cssi/SciSciGPT-SciSciNet huggingface dataset:
The impact of climate change on wind and solar resources in southern Africa

Abstract The mitigation of potential climate change while sustaining energy resources requires global attention and cooperation. Among the numerous strategies to reduce Green House Gas (GHG) emissions is to decommission carbon intensive electricity production while increase the deployment of renewable energy technologies – such as wind and solar power generation. Yet the generation capacity, availability, and intermittency of these renewable energy sources are strongly climate dependent – and may also shift due to unavoidable human-induced change. In this study, we present a method, based on previous studies, that estimates the risk of climate-change on wind and solar resource potential. The assessment combines the risk-based climate projections from the Integrated Global Systems Model (IGSM), which considers emissions and global climate sensitivity uncertainty, with more regionally detailed climate information from 8 GCMs available from the Coupled Model Intercomparison Project phase 3 (CMIP-3). Southern Africa, specifically those in the Southern African Development Countries (SADC), is used as a case study. We find a median change close to zero by 2050 in the long-term mean of both wind speed and Global Horizontal Irradiance (GHI), both used as indicators of changes in electricity production potential. Although the extreme possibilities range from about −15% to +15% change, these are associated with low probability. The most prominent effect of a modest climate mitigation policy is seen in the doubled likelihood of the mode of the distribution of wind power change. This increased likelihood is made at the expense of decreased likelihood in the large changes of the distribution, but these trade-offs with the more extreme likelihoods are not symmetric with respect to the modal change.
Questioning Photovoice Research Whose Voice

Photovoice is an important participatory research tool for advancing health equity. Our purpose is to critically review how participant voice is promoted through the photovoice process of taking and discussing photos and adding text/captions. PubMed, Scopus, PsycINFO, and Web of Science databases were searched from the years 2008 to 2014 using the keywords photovoice, photonovella, photovoice and social justice, and photovoice and participatory action research. Research articles were reviewed for how participant voice was (a) analyzed, (b) exhibited in community forums, and (c) disseminated through published manuscripts. Of 21 studies, 13 described participant voice in the data analysis, 14 described participants' control over exhibiting photo-texts, seven manuscripts included a comprehensive set of photo-texts, and none described participant input on choice of manuscript photo-texts. Photovoice designs vary in the advancement of participant voice, with the least advancement occurring in manuscript publication. Future photovoice researchers should expand approaches to advancing participant voice.
Research on the relationship of matrix metalloproteinase- 9,homocysteine levels and cerebral infarction

Objective To investigate thedynamic changes of serum matrix metalloproteinase- 9( MMP- 9) levels and homocysteine( Hcy) levels in patients with cerebral infarction and its their clinical significance. Methods One hundred and fifty 150 hospitalized patients with cerebral infarction were continuously collected as study group. According to whether there is hemorrhage with the head computerized tomography examination,patients were divided into hemorrhagic transformation( HT) group and non- hemorrhagic transformation( non- HT) group. Based on the size of the infarction area we also divide patients into groups to test their blood MMP- 9 levels by enzyme- linked immuno sorbent assay( ELISA) and to analyze combined with patients clinical symptoms and their cranial CT changes. Results The serum MMP- 9 level in the patients with HT [( 339. 2 ±192. 4) ng /ml]was significantly higher than that in the cerebral infarction patients( P 0. 01). MMP- 9 level in HT group rises obviously and it was higher in large infarction group than that in medium or small infarction group. The comparison among three groups has no statistical significant,nor does in the comparison between large infarction group and medium,small infarction group,because there is no obvious difference in the comparison between HT group and non- HT group( P 0. 01). Conclusion MMP- 9 and Hcy may be involved in the pathogenesis of cerebral infarction,which is one of the independent risk factors of cerebral infarction. The serum level of MMP- 9 may indicate the severity and prognosis of disease,and devotes early prediction to the hemorrhagic transformation of cerebral infarction. Hardly does Hcy have the relevant significance. Detection of MMP- 9 level may increase the safety of clinical treatment,prevention of hemorrhagic transformation,and has significance for improving the prognosis.
Primary biliary cirrhosis and the molecular cell biology of the nuclear envelope

I hope I have demonstrated how basic research on the molecular cell biology of the nuclear envelope has provided information about the autoimmune disease PBC. I have given several examples of how highly specific immunologic reagents, obtained from patients with this disease, have been of value in experiments on the basic cell biology of the nuclear envelope. Continued work should provide further clues on how autoimmunity underlies the pathophysiology of PBC and should also provide additional reagents to study the processes of nuclear protein targeting and cell division.
Risk Factors for Early ACL Reconstruction Failure in Pediatric and Adolescent Patients: A Review of 561 Cases.

