cssi/SciSciGPT-SciSciNet huggingface dataset:
Early Intervention with HSCT Patients to Improve Access to and Knowledge of Palliative Care

Literature support Meetings facilitated by the Palliative Care team Meeting #1 outpatient Focus on information for patient and family about palliative care Meeting #2 inpatient – Focus on individualization of plan of care for patient Referral to Support Services and Palliative Care Clinic upon discharge, if needed Interventions by Palliative Care defined Advanced Care Navigation – “preparedness planning” • Maintain hope • Help patient be prepared for the unexpected • Reinforce DPOA and Advanced Directives Provide consistent supportive communication • Discuss what patient values and their hopes for transplant • What is meaningful to them • Collaboration about Goals of Care • Anticipatory guidance – resources and referrals Physician order for Palliative Care consult placed on admission to be initiated by patient, family, nurses, social worker, chaplain or other colleague involved in patient’s care. Process algorithm developed to engage multidisciplinary colleagues in the project.
Research on Dynamic Reliability and Failure Rate of Cemented Carbide Cutting Tool

Based on the main failure mode of cemented carbide cutting tool and the influence of impact loading times on cutting tool reliability,a mathematical model on dynamic reliability of cemented carbide cutting tool was built by using the theory of stress-strength interference model and stochastic process,and the change rule of reliability was also obtained. On this basis,with impact loading times and machining time as the metrics respectively,the failure rate models were established. The results showthat cutting tool reliability decreases gradually with the increase of impact loading times and machining time,and cutting tool failure rate characteristics of "bathtub"curve. According to this curve,the earlier,random and wear-out failure period of cutting tool can be divided accurately,that provides a theoretical basis for tool selection test,repair time and reliability life.
Investigation of An Incidence of Foodborne Acute Arsenic Poisoning

Objective To study the epidemiological characteristics of a case of the poisoning.Methods Descriptive epidemiological study was performed.Questionnaire type survey using the "food poisoning questionnaire of guangzhou" was conducted during the face-to-face interview.Specimens from the patients,residual foods,and environmental samples were collected for the laboratory testing.Results Among the 86 employees having the same supper,48 employees(20 males and 28 females,median age was 28,ranged from 18～45) consumpting Zicaidanhua soup had the symptoms of food poisoning and the attack rate was 100%.The average incubation period was 35 minutes(ranged from 1 to 240 minutes) .The was no correlation between the disease development and the types of work in these patients.The major clinical symptoms were nausea(48 [100%]) ,vomiting(48 [100%]) ,headache(20 [41.67%]) ,swirling(23 [47.92%]) ,chilling(9 [18.75%]) and diarrhea(6 [12.50%]) .Arsenic compound was found in 19 samples of the vomits(median concentration was 24.50 ml/L,ranged from 0.45～134 mg/L) 1 sample of Zicaidanhua soup had a high concentration of arsenic(783 mg/L) .The average intake of arsenic was 196 mg.Conclusion The cause of an incidence of foodborne acute arsenic poisoning related to the consumption of Zicaidanhua soup was analyzed.
Role of low-grade inflammation in osteoarthritis.

Purpose of reviewInflammatory changes in joint tissues can be detected by modern imaging techniques in osteoarthritis patients, but may be clinically subtle compared with many other types of arthritis. These changes associate with disease progression and clinical severity, and many inflammatory medi
In Reply: Obstructive sleep apnea.

IN REPLY : We thank Dr. Keller for his thorough reading of our article.[1][1] Regarding the predictive value of neck circumference for obstructive sleep apnea, (OSA), neck circumference is one of many tools to screen for OSA. If neck circumference greater than 38 cm is applied without other
Regulatory Approval Asynchrony, LLP, and Implications for Biotech R&D and Innovation

Progress toward sustainable and profitable farming systems using a full technology toolbox is needed to accelerate agricultural productivity globally. Increasing agricultural productivity is one of the keys to ensuring global food security. Food security is a serious issue for many countries that are dependent on commodity markets to meet their needs or supplement domestic agricultural productivity. High dependence on imports places countries at risk of production shortfalls, supply constraints, and price volatility due to growing global demand and competition for grain commodities. Prolonged regulatory timelines due to asynchronous approvals coupled with a lack of harmonized policies on low-level presence of unapproved events contribute to uncertainty that directly impacts product launches and indirectly affects the pace of research, development, commercialization, and import of innovative products. The public and private sector technology pipelines are producing new discoveries and developing innovations that promise to increase the pace of crop genetic improvement. While the opportunities for delivering more productive, pest resistant crops that use less water and inputs per unit production are real, success will depend on establishing efficient, predictable, and rational evidence-based regulatory frameworks.
Incidence of Radioiodine-induced Gastritis and the Dosage of I-131 Ablation for Differentiated Thyroid Cancer: Results of a Multi-year Analysis

