cssi/SciSciGPT-SciSciNet huggingface dataset:
Turbulence measurements in the northern gulf of Mexico: Application to the Deepwater Horizon oil spill on droplet dynamics

Abstract An integrated observational field effort that makes simultaneous and collocated measurements of turbulence and fine-scale parameters has been conducted near the Deepwater Horizon oil spill site in the northern Gulf of Mexico (GOM). Full water column profiles are collected across the continental slope in July 2013. The observational results suggest that strong turbulence is patchy and mostly measured in the thermocline and deepwater when using the buoyancy Reynolds number, Re b =200 criterion, the boundary between weak and strong turbulence. Bottom enhanced turbulence is often seen on the continental slope. Using the ratio of the turbulent velocity scale and the oil droplets rising velocity, we develop criteria for when turbulence will dominate the movement of oil droplets and when turbulence can be ignored. Based on the data collected, for oil droplets with rising velocity greater than 6×10 −3 m s −1 , the turbulence effect can be ignored on the continental slope of the northern GOM. For oil droplets with rising speed less than 10 −4 m s −1 , their motions will be affected by the turbulent flow at all depths. For oil droplets with rising speed between 10 −4 and 6×10 −3 m s −1 , the role of turbulence will depend on the strength of the local turbulence and water stratification. We also relate turbulent velocity to the size and density of oil droplets by estimating the rising velocity of different size oil droplets due to balance between buoyancy and drag force. Droplet size and density difference are the two critical parameters in determining the role of turbulence.
Network representations and match filters for invariant object recognition

Artificial Intelligence (AI) deals with the types of problem solving and decision making that humans continuously face in dealing with the world. Such activity involves by its very nature complexity, uncertainty, and ambiguity which can “distort” the phenomena (e.g., imagery) under observation. However, following the human example, any artificial vision system should process information such that the results are invariant to the vagaries of the data acquisition process.
Step-to-Step Variability in Tibiofemoral Contact Force During Walking Measured by an Instrumented Knee Implant

Understanding the dynamic loading at the knee can provide critical information for characterizing normal as well as pathologic conditions. However, measuring or predicting this loading from extrinsic measurement remains an unmet challenge. Part of the complexity of generalizing the tibiofemoral loading is that contact force patterns are largely subject specific and vary within subjects based on the activity performed and the specific muscle activation patterns exhibited [1]. While several studies have quantified the intra-subject variability in extrinsic knee kinematics and kinetics during repetitive activities of daily living [2,3], changes in patterns of muscle contraction can yield substantial step-to-step variability in tibiofemoral contact force with minimal changes in extrinsic kinetics due to the potential influence of muscle co-contraction. Knowledge of this step-to-step tibiofemoral loading variability could play an integral role in improving the interpretation of analytical contact force predictions.© 2009 ASME
HSS-matrix based fast direct volume integral equation solver for electrodynamic analysis

We represent the dense system of volume integral equation (VIE) by an HSS (hierarchically ?"emiseparable) matrix. We then exploit the structure of the HSS matrix and develop a fast direct VIE solver. This solver has O(MogN) complexity in factorization, O(N) complexity in matrix solution as well as memory irrespective of electrical size. For solving electrically small problems whose rank is constant, its complexity is strictly O(N) in both time and memory. The HSS-representation has a controlled accuracy; and the direct solution of the HSS matrix does not involve further approximation. Numerical simulations of large-scale scattering problems involving millions of unknowns on a single core CPU have demonstrated its complexity and accuracy.
Y-Chromosome evidence of an African origin of Dravidian agriculture

Y-linked markers provide loci to investigate genetic connections between human populations that can offer abundant anthropological information. Ancestry informative markers for Dravidian speaking populations in India that cultivate African cultigens were analyzed. The frequency of shared Y-chromosomes and HLAs between Dravidian and African populations is consistent with a possible African origin for millet, the principal food staple of Dravidian speakers in India. The evolutionary and epidemiological implications of these findings are reported herein. Key words: Human leukocyte antigen (HLA), sickle cell anemia, haplotype, Y-chromosome, haplogroup, mtDNA.
Wrong side dilated pupil. Author response.

Editors' Note: Lekhra gives 2 possible explanations for the wrong side dilated pupil in Wijdicks' case. Commenting on the clinical reasoning case regarding the unusual cause of transverse myelitis, Ghuman and Kaur discuss why …
Insights into zinc and cadmium biology in the nematode Caenorhabditis elegans

Zinc is an essential metal that is involved in a wide range of biological processes, and aberrant zinc homeostasis is implicated in multiple human diseases. Cadmium is chemically similar to zinc, but it is a nonessential environmental pollutant. Because zinc deficiency and excess are deleterious, animals require homeostatic mechanisms to maintain zinc levels in response to dietary fluctuations. The nematode Caenorhabditis elegans is emerging as a powerful model system to investigate zinc trafficking and homeostasis as well as cadmium toxicity. Here we review genetic and molecular studies that have combined to generate a picture of zinc homeostasis based on the transcriptional control of zinc transporters in intestinal cells. Furthermore, we summarize studies of cadmium toxicity that reveal intriguing parallels with zinc biology.
The Scalar Case