BACKGROUND Anterior cruciate ligament (ACL) reconstruction failure is relatively common in young high-risk athletes. The purpose of this study was to examine a single center's 10-year experience with ACL reconstructions in pediatric and adolescent patients to better define short-term failure rates and risk factors for revision ACL surgery. METHODS This institutional review board-approved retrospective study included all patients who underwent a primary ACL reconstruction between 2002 and 2013. Chart and radiographic review was performed to assess patient demographic, injury, and surgical data including growth plate status, concomitant ligament/meniscus/cartilage injury, surgical procedures, femoral drilling technique, graft source and type, femoral and tibial fixation devices, and graft size. Graft failures had to be confirmed both with clinical examination and magnetic resonance imaging or the patient had to undergo a revision ACL reconstruction. Potential factors associated with failure were evaluated using either parametric or nonparametric analysis as appropriate. RESULTS A total of 561 ACL reconstructions were performed that met our inclusion criteria. The average patient age was 15.4 years (range, 5 to 19 y) and 53% of the patients were male. In all, 54 failures were identified for a 9.6% failure rate. Soft tissue grafts were twice as likely to fail compared with patellar tendon grafts (13% vs. 6%; P<0.001). Multivariate analysis revealed that graft choice (soft tissue vs. patellar tendon) was the primary variable predictive of failure (P<0.05), with interactions/mediating effects contributed by maturity (growth plate status) and ACL technique (P<0.05). The average time to failure was 13.6 months and hamstring grafts and anatomic femoral tunnels were both found to fail earlier (P<0.05). During the study period, approximately 8% of patients sustained a contralateral ACL injury. CONCLUSIONS ACL failure rates in adolescent and pediatric patients vary based on patient age, graft selection, and surgical technique. Bone patellar tendon bone autografts had the lowest failure rate in this high-risk population. LEVEL OF EVIDENCE Level IV-retrospective case series.
Hepatic trauma in adults.

Some 15 to 20 per cent of all blunt abdominal injuries involve the liver, which is also the intra-abdominal organ most frequently injured with penetrating trauma. The type and extent of liver injuries are described, and the operative procedure is presented.
Challenges managing end-stage renal disease and kidney transplantation in a child with MTFMT mutation and moyamoya disease

Moyamoya disease is a chronic cerebrovascular disorder with progressive stenosis. We describe a four-yr-old female with features of moyamoya disease referred to our center for kidney transplant evaluation with ESRD secondary to presumed renal dysplasia along with concern for cerebral vascular anomalies. With her constellation of organ involvement, a genetic workup revealed a homozygous, frameshift mutation in the mitochondrial methionyl-tRNA formyltransferase gene. Given her vascular anomalies and evidence of prior infarcts seen on cerebral imaging, it was felt that her risk of future stroke events was high and that hypotension or intravascular volume depletion would further exacerbate this risk. In hopes of improving her tenuous cerebral perfusion, she underwent a bilateral temporal craniotomy for superficial temporal artery to middle cerebral artery bypass. We highlight the challenges faced in a child with ESRD and kidney transplantation when cerebral vasculature is compromised. A multidisciplinary approach is critical in determining the need for a revascularization procedure prior to transplant and to help reduce the risk of ischemic or hemorrhagic events in this patient population.
Receptor Tyrosine Kinases in Osteosarcoma: Not Just the Usual Suspects

Despite aggressive surgical and chemotherapy protocols, survival rates for osteosarcoma patients have not improved over the last 30 years. Therefore, novel therapeutic agents are needed. Receptor tyrosine kinases have emerged as targets for the development of new cancer therapies since their activation leads to enhanced proliferation, survival, and metastasis. In fact, aberrant expression and activation of RTKs have been associated with the progression of many cancers. Studies from our lab using phosphoproteomic screening identified RTKs that are activated and thus may contribute to the signaling within metastatic human osteosarcoma cells. Functional genomic screening using siRNA was performed to distinguish which of the activated RTKs contribute to in vitro phenotypes associated with metastatic potential (motility, invasion, colony formation, and cell growth). The resulting RTK hits were then validated using independent validation experiments. From these results, we identified four RTKs (Axl, EphB2, FGFR2, and Ret) that have not been previously studied in osteosarcoma and provide targets for the development of novel therapeutics.
Soliloquies Divine: God's Self-Addressed Rhetoric in the Old Testament

Very little has been written about the quite noticeable tendency of God to address himself in the Old Testament, starting with the opening chapters in Genesis and continuing, intermittently, until 2 Kings. These speeches may very well be the oldest examples we have of what James Hirsh calls “self-addressed soliloquies,” but they cannot be analyzed based on some of the theoretical ideas of Kenneth Burke, Chaim Perelman and Lucie Olbrechts-Tyteca, Augustine (who invented the term), or Harold Bloom. As my analysis of these speeches shows, God9s rhetoric in these speeches, his ethos, is highly elliptical, ironic, and contradicts most of what readers expect from a soliloquy.
Cough detection in cystic fibrosis, primary ciliary dyskinesia and health

