cssi/SciSciGPT-SciSciNet huggingface dataset:
Older women's willingness to discontinue Papanicolaou test screening.

We surveyed our patients to assess their willingness to discontinue Papanicolaou testing. Our findings differ from those of previous studies, with 72% of our eligible respondents voicing willingness to discontinue screening. There may be many reasons for this, including linking the recommendation with the name of the patient9s own physician.
Economic preconditions that made possible application of commercial computing in the United States

This article argues that it would have become very difficult for computers to have come into being, and subsequently be adopted by businesses, if the United States economy were not large and healthy. The author demonstrates that there were characteristics of the economy that facilitated the development and use of computers in the United States, beginning in the 1950s and continuing down to the present.
Software Quality Imputation in the Presence of Noisy Data

The detrimental effects of noise in a dependent variable on the accuracy of software quality imputation techniques were studied. The imputation techniques used in this work were Bayesian multiple imputation, mean imputation, instance-based learning, regression imputation, and the REPTree decision tree. These techniques were used to obtain software quality imputations for a large military command, control, and communications system dataset (CCCS). The underlying quality of data was a significant factor affecting the accuracy of the imputation techniques. Multiple imputation and regression imputation were top performers, while mean imputation was ineffective.
Characterization of the Interaction of C60 with Au(111)

The nucleation, growth and structure of C60, films on Au(111) was studied using UHV-STM/S, LEED, AES, and TOF-SIMS and the results were compared with previous results for a mixed fullerene film (E.I. Altman and R.J. Colton, Surface Science, in press). The presence of the larger fullerenes was found to have no significant effect on either the growth or the structure of the fullerene films. In both cases, close-packed layers with a lattice constant of 1.0 nm grow out from the steps on both the upper and lower terraces. No LEED pattern due to C, was observed, however, STM indicated that two ordered structures predominate on the Au(111) surface: (1) a layer with a periodicity of approximately 38 Au spacings; and (2) a layer with a 2✓3x2✓3 R30° unit cell. In both structures, STM images show an apparently “inhomogeneous” film with some molecules brighter than others. The presence of brighter molecules was not due to larger fullerenes as in the earlier study; TOF-SIMS indicated the film contained only C60. Time lapsed STM images, intramolecular contrast, and STS results showed that the “inhomogeneity” of the film can be attributed to electronic differences between molecules bound in different rotational orientations on the surface. Tunneling spectra indicate that the variation in bonding is primarily due to the efficiency of coupling between the C60 LUMO and the Au surface. A number of internal structures were observed that appear to be due to a convolution of the structure of the C60 molecule and the underlying Au(111).
Epidemiologic, Clinicopathologic, Diagnostic, and Management Challenges of Pityriasis Rubra Pilaris: A Case Series of 100 Patients.

Importance Pityriasis rubra pilaris (PRP) is a rare papulosquamous disorder with limited epidemiologic and clinicopathologic data. Little information is available on long-term outcomes, comorbidities, and treatment efficacy. Objective To evaluate objective and subjective disease experience metrics from the perspectives of patients and clinicians. Design, Setting, and Participants One hundred patients with a putative diagnosis of PRP and who elected to participate completed a comprehensive survey, followed by acquisition of their medical records, including histopathology slides and reports. The data were analyzed separately from the health care clinician and the patient perspectives. Two academic dermatologists examined clinical notes, pathology reports, and photographs, confirming diagnoses via predetermined criteria. Patients were categorized into 4 levels of diagnostic certainty to allow stratification of the findings for subgroup analysis. Patients with a diagnosis of PRP were solicited through patient support organization websites. Main Outcomes and Measures Clinical outcomes, unexpected association of comorbidities, and efficacy (or lack of it) of various treatment modalities. Results Among the 100 patients, 50 were diagnosed as having classic, unquestionable PRP. The patients were a median of 61 years old (range, 5-87 years), and 46% were female. Fifty were categorized as level 1 diagnostic certainty, 15 as level 2, 30 as level 3, and 5 as level 4. Of the level 1 patients, 13 (26%) were correctly diagnosed at initial presentation; diagnosis was delayed, on average, by 29 months (range, 0.25-288 months; median, 2 months); and 27 (54%) having undergone 2 or more biopsies. At enrollment, PRP symptoms had persisted in 36 patients (72%) for an average of 58 months (range, 1-300 months; median, 30 months). Thirty-one patients (62%) had comorbidities, including hypothyroidism (20%). Nearly all patients (98%) received some form of therapy. Patients cited topical emollients, corticosteroids, and salicylic acid along with oral retinoids, methotrexate, and tumor necrosis factor inhibitors as most helpful. Conclusions and Relevance Pityriasis rubra pilaris remains a challenging diagnosis without established and specific treatment. Our data highlight new potential avenues for research with therapeutic perspective.
Zur Kenntnis des eosinophilen Bronchialkatarrhs