The aim of this chapter is to discuss some full (that is everywhere) regularity results for scalar-valued weak solutions to second order elliptic equations in divergence forms. Weak solutions only belong to some Sobolev space (consequently, neither are they necessarily continuous nor do derivatives a priori exist in the classical sense), and hence, their regularity needs to be investigated. We here prove local Holder regularity of weak solution and present two different (and classical) strategies of proof dating back to the late 1950s. First, we explain De Giorgi’s level set technique, in a unified approach that applies both to weak solutions of elliptic equations and to minimizers of variational integrals, via the study of Q-minimizers of suitable functionals. We then address, for the specific case of linear elliptic equations, an alternative proof of the everywhere regularity result of weak solutions via Moser’s iteration method.
The Place of Animals in the Economy

The normal experience of non-human animals in the industrialized world usually includes significant harm at the hands of humans. At the same time, the normal experience of humans in the industrialized world is to encounter other living species of animals only in relatively peaceful situations. Consider that a representative animal’s experience is that of the hog confined for his short life until he is slaughtered. A representative human’s experience is their interaction with the neighbor’s cat. This basic difference summarizes one of the main conclusions of this book, that the economy has been shaped by and for humans, often to the detriment of animals, but that this exploitation is largely not visible to the average human beneficiary.
SPLIT DEFECT OF SWISS CHEESE

In a preceding paper we reported that certain strains of Propionibacterium which grow at low temperatures are able to split Swiss cheese. The metabolic characteristics of these strains differ from those of strains unable to grow and produce CO2 at low temperatures. The optimal pH for malate dehydrogenase activity of cell-free extracts of the low-temperature growing strains was 7.5, whereas it was 8.5 for strains lacking the ability to grow at low temperatures. Arrhenius plots of enzymic specific activity for lactate and malate dehydrogenases of cell-free extracts obtained from low-temperature growing strains showed greatest activities at temperatures below 10 C. At 15 C or greater, cell-free extracts of strains without low-temperature growth ability showed equal or greater lactate or malate dehydrogenase specific activities. Thus, enzymes of low-temperature growing strains showed greater capacities for activity at both lower temperatures and lower pH. These data support the hypothesis that such strains at...
Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

Abstract Purpose To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). Methods NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011–2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs. Hospital fixed effects were included to yield within-hospital estimates of disparities. Results GLM models demonstrated that Blacks with aphasia experienced 1.9 days longer lengths of stay compared to Whites with aphasia after controlling for demographic characteristics, 1.4 days controlling for stroke/illness severity, 1.2 days controlling for observed hospital characteristics, and ~ 1 extra day controlling for unobserved hospital characteristics. Similarly, Blacks accrued ~$2047 greater total costs compared to Whites after controlling for demographic characteristics, $1659 controlling for stroke/illness severity, $1338 controlling for observed hospital characteristics, and ~$1311 greater total costs after controlling for unobserved hospital characteristics. Conclusions In the acute hospital setting, Blacks with aphasia utilize greater hospital services during longer hospitalizations and at substantially higher costs in the state of NC. A substantial portion of the adjusted difference was related to the hospital treating the patient. However, even after controlling for the hospital, the differences remained clinically and statistically significant.
An Egyptian Game in Athens

Egyptian playing pieces found at Greek sites signal the possible introduction of senet in the Aegean region but no actual board has yet been excavated in Greece. The senet board with a recumbent lion, exhibited in the National Archaeological Museum at Athens and published here for the first time, was in fact collected in Egypt. Instead this object provides a rare example of an Egyptian board featuring an ornamental animal on the edge of the board. Stylistic comparisons between this board and other decorated examples suggest that senet boards—documented in the Levant, Cyprus, and Nubia—have inspired other versions of race games beyond these regions, possibly including a series of Neo-Assyrian games of fifty-eight holes with animals on their flat end.
Seed-Initiated Anisotropic Growth of Unidirectional Armchair Graphene Nanoribbon Arrays on Germanium

It was recently discovered that the chemical vapor deposition (CVD) of CH4 on Ge(001) can directly yield long, narrow, semiconducting nanoribbons of graphene with smooth armchair edges. These nanoribbons have exceptional charge transport properties compared with nanoribbons grown by other methods. However, the nanoribbons nucleate at random locations and at random times, problematically giving rise to width and bandgap polydispersity, and the mechanisms that drive the anisotropic crystal growth that produces the nanoribbons are not understood. Here, we study and engineer the seed-initiated growth of graphene nanoribbons on Ge(001). The use of seeds decouples nucleation and growth, controls where growth occurs, and allows graphene to grow with lattice orientations that do not spontaneously form without seeds. We discover that when the armchair direction (i.e., parallel to C—C bonds) of the seeds is aligned with the Ge⟨110⟩ family of directions, the growth anisotropy is maximized, resulting in the formation...
The Effect of Philipp Melanchthon's Separation of Philosophy and Theology: Lutheran Educational Reforms in Context of Contemporary Catholic Educators