Objectives: In Cystic fibrosis (CF) and Primary ciliary dyskinesia (PCD) medical history of cough is important to identify disease progress, infective exacerbations and response to therapy. Thus treatment decisions are based on highly subjective patient´s reports what emphasises the need for objective cough monitoring. Methods: We investigated 28 healthy subjects (age 22.5 years (12; 43); median (min; max)), 21 patients with CF (26 (10; 44)) and 17 PCD patients (21 (9; 43)) at the University children´s hospital Muenster, Germany. In all patients cough-sounds were recorded and analysed with LEOSound-Monitor® (Heinen und Lowenstein, Bad Ems, Germany) during sleep. Kruskal-Wallis, Mann Whitney U test and Spearman´s correlation were applied. Results: The median (min; max) recorded time for healthy subjects, CF and PCD was 6.58 hours (5.42; 8.28), 7:58 (6:02; 9:46) and 7:51 (5:50; 9:34), respectively; cough counts per hour (cough/h median (min; max)) was 0 (0.0; 1.14), 2.15 (0.0; 62.6) and 0.37 (0.00; 7.75), respectively. Cough/h was statistically different between healthy subjects and CF (p Conclusions: Cough detection with LEOSound-Monitor® is feasible in CF, PCD and healthy subjects. CF and PCD patients cough significantly more than healthy subjects. Cough in CF and PCD correlates with parameters of disease severity, which indicates the usefulness of cough monitoring in CF and PCD.
New approach for the correlation of fatigue crack growth in metals on the basis of the change in net-section strain energy

Abstract A new approach to correlate fatigue crack growth data of metals on the basis of the change in net-section strain energy is presented. Extensive experimental data, including some historically significant fatigue crack growth data, generated using center-cracked (CCT) and single-edge notched (SENT) tension specimens, are used to demonstrate this correlation. It is shown that this correlation, quite remarkably, is as strong as that based on the stress intensity factor range (ΔK) in fracture mechanics. The reason for this surprising similarity is explored using the analysis of the net-section stress increase in fracture mechanics specimens. It is found that the actual role of the finite-width-correction factor in fracture mechanics is to create the stress amplification effect on the finite specimen, having a given crack length, to produce the same K as that of an infinite specimen. The present work demonstrates that the phenomenon of fatigue crack growth can be easily understood on the basis of the accumulated change in net-section strain energy which directly relates to the accumulated work done at the loading ends, which determines the rate of fatigue crack growth. It is a simpler and a physical approach for the accurate description of fatigue crack growth behavior of metals. The approach simultaneously validates the use of fracture mechanics parameters (∆K) for fatigue crack growth, by providing the insight that the physical meaning of stress intensity factor is embedded in the change in the net-section strain energy.
An efficient microwave assisted synthesis of N′-aryl/(alkyl)-substituted N-(4-hydroxy-6-phenylpyrimidin-2-yl)guanidines: Scope and limitations

Abstract Treatment of N-[(4-hydroxy-6-phenyl)pyrimidin-2-yl]cyanamide with 1° alkyl or arylamines in isopropyl alcohol for only 10 min at 110–120 °C under microwave conditions gave the corresponding N′-alkyl(aryl)guanidine derivatives in excellent yields (65–84%). Isolated yields were greatest when >1.0 equiv. of amines were employed, but excellent results were also obtained when aryl and alkylamines were reacted with a more atom-economical loading (1.0 equiv.; 70% and 72% ave. yields, respectively). Arylamines with either highly electron withdrawing substituents (e.g. CO 2 H) or pi-deficient heterocycles (e.g. variously substituted aminopyridines) did not work well under these conditions, and reaction with ureas and/or amino acids did not give detectable products. Work-up was exceedingly simple, and involved simple collection and washing of product on a sintered glass funnel. Products were obtained in analytically pure form and required approximately 1 h to prepare, start to finish.
Abstract P139: Heart Failure Is Initiated By and Progresses Because of Normal Responses of Energy Metabolism to Stress

Objectives The mechanism underlying heart failure (HF) after an index cardiac event is unknown but should have several characteristics. HF is a modern problem, so it will likely be a general response and be able to encompass the variety of initiating cardiac lesions as well as significant stress (e.g. exertion). The consequences should lead to the many alterations found in HF. [ATP] falls when energy demand outstrips supply (e.g. ischemia) but do not recover promptly with reperfusion because AMP is quickly catabolized and unavailable for recharging. [ATP] recovery is slow and limited by the availability of ribose-5-P. Ribose is not used as fuel and is channeled into nucleotide (ATP) synthesis allowing the effects of [ATP] recovery on function to be studied. Our hypothesis was that HF results from these responses of energy metabolism to stress which lower [ATP[ and affect the numerous myocardial reactions whose activity depends on [ATP]. The ability of ribose to quickly increase [ATP] allows these effects to be studied. Methods The effects of ribose infusion on two models of myocardial stress were studied. (1) An intact canine model of global ischemia which allowed serial myocardial biopsies and detailed function analysis. (2) A rat myocardial infarction model which allowed ECHO analysis of the remote myocardium. Results Conclusions 1) When energy demand outstripped supply (either from ischemia or increased work) myocardial [ATP] falls and recovery was slow. 2) Ribose is the limiting precursor for [ATP] recovery and infusion allowed the relationship between [ATP] and function to be studied. 3) In both myocardial ischemia recovery and increased load (from MI) ribose enhanced [ATP] and improved function. 4) The response of myocardial energy metabolism response to stress results in lower [ATP] which will decrease the activity of many function related reactions. 5) HF could begin and progress from these reactions of energy metabolism to cardiac stress.
Generation of Mammalian Host-Adapted Borrelia burgdorferi by Cultivation in Peritoneal Dialysis Membrane Chamber Implantation in Rats

The transmission, survival, and virulence of Borrelia burgdorferi depend upon the spirochete's ability to modulate its transcriptome as it cycles between its arthropod vector and reservoir host. This complex adaptive process is collectively referred to as "host-adaptation." The paucibacillary nature of borrelial infections precludes the detailed analysis of host adaptation within infected mammalian tissues. To circumvent this limitation, we (J Clin Invest 101:2240-2250, 1998) developed a model system whereby spirochetes are cultivated within dialysis membrane chambers (DMCs) surgically implanted within the peritoneal cavity of a rat. Spirochetes within DMCs are exposed to many, if not all, of the environmental signals and physiological cues required for mammalian host adaptation but are protected from clearance by the host's immune system.
Increased testicular estradiol during the neonatal interval reduces Sertoli cell numbers.