257 Objectives One of the potential side effects of radioactive iodine ablation with I-131 (RAI) in differential thyroid cancer (DTC) is radiation gastritis, which is caused by irradiation of the gastric mucosa from I-131. Our aim was to determine if the incidence of radioiodine-induced gastritis (RIG) depends upon the dosage of I-131 dispensed to the patient. Methods From 2005 to 2014, all patients undergoing RAI for DTC were questioned regarding gastritis-related symptoms (nausea, vomiting, etc.) upon their visit for the post-ablation I-131 whole-body scan one week after the RAI. Excluded from this study were patients with known gastric and gastroesophageal disorders, such as peptic ulcer disease, gastroesophageal reflux, and diabetic gastroparesis. We also excluded patients with prior gastric surgery. The remaining patients were classified into 3 groups according to the I-131 dosage; 100mCi (N=257), 150mCi (N=196) and 200mCI (N=105). Results Of the 257 patients receiving 100mCi of I-131, 178 (68.26%) complained of gastritis symptoms, compared to 139 of the 196 patients (70.92%) receiving 150mCi, and 77 of the 105 patients who received 200mCi (73.33%) of I-131. There was no association between the incidence of RIG and the dosage of I-131 dispensed, according to chi-square analysis (0.421), and a p value of 0.81. Conclusions Over a 10-year interval involving a total of 558 patients undergoing RAI for DTC, there was no proportional relationship between the dosage of I-131 administered and the incidence of RIG, contrary to what one might expect. A patient receiving 200mCi is no more likely to develop RIG as one receiving 100mCi.
Differential Impact of Chronic Hyperglycemia on Humoral Versus Cellular Primary Alloimmunity.

Diabetes is prevalent among solid organ transplant recipients and is universal among islet transplant recipients. Whereas diabetes is often considered to result in an immune-compromised state, the impact of chronic hyperglycemia on host alloimmunity is not clear. Potential immune-modifying effects of obesity, autoimmunity, or diabetogenic agents like streptozotocin may confound understanding alloimmunity in experimental models of diabetes. Therefore, we sought to determine the role of chronic hyperglycemia due to insulinopenia on alloimmunity using the nonautoimmune, spontaneously diabetic H-2b-expressing C57BL/6 Ins2Akita mice (Akita). Akita mice harbor a mutated Ins2 allele that dominantly suppresses insulin secretion, resulting in lifelong diabetes. We used BALB/c donors (H-2d) to assess alloimmunization and islet transplantation outcomes in Akita recipients. Surprisingly, chronic hyperglycemia had little effect on primary T-cell reactivity after alloimmunization. Moreover, Akita mice readily rejected islet allografts, and chronic hyperglycemia had no impact on the magnitude or quality of intragraft T-cell responses. In contrast, allospecific IgM and IgG were significantly decreased in Akita mice after alloimmunization. Thus, whereas diabetes influences host immune defense, hyperglycemia itself does not cause generalized alloimmune impairment. Our data suggest that immune compromise in diabetes due to hyperglycemia may not apply to cellular rejection of transplants.
Evaluation of radar and infrared imagery of sedimentary rock terrane, south-central Yellowstone National Park, Wyoming

Radar and infrared imaging techniques for differentiating rock types and delineating structural features
Distributed backscattering in production O-band Si nanophotonic waveguides

Backscattering in integrated photonic waveguides can significantly impact the performance of optical systems. However, it has not been extensively studied in the literature and measurements on waveguides fabricated in production foundry processes are particularly lacking in view of their importance to technology. Here we experimentally measure and analyze distributed backscattering in various production O-band silicon photonic waveguides. We find the measured backscattering to scale from -18 to -36 dB/mm. Measured trends across waveguide geometry and polarization are consistent with stochastic defects on waveguide sidewalls being the dominant source of distributed backscattering in production Si waveguides. For production SiNx waveguides, both sidewall and cladding defects need to be considered to fit measured trends.
Bridging the Gap: Direct Behavior Rating–Single Item Scales

Direct Behavior Ratings (DBRs) are behavioral assessment methods that combine the benefits of systematic direct observation and behavior rating scales. That is, DBRs involve the observation of oper...
Mobility and volatility: What is behind the rising income inequality in the United States

Abstract Inequality of family incomes in the United States has increased significantly in the past four decades. This is largely interpreted as a result of unequal mobility, e.g., the rich can get richer at a faster pace than the rest of the population. However, using nationally representative data and the Fokker–Planck equation, our study shows that income mobility in the United States has remained stable. Instead, we find another factor – income volatility, which measures the instability of incomes – has increased considerably and caused the surge of income inequality. In addition, the rising volatility is associated with the plummeting of income-growth opportunity, creating the feeling that the American Dream is in decline. Volatility has often been overlooked in previous studies on inequality, partially because mobility and volatility are usually studied separately. By contrast, the Fokker–Planck equation takes both mobility and volatility into consideration, making it a more comprehensive model.
Histologic and ultrastructural features in early and advanced phases of Zellweger spectrum disorder (infantile Refsum disease).