An Hand einer Reihe von selbstbeobachteten Fallen wird der in seinen Grundlinien schon vor 32 Jahren vonTeichmuller erstmalig als einheitliches Krankheitsbild erkannte eosinophile Bronchialkatarrh erneut beschrieben. Er verdient zufolge seiner relativen Haufigkeit mehr Beachtung als bisher. Im Lichte neuerer Anschauungen und Erkenntnisse, insbesondere der modernen Allergieforschung, kann die Krankheit noch klarer umrissen werden und ist am besten als „Forme fruste“ des Asthma bronchiale zu charakterisieren. Daraus ergeben sich fUr Erkennung, Beurteilung und Behandlung die gleichen Gesichtspunkte wie beim voll entwickelten Asthma, von dem sich der eosinophile Katarrh nur durch das Fehlen der Krampfkomponente und die bessere Prognose unterscheidet.
Determining Low-Temperature Threshold for Pupal Development of the Western Cherry Fruit Fly for Use in Phenology Models

Three methods were used in determining the low-temperature threshold for pupal development of the western cherry fruit fly, Rhagoletis indifferens Curran. The standard x-intercept method using regression analysis of all data points (13.0, 15.5, 17.0, 19.5, 21.0, 22.0, 25.5°C) yielded a threshold of 10.2°C. A modified method using only median data points increased the threshold to about 13°C. A third method using oneway analysis of variance and taking into consideration the relative number of occurrences in the field of the various temperatures used as treatments in the experiment yielded a base threshold of 8.3°C. A comparison of effectiveness of the three proposed thresholds (8.3, 10.2, l1.7°C) indicated that least variation in predicted emergence was noticed by using an 8.3°C threshold.
Cobaltocenium-Containing Methacrylate Homopolymers, Block Copolymers, and Heterobimetallic Polymers via RAFT Polymerization

Cobaltocenium-containing methacrylate homopolymer, poly(2-(methacrylolyoxy)ethyl cobaltoceniumcarboxylate hexafluorophosphate) (PMAECoPF6), was prepared by reversible addition–fragmentation chain transfer polymerization (RAFT). Using the homopolymer as a macroinitiator, three different diblock copolymers, including a novel heterobimetallic diblock copolymer with ferrocene units as the second block, were synthesized via chain extension. Kinetic studies showed that all chain extension followed a controlled/living process under relatively lower conversion. The heterobimetallic diblock copolymer self-assembled into spherical micelles in selective solvents. The formation of aggregates depended on the location of the ferrocene block in the micelles. While the ferrocene units were susceptible to oxidation toward decomposition, the cobaltocenium moiety exhibited extraordinary stability to maintain its structure integrity.
Intolerance of sublingual buprenorphine-naloxone during induction in a patient with end-stage liver disease: A case report.

Abstract Introduction: Sublingual buprenorphine is indicated for opioid dependence. It comes in 2 formulations: a mono buprenorphine product (BUP) and a combination product containing naloxone (BUP-NAL), which functions as an abuse deterrent. Sublingual naloxone does not reach clinically significant levels except in cases of hepatic impairment, where its metabolism can be impaired. Substantial naloxone accumulation could block the therapeutic effects of buprenorphine. The risk of hepatic impairment is elevated in the opioid dependence population, and our case highlights the need for careful evaluation of hepatic function and consideration of BUP. Case/Results: We report a patient with end-stage liver disease who began BUP-NAL induction with modest improvement on treatment day 1 followed by sustained withdrawal after receiving an observed dose on day 2. He returned to the clinic 2 days after his second successive day of BUP-NAL, vomiting and complaining of persistent withdrawal. To avoid potential accumula...
Arizona's Emergency Medical Services for Children Pediatric Designation System for Emergency Departments.

Abstract Background In 2012, a voluntary certification program called Pediatric Prepared Emergency Care (PPEC) was established in Arizona as a system for pediatric emergency preparedness. Emergency medicine and pediatric specialists generated basic, intermediate, and advanced designation criteria. Dedicated medical management by a pediatric emergency specialist is required for advanced centers. Designation follows a site visit, review, and approval by the subcommittee and the Arizona Chapter of the American Academy of Pediatrics. Discussion Arizona has 5 designated pediatric emergency departments, all of which are in the southeast part of the state. Therefore, a designation system was implemented so that all emergency departments statewide can receive more training, support, and supervision of pediatric care. The goal was to create a self-sustaining network with active participation from member institutions while fostering the pediatric commitment. Since its inception, 39 hospitals and 5 tribal facilities have joined PPEC, equating to 51% of Arizona's emergency facilities. Of the hospitals, 7 are advanced, 6 are intermediate, and 17 are basic centers. In 2015, all of the 9 sites due for recertification were recertified. The multiple tiers allow for mutual accountability, sharing of resources, and improved quality of care for pediatrics in emergency departments statewide. Conclusion PPEC enhances the quality of pediatric emergency preparedness by means of voluntary certification. The primary limitations are sustainability and funding, because an Emergency Medical Services for Children grant has offset the cost until now. The number of member facilities in this designation system is continually growing, and universal recertification shows sustainability.
Patterns in patents : Searching the forest not the trees