Previous studies have demonstrated that reducing endogenous testicular estradiol in neonatal boars would stimulate increased proliferation of Sertoli cells during the neonatal interval. The objective of this experiment was to determine if increasing testicular estradiol would have the opposite effect of reducing Sertoli cell numbers during the neonatal interval. Five littermate pairs of boars were evaluated with one littermate receiving a silastic implant containing estradiol and the second receiving only silastic at 1.5 weeks of age. Testes were recovered at 6.5 weeks of age and Sertoli cell numbers determined. Littermates treated with exogenous estradiol had approximately two-thirds as many Sertoli cells as their control littermates (P < 0.001). This is additional evidence for regulation of Sertoli cell numbers during the neonatal interval by intra-testicular estradiol.
Association of Depressive Symptoms with Lapses in Antiretroviral Medication Adherence Among People Living with HIV: A Test of an Indirect Pathway

Viral suppression, a critical component of HIV care, is more likely when individuals initiate antiretroviral therapy (ART) early in disease progression and maintain optimal levels of adherence to ART regimens. Although several studies have documented the negative association of depressive symptoms with ART adherence, less is known about how depressed mood relates to intentional versus unintentional lapses in adherence as well as the mechanisms underlying this association. The purpose of the current study was to examine the association of depressive symptoms with ART adherence, assessed as a multidimensional construct. Secondarily, this study conducted preliminary indirect path models to determine if medication self-efficacy could explain the depressed mood-adherence relationship. Depressive symptoms were not associated with 95% ART taken, self-reported viral load, deliberate adjustments to ART regimens or skipped ART doses. However, the indirect association of depressive symptoms via decrements in medication self-efficacy was significant for 95% ART taken, self-reported viral load and skipped ART doses, but not deliberate changes to ART regimens. In this sample of HIV-positive outpatients, there is evidence to support medication self-efficacy as a potential mechanism underlying the association between depressive symptoms and ART adherence. Additional longitudinal studies are needed to formally examine medication taking self-efficacy as a mediator.
Legal Protections for Atypical Employees: Employment Law for Workers Without Workplaces and Employees with Employers

In the United States, the decentralization of production has fostered the growth of many types of atypical employment, most notably temporary employment, homework, and dependent independent contractors. The labor and employment laws in the U.S. were designed for long-term employees, so that criteria for eligibility and schedules of benefits assume an on-going employment relationship with a single employer. As the numbers of atypical employees grows, more and more individuals find themselves lacking basic protection for minimum wage, health and safety, retirement security, industrial injury, and collective bargaining rights. This article surveys major U.S. employment laws to demonstrate that temporary workers, homeworkers, and independent contractors face practical as well as legal barriers that prevent them from getting full coverage under existing labor and employment laws.
Metastatic Squamous Cell Carcinoma of the Cervix Secreting Ectopic Serum Beta Human Chorionic Gonadotropin

An elevated serum beta human chorionic gonadotropin (beta-hCG) level in a female patient usually demonstrates the presence of a pregnancy or to a lesser extent, gestational trophoblastic disease or ovarian germ cell tumours. We report a case of metastatic cervical squamous cell carcinoma (SCC) presenting with an elevated serum beta-hCG. A 44-year-old Vietnamese lady, para 3, with a past surgical history of a Cesarean section and tubal ligation, was first diagnosed with stage 3B cervical SCC in November 2016 and underwent chemoradiation. She completed her treatment uneventfully and remained disease-free. She then presented to the emergency department in January 2018 complaining of right lower back and abdominal pain for 2 weeks. Her urine pregnancy test was positive and her serum beta-hCG was done which showed an elevated level of 593 IU/mL. Further investigations showed no intra or extra-uterine pregnancy and a magnetic resonance imaging (MRI) of the abdomen and pelvis revealed no pelvic recurrence but presence of a large liver mass and para-aortic lymphadenopathy. Biopsy of the mass confirmed recurrent metastatic cervical SCC. She was not a suitable candidate for surgery and was counseled for palliative chemotherapy. beta-hCG trending revealed a downward trend after commencing on palliative chemotherapy. Ectopic secretion of beta-hCG from tumour cells is a consideration in a patient who has detectable serum beta-hCG but no clinical evidence of pregnancy. Although rare, metastatic or recurrent cervical SCC can secrete serum beta-hCG and case reports have shown presence of serum beta-hCG even in non-gynecological tumours. Larger studies are required to investigate the full potential of serum or urinary beta-hCG in the role of prognosticating SCC of the cervix. J Med Cases. 2018;9(8):252-254 doi: https://doi.org/10.14740/jmc3103w
Regulatory Issues in Outdoor Advertising: A Content Analysis of Billboards:

The regulation of outdoor advertising has been subject to continued controversy. Although many arguments have been made both for and against restrictive regulation of billboards, the focus of these...
Proceedings of the seventh ACM SIGPLAN international conference on Functional programming

This volume contains the papers presented at the Seventh ACM SIGPLAN International Conference on Functional Programming (ICFP 2002). The meeting was held in Pittsburgh, USA, on 4-6 October 2002, as part of PLI 2002, the Colloquium on Principles, Logics and Implementations of High-Level Programming Languages. The scope of ICFP includes all languages that encourage programming with functions, including both purely applicative and imperative languages, as well as languages that support objects and concurrency. The topics covered range from principles to practice, from foundations to features, and from abstractions to applications.The call for papers led to 76 submissions, from which the program committee selected 24. Each submission was assigned to at least three committee members, each of whom often solicited an external review. Final decisions were made at a one and a half day meeting in Cambridge. All program committee members attended the meeting.Paper submission and review management was performed with the help of the Microsoft Conference Management Tool, and I am particularly grateful for the technical support of Jonathan Simon at Microsoft Research in Redmond.
Simultaneous editing of GABA and GSH with Hadamard‐encoded MR spectroscopic imaging

Purpose To evaluate the feasibility of simultaneous MR spectroscopic imaging (MRSI) of gamma-aminobutyric acid (GABA) and glutathione (GSH) in the human brain using Hadamard Encoding and Reconstruction of MEGA-Edited Spectroscopy (HERMES). Methods Point RESolved Spectroscopy (PRESS)-localized MRSI was performed in GABA and GSH phantoms and in the human brain (n = 3) using HERMES editing and compared to conventional MEGA editing of each metabolite. Multiplet patterns, signal intensities, and metabolite crosstalk were compared between methods. GABA+ and GSH levels were compared between methods for bias and variability. Linear regression of HERMES-MRSI GABA+/H2 O and GSH/H2 O versus gray matter (GM) fraction were performed to assess differences between GM and white matter (WM). Results Phantom HERMES-MRSI scans gave comparable GABA+ and GSH signals to MEGA-MRSI across the PRESS-localized volume. In vivo, HERMES-reconstructed GABA+ and GSH values had minimal measurement bias and variability relative to MEGA-MRSI. Intersubject coefficients of variation (CV) from two regions within the PRESS-localized volume for HERMES and MEGA were 6-12% for GABA+ and 6-19% for GSH. Interregion CVs were 5-15% for GABA+ and 3-17% for GSH. The GABA+/H2 O and GSH/H2 O ratios were ~1.8 times higher and ~1.9 times higher, respectively, in GM than in WM. Conclusion HERMES-MRSI of GABA+ and GSH was found to be practical in the human brain with minimal measurement bias and comparable variability to separate MEGA-edited acquisitions of each metabolite performed in double the scan time. The HERMES-MRSI is a promising method for simultaneously mapping the distribution of multiple low-concentration metabolites.
High-fidelity geometry generation from CT data using convolutional neural networks

The X-ray Fuel Spray research at Argonne National Laboratory is aimed at utilizing synchrotron X-ray diagnostics for providing insights into automotive fuel injection. One important task is to generate high-fidelity geometries or iso-surfaces of steel fuel injector nozzles from X-ray Computed Tomography measurements, to be used as inputs to realistic CFD simulations of fuel injector flow. These fuel nozzles contain 3D features between 5 - 500 micron and are imaged at a pixel resolution of 1 micron. The main bottleneck to automated generation of an STL geometry from X-ray CT data is the segmentation or surface determination process – conversion of the CT volume into a binary map that classifies each voxel as belonging to either injector metal or flow domain, accurately locating the metal surface at the transitions between these domains. Here, we describe our recent success in automating the segmentation process itself, which is challenging because various artifacts that arise from X-ray imaging and CT reconstruction confound the identification of threshold values needed for traditional segmentation algorithms. A convolutional neural network (CNN) coupled with a tailored loss function is implemented to achieve state-of-the-art accuracy in surface localization with limited manual intervention. Through data augmentation, the model can be trained on less than 30% of the slices drawn from two CT scans of different automotive injectors that were manually segmented and is tested on a third. Our architecture achieves state-of-the-art accuracy at lower computation time and GPU memory requirement compared to U-net, one of the most popular architectures for image segmentation.
Conformational flexibility of fork-remodeling helicase Rad5 shown by full-ensemble hybrid methods

Several pathways exist to bypass DNA damage during replication. One such pathway is template switching. The Rad5 protein plays two important roles in template switching: it is an E3 ubiquitin ligase that catalyzes PCNA poly-ubiquitylation and it is a helicase that converts replication forks to chicken foot structures. To understand the structure, conformational flexibility, and mechanism of Rad5, we used a full-ensemble hybrid method combining Langevin dynamics simulations and small-angle X-ray scattering. From these studies, we generated the first experimentally validated, high-resolution structural model of Rad5. We found that Rad5 is more compact and less extended than is suggested by its large amount of predicted intrinsic disorder. Thus, Rad5 likely has a novel intra-molecular interaction that limits the range of conformational space it can sample. We provide evidence for a novel interaction between the HIRAN and the helicase domains of Rad5, and we discuss the biological and mechanistic implications of this.
TOP: Optimizing Vehicle Driving Speed with Vehicle Trajectories for Travel Time Minimization and Road Congestion Avoidance