Zellweger spectrum disorders (ZSD) are rare autosomal recessive inherited metabolic disorders and include severe (Zellweger syndrome) and milder phenotypes [neonatal adrenoleukodystrophy and infant...
Therapeutic use of botulinum toxin in pain treatment

Botulinum toxin is one of the most potent molecule known to mankind. A neurotoxin, with high affinity for cholinergic synapse, is effectively capable of inhibiting the release of acetylcholine. On the other hand, botulinum toxin is therapeutically used for several musculoskeletal disorders. Although most of the therapeutic effect of botulinum toxin is due to temporary skeletal muscle relaxation (mainly due to inhibition of the acetylcholine release), other effects on the nervous system are also investigated. One of the therapeutically investigated areas of the botulinum neurotoxin (BoNT) is the treatment of pain. At present, it is used for several chronic pain diseases, such as myofascial syndrome, headaches, arthritis, and neuropathic pain. Although the effect of botulinum toxin in pain is mainly due to its effect on cholinergic transmission in the somatic and autonomic nervous systems, research suggests that botulinum toxin can also provide benefits related to effects on cholinergic control of cholinergic nociceptive and antinociceptive systems. Furthermore, evidence suggests that botulinum toxin can also affect central nervous system (CNS). In summary, botulinum toxin holds great potential for pain treatments. It may be also useful for the pain treatments where other methods are ineffective with no side effect(s). Further studies will establish the exact analgesic mechanisms, efficacy, and complication of botulinum toxin in chronic pain disorders, and to some extent acute pain disorders.
Biological Implications of Breast Cancer Surgery

We have recently published findings from two randomized clinical trials carried out by the National Surgical Adjuvant Breast and Bowel Project (NSABP) to determine the efficacy of alternative local and regional treatments of primary operable breast cancer (1,2). Those investigations represent a continuum of effort by us for almost two decades to resolve as definitively as possible existing controversies relative to the local-regional management of primary breast cancer. The first study (Protocol B-04) was begun in 1971 and the specific aims of that trial were to determine (a) whether in patients with clinically negative axillary nodes total mastectomy, followed by delayed axillary dissection in those who subsequently had positive axillary nodes, was as effective as radical mastectomy, (b) whether the outcome of total mastectomy followed by postoperative regional
Abstract 2829: Degeneration of Ventricular Tachycardia Into Ventricular Fibrillation Following Right Ventricular Dilation

Studies showed that hemodynamics changes during arrhythmias lead to rapid dilation of right ventricle (RV). RV dilation results in a gradient of refractoriness between left ventricle (LV) and RV through mechano-electric feedback (MEF). We hypothesize that the gradient of refractoriness between LV and RV caused by MEF in the dilated RV is responsible for the degradation of ventricular tachycardia (VT) to ventricular fibrillation (VF). We employed a 3D model of rabbit ventricular electromechanics that incorporated a non-selective cationic stretch-activated channel (SAC). To simulate isovolumic ventricular contraction during VT and VF, a heuristic model of calcium dynamics of the cardiac myofilament with accurate force-rate dependence was included. The conductivity of the SAC depended on the magnitude of the local strain. Two different reversal potentials (−60, −10mV) were tested in the model. VT was induced by S1-S2 pacing. RV was dilated to twice its initial volume over a period of 0.5s following S2. Cases without and with RV dilation were compared. S1-S2 pacing resulted in two stable spiral waves, one on the posterior wall and another on the anterior. Breakup of spiral waves occurred only in the case of RV dilation with SAC of −10mV reversal potential. The wave breakup was due to inactivation of Na channels at elevated resting potential mediated by the stretch-induced current. 2s after the onset of arrhythmia, the patterns of VF were organized into a single stable spiral wave in LV lateral wall and multiple reentrant circuits in RV free wall (Fig 1). RV dilation establishes a gradient of refractoriness between RV and LV with the recruitment of SAC, which causes degeneration of VT into VF.
Accurate Estimation of the Polymer Coverage of Hairy Nanoparticles

Understanding and predicting the mechanisms underpinning the self-assembly of polymer-grafted nanoparticles (PGNPs) are important for controlling the engineering applications of these novel materials. The self-assembly of these materials is driven by their surfactancy, i.e., by the fact that the (inorganic) nanoparticles energetically dislike the (organic) polymer tethers. In previous work we developed a model in which a grafted polymer chain was treated as a rigid equivalent sphere (ES) which was impenetrable to the NPs, but completely penetrable to other ESs. This description, along with a geometric analogy with patchy particles, allowed us to facilely explain the self-assembly of PGNPs. However, since we model an ES as being completely penetrable to other ESs but impenetrable to the NPs the physical correspondence between a "real" grafted polymer and an ES is not clear. The application of the ES model to experiments and to computer simulations has therefore seen limited success, and only qualitative agreement has been obtained. In this paper, we develop a more realistic description, termed the modified ES (mES) model, based on the work of Daoud and Cotton on curved polymer brushes, which takes the impenetrability of the individual chain monomers into account. While this approach increases the complexity of our formalism, we find that the resulting mES model quantitatively captures computer simulation results on the structure of the PGNPs and also quantitatively explains their self-assembly over a broad range of conditions.
Cross-Compartment Herbivory Effects on Antagonists and Mutualists and Their Consequences for Plant Fitness