Sometimes, you can learn more from the pattern of a company's patenting and patent citing activity than from any specific patent. You can use these patterns to draw a profile of a company or technology, whether for technology scouting, competitive intellignece, or investigating a potential partner. Although the author uses the STN commands to demonstrate how this process works, he presents a variety of useful strategies that are applicable on almost any search system
Abstract 3459: Effects of Dehydroepiandrosterone (DHEA) treatment on serum methylation, oxidative and nitrosative stress biomarkers in an obesity model of mammary carcinogenesis

Free oxygen and free nitrogen radicals, commonly named as reactive oxygen species (ROS) and reactive nitrogen species (RNS) play an important role in cancer promotion. The cumulative effect of ROS/RNS termed oxidative and nitrosative stress is commonly seen in the development of several cancers. Obesity has been also linked with the risk of development of various cancers, including breast cancer. DHEA is a dietary supplement used as an anti-cancer agent and anti-obesity supplement. Previously, we reported that obese rats fed DHEA had lower body weight gain and developed no mammary tumor in DMBA model. The effect of DHEA on development of oxidative/nitrosative stress is not known. The objectives of this study were to investigate the possible mechanism of DHEA tumor protection by determining the DHEA effects on serum concentration of methylation cycle metabolites, oxidative and nitrosative stress biomarkers. Twenty (20) six-week-old obese female Zucker rats were randomly assigned ad libitum to water and a diet of either chow as a control diet or chow with the addition of DHEA at a concentration of 6 g/kg of chow as a DHEA diet. All rats were orally gavaged at age 50 days with 65 mg DMBA/kg body weight and were sacrificed 155 days later. Serum concentration of Methionine, S-sdenosylmethionine (SAM), S-adenosylhomocysteine (SAH), homocysteine, free reduced glutathione (fGSH), oxidized glutathione (GSSG), nitroglutathione (GSNO), free Cysteine, Cystine and 3-nitroTyrosine (3NT) were measured by HPLC method with electrochemical detection or LC-MS method. There were no significant differences in serum concentration of fGSH between control and DHEA fed-rats. However, DHEA-fed rats had lower (P Citation Format: Reza Hakkak, Soheila Korourian, Teresa Evans, Oleksandra Pavliv, Stepan Melnyk. Effects of Dehydroepiandrosterone (DHEA) treatment on serum methylation, oxidative and nitrosative stress biomarkers in an obesity model of mammary carcinogenesis. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3459.
Implication de l’activation de la réponse intégrée au stress par la fragmentation du sommeil au cours de la grossesse dans l’émergence d’un profil dysmétabolique au sein de la progéniture

Introduction La grossesse s’accompagne de facon frequente d’une fragmentation du sommeil (FS) en particulier chez les femmes obeses et au cours du dernier trimestre en rapport avec une prevalence accrue des troubles respiratoires nocturnes. Cette FS gestationnelle peut induire une obesite et une dysfonction metabolique au sein de la progeniture adulte. Par ailleurs, la FS peut induire une reponse integree au stress, cascade moleculaire intracellulaire pouvant aboutir a des perturbations metaboliques. Nous avons emis l’hypothese que la descendance de souris presentant une mutation de deux genes impliques dans la reponse integree au stress (CHOP et GADD34) serait protegee des consequences metaboliques de la FS gestationnelle. Methodes Des souris enceintes presentant la double mutation (DM) CHOP et GADD34 et des souris enceintes sauvages (SA) ont ete soumises a une FS pendant les 5 derniers jours de la grossesse ou a des conditions de sommeil normal (SN). Le poids des animaux et de la graisse viscerale ainsi que l’index HOMA-IR ont ete etudies au sein de la descendance a l’âge de 24 semaines. Les lymphocytes Treg ainsi que les macrophages M1, M2 et Lyc6chigh ont ete analyses par cryometrie en flux dans la graisse viscerale des animaux. L’impact des exosomes plasmatiques issues des animaux de la descendance sur la proliferation, la differenciation adipocytaire et la sensibilite a l’insuline in vitro a ete evaluee. Resultats Les souris FS-SA mâles presentaient une augmentation du poids total, de la masse de graisse viscerale et de l’HOMA-IR par rapport aux souris SN-SA alors que la FS n’avait aucun impact sur ces parametres chez les souris DM. Le nombre de macrophages pro-inflammatoires Ly-6chigh et le ratio M1/M2 etaient augmentes alors que le nombre de macrophages FoxP3+ Tregs etait diminue chez les souris FS-SA mais non modifies chez les souris FS-DM. Les exosomes issus des animaux FS-SA entrainaient une augmentation de la proliferation et de la differentiation adipocytaire et une diminution de la sensibilite a l’insuline in vitro. La FS ne modifiait pas l’impact in vitro des exosomes issus des souris DM sur ces derniers parametres. Conclusion L’activation de la reponse integree au stress par la FS gestationnelle participe au developpement d’un profil dysmetabolique au sein de la descendance adulte et les exosomes plasmatiques retiennent quelques-unes de ces proprietes. Leur contenu en ARN et ADN est donc susceptible de reveler quelques-uns des mecanismes impliques.
Looking to the future of organs-on-chips: interview with Professor John Wikswo