Traffic congestion control is pivotal for intelligent transportation systems. Previous works optimize vehicle speed for different objectives such as minimizing fuel consumption and minimizing travel time. However, they overlook the possible congestion generation in the future (e.g., in 5 minutes), which may degrade the performance of achieving the objectives. In this article, we propose a vehicle Trajectory–based driving speed OPtimization strategy (TOP) to minimize vehicle travel time and meanwhile avoid generating congestion. Its basic idea is to adjust vehicles’ mobility to alleviate road congestion globally. TOP has a framework for collecting vehicles’ information to a central server, which calculates the parameters depicting the future road condition (e.g., driving time, vehicle density, and probability of accident). Based on the collected information, the central server also measures the friendship among the vehicles and considers the delay caused by red traffic signals to help estimating the vehicle density of the road segments. The server then formulates a non-cooperative Stackelberg game considering these parameters, in which when each vehicle aims to minimize its travel time, the road congestion is also proactively avoided. After the Stackelberg equilibrium is reached, the optimal driving speed for each vehicle and the expected vehicle density that maximizes the utilization of the road network are determined. Our real trace analysis confirms some characteristics of vehicle mobility to support the design of TOP. Extensive trace-driven experiments show the effectiveness and superior performance of TOP in comparison with other driving speed optimization methods.
Cost-effectiveness of Stapedectomy vs Hearing Aids in the Treatment of Otosclerosis.

Importance Otosclerosis can be managed through surgical treatment, such as stapedectomy, or through hearing amplification with hearing aids. To our knowledge, there has been no cost-effectiveness analysis of these 2 treatment methods. Objective To determine the cost-effectiveness of stapedectomy vs hearing aid use for the treatment of otosclerosis. Design and Setting In this cost-effectiveness analysis, a decision tree was built to model the treatment choices for otosclerosis. The tree was run as a Markov model of a case patient aged 30 years. The model spanned the patient’s lifetime to determine total costs of management of otosclerosis with stapedectomy or hearing aids. Cost-effectiveness was measured using an incremental cost-effectiveness ratio, with a willingness to pay of $50 000 per quality-adjusted life-year (QALY) considered cost-effective. One-way sensitivity analyses were performed for all variables. A 2-way sensitivity analysis was performed for the cost of stapedectomy vs the cost of hearing aids. Probabilistic sensitivity analysis was performed to determine the likelihood that stapedectomy would be cost-effective across a range of model inputs. Interventions Stapedectomy vs hearing aid use. Main Outcomes and Measures The primary objective of this study was to determine the cost-effectiveness of stapedectomy vs hearing aids in the treatment of otosclerosis. The secondary objectives were to determine which factors are associated with the cost-effectiveness of the interventions. Results Stapedectomy had an estimated lifetime cost of $19 417.95, while hearing aids had an average lifetime cost of $16 439.94. Stapedectomy also had a benefit of 16.58 QALYs, and hearing aids had a benefit of 15.82 QALYs. Stapedectomy increases lifetime costs by $2978.01, with a benefit of 0.76 QALYs compared with hearing aids. The incremental cost-effectiveness ratio for stapedectomy is $3918.43 per QALY. The model was sensitive to the cost of stapedectomy and the cost of stapedectomy revision surgery. Probabilistic sensitivity analysis showed that stapedectomy was cost-effective compared with hearing aids 99.98% of the time. Conclusions and Relevance Stapedectomy appears to be a cost-effective option for treating otosclerosis compared with hearing aid use, from the patient perspective.
Keeping a 2009 Design Award-Winning Intensive Care Unit Current: A 13-Year Case Study

In a complex medical center environment, the occupants of newly built or renovated spaces expect everything to "function almost perfectly" immediately upon occupancy and for years to come. However, the reality is usually quite different. The need to remediate initial design deficiencies or problems not noted with simulated workflows may occur. In our intensive care unit (ICU), we were very committed to both short-term and long-term enhancements to improve the built and technological environments in order to correct design flaws and modernize the space to extend its operational life way beyond a decade. In this case study, we present all the improvements and their background in our 20-bed, adult medical-surgical ICU. This ICU was the recipient of the Society of Critical Care Medicine's 2009 ICU Design Award Citation. Our discussion addresses redesign and repurposing of ICU and support spaces to accommodate expanding clinical or entirely new programs, new regulations and mandates; upgrading of new technologies and informatics platforms; introducing new design initiatives; and addressing wear and tear and gaps in security and disaster management. These initiatives were all implemented while our ICU remained fully operational. Proposals that could not be implemented are also discussed. We believe this case study describing our experiences and real-life approaches to analyzing and solving challenges in a dynamic environment may offer great value to architects, designers, critical care providers, and hospital administrators whether they are involved in initial ICU design or participate in long-term ICU redesign or modernization.
Screening for Unhealthy Drug Use: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Importance Illicit drug use is among the most common causes of preventable morbidity and mortality in the US. Objective To systematically review the literature on screening and interventions for drug use to inform the US Preventive Services Task Force. Data sources MEDLINE, PubMed, PsycINFO, Embase, and Cochrane Central Register of Controlled Trials through September 18, 2018; literature surveillance through September 21, 2019. Study selection Test accuracy studies to detect drug misuse and randomized clinical trials of screening and interventions to reduce drug use. Data extraction and synthesis Critical appraisal and data abstraction by 2 reviewers and random-effects meta-analyses. Main outcomes and measures Sensitivity, specificity, drug use and other health, social, and legal outcomes. Results Ninety-nine studies (N = 84 206) were included. Twenty-eight studies (n = 65 720) addressed drug screening accuracy. Among adults, sensitivity and specificity of screening tools for detecting unhealthy drug use ranged from 0.71 to 0.94 and 0.87 to 0.97, respectively. Interventions to reduce drug use were evaluated in 52 trials (n = 15 659) of psychosocial interventions, 7 trials (n = 1109) of opioid agonist therapy, and 13 trials (n = 1718) of naltrexone. Psychosocial interventions were associated with increased likelihood of drug use abstinence (15 trials, n = 3636; relative risk [RR], 1.60 [95% CI, 1.24 to 2.13]; absolute risk difference [ARD], 9% [95% CI, 5% to 15%]) and reduced number of drug use days (19 trials, n = 5085; mean difference, -0.49 day in the last 7 days [95% CI, -0.85 to -0.13]) vs no psychosocial intervention at 3- to 4-month follow-up. In treatment-seeking populations, opioid agonist therapy and naltrexone were associated with decreased risk of drug use relapse (4 trials, n = 567; RR, 0.75 [95% CI, 0.59 to 0.82]; ARD, -35% [95% CI, -67% to -3%] and 12 trials, n = 1599; RR, 0.73 [95% CI, 0.62 to 0.85]; ARD, -18% [95% CI, -26% to -10%], respectively) vs placebo or no medication. While evidence on harms was limited, it indicated no increased risk of serious adverse events. Conclusions and relevance Several screening instruments with acceptable sensitivity and specificity are available to screen for drug use, although there is no direct evidence on the benefits or harms of screening. Pharmacotherapy and psychosocial interventions are effective at improving drug use outcomes, but evidence of effectiveness remains primarily derived from trials conducted in treatment-seeking populations.
Aerodynamic Data Fusion Toward the Digital Twin Paradigm

This paper considers the fusion of two aerodynamic data sets originating from differing types of physical or computer experiments. This paper specifically addresses the fusion of 1) noisy and in-co...
China's New Asia Policy

China’s Asian policy has changed significantly since the global financial crisis. Yet the argument here is that in essence, it has not changed. China’s ambition, as first articulated by Mao Zedong, was and has remained to achieve national greatness. Over time, the goal itself has become more focused on China’s own national interests and less on transforming the international order. The means to this end have always been flexible, depending on China’s growth in capabilities and on the opportunities offered by the international environment. In the first decades of the 21st century, China perceived a strategic opportunity to achieve major advances towards achieving this goal, focusing on its immediate regional environment. To do so, it has devised tactics shrewdly designed to do so without precipitating a confrontation with the United States or impinging on its core interests. This “new course” in Chinese foreign policy, addressed primarily to the Asian neighbourhood, was confirmed with mostly cosmetic adjustments in the 2012–13 transition to the fifth generation of the Communist Party of China (CCP) leadership and seems likely to remain in effect for the foreseeable future. The implications of this new Asia policy have already achieved modest success and more importantly no convincing defence has yet been devised.
The Emergency Department Systolic Blood Pressure Relationship After Traumatic Brain Injury.

Abstract Background Blood pressure alterations in patients with traumatic brain injury (TBI) have been shown to be associated with increased mortality. However, there is paucity of data describing the optimal emergency department (ED) systolic blood pressure (SBP) target during the initial evaluation. The aim of our study was to assess the association between SBP on presentation and mortality in patients with TBI. Methods We performed a retrospective (2015-2016) review of the American College of Surgeons Trauma Quality Improvement Program database and included all adult (age ≥18y) trauma patients who had TBI on presentation. The outcome measure was in-hospital mortality at different ED-SBP values. A subanalysis by age and TBI severity in accordance with the Glasgow Coma Scale (GCS) was performed (mild (GCS ≥13), moderate (GCS 9-12), and severe (≤8)). Multivariate logistic regression analysis was performed. Results A total of 94,411 adult trauma patients with TBI were included. Mean age was 59 ± 21y, 62% were male, and median GCS was 15 [14-15]. Mean SBP was 147 ± 28 mmHg, and overall mortality was 8.6%. The lowest rate of mortality was noticed at ED SBP between 110 and 149 mmHg, whereas the highest mortality was at admission SBP 190 mmHg. On regression analysis, SBP between 130 and 149 mmHg (odds ratio = 0.92; P = 0.68) was not associated with increased odds of mortality relative to SBP between 110 and 129 mmHg. On subanalysis based on severity of TBI (mild 80.9%, moderate 5.3%, and severe 13.8%), patients with SBP between 110 and 149 mmHg were less likely to die across all TBI groups. Conclusions The optimal ED-SBP range for patients with TBI seems to be age and severity dependent. The optimum range might guide clinicians in developing resuscitation protocols for managing patients with TBI. Level of Evidence Level III Prognostic.
Single-phase, natural circulation annular flow measurements for cartridge loop irradiation experiments

Abstract The nuclear industry is increasingly considering cartridge-style experiments for irradiation testing of advanced reactor fuels and materials under flowing conditions. Cartridge loops do not require the extensive support infrastructure that are necessary for external flow loops and minimize the possibility of coolant solidification over the long distance from the reactor to the external facilities. However, there is a general lack of quality flow data for internally heated fluids in an annular configuration representative of a cartridge-type irradiation experiment, particularly one with natural circulation. To address this data need, a series of experiments was conducted to measure the natural circulation flow rates of pressurized water in a sealed, internally heated vessel with annular flow conditions that represent a molten salt or sodium cartridge loop. Temperatures and flow rates were measured under steady-state and transient conditions. This paper describes the facility, methods, and results of the experiments, including the determination of nondimensional parameters. A simple 1D model of the natural convection flow rates agrees well with the experimental results. Applying this model to simulate a liquid salt cartridge experiment predicts that natural circulation flow might be able to provide liquid salt Reynolds numbers similar to those of some molten salt reactor concepts at relevant power densities.
A novel glucocorticoid and androgen receptor modulator reduces viral entry and innate immune inflammatory responses in the Syrian Hamster model of SARS-CoV-2

Since its initial discovery in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of COVID19, has spread worldwide and despite significant research efforts, treatment options remain limited. Replication of SARS-CoV-2 in lung is associated with marked infiltration of macrophages and activation of innate immune inflammatory responses triggered, in part, by heightened production of interleukin-6 (IL-6) that recruits lymphocytes to the site of infection that amplify tissue injury. Antagonists of the glucocorticoid and androgen receptors have shown promise in experimental models of COVID19 and in clinical studies, because cell surface proteins required for viral entry, angiotensin converting enzyme 2 (ACE2) and the transmembrane serine protease 2 (TMPRSS2), are transcriptionally regulated by these receptors. We therefore postulated that the glucocorticoid (GR) and androgen receptor (AR) antagonist, PT150, would reduce infectivity of SARS-CoV-2 and prevent inflammatory lung injury in the Syrian golden hamster model of COVID19. Animals were infected intranasally with 2.5 x 104 TCID50/ml equivalents of SARS-CoV-2 (strain 2019-nCoV/USA-WA1/ 2020) and PT150 was administered by oral gavage at 30 and 100 mg/Kg/day for a total of 7 days. Animals were then examined at days 3, 5 and 7 post-infection (DPI) for lung histopathology, viral load and production of proteins regulating the initiation and progression of SARS-CoV-2 infection. Results of these studies indicated that oral administration of PT150 decreased replication of SARS-CoV-2 in lung, as well as expression of ACE2 and TMPRSS2 protein. Hypercellularity and inflammatory cell infiltration driven by macrophage responses were dramatically decreased in PT150-treated animals, as was tissue damage and expression of IL-6. Molecular modeling suggested that PT150 binds to the co-activator interface of the ligand binding domain of both AR and GR and thereby acts as an allosteric modulator and transcriptional repressor of these receptors. Phylogenetic analysis of AR and GR across multiple species permissive to SARS-CoV-2 infection revealed a high degree of sequence identity maintained across species, including human, suggesting that the mechanism of action and therapeutic efficacy observed in Syrian hamsters would likely be predictive of positive outcomes in patients. PT150 is therefore a strong candidate for further clinical development for the treatment of COVID19 across variants of SARS-CoV-2.
The Harms of Structural Whiteness on Weapon Carrying, Policing, and Child Health.

We live in a country that “adultifies” and criminalizes children simply for not being white. “Adultification” is the process by which certain children are perceived as older than their actual age and, as a result, are regarded as less innocent and subject to callous and sometimes violent treatment. This misperception of Black children begins as young as age 5 for Black girls and age 10 for Black boys and is far from benign.1,2 Misperceptions of children that deny them the presumption of innocence affect the ways we, as a society, protect children, legally and socially.1,2 Consequently, when children of color are routinely misperceived as older, the protections typically afforded all children as a function of their age and developmental stage can come to uniquely benefit white children as a material advantage of their whiteness. This process has two related effects: it absolves white children from scrutiny, and it contributes to the inordinate policing of children of color. In this issue of Pediatrics , Jewett et al3 examine patterns of weapon carrying in US schools among white, Black, and Hispanic boys. Using data from the Youth Behavior Surveillance System from 1993 to 2019, Jewett et al3 compared self-reported weapon carrying in US high schools by race and/or ethnicity, age, and school climate. Their results expose troubling patterns of weapon carrying in white boys that impugn the common justifications used to disproportionately punish and police Black … Address correspondence to Rhea W. Boyd, MD, MPH, Sutter Health, 2200 River Plaza Dr, Sacramento, CA 95833. E-mail: rhea{at}cachildrenstrust.org