The rapid growth of research on ecological linkages between above- and belowground organisms has revealed that herbivores, whether feeding on shoot tissues aboveground or root tissues in the soil, can have indirect effects on plant-associated organisms on the opposite side of the soil surface. These indirect interactions, mediated by shared host plants, can include both antagonists, such as other herbivores, and mutualists like mycorrhizal fungi or pollinators. Here, I review current knowledge on these cross-compartment effects of herbivory and their potential impacts on plants. Herbivory effects vary in direction and magnitude, with impacts on other herbivores driven by both plant nutritional changes and resistance traits, depending on the herbivores involved and the order of herbivore attack. Herbivory can also alter plant interactions with mycorrhizae and pollinators, although these are studied considerably less often than indirect effects on herbivores. Although shifts in positive or negative interactions could feedback to influence plant growth and fitness, few studies have included assessment of plant performance, and those that have indicate that feedbacks may be less important than initial direct effects of herbivory. Finally, I suggest future directions to build on existing knowledge, encouraging work that examines feedbacks of indirect effects on plants, that incorporates a wider range of organisms in studies, and that focuses on how interactions vary with environmental conditions and in a broader community context.
Deleterious Mutation Burden and Its Association with Complex Traits in Sorghum ( Sorghum bicolor ).

Sorghum (Sorghum bicolor L.) is a major food cereal for millions of people worldwide. The sorghum genome, like other species, accumulates deleterious mutations, likely impacting its fitness. The lack of recombination, drift, and the coupling with favorable loci impede the removal of deleterious mutations from the genome by selection. To study how deleterious variants impact phenotypes, we identified putative deleterious mutations among ∼5.5 M segregating variants of 229 diverse biomass sorghum lines. We provide the whole-genome estimate of the deleterious burden in sorghum, showing that ∼33% of nonsynonymous substitutions are putatively deleterious. The pattern of mutation burden varies appreciably among racial groups. Across racial groups, the mutation burden correlated negatively with biomass, plant height, specific leaf area (SLA), and tissue starch content (TSC), suggesting that deleterious burden decreases trait fitness. Putatively deleterious variants explain roughly one-half of the genetic variance. However, there is only moderate improvement in total heritable variance explained for biomass (7.6%) and plant height (average of 3.1% across all stages). There is no advantage in total heritable variance for SLA and TSC. The contribution of putatively deleterious variants to phenotypic diversity therefore appears to be dependent on the genetic architecture of traits. Overall, these results suggest that incorporating putatively deleterious variants into genomic models slightly improves prediction accuracy because of extensive linkage. Knowledge of deleterious variants could be leveraged for sorghum breeding through either genome editing and/or conventional breeding that focuses on the selection of progeny with fewer deleterious alleles.
Sparse Recovery Via Variational Bayesian Inference: Comparing Bernoullis-Gaussians-Inverse Gamma And Gaussians-Inverse Gammas Modeling

We investigate the performance of sparse signal recovery from a set of compressively sensed noisy measurements using variational Bayesian (VB) inference. The framework considered here is sparse Bayesian learning with no specific structure other than sparsity assumed on the signal. Two models are considered here, the issues of each model is studied, and the performances in reconstruction are compared. These models have been already applied to the compressive sensing problems implemented via expectation-maximization algorithm, Markov chain Monte Carlo (MCMC), etc., for different structures of the solution. However, the issues when using variational Bayes inference for only promoting the sparsity have not been investigated. This paper provides details on such modeling and the issues accompanied with each modeling are discussed.
Making mentoring meaningful: hospitality and tourism students’ perceptions of mentoring

Mentoring has received considerable attention in higher education and industry, but little is known about perceptions of mentoring within disciplines, including that of hospitality and tourism. Thi...
Recovery of offline and online sentence processing in aphasia: Language and domain-general network neuroplasticity

This paper examined the effects of treatment on both offline and online sentence processing and associated neuroplasticity within sentence processing and dorsal attention networks in chronic stroke-induced agrammatic aphasia. Twenty-three neurotypical adults and 19 individuals with aphasia served as participants. Aphasic individuals were randomly assigned to receive a 12-week course of linguistically-based treatment of passive sentence production and comprehension (N = 14, treatment group) or to serve as control participants (N = 5, natural history group). Both aphasic groups performed two offline tasks at baseline and three months following (at post-testing) to assess production and comprehension of trained passive structures and untrained syntactically related and unrelated structures. The aphasic participants and a healthy age-matched group also performed an online eyetracking comprehension task and a picture-verification fMRI task, which were repeated at post-testing for the aphasic groups. Results showed that individuals in the treatment, but not in the natural history, group improved on production and comprehension of both trained structures and untrained syntactically related structures. Treatment also resulted in a shift toward more normal-like eye movements and a significant increase in neural activation from baseline to post-testing. Upregulation encompassed right hemisphere regions homologs of left hemisphere regions involved in both sentence processing and domain-general functions and was positively correlated with treatment gains, as measured by offline comprehension accuracy, and with changes in processing strategies during sentence comprehension, as measured by eyetracking. These findings provide compelling evidence in favor of the contribution of both networks within the right hemisphere to the restoration of normal-like sentence processing patterns in chronic aphasia.
Hyperspectral imaging in medical applications