Although both Catholics and Protestants alike have condemned Philipp Melanchthon for theological views, many have praised his educational reforms. The following is a study of the development of Mel...
Numerical artifacts in the discontinuous Generalized Porous Medium Equation: How to avoid spurious temporal oscillations

Abstract Numerical discretizations of the Generalized Porous Medium Equation (GPME) with discontinuous coefficients are analyzed with respect to the formation of numerical artifacts. In addition to the degeneracy and self-sharpening of the GPME with continuous coefficients, detailed in [1] , increased numerical challenges occur in the discontinuous coefficients case. These numerical challenges manifest themselves in spurious temporal oscillations in second order finite volume discretizations with both arithmetic and harmonic averaging. The integral average, developed in [2] , leads to improved solutions with monotone and reduced amplitude temporal oscillations. In this paper, we propose a new method called the Shock-Based Averaging Method (SAM) that incorporates the shock position into the numerical scheme. The shock position is numerically calculated by discretizing the theoretical speed of the front from the GPME theory. The speed satisfies the jump condition for integral conservation laws. SAM results in a non-oscillatory temporal profile, producing physically valid numerical results. We use SAM to demonstrate that the choice of averaging alone is not the cause of the oscillations, and that the shock position must be a part of the numerical scheme to avoid the artifacts.
Qetch: Time Series Querying with Expressive Sketches

Query-by-sketch tools allow users to sketch a pattern to search a time series database for matches. Prior work adopts a bottom-up design approach: the sketching interface is built to reflect the inner workings of popular matching algorithms like Dynamic time warping (DTW) or Euclidean distance (ED). We design Qetch, a query-by-sketch tool for time series data, top-down. Users freely sketch patterns on a scale-less canvas. By studying how humans sketch time series patterns we develop a matching algorithm that accounts for human sketching errors. Qetch's top-down design and novel matching algorithm enable the easy construction of expressive queries that include regular expressions over sketches and queries over multiple time series. Our demonstration showcases Qetch and summarizes results from our evaluation of Qetch's effectiveness.
NeuroVR™ Simulator in Neurosurgical Training

In an era where neurosurgical training must counterbalance work-hours restrictions and patient safety with highly sophisticated technical mastery, virtual reality (VR) simulation offers a viable educational alternative to the Halstedian apprenticeship model in a risk-free environment. Furthermore, residency training is moving toward the use of proficiency performance benchmarks to acquire a minimum competency standard.
Adolescents Spending Time Alone With Pediatricians During Routine Visits: Perspectives of Parents in a Primary Care Clinic

Abstract Purpose To increase understanding of parental perspectives on time alone and of factors that influence adolescent communication with physicians in a pediatric clinic. Methods The sample consisted of 91 parents of adolescents aged 14–17 years who attended a well child visit at one primary care pediatric practice and completed a 2-week follow-up phone call as part of a larger study on adolescent health and communication. Parents reported whether their child met alone with the pediatrician, rated the importance of him or her having time alone with the physician, and responded to open-ended questions regarding barriers and facilitators of adolescent-physician communication. Bivariate and multivariate analyses tested associations of parent and adolescent characteristics with perceived parental importance of time alone. We conducted content analyses of responses to open-ended questions. Results Slightly more than half of parents (n = 53, 58%) indicated that it was “a lot” important for their adolescents to meet alone with the pediatrician; parents of males were more likely than parents of females to select this highest rating (73% vs. 43%, χ2(1) = 8.34, p = .004; adjusted odds ratio 4.88, 95% confidence interval 1.84–12.96). Responses to open-ended questions identified numerous adolescent, parent, and provider factors that parents perceived to influence adolescent-physician communication during well child visits, such as preparation for visit, rapport and familiarity with the pediatrician, privacy concerns, time alone with the pediatrician, emotional comfort, trust, and support. Conclusions Most parents thought time alone was highly important for their own adolescent in a primary care setting, and parents described additional strategies to facilitate adolescent communication.
I’m Doing This My Own Way: Redeeming NYPD Blue’s Racist Hero

The heroes in nineties dramas like NYPD Blue and ER are imperfect characters, and given the stressful nature of their work in urban institutions, their imperfections could overwhelm them if not for the support of their coworkers. Ultimately, the characters must rely on the familial bonds that form in their workplace. This chapter examines the redemption of NYPD Blue’s racist, bigoted protagonist, Detective Sipowicz. His underlying decency contrasts sharply with the dramatic violence of the Los Angeles police officers videotaped beating Rodney King two years before N.Y.P.D. Blue debuted.
Social Structure and Personality

