was feasible and reduced the number of SB tests.
Smoking Cessation with Text Messaging and App-Based Interventions

Automated text messaging interventions are more effective than minimal smoking cessation support (absolute risk reduction [ARR] = 3%; 95% CI, 1% to 5%).
Metabolites Associated with Early Cognitive Changes Implicated in Alzheimer's Disease

Background Understanding metabolic mechanisms associated with cognitive changes preceding an Alzheimer's disease (AD) diagnosis could advance our understanding of AD progression and inform preventive methods. Objective We investigated the metabolomics of the early changes in executive function and delayed recall, the earliest aspects of cognitive function to change in the course of AD development, in order to better understand mechanisms that could contribute to early stages and progression of this disease. Methods This investigation used longitudinal plasma samples from the Wisconsin Registry for Alzheimer's Prevention (WRAP), a cohort of participants who were dementia free at enrollment and enriched with a parental history of AD. Metabolomic profiles were quantified for 2,324 fasting plasma samples among 1,200 participants, each with up to three study visits, which occurred every two years. Metabolites were individually tested for association with executive function and delayed recall trajectories across age. Results Of 1,097 metabolites tested, levels of seven were associated with executive function trajectories, including an amino acid cysteine S-sulfate and three fatty acids, including erucate (22 : 1n9), while none were associated with delayed recall trajectories. Replication was attempted for four of these metabolites that were present in the Vietnam Era Twin Study of Aging (VETSA). Although none reached statistical significance, three of these associations showed consistent effectdirections. Conclusion Our results suggest potential metabolomic mechanisms that could contribute to the earliest signs of cognitive decline. In particular, fatty acids may be associated with cognition in a manner that is more complex than previously suspected.
Modelling and Evolution of Conducting Filament in TiOx Memristor Using Conducting Atomic Force Microscopy.

Conducting filament evolution in TiOx based resistive switching memory fabricated by simple oxidation of Ti film is investigated. Formation of titanium oxide is confirmed from the X-ray diffraction study. Forming is required to initiate the switching process. A bipolar analog switching is observed with a positive set and negative reset voltage. The switching properties in TiOx layer owing to the formation of conducting filament is confirmed from the conducting atomic force micrograph at different bias voltage. A significant change in surface topography as a filament formation during set and reset is presented. Conduction mechanism inside the device at various voltage and effect of tunnel width on current is studied. The effective tunnel width of conduction filament and related parameters for device using device modelling (Threshold Adaptive Memristor model) is studied. The device can be used for synaptic applications.