Abstract Hyperspectral imaging (HSI) is an emerging imaging modality for medical applications, especially in disease diagnosis and image-guided surgery. HSI acquires three-dimensional data set called hypercube with two spatial dimensions and one spectral dimension. Spatially resolved spectral obtained by HSI provides diagnostic information about the tissue physiology, morphology, and composition. This chapter presents an overview of literature on medical hyperspectral imaging (MHSI) technology and its applications. The aim of this chapter is threefold: an introduction for those new to the field of MHSI, an overview for those working in the field, and a reference for those searching for literature on a specific application. This chapter starts to review the basic mechanisms of MHSI and then classify MHSI technology based on acquisition mode, spectral range and spatial resolution, measurement mode, dispersive devices, detector arrays, and combination with other techniques. Image analysis methods for MHSI are summarized with preprocessing, feature extraction and selection, image classification methods. The part on applications is a reference of the literature available on disease diagnosis and surgical guidance. MHSI applications on cancer detection, cardiology, pathology, retinal imaging, diabetic foot, shock, tissue pathology, mastectomy, gallbladder surgery, renal surgery, and abdominal surgery are reviewed. This chapter closes with a discussion on future challenges and perspectives.
The Knowledge We Have Lost in Information: The History of Information in Modern Economics

This book is not self-evident. To understand it, the reader must insert it into the development of economic theory, especially the thought of Friedrich Hayek. As an addition to previous scholarship...
Chapter 1 – Getting Started

Chapter 1 sets the stage for photo interpretation by discussing the basic physics of solar energy interaction with our targets (natural hazards), and the film that we use to capture the interactions. Aspects of image resolution (spatial, spectral, and signal) and the importance of 3-dimensional viewing are emphasized. Finally, I present my general strategy for image interpretation by observing that images comprise only two kinds of unique information (color and texture). I then present a strategy for image interpretation involving seven recognition keys (color, texture, shape, pattern, size, shadow, and location), and demonstrate using a single aerial photograph (Figure 1).
Early-onset Exfoliation Syndrome: A Literature Synthesis.

Precis We conducted a literature review of younger patients with exfoliation syndrome (XFS) in an attempt to identify case similarities and better understand disease etiology. Purpose XFS that predisposes to secondary glaucoma is a strongly age-related condition. We performed a literature review of XFS and exfoliation glaucoma (XFG) in patients aged younger than 40 years to examine potential common characteristics and gain clues to its etiology. Methods We conducted a broad literature search with appropriate keywords and manually extracted key demographic and ocular features on younger XFS and XFG cases. Articles that did not provide past ocular history on early-onset XFS/XFG were excluded. Results We identified 12 cases of XFS and XFG in patients from 13 to 40 years old (8 females; 11 White; 5 from Iran). All had past ocular history remarkable for intraocular surgery for other glaucoma conditions (7 cases), other ocular diseases (3 cases), or ocular trauma (2 cases). Conclusions All reported early-onset XFS and XFG cases arise in the setting of events that produced a significant disruption of the blood-aqueous barrier. Understanding the metabolic alterations of aqueous humor from such cases could provide clues regarding how exfoliation material forms.
DBS targeting for essential tremor using intersectional dentato-rubro-thalamic tractography and direct proton density visualization of the VIM: technical note on 2 cases

Objective Direct visualization of the ventral intermediate nucleus (VIM) of the thalamus on standard MRI sequences remains elusive. Therefore, deep brain stimulation (DBS) surgery for essential tremor (ET) indirectly targets the VIM using atlas-derived consensus coordinates and requires awake intraoperative testing to confirm clinical benefits. The objective of this study was to evaluate the utility of proton density (PD)-weighted MRI and tractography of the intersecting dentato-rubro-thalamic tract (DRTT) for direct "intersectional" targeting of the VIM in ET. Methods DBS targets were selected by identifying the VIM on PD-weighted images relative to the DRTT in 2 patients with ET. Tremor reduction was confirmed with intraoperative clinical testing. Intended target coordinates based on the direct intersectional targeting technique were compared with consensus coordinates obtained with indirect targeting. Pre- and postoperative tremor scores were assessed using the Fahn-Tolosa-Marin tremor rating scale (TRS). Results Planned DBS coordinates based on direct versus indirect targeting of the VIM differed in both the anteroposterior (range 0 to 2.3) and lateral (range -0.7 to 1) directions. For 1 patient, indirect targeting-without PD-weighted visualization of the VIM and DRTT-would have likely resulted in suboptimal electrode placement within the VIM. At the 3-month follow-up, both patients demonstrated significant improvement in tremor symptoms subjectively and according to the TRS (case 1: 68%, case 2: 72%). Conclusions Direct intersectional targeting of the VIM using PD-weighted imaging and DRTT tractography is a feasible method for DBS placement in patients with ET. These advanced targeting techniques can supplement awake intraoperative testing or be used independently in asleep cases to improve surgical efficiency and confidence.
What's New in Orthopaedic Rehabilitation.

Injuries and disorders of the musculoskeletal system cause pain and loss of function, thereby leading to disability. The goal of rehabilitation medicine is to restore function in individuals with disability. This article presents evidence from studies published from March 2015 to February 2016 in the area of orthopaedic rehabilitation. Original articles from the American Journal of Physical Medicine & Rehabilitation, The American Journal of Sports Medicine, Archives of Physical Medicine and Rehabilitation, The Clinical Journal of Pain, JAMA, The Journal of Bone & Joint Surgery, The Journal of Pain, Journal of Shoulder and Elbow Surgery, The New England Journal of Medicine, Physical Therapy, and PM&R were considered. We screened the manuscript titles and abstracts of these select journals and included articles that were considered to be of high impact and value to readers. This Update is divided into sections based on subspecialty areas in physical medicine and orthopaedic rehabilitation. ### Osteoarthritis Intra-articular administration of hyaluronic acid is a pharmacological approach to the management of knee osteoarthritis. Several formulations of hyaluronic acid are commercially available. Altman et al. performed a meta-analysis of trials assessing the efficacy of hyaluronic acid formulations according to molecular weight1. Hyaluronic acid products with a molecular weight of ≥3,000 kDa had a pooled effect size of −0.52 (95% confidence interval [CI], −0.56 to −0.48) when pain reduction was the outcome. These were more efficacious than products that were 1,500 kDa and those that were ≤1,500 kDa in molecular weight. Whole-body vibration mediates the activation of alpha (α) motor neurons, which cause muscle contractions, thereby leading to increased muscle strength2. A recent meta-analysis of 5 studies showed preliminary data for improved pain and function with whole-body vibration training among patients with knee osteoarthritis compared with controls2. ### Total Knee Arthroplasty With increasing emphasis on cost-containment and …
Diagnostic Value of 16S Ribosomal RNA Gene Polymerase Chain Reaction/Sanger Sequencing in Clinical Practice.

BACKGROUND Accurate microbiologic diagnosis is important for appropriate management of infectious diseases. Sequencing-based molecular diagnostics are increasingly used for precision diagnosis of infections. However, their clinical utility is unclear. METHODS We conducted a retrospective analysis of specimens that underwent 16S ribosomal RNA (rRNA) gene polymerase chain reaction (PCR) followed by Sanger sequencing at our institution from April 2017 through March 2019. RESULTS A total of 566 specimens obtained from 460 patients were studied. Patients were considered clinically infected or noninfected based on final diagnosis and management. In 17% of patients, 16S rRNA PCR/sequencing was positive and in 5% of patients, this test led to an impact on clinical care. In comparison, bacterial cultures were positive in 21% of patients. Specimens with a positive Gram stain had 12 times greater odds of having a positive molecular result than those with a negative Gram stain (95% confidence interval for odds ratio, 5.2-31.4). Overall, PCR positivity was higher in cardiovascular specimens (37%) obtained from clinically infected patients, with bacterial cultures being more likely to be positive for musculoskeletal specimens (P < .001). 16S rRNA PCR/sequencing identified a probable pathogen in 10% culture-negative specimens. CONCLUSION 16S rRNA PCR/sequencing can play a role in the diagnostic evaluation of patients with culture-negative infections, especially those with cardiovascular infections.
Compressive sensing and reception for MIMO-OFDM based cognitive radio

This paper explores a novel receiver architecture for multiple-input multiple-output (MIMO) and orthogonal frequency division multiplexing (OFDM) based cognitive radio (CR) that utilizes compressive sensing (CS) technique. Assuming that a limited number of subcarriers are used simultaneously in one MIMO-OFDM channel, we show that the conventional MIMO receiver can be replaced with the proposed receiver to compressively sample signals. In the proposed reception architecture, signals from multiple antennas are mixed and sampled with less hardware by exploiting the sparsity in the OFDM channel usage. Applying the CS technology to the receiver directly reduces the power consumption in mixed signal circuit which is attributable to less number of analog-to-digital converters (ADCs). A new streamlined algorithm for digital signal processing (DSP) to recover the compressively sensed data is also devised. Besides the simplification of the signal sensing, the simulation results also show that the reception fidelity of the proposed architecture outperforms that of the conventional maximum likelihood (ML) MIMO detector when the channel is lightly loaded.
Tracheid length prediction in Pinus palustris by means of near infrared spectroscopy: the influence of age

The prediction of tracheid length using near infrared (NIR) wavelengths can provide either useful or misleading calibrations depending on the context. This can happen since tracheid length is not directly related to the absorbance at any wavelength but is instead the result of a secondary correlation with some unknown chemical constituent. In this work, the effect of tree age and height on NIR predictability was investigated since tracheid length and chemistry may vary as a function of location within the tree. It was found that tracheid length predictability did not change with height but decreased with age. As a result, predicting tracheid length regardless of age was good (R2 = 0.72) while predictability holding age and height constant was mostly low to moderate with the exception of rings 1 and 4 which was quite strong.
Effective resonance integrals of separated tungsten isotopes from reactivity measurements.

Effective resonance integrals for separated tungsten isotopes and natural W and Au determined from epicadmium reactivity measurements
Quantitation of Opioids in Blood and Urine Using Gas Chromatography-Mass Spectrometry (GC-MS)

The opioid and 6-acetylmorphine assays utilize gas chromatography-mass spectrometry (GC-MS) for the analysis of morphine, codeine, hydromorphone, hydrocodone, and 6-acetylmorphine in blood and urine. The specimens are fortified with deuterated internal standard and a five-point calibration curve is constructed. Specimens are extracted by mixed-mode solid phase extraction. The morphine, codeine, hydromorphone, hydrocodone, and 6-acetylmorphine extracts are derivatized with N-methyl-bis(trifluoroacetamide) (MBTFA) producing trifluoroacetyl derivatives. The final extracts are then analyzed using selected ion monitoring GC-MS.
Response to Intervention as a Vehicle for Powerful Mental Health Interventions in the Schools

School psychologists can work within a Response to Intervention (RtI) framework to increasingly promote the mental health of students. This article shares the unfolding of two composite case studies that exemplify how a practicing school psychologist can use a problem-solving framework to deliver effective mental health interventions to individual students. The first case involved an elementary school student who markedly improved in terms of on-task behavior, and the second case concerned a high school student who overcame school refusal and negative affect. The advantages of providing brief counseling and psychological consultation prior to a possible full evaluation or special education placement are discussed.
Social Change and Entry to Adulthood

The effects of social change on the transition to adulthood are manifest in large-scale societal and institutional changes, alterations in relationships and networks, and shifts in individual psychological orientations and behaviors. This essay reviews key foundational work that has established the framework for our understanding of social change and the transition to adulthood, highlighting Mannheim and Elder's theoretical contributions and early empirical studies of age norms, status attainment, and the timing and sequencing of adult role markers. It then describes major ongoing programs of research on the movement from school to work, pathways of transition, familial financial and residential support of transitioning children, and both adult roles and character traits as sources of adult identity. Finally, in view of ongoing societal trends, it calls for future studies of inequality and its implications for the diverging destinies of youth that depend on their social class origin, race, and gender; shifts in the bases of youth age-related and other identities; the consequences of social media for transitional dynamics; and the implications of transitional patterns for young adult health, cross-national comparative studies, and youth responses to climate change. Keywords: social change; transition to adulthood; school-to-work transition; age norms; adult identity; generation; career establishment; family formation
Lymphoproliferative Disorders Associated with Primary Immune Disorders

Lymphoma-like lesions and lymphomas occur in patients with underlying primary immunodeficiencies. There are currently more than 180 of these processes identified and the clinical manifestations, pathogenesis, and pathologic features are variable. Primary immune disorders (PIDs) may involve innate or adaptive immunity and the basic defect can occur at any level of the immune system, including disorders of cytokines and cytokine receptors; antigen presentation, receptors, and signaling; accessory and adhesion molecules, or metabolic defects. Primary immune disorders, at time of initial diagnosis, may be asymptomatic or patients can have recurrent infections or lymphoproliferations.
Digital Circuit Design Challenges and Opportunities in the Era of Nanoscale CMOS

Well-designed circuits are one key ldquoinsulatingrdquo layer between the increasingly unruly behavior of scaled complementary metal-oxide-semiconductor devices and the systems we seek to construct from them. As we move forward into the nanoscale regime, circuit design is burdened to ldquohiderdquo more of the problems intrinsic to deeply scaled devices. How this is being accomplished is the subject of this paper. We discuss new techniques for logic circuits and interconnect, for memory, and for clock and power distribution. We survey work to build accurate simulation models for nanoscale devices. We discuss the unique problems posed by nanoscale lithography and the role of geometrically regular circuits as one promising solution. Finally, we look at recent computer-aided design efforts in modeling, analysis, and optimization for nanoscale designs with ever increasing amounts of statistical variation.
Dietary clofibrate stimulates the formation and size of estradiol-induced breast tumors in female August-Copenhagen Irish (ACI) rats.

Abstract Administration of 0.4% clofibrate in the diet stimulated estradiol (E2)-induced mammary carcinogenesis in the August-Copenhagen Irish (ACI) rat without having an effect on serum levels of E2. This treatment stimulated by several-fold the NAD(P)H-dependent oxidative metabolism of E2 and oleyl-CoA-dependent esterification of E2 to 17β-oleyl-estradiol by liver microsomes. Glucuronidation of E2 by microsomal glucuronosyltransferase was increased moderately. In contrast, the activity of NAD(P)H quinone reductase 1 (NQO1), a representative monofunctional phase 2 enzyme, was significantly decreased in liver cytosol of rats fed clofibrate. Decreases in hepatic NQO1 in livers of animals fed clofibrate were noted before the appearance of mammary tumors. E2 was delivered in cholesterol pellets implanted in 7–8-week-old female ACI rats. The animals received AIN-76A diet containing 0.4% clofibrate for 6, 12 or 28 weeks. Control animals received AIN-76A diet. Dietary clofibrate increased the number and size of palpable mammary tumors but did not alter the histopathology of the E2-induced mammary adenocarcinomas. Collectively, these results suggest that the stimulatory effect of clofibrate on hepatic esterification of E2 with fatty acids coupled with the inhibition of protective phase 2 enzymes, may in part, enhance E2-dependent mammary carcinogenesis in the ACI rat model.
Open adhesiolysis is more effective in reducing adhesion reformation than laparoscopic adhesiolysis in an experimental model

Background: This study compared adhesion reformation after open and laparoscopic adhesiolysis in a rat model. Methods: Adhesions were induced by surgically creating ischaemic buttons on the peritoneal side wall. After 7 days the animals underwent laparoscopy with carbon dioxide insufflation or laparotomy to score and lyse adhesions. Peritoneal tissue and fluid were collected after 24 h in a subset of animals, and adhesion reformation was scored 7 days after lysis in the remainder. Tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI) 1, transforming growth factor (TGF) β1 and tumour necrosis factor (TNF) α mRNA, and total fibrinolytic activity were assessed. The abdomen of non-operated animals was insufflated for 7, 15 or 30 min with carbon dioxide, after which tPA and PAI-1 mRNA and total fibrinolytic activity were measured. Results: Animals that underwent open adhesiolysis had 60 per cent fewer reformed adhesions than the laparoscopic adhesiolysis group (P < 0·001). There were no differences in tPA activity or tPA, PAI-1 and TNF-α mRNA between groups, but TGF-β1 mRNA levels were significantly increased in the open group. Carbon dioxide insufflation did not affect peritoneal tPA activity. Conclusion: Open adhesiolysis may be more beneficial in minimizing adhesion reformation in the management of adhesion-related complications. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Test commander: providing automated tests

When software is written the developer will typically test error conditions as time progresses. Rarely will the developer have the time to go back and re-test all error conditions after every code change. This software provides a means to create a suite of software tests that can be run automatically as the code is developed. The developer can add additional tests as development proceeds and avoid the extra time at the end of a project to re-run tests manually. This system has been used to test both hardware and software reliability. The tool is flexible, informative, and invaluable when it comes to ensuring quality software. It has been used for acceptance tests for Gemini's Data Handling System, Multi-Object Spectrograph, Adaptive Optics System, and CFHT's Mega Prime instrument.© (2002) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Importance of tissue morphology relative to patient reports of symptoms and functional limitations resulting from median nerve pathology.

Significant data exist for the personal, environmental, and occupational risk factors for carpal tunnel syndrome. Few data, however, explain the interrelationship of tissue morphology to these factors among patients with clinical presentation of median nerve pathology. Therefore, our primary objective was to examine the relationship of various risk factors that may be predictive of subjective reports of symptoms or functional deficits accounting for median nerve morphology. Using diagnostic ultrasonography, we observed real-time median nerve morphology among 88 participants with varying reports of symptoms or functional limitations resulting from median nerve pathology. Body mass index, educational level, and nerve morphology were the primary predictive factors. Monitoring median nerve morphology with ultrasonography may provide valuable information for clinicians treating patients with symptoms of median nerve pathology. Sonographic measurements may be a useful clinical tool for improving treatment planning and provision, documenting patient status, or measuring clinical outcomes of prevention and rehabilitation interventions
Emergency Management of Seizures: An Overview

Summary: The drugs currently used in the emergency management of seizures are chiefly phenytoin, phenobarbital, diazepam, lorazepam, and paraldehyde. The combination of intravenous phenytoin and lorazepam has the advantages of rapid onset of action, sustained efficacy, and freedom from drug interactions. The intermittent oral or rectal administration of diazepam is especially useful for acute home treatment of recurrent seizures. Phenytoin prodrug (ACC-9653), an investigational new drug, is promptly absorbed after intramuscular injection. Unlike phenytoin, it does not require propylene glycol and high alkalinity for solubility and therefore does not produce soft-tissue injury after parenteral administration. It appears to be close to an ideal drug for the emergency management of seizures.
Interstellar neutral hydrogen in the heliosphere

Abstract A fluid model is introduced to study the flow of interstellar neutral hydrogen in the heliosphere. We calculate the normalized density N H N H ∞ bulk velocity V H V H ∞ , and temperature T H T H ∞ of interstellar hydrogen as functions of r λ and z λ where λ is the ionization scale length. The fluid solution is much less time-consuming than the kinetic theory solutions.
Biosynthetic Origins of the Carbon Skeleton of Heme d1

Abstract 13 C-labeling experiments were performed to determine the simple precursor metabolites that contribute to the tetrapyrrole skeleton of heme d 1 . By use of 5-[4- 13 C]aminolevulinic acid it was determined that the skeleton is derived from 8 eq of this acid and that the labeled carbons appeared at sites Cl, C3, C6, C8, C11, C13, C17, and C19 (IUB-IUPAC tetrapyrrole nomenclature). In the course of this study, it was discovered that the glycine-succinyl-coenzyme A pathway to 5-aminolevulinate is not operative in Pseudomonas aeruginosa . 13 C chemical shifts are reported for the complete skeleton of the free base porphyrin d 1 methyl ester derivative, except for C4 and C9.