John Wikswo talks to Francesca Lake, Managing Editor: John is the founding Director of the Vanderbilt Institute for Integrative Biosystems Research and Education (VIIBRE). He is also the Gordon A Cain University Professor; a B learned Professor of Living State Physics; and a Professor of Biomedical Engineering, Molecular Physiology and Biophysics, and Physics. John earned his PhD in physics at Stanford University (CA, USA). After serving as a Research Fellow in Cardiology at Stanford, he joined the Department of Physics and Astronomy at Vanderbilt University (TN, USA), where he went on to make the first measurement of the magnetic field of an isolated nerve. He founded VIIBRE at Vanderbilt in 2001 in order to foster and enhance interdisciplinary research in the biophysical sciences, bioengineering and medicine. VIIBRE efforts have led to the development of devices integral to organ-on-chip research. He is focusing on the neurovascular unit-on-a-chip, heart-on-a-chip, a missing organ microformulator, and microfluidic pumps and valves to control and analyze organs-on-chips.
Fate mapping neurons and glia derived from Dbx1-expressing progenitors in mouse preBötzinger complex.

The brainstem preBotzinger complex (preBotC) generates the inspiratory breathing rhythm, and its core rhythmogenic interneurons are derived from Dbx1-expressing progenitors. To study the neural bases of breathing, tamoxifen-inducible Cre-driver mice and Cre-dependent reporters are used to identify, record, and perturb Dbx1 preBotC neurons. However, the relationship between tamoxifen administration and reporter protein expression in preBotC neurons and glia has not been quantified. To address this problem, we crossed mice that express tamoxifen-inducible Cre recombinase under the control of the Dbx1 gene (Dbx1CreERT2) with Cre-dependent fluorescent reporter mice (Rosa26tdTomato), administered tamoxifen at different times during development, and analyzed tdTomato expression in the preBotC of their offspring. We also crossed Rosa26tdTomato reporters with mice that constitutively express Cre driven by Dbx1 (Dbx1Cre) and analyzed tdTomato expression in the preBotC of their offspring for comparison. We show that Dbx1-expressing progenitors give rise to preBotC neurons and glia. Peak neuronal tdTomato expression occurs when tamoxifen is administered at embryonic day 9.5 (E9.5), whereas tdTomato expression in glia shows no clear relationship with tamoxifen timing. These results can be used to bias reporter protein expression in neurons (or glia). Tamoxifen administration at E9.5 labels 91% of Dbx1-derived neurons in the preBotC, yet only 48% of Dbx1-derived glia. By fate mapping Dbx1-expressing progenitors, this study illustrates the developmental assemblage of Dbx1-derived cells in preBotC, which can be used to design intersectional Cre/lox experiments that interrogate its cellular composition, structure, and function.
Abstract TP410: Race/ethnicity Modifies Increased Recurrent Event Risk For Female Stroke Survivors

INTRODUCTION: Demographic disparities in recurrent events among stroke survivors have received some attention, but little is known about the impact of gender. We explored whether gender was associa...
State and Non-State Choices in Liberia

Liberia reveals contingencies in state choices. I offer a narrative where the agency of states can be recovered in spite of a contested process—especially in regulating maritime PMSCs. Choices on Montreux were not independent of the strategies of other actors, especially the United States. The development is dominated by private authority and includes influence of shipping and insurance industry as well as that of the Liberian maritime authority endorsing the first blueprints for security standards on board ships that is later adopted by the International Maritime Organization.
The Ordinal Equivalence of the Johnston Index and the Established Notions of Power

(1978) proposed a number valued index that measures the power that individual voters have in a simple voting game. In this paper we show that the influence (or desirability) relation introduced by Isbell (1958) is a sub-preordering of the Johnston index for every simple voting game. Furthermore, the preorderings induced by the Johnston, Shapley-Shubik and Banzhaf-Coleman indices coincide if and only if the simple voting game is swap robust.
Aerodynamics of Fossil Pollen: Implications for Understanding Pollination Biology in Extinct Plants

Abstract Although sacci are now known to play both aerodynamic and buoyancy roles, few published studies have explored anemophily in fossil plants, particularly aerodynamic characteristics of pollen from putatively wind-pollinated groups. The objective of this study was to empirically investigate the aerodynamic effects of key pollen characters through electron microscopy, mathematical modeling, and experiments using scaled-up physical models. Five structurally different fossil pollen types were studied: three bisaccate (Caytonanthus, Pteruchus, Pinus), one monosaccate (Gothania), and one nonsaccate (Monoletes). For all saccate taxa, geometrical differences in overall shape and saccus size impacted pollen drag, and the presence of sacci produced measurable differences in the drag coefficient and shape factor (resistance coefficient). Grains of Pinus and Pteruchus had higher drag coefficients, remained airborne longer, and their sacci increased aerodynamic efficiency, whereas Gothania fell faster. This is the first study to experimentally demonstrate that sacci and grain geometry affect the aerodynamics of fossil pollen.
Tactile Approaches to Help Learners Visualize Key Processes in Environmental Health Sciences