Social structure and personality (SSP) research is concerned with the relationship between macro-social systems or processes and individual feelings, attitudes, and behaviors. It is considered a perspective or framework rather than a theoretical paradigm because it is not associated with general theoretical claims that transcend specific substantive problems. Rather, it provides a set of orienting principles that can be applied across diverse substantive areas. These principles direct our attention to the hierarchically organized processes through which macrostructures come to have relevance for the inner lives of individual persons and, in theory, the processes through which individual persons come to alter social systems. Although the SSP name implies an exclusive focus on social structures, SSP research is concerned more broadly with social systems, sets of "persons and social positions or roles that possess both a culture and a social structure" (House, 1981, p. 542). Whereas House (1981) notes that social structure can be used to refer to "any or all aspects of social systems," he and other SSP researchers define social structure more precisely as "a persisting and bounded pattern of social relationships (or pattern of behavioral intention) among the units (persons or positions) in a social system" (House, 1981, p. 542, emphasis in the original). This definition encompasses features of the macro-social order such as the structure of the labor market and systems of social stratification as well as processes such as industrialization. In contrast, culture is used in SSP research to refer to "a set of cognitive and evaluative beliefs— beliefs about what is or what ought to be—that are shared by the members of a social system and transmitted to new members" (House, 1981, p. 542). The distinction between structure and culture is not always maintained in practice (a point we discuss in more detail later), but
A Bilateral Decision Support Platform for Public Charging of Connected Electric Vehicles

As electric vehicles (EVs) proliferate and dominate the roads, public charging will be required extensively. Wide range coverage of energy information is required on fingertips for taking decisions at different levels and for all stakeholders. For this reason, a need arises for a correlated and all-inclusive framework that trades the unilateral discriminatory benefits with the combined benefit of all. At the heart of such frameworks lies communication technologies to support and manage energy transfer between vehicles and the power grid, known as the Internet of EVs. This paper adds two main contributions to the work presented in the literature on the subject matter. First, the communication requirements, standards, and protocols for applications involving this mobile prosumer management in the pre-connection stage to the electric grid are outlined. Second, and based on the aforementioned assessment, this paper proposes a decentralized hierarchical multiagent system that serves as a framework for real-time bilateral decision support for EVs and the power system. The effectiveness of the proposed framework and the credibility of using the communication middleware and means are experimentally verified on a group of connected vehicles communicating with a higher end server. Also, the seamless integration between the on-board and the higher end decision support systems is demonstrated in case studies.
Responses of Anastrepha suspensa, Diachasmimorpha longicaudata, and Sensitivity of Guava Production to Heterorhabditis bacteriophora in Fruit Fly Integrated Pest Management.

Caribbean fruit fly, also known as Caribfly or Anastrepha suspensa , is a major tephritid pest of guavas. A virulent entomopathogenic nematode (EPN) species was investigated to suppress the fruit-to-soil stages of Caribflies, which are also attacked by the koinobiont parasitoid Diachasmimorpha longicaudata in south Florida. The main objective was to develop a feasible and cost-effective EPN-application method for integrated pest management (IPM) of Caribfly to improve guava production. Naturally infested guavas were treated with increasing Heterorhabditis bacteriophora infective juvenile (IJ) concentration or rate (0, 25, 50, …, 1,600 IJs cm -2 ) in field trials to measure the optimum IJ rate and then examine sensitivity of producing guavas to inclusion of Heterorhabditis bacteriophora in Caribfly IPM plans. Relative survival of Caribfly in treatments significantly decreased with increasing IJ rate from 0 to 100 IJs cm -2 . Similarly, probability of observing large numbers of parasitoid wasps ( Diachasmimorpha longicaudata ) in EPN treatments significantly declined with increasing IJ rate (0-100 IJs cm -2 ), even though the non-target effects of Heterorhabditis bacteriophora on relative survival of Diachasmimorpha longicaudata could not be determined because of few emerging parasitoid wasps. Optimum suppression (⩾ 60%) of Caribfly was consistently achieved at 100 IJs cm -2 or 17,500 IJs fruit -1 . Profitability analysis showed that Heterorhabditis bacteriophora can be included in Caribfly IPM tactics to produce guavas. Costs of EPNs in Caribfly IPM are minimized if Heterorhabditis bacteriophora is strategically applied by spot treatment of fruit. Repayment of costs of EPN-augmentation by spot treatments appears achievable by recovering 5.71% of the annual yield losses (⩾1,963 kg ha -1 ≈ US$ 8,650 ha -1 ), which are largely due to Caribfly infestation. Hectare-wide EPN-augmentation (or broadcasting) method requires more fruit recovery than the total annual yield losses to repay its high costs. Profitability of guava production in south Florida will not be very sensitive to marginal costs of the spot treatment method, when compared to the field-wide broadcasting of Heterorhabditis bacteriophora .
Pinpointing Disability Accommodation Needs: What Evidence Is Most Relevant?

Diagnosticians who recommend educational accommodations for postsecondary students with learning, cognitive, and psychiatric disabilities often reference specific diagnostic test scores as a basis for the recommended accommodations. Moreover, accommodation decision-makers often follow diagnosticians’ lead and/or rely on the diagnostic scores themselves to make and justify accommodation determinations. The present paper considers the ecological validity of these diagnostic test scores, focusing on their generalizability across time, setting, and dimension of performance. A wide variety of research suggests a need for circumspection and care when using diagnostic test scores to make accommodation decisions. Illustrative data are presented showing that scores from diagnostic cognitive tests do not significantly predict students’ ability to access a realistic test. Diagnostic tests should not be unduly criticized, and data from these tests can be helpful, but both clinicians and accommodation decision-makers should carefully consider issues of diagnostic test scores’ ecological validity and make nuanced conclusions about the needs of a client/applicant based on a wide variety of evidence.
Turbidity Current Observations in a Large Reservoir Following a Major Wildfire

AbstractTurbidity currents are generated when denser river water plunges and flows along the bottom of a lake, reservoir, or ocean. The plunging and downstream movement are driven by density differ...
Choice or Sequester? A Classroom Simulation in Budgetary Politics

Simulations, like many games of sport and politics, are capable of producing complex, entertaining and, often, instructive behavior on the basis of a simple format and small set of rules which structure the activity. Although the real congressional budget process is highly complex, the simple simulation materials presented here reproduced an authentic process and set of outcomes for the students involved in it. In our “run” of this simulation last fall, these results came as quite a surprise to the student participants, who began the exercise skeptical both of Congress' efforts to reduce the deficit and of the power of simulations to capture real, complex phenomena. After the simulation, the shared experience provided a basis for several discussions of the merits of different explanations of policy outcomes: those achieved in the simulation, in the current Congress, and by policy makers more generally. This simulation was developed for use in an introductory course in public policy, but it is equally well-suited for any course involving legislative policy making or national taxing and spending policy. The simulation materials themselves are provided in the last section of this presentation. The next sections describe the context of the simulation in the course, how it worked when we used it, and the character of the discussion which resulted from it. The purposes of this introductory course in public policy are first, to introduce students to the substance of public policies, for example, to what defense policy or tax policy actually consists of, and second, and more important, to develop in students a capacity to think critically about why particular policy outcomes evolve as they do. We use texts, such as Dye's Understanding Public Policy (1987), which combine substantive material with different theoretical approaches. The simulation comes at the point in the course where we are shifting from political explanations of policy choices to structural and environmental theories; that is, from explanations which reference the interests and intentions of policy makers, to theories which explain choice in terms of constraints, such as the amount of resources available, which cannot easily be manipulated by decision makers.
Best Practices and Research Perspectives with Immigrant Groups

There are roughly 40 million immigrants living in the USA. To date, there is little literature and research directly exploring best practice and research perspectives in immigrant groups. The aim of this chapter is to review the existing data on research via three critical variables: immigration status, acculturation, and resiliency in relation to mental health. In addition, practice perspectives in assessment via linguistic and psychometric considerations, and practical solutions are considered and effective counseling perspectives are discussed. Lastly, a new psychiatric perspective with immigrant groups and future directions are introduced which has many clinical practice implications for the large number of Latino immigrants that continue crossing the Southwestern US border each day.
β-Lactamase Responsive Supramolecular Hydrogels with Host–Guest Self-Healing Capability

Smart supramolecular materials have gained popularity for a range of applications, including sensing, drug delivery, and tissue engineering. In this work, we describe a “host–guest” supramolecular ...
Rehabilitation following an acute traumatic first rib fracture in a collegiate football player: a case report and literature review.

Background and purpose Isolated fractures involving the first rib are rare and often difficult to diagnose. There is a paucity of literature regarding isolated fractures and even fewer reported cases involving those due to contact. The purpose of this case report is to describe the mechanism of injury, differential diagnosis, rehabilitation, and return to sport decision making for an isolated first rib fracture secondary to acute trauma in a collegiate football player. Case description An 18 year-old right-hand dominant male collegiate football player was involved in a facemask-to-facemask collision during a football game while playing defensive back. His chief complaint during the sideline evaluation was left-sided neck and shoulder pain with concomitant clicking reported with active movement of his left shoulder. Outcomes A musculoskeletal ultrasound performed in the training room suggested a possible scapular spine fracture. However, a subsequent magnetic resonance image revealed an acute isolated anterolateral fracture of the first rib. The subject was treated conservatively with extensive rehabilitation and was able to return to full participation for summer training camp as well as the fall football season at the same level of play as prior to injury. Discussion An isolated first rib fracture is extremely rare due to the unique anatomical location of the first rib posterior to the clavicle, as well as the surrounding shoulder girdle and associated layer of musculature. Identifying this injury can be challenging due to vaguely reported symptoms and the paucity of reported incidences. In the setting of an isolated injury, conservative management including structured rehabilitation can lead to successful outcomes and return to play. This is the first published rehabilitation guideline for an acute isolated first-rib fracture secondary to trauma. Level of evidence 4 - Single case report.
The Meaning of the “Marketplace of Ideas” in First Amendment Law

The 1919 First Amendment opinions of Oliver Wendell Holmes and Louis Brandeis comprise the seminal texts in the cannon that now includes hundreds of decisions by the Supreme Court of the United Sta...
Neuroimaging findings in Emanuel Syndrome

Emanuel syndrome is a rare inherited chromosomal abnormality caused by an unbalanced translocation of chromosomes 11 and 22. Clinically, Emanuel syndrome is characterized by a wide spectrum of congenital anomalies, dysmorphisms, and developmental disability often confused with other similar syndromes. Outside of genetic testing, diagnosis remains challenging and current literature on typical radiologic findings is limited. We present classic neuroimaging findings of Emanuel syndrome consistent with prior literature including microcephaly, microretrognathia, external auditory canal stenosis, and cleft palate; and also introduce the additional maxillofacial anomaly of dysplastic middle ear ossicles, to our knowledge not previously described in the literature. Recognition of findings leading to earlier diagnosis of Emanuel syndrome may improve outcomes and quality of life for patients and their families.
Anti-MOG Antibody associated Encephalomyelitis in an HIV-Positive Patient (1730)

Objective: N/A Background: Myelin oligodendrocyte glycoprotein (MOG) is found solely on myelin and oligodendrocytes in the central nervous system (CNS) and is a target of demyelinating auto-antibodies. Anti-MOG antibody demyelination is associated with acute disseminated encephalomyelitis, optic neuritis, and/or transverse myelitis. Design/Methods: N/A Results: A 62-year-old unimmunized man with HIV well-controlled on anti-retroviral therapy presented with abrupt onset burning sensation below the T4 dermatomal level followed by ascending numbness in his lower extremities. He had experienced an antecedent upper respiratory infection and bilateral parotid gland swelling. Within weeks he developed bowel incontinence, urinary retention, gait instability and dysarthria. MRI brain, cervical and thoracic spine with and without contrast demonstrated multiple patchy contrast-enhancing lesions in the cervical and thoracic cord spanning 2–4 vertebrae, as well as a non-enhancing T2 hyperintense right cerebellopontine junction lesion. CSF evaluation revealed 5 nucleated cells, mildly elevated protein, no unique oligoclonal bands, and infectious studies were negative. Serum aquaporin-4 antibody testing was negative. Serum mumps IgM was negative and IgG was positive. He was treated with 3 days of IV methylprednisolone with gradual neurological improvement. Two months later, serum anti-MOG antibody was positive at a titer of 1:100. Repeat imaging demonstrated persistence of the right cerebellopontine lesion and resolution or improvement of cord signal abnormalities. Repeat anti-MOG antibody testing 8 months after initial titer was negative. Conclusions: While anti-MOG antibody associated inflammatory disorders and encephalopathy have been reported following other viral infections, this is the first case of anti-MOG associated encephalomyelitis preceded by presumed acute mumps infection. Post-infectious anti-MOG antibody titers often become negative within months of the acute illness supporting a favorable prognosis; these cases are not typically treated with long-term immunosuppression. Transverse myelitis is a known sequela of primary HIV infection, however our patient had been well controlled on anti-retroviral therapy suggesting alternative explanation for his CNS inflammatory pathology. Disclosure: Dr. Arca has nothing to disclose. Dr. Grill has nothing to disclose.
Evidence for fasting induced extra-adrenal steroidogenesis in the male brown anole, Anolis sagrei.

Glucocorticoids (GCs) and dehydroepiandrosterone (DHEA) are steroids secreted by the adrenal glands into circulation to effect distant target tissues and coordinate physiological processes. This classic systemic view of steroids has been challenged by evidence that other tissues can independently synthesize their own steroids. Little is known however regarding circumstances that can promote this extra-adrenal steroidogenesis. Here we tested if fasting can induce tissues to increase GC and DHEA synthesis in the brown anole lizard Anolis sagrei. Lizards fasted for eight days lost body mass and increased fatty acid oxidation. Fasting also increased plasma concentrations of DHEA and corticosterone, but not cortisol. Corticosterone concentration within the adrenals, heart, intestines, lungs and liver exceeded that in plasma, with the latter two increasing with fasting. Levels of DHEA in the adrenals and heart were higher than in plasma, but no significant effect of fasting was observed, expect for a noticeable increase in intestinal DHEA. Two steroidogenic genes, the steroidogenic acute regulatory (Star) protein and Cyp17a1, a cytochrome P450 enzyme, were expressed in several tissues including the liver, lungs and intestines, which were increased with fasting. Continued research should aim to test for expression of additional enzymes further along the steroidogenic pathway. Nonetheless these data document potential extra-adrenal steroidogenesis as a possible mechanism for coping with energy shortages, although much work remains to be done to determine the specific roles of locally synthesized steroids in each tissue.
A Heuristic Evaluation of Usability for Environmental Control Units’ Eye-Tracking Interfaces at Veterans Affairs Spinal Cord Injuries and Disorders Centers:

Heuristic evaluation is a valid method for assessing interface usability. Results derived from these methods are useful in identifying the most impactful design elements influencing usability and u...
Disruption and Disagreement: Emancipation and Education in Clayton Christensen and Jacques Rancière

In this paper, I will examine the varying uses of the concept of disruption in education, with particular focus on its use by Clayton Christensen and other ‘education reform’ advocates on the one hand, and Jacques Ranciere’s ideas of dissensus and intellectual emancipation on the other. Despite the odd juxtaposition, the two ideas share deep similarities: both strive to democratize education through a structural shock to the status quo. However, I argue that it is more accurate to understand disruption rhetoric as technocratic in nature and deeply rooted in capitalism. Ranciere’s understanding of disruption as liberation reflects a deeper and more fundamental disturbance to the status quo. I conclude by discussing the insights these concepts provide into neoliberalism and possibilities for resisting it.
Research Engagement and Experiences of Participants in the Mechanical Circulatory Support: Measures of Adjustment and Quality of Life (MCS A-QOL) Study

Purpose Adults with chronic diseases often have difficulty engaging in research due to disease burden. In a secondary analysis, we examined mechanical circulatory support (MCS) patients’ engagement in and experience of a health-related quality of life (HRQOL) research study (MCS A-QOL). Methods Pre- or post-MCS implant, demographic and clinical data were collected from participants, medical records, and INTERMACS. They completed HRQOL questionnaires and a semi-structured interview about their research experience. Logistic regression was used to identify patient characteristics associated with study engagement (i.e., questionnaire completion). Qualitative analysis of interview responses used a thematic approach. Results Of 1011 eligible adults at 12 U.S. sites, 877 (87%) enrolled (10/26/16 to 2/29/20) and 687 of enrolled (78%) engaged in the study (Table). Characteristics associated with study engagement were non-Hispanic White race (OR=1.69, 95%CI=1.17-2.46) and less severe pre-implant INTERMACS profile (OR=1.12, 95%CI=1.02-1.22). On interview, 30% of participants reported their experience was better than expected—they enjoyed completing questionnaires (“Questions were thought-provoking”), participating in research (“It was involved but straightforward”), and valuing research (“I am glad to help these studies however I can”). Among the few with worse-than-expected experiences (8%), they described lengthy questionnaires (“Many questions seemed repetitive”), technology difficulties (“the iPad timed out a couple of times”), or general dissatisfaction (“I am now sorry that I agreed to do it”). Conclusion MCS patients were open to engaging in research and enjoyed contributing to HRQOL research. Engagement was reduced by disease acuity and among racial/ethnic minorities. Research participation did not adversely burden MCS patients, which supports their participation in future psychosocial research studies.
Age Differences in Estimating Physical Activity by Wrist Accelerometry Using Machine Learning

Accelerometer-based fitness trackers and smartwatches are proliferating with incessant attention towards health tracking. Despite their growing popularity, accurately measuring hallmark measures of physical activities has yet to be accomplished in adults of all ages. In this work, we evaluated the performance of four machine learning models: decision tree, random forest, extreme gradient boosting (XGBoost) and least absolute shrinkage and selection operator (LASSO), to estimate the hallmark measures of physical activities in young (20–50 years), middle-aged (50–70 years], and older adults (70–89 years]. Our models were built to recognize physical activity types, recognize physical activity intensities, estimate energy expenditure (EE) and recognize individual physical activities using wrist-worn tri-axial accelerometer data (33 activities per participant) from a large sample of participants (n = 253, 62% women, aged 20–89 years old). Results showed that the machine learning models were quite accurate at recognizing physical activity type and intensity and estimating energy expenditure. However, models performed less optimally when recognizing individual physical activities. F1-Scores derived from XGBoost’s models were high for sedentary (0.955–0.973), locomotion (0.942–0.964) and lifestyle (0.913–0.949) activity types with no apparent difference across age groups. Low (0.919–0.947), light (0.813–0.828) and moderate (0.846–0.875) physical activity intensities were also recognized accurately. The root mean square error range for EE was approximately 1 equivalent of resting EE [0.835–1.009 METs]. Generally, random forest and XGBoost models outperformed other models. In conclusion, machine learning models to label physical activity types, activity intensity and energy expenditure are accurate and there are minimal differences in their performance across young, middle-aged and older adults.
How Did the COVID-19 Pandemic Affect Trends in Facial Trauma?

Study Design:Retrospective cohort analysis.Objective:To examine the impact the COVID-19 pandemic and its accompanying societal measures had on the incidence, characteristics, and management of maxi...
Making 'Meaningful Access' Even Less Meaningful: Judicial Gatekeeping Under Title II of the Americans with Disabilities Act

Title II of the Americans with Disabilities Act has sweeping breadth, prohibiting disability discrimination by public entities in activities as diverse as zoning, voting, law enforcement, and public education. While judicial gatekeeping of employment discrimination claims under Title I has received considerable academic attention, similar patterns of judicial enforcement of Title II have not been adequately explored. This article demonstrates that courts are avoiding the issue of whether public entities are reasonably accommodating individuals with disabilities by 1) hair-splitting whether something is a “service, program, or activity” of a public entity; 2) finding the plaintiff failed to identify a public “benefit” or denial of the opportunity to participate in a public function; and 3) erroneously distinguishing between accommodation claims and facilities access claims. Judicial gatekeeping on these threshold issues is particularly significant because public entities are required to provide “meaningful access,” and courts are in effect shifting the metric as to what is “meaningful.” As with Title I, at least some courts appear to be motivated by the belief accommodation law grants special benefits to individuals with disabilities. Congress explicitly rejected that when it enacted the ADA Amendments Act of 2008, reversing courts’ narrow construction of the definition of “disability” under the Act. This article concludes by proposing that courts should approach Title II claims consistent with the overarching intent of the Amendments Act, which calls on courts to focus on the merits of ADA claims.
Enhanced rates of detection and treatment of depression and anxiety disorders among adult patients with epilepsy using automated EMR-based screening.

Abstract Objective Depression and anxiety disorders are common among patients with epilepsy (PWE). These comorbidities have been shown to influence prognosis and may have a greater impact on quality of life than seizure control. Despite guideline recommendations and expert consensus to regularly screen for and treat both conditions, there is evidence that they are underdiagnosed and undertreated. Our goal was to test a novel screening method to determine if it would increase the rate of detecting and treating depression and anxiety disorders among PWE. Method The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and the Brief Epilepsy Anxiety Survey Instrument (brEASI) were selected as validated screening instruments for depression and anxiety disorders, respectively. They were sent via an electronic medical record-linked patient portal to all patients of four epileptologists 48 h prior to their clinic appointment. We evaluated whether this increased the rate of detecting and treating depression and anxiety disorders relative to a historical control group. Results A total of 563 patients were included of whom 351 were sent the screening instruments. 62.7% of patients completed the screening instruments of whom 47.7% screened positive for either depression only (16.4%), anxiety disorders only (5.5%) or both (25.9%); a statistically significant increase relative to the control group. There was also a significantly increased proportion of patients for whom treatment was initiated for depression (p Conclusions We identified an easily applicable and efficient means of enhancing detection and treatment rates for depression and anxiety disorders among PWE in a busy clinic setting.
Understanding the Extent to which Content Quality Metrics Measure the Information Quality of Summaries

Reference-based metrics such as ROUGE or BERTScore evaluate the content quality of a summary by comparing the summary to a reference. Ideally, this comparison should measure the summary’s information quality by calculating how much information the summaries have in common. In this work, we analyze the token alignments used by ROUGE and BERTScore to compare summaries and argue that their scores largely cannot be interpreted as measuring information overlap. Rather, they are better estimates of the extent to which the summaries discuss the same topics. Further, we provide evidence that this result holds true for many other summarization evaluation metrics. The consequence of this result is that the most frequently used summarization evaluation metrics do not align with the community’s research goal, to generate summaries with high-quality information. However, we conclude by demonstrating that a recently proposed metric, QAEval, which scores summaries using question-answering, appears to better capture information quality than current evaluations, highlighting a direction for future research.
Application of myoelectric elbow flexion assist orthosis in adult traumatic brachial plexus injury: a retrospective clinical study.

BACKGROUND Adult traumatic brachial plexus injuries (BPIs) can result in severe impairment following penetrating wounds, falls, and motor vehicle accidents or other high-energy trauma. OBJECTIVE Quantify functional outcomes of adult patients with a BPI using a myoelectric orthosis to restore elbow flexion. STUDY DESIGN Retrospective review. METHODS A clinic specializing in the BPI treatment at a large academic medical center tested nineteen adult patients with BPI. These patients had failed to achieve antigravity elbow flexion following their injury and observation or surgical reconstruction. They were provided a myoelectric elbow orthosis (MEO) if they had detectable electromyography signals. RESULTS There was significant improvement in strength and significant reductions in function and pain when using an MEO. Following initiation of the MEO, 12 of the 19 patients had clinical improvements in muscle strength, 15 patients showed improvement in their DASH, and 13 patients reported improvements in their Visual Analog Scale. CONCLUSION The use of an MEO improves elbow flexion strength, increases function, and reduces pain in the majority of patients with BPI and inadequate elbow flexion following observation or surgical reconstruction.