This chapter describes how hands-on models, or manipulatives, can be employed to improve the environmental health literacy of a variety of people, from science teachers and students in classrooms, to global audiences in large festival gatherings. Environmental health concepts can be quite abstract. For example, the effect of wood smoke on human lungs. People are concerned about the exposure to toxic molecules from the smoke, but find an explanation of the chemical process by which wood smoke harms human health too difficult to fully understand. Hands-on activities and models are a visual and tactile way of communicating essential molecular environmental health concepts in an inviting way without requiring a technical background.
The pure rotational spectrum of YbOH

Abstract The pure rotational spectrum of YbOH has been recorded and analyzed to produce fine and magnetic hyperfine parameters for the X ∼ 2 Σ + ( 0 , 0 , 0 ) state. These parameters are compared with those determined from the optical study (Melville and Coxon, 2001) and with the values for YbF (Dickinson et al., 2001). The results support the existence of an unobserved perturbing state near the A ∼ 2 Π 1 / 2 state, similar to that previously found in YbF. The precisely determining parameters lays the foundation for laser cooling YbOH, which will aid in the search for new physics beyond the standard model.
The use of site symmetry in constructing symmetry adapted functions

It is shown that the application of a projection operator from a given group to a function is equivalent to the successive application of projection operators from factor groups of the starting group to that function. When used with the factor groups representing the site symmetry of a position and the simplest group of interchanges of positions, this concept provides a very simple method for obtaining symmetry adapted linear combinations of basis functions.
Nearly Optimal State Feedback Controls for Delay Differential Equations with a Small Parameter

Abstract Nearly optimal control of differential delay systems driven by wideband noise processes and with a small parameter is considered in this work. A probabilistic approach is taken, and the methods of weak convergence are employed. By applying optimal or δ-optimal controls of the limit process (a diffusion process) to the wideband noise driven system, a "good" or nearly optimal control for the actual system is obtained.
Deterring Rogue Regimes: Rethinking Deterrence Theory and Practice

Report on a projet to facilitate the translation and analysis of sources from the Conflict Records Research Center (CRRC) at the National Defense University to learn lessons about preventing proliferation and deterring WMD use and to discuss these lessons with U.S. government officials. The project succeeded in improving our understanding of Iraqi decision-making regarding WMD and deterrence, and provided comparative lessons to be learned from this history for U.S. nuclear weapons policy toward new and potential nuclear weapons proliferators.
Transcription Factors That Govern Development and Disease: An Achilles Heel in Cancer.

Development requires the careful orchestration of several biological events in order to create any structure and, eventually, to build an entire organism. On the other hand, the fate transformation of terminally differentiated cells is a consequence of erroneous development, and ultimately leads to cancer. In this review, we elaborate how development and cancer share several biological processes, including molecular controls. Transcription factors (TF) are at the helm of both these processes, among many others, and are evolutionarily conserved, ranging from yeast to humans. Here, we discuss four families of TFs that play a pivotal role and have been studied extensively in both embryonic development and cancer—high mobility group box (HMG), GATA, paired box (PAX) and basic helix-loop-helix (bHLH) in the context of their role in development, cancer, and their conservation across several species. Finally, we review TFs as possible therapeutic targets for cancer and reflect on the importance of natural resistance against cancer in certain organisms, yielding knowledge regarding TF function and cancer biology.
Application of Variational Asymptotic Method for Structural Analysis of Fan Rotor Blades in Boundary Layer Ingesting Flow Field

Boundary Layer Ingestion (BLI) appears to be a promising technology for reducing aircraft fuel burn. Despite potential benefits, there are several challenges associated with BLI. A primary concern is the structural integrity of the fan blades experiencing unsteady forces due to unequal work input from the rotor at different circumferential locations of the engine annulus. In the conceptual design phase, rapid turnaround is as important as measuring the stresses accurately. Through the present work, the authors present a computationally efficient framework for measuring natural frequencies and analyzing time histories of 3-D stresses in nonlinear transient structural analyses of rotating fan blades. This framework uses state of the art tools developed for beam modeling based on Variational Asymptotic Method and the Geometrically Exact Beam Theory. The authors also provide verification of the present framework against 3-D finite element analysis performed in COMSOL.
Firearms and protective orders in intimate partner homicides.

To determine differences among intimate partner homicides (IPH) by whether or not a firearm was used in and whether a protective order (PO) was filed prior to IPH. We identified all incidents of IPH recorded in the National Violent Death Reporting System from 2003 to 2018, based on the relationship between victim and perpetrator. We characterized incidents, perpetrators and victims in IPH cases by whether or not a firearm was used, and whether a PO had been sought or issued prior to the IPH. We identified 8375 IPH incidents with a total of 9130 victims. Overall 306 (3.3%) victims were killed in a firearm IPH with PO, 4519 (53.9%) in a firearm IPH without PO, 176 (2.1%) in a non-firearm IPH with PO and 3416 (40.7%) in a non-firearm IPH without PO. Based on review of incident narratives, 5.4% (n = 451) of incidents involved a previously-granted or sought PO, and none of which had explicitly mentioned firearm removal as a part of the PO. The majority of victims were killed with a firearm. Prior literature suggests that POs with firearm removal may be effective strategies for reducing risk of IPH, but we found no documentation in the narratives that firearm removal was a condition in the POs identified. As very few IPH narratives included documentation of a PO, it is likely that ascertainment of PO status is incomplete and could be an area for improvement in NVDRS data collection efforts.
Is the current insurance structure leading to seasonality in demand for spinal surgery? A quarterly, yearly, and insurance based analysis.

Abstract Background Elective lumbar fusion is a commonly employed procedure for degenerative lumbar spine disease. With healthcare costs rising reimbursement for procedures may be restricted by payers. Additionally, patients may undergo elective fusion once deductibles are covered, typically in the fourth quarter in a given year. The objective of this study was to analyze the trends in utilization for posterior lumbar fusion (PLF) earlier in the year (Q1-Q3) as compared to the end of the year(Q4). Variations in this proposed trend by insurance type were also studied as a primary outcome. Methods We queried the Healthcare Cost and Utilization Project-National Inpatient Sample (HCUP-NIS) between January 1, 2012 and December 31, 2014 for patients diagnosed with lumbar disc degenerative disease (DDD). Outcomes of interest included utilization and frequency of PLF. Results 221,466 patients hospitalized with Lumbar DDD between 2012 and 2014 were identified. Of these, 67,343(30.4 %) underwent a PLF procedure. The likelihood of lumbar fusion in patients hospitalized with DDD was significantly higher in the 4th quarter, compared to 1st quarter (OR1.13, p Conclusion These results indicate that utilization of PLF is higher at the end of the year relative to the beginning, especially for patients with private insurance. This may be due to deductibles that have previously been paid off, lowering out-of-pocket expenses.
Syringomatous adenoma of the nipple with microcalcifications on mammography: A case report.

Syringomatous adenoma of the nipple (SAN) is a rare benign lesion which often presents as a subareolar mass with associated nipple shape changes including pruritus, crusting, and discharge It is thought that syringomatous tumors arise from eccrine glands of the nipple and areola. Due to its locally infiltrative growth pattern the main differential is with low-grade adenosquamous carcinoma which requires more aggressive surgical treatment. Syringomatous adenoma of the nipple can recur, and therefore complete local excision is recommended. We present a case of a syringomatous adenoma of the nipple diagnosed after nearly 5 years of observation with microcalcifications noted on mammography.
Recovering the Race Analogy in LGBTQ Religious Exemption Cases

Should LGBT-rights advocates analogize to race when wedding vendors seek religious exemptions from state public accommodation laws so that they may refuse service to same-sex couples? These wedding vendors concede that courts would reject their religious exemption claim when asserted to refuse serving a different-sex African-American couple. Should the analysis and outcome be the same for religious exemptions sought to refuse serving a same-sex couple? Both the ideological left and ideological right contest the use of the race analogy in these cases, although for largely different reasons. On the ideological right, today’s exemptions seekers bristle at the comparison to the vendors of the 1960s who sought to justify racial discrimination based on religious beliefs. They contend that the vendors of the 1960s were actually racists using religion as a cover for their bigotry. In contrast, today’s wedding vendors contend that they are asserting honorable and sincerely held religious beliefs that justify sexual orientation discrimination. On the ideological left, scholars contend that the race analogy is detrimental to coalition building among marginalized communities, that it leads to essentialism, and that it unduly constricts both the vision of civil rights and the agenda of the LGBT movement. This article tackles the opposition from both the ideological left and the right and makes the argument that LGBT-rights advocates should deploy the race analogy in the wedding vendor cases. In doing so, it adds to the scholarly dialogue about the propriety of the race analogy and contributes to that body of scholarship a taxonomy of the race analogy in the LGBT-rights movement. The race analogy in today’s wedding vendor cases is tantalizing to LGBT-rights advocates because the Court has — in the 1960s case of Piggie Park v. Newman — rejected a religious exemption claim in the context of racial discrimination. The analogy thus played a prominent role in the advocacy surrounding Masterpiece Cakeshop v. Colorado Civil Rights Commission. In that case, the U.S. Supreme Court left open the merits questions concerning religious exemptions. It also left unanswered the ancillary question of whether it will accept or reject the race analogy in these cases — an analogy that, if accepted by the Court, would have significant (if not dispositive) weight in resolving these cases against the wedding vendors. As the Court prepares to take up another religious exemption case in its October 2020 Term, the race analogy will again be raised, litigated, and debated. The article adds a new layer of scholarly dialogue to the race analogy debate by contending that its use in these cases is a constructive method of making legible the intersecting interests of marginalized groups in the marketplace as well as revealing the errant exceptionalism — the lack of doctrinal coherence — if the Court were to permit a religious exemption for one protected class (sexual orientation) but not another (race).
Changes in marrow adipose tissue in relation to changes in bone parameters following estradiol replacement in adolescent and young adult females with functional hypothalamic amenorrhea.

Abstract Context Low energy availability causes disruption of hypothalamic gonadotropin-releasing hormone secretion leading to functional hypothalamic amenorrhea (FHA) and hypoestrogenism, which in turn contributes to decreased bone mineral density (BMD) and increased bone marrow adipose tissue (MAT). Transdermal estradiol administration in physiologic doses increases BMD in adolescents and adults with FHA. However, the impact of estrogen replacement on MAT in relation to changes in BMD has not been studied in adolescents and young adults. We hypothesized that physiologic estrogen replacement would lead to decreases in MAT, associated with increases in BMD. Methods and materials We studied 15 adolescent and young adult females with FHA (14–25 years). All participants received a17β- estradiol transdermal patch at a dose of 0.1 mg/day (applied twice weekly) for 12 months. Participants also received cyclic progestin for 10–12 days each month. We quantified MAT (lipid/water ratio) of the fourth lumbar (L4) vertebral body and femoral diaphysis by single proton (1H)-magnetic resonance spectroscopy, and compartmental volumetric BMD of the distal radius and tibia using high-resolution peripheral quantitative computed tomography. Results Transdermal estradiol therapy over 12 months resulted in a decrease in MAT at the lumbar (L4) vertebra from 0.92 ± 0.55 at baseline to 0.63 ± 0.29 at 12-months (p = 0.008), and an increase in radial and tibial cortical vBMD (p = 0.006, p = 0.0003). Changes in L4 MAT trended to be inversely associated with changes in radial cortical vBMD (rho = −0.47, p = 0.08). Conclusion We show that in adolescent and young adult girls with FHA, MAT decreases following transdermal estrogen therapy and these changes are associated with increased cortical vBMD.
Lump dynamics in the CP^1 model on the torus

The topology and geometry of the moduli space, M_2, of degree 2 static solutions of the CP^1 model on a torus (spacetime T^2 x R) are studied. It is proved that M_2 is homeomorphic to the left coset space G/G_0 where G is a certain eight-dimensional noncompact Lie group and G_0 is a discrete subgroup of order 4. Low energy two-lump dynamics is approximated by geodesic motion on M_2 with respect to a metric g defined by the restriction to M_2 of the kinetic energy functional of the model. This lump dynamics decouples into a trivial ``centre of mass'' motion and nontrivial relative motion on a reduced moduli space. It is proved that (M_2,g) is geodesically incomplete and has only finite diameter. A low dimensional geodesic submanifold is identified and a full description of its geodesics obtained.
Carbohydrate Drink Use During 30 Minutes of Variable-Intensity Exercise Has No Effect on Exercise Performance in Premenarchal Girls.

Purpose This study examined the physiological, perceptual, and performance effects of a 6% carbohydrate (CHO) drink during variable-intensity exercise (VIE) and a postexercise test in premenarchal girls. Methods A total of 10 girls (10.4 [0.7] y) participated in the study. VO2peak was assessed, and the girls were familiarized with VIE and performance during the first visit. The trial order (CHO and placebo) was randomly assigned for subsequent visits. The drinks were given before VIE bouts and 1-minute performance (9 mL/kg total). Two 15-minute bouts of VIE were completed (10 repeated sequences of 20%, 55%, and 95% power at VO2peak and maximal sprints) before a 1-minute performance sprint. Results The mean power, peak power, heart rate (HR), %HRpeak, and rating of perceived exertion during VIE did not differ between trials. However, the peak power decreased, and the rating of perceived exertion increased from the first to the second bout. During the 1-minute performance, there were no differences between the trial (CHO vs placebo) for HR (190 [9] vs 189 [9] bpm), %HRpeak (97.0% [3.2%] vs 96.6% [3.0%]), rating of perceived exertion (7.8 [2.3] vs 8.1 [1.9]), peak power (238 [70] vs 235 [60] W), fatigue index (54.7% [10.0%] vs 55.9% [12.8%]), or total work (9.4 [2.6] vs 9.4 [2.1] kJ). Conclusion CHO supplementation did not alter physiological, perceptual, or performance responses during 30 minutes of VIE or postexercise sprint performance in premenarchal girls.
Advanced Surgical Techniques in Venous Thoracic Outlet Syndrome

Venous thoracic outlet syndrome (VTOS) is a relatively uncommon syndrome secondary to extrinsic compression from the first rib on the subclavian vein leading to thrombosis. The primary treatment for VTOS is surgical decompression with first rib resection. Despite removal of the first rib, there is a subset of patients with advanced venous disease and severe symptoms who require venous reconstruction with open repair. Wide exposure to the axillosubclavian vein for reconstruction can be achieved with transsternal extension or claviculectomy. Strategies for open venous reconstruction depend on the extent of disease, but include jugular vein turndown, endovenectomy with patch venoplasty, and venous bypass. Patency of venous reconstruction can be improved with a temporary arteriovenous fistula. Open venous reconstruction for VTOS with advanced venous disease is tolerated well with good outcomes.
Growing Up in the Age of COVID-19 through the Lens of Psychodynamic Theory

The long-term effects of the global COVID-19 pandemic on individuals, families, and society are not yet known. For social workers, it is critical to consider how the pandemic is impacting families,...
What's a Nice Company like Goldman Sachs Doing in the Supreme Court?

This essay considers the issues raised in the latest securities fraud class action to reach the Supreme Court – Goldman Sachs v. Arkansas Teacher Retirement System – and finds that the claims asserted therein against Goldman Sachs on behalf of open-market buyers of its common stock are claims that should have been asserted on behalf of Goldman Sachs (by means of a derivative action) and against the individuals who caused the losses at issue. The losses suffered by individual buyers of Goldman Sachs stock during the extraordinarily long forty-month alleged fraud period are minimal if they exist at all. Moreover, the law is quite clear that claims on behalf of the company arising from the same constellation of facts should take precedence over any claims on behalf of individual buyers. Yet the practice that has evolved is the opposite: Class claims take priority and company claims are settled for non-monetary governance reforms of dubious value rather than for real money. The forces that have led to this classic example of market failure are both fascinating and sinister. But the bottom line is that ordinary investors – such as investors in well-diversified mutual funds and index funds – end up losing far more than they gain from class actions. Indeed, index fund investors effectively pay out about twenty dollars for every dollar they recover. Thus, the best hope for reforming the system is for index funds to step up and intervene to assert the interests of diversified investors in favor of litigating such claims as derivative actions rather than as class actions.
The Effect of a Fennel Extract on the STAT Signaling and Intestinal Barrier Function

Background: Foeniculum vulgare, F. vulgare, commonly known as fennel, is believed to be one of the worlds oldest medicinal herbs and has been exploited by people for centuries as a nutritional aid for digestive disorders. In many southeast Asian countries it is ingested as an after-meal snack, mukhvas, due to its breath-freshening and digestive aid properties. F. vulgare is used in some countries, such as Iran, as a complementary and alternative treatment for inflammatory bowel disease (IBD). Methods: This study investigated the effects of F. vulgare on the barrier function of the intestinal epithelium Signal Transducer and Activator of Transcription (STAT) pathway, which is active in inflammatory bowel disease. To study the protective effects of F. vulgare extract in vitro, monolayers derived from the T84 colonic cell line were challenged with interferon-gamma (IFN-γ) and monitored with and without F. vulgare extract. To complement our in vitro studies, the dextran sodium sulfate induced murine colitis model was employed to ascertain whether the protective effect of F. vulgare extract can be recapitulated in vivo. Results: F. vulgare extract was shown to exert a protective effect on TEER in both T84 and murine models and showed increases in tight junction-associated mRNA in T84 cell monolayers. Both models demonstrated significant decreases in phosphorylated STAT1 (pSTAT1), indicating reduced activation of the STAT pathway. Additionally, mice treated with F. vulgare showed significantly lower ulcer indices than control mice. Conclusions: We conclude barrier function of the gastrointestinal tract is improved by F. vulgare, suggesting the potential utility of this agent as an alternative or adjunctive therapy in IBD.
U.S. Catholic bishops' silence and denialism on climate change

The Catholic Church recognizes climate change as a moral issue, has called for social action, and has the institutional potential to meaningfully address climate change. Many hoped Pope Francis's 2015 encyclical Laudato Si' would spark widespread climate action. However, our quantitative and qualitative content analyses show that U.S. Catholic bishops responsible for leading the Church were silent and denialist about climate change around Laudato Si'. Using a newly constructed dataset of 12,077 columns published by U.S. Catholic bishops in the official publications for 171 of the 178 U.S. Catholic dioceses between June 2014 – June 2019, we find that (1) as a group, U.S. Catholic bishops were generally silent about climate change and (2) as a group, when U.S. Catholic bishops did mention climate change, they often: (a) diminished and distanced themselves from Church teaching on this issue; (b) downplayed parts of Laudato Si' that conflict with a conservative political identity/ideology; and (c) emphasized parts of Laudato Si' that correspond to a conservative political identity/ideology. On climate change, our findings indicate individual U.S. Catholic bishops' diocesan communications have collectively snuffed out the spark of Laudato Si'. Our findings suggest politics may trump religion in influencing climate change beliefs even among religious leaders, and that the American Catholic Church subtly engages in climate denialism even though its top religious leader (Pope Francis) has emphasized the scientific reality and urgency of climate change.
Assuring Autonomous UAS Traffic Management Systems Using Explainable, Fuzzy Logic, Black Box Monitoring

Researchers have shown via simulation and early flight tests the feasibility and safety benefit of adding autonomy to the concept of unmanned aircraft system (UAS) Traffic Management (UTM), which is the Federal Aviation Administration’s (FAA) vision for air traffic management below 400 feet. Such simulations are a complex interaction between UAS, UAS operators, and the UTM system. Autonomy in this system is achieved through the algorithms used for strategic de-confliction (UAS launch scheduling) and flight planning (creates waypoints from delays introduced by scheduling), which have been shown to improve safety in congested UAS airspace. However, autonomous algorithms have been known to make poor decisions without notice, and thus need to be constantly monitored to prevent these decisions from negatively affecting airspace performance and safety. This is the impetus for developing and implementing a fuzzy assurance black box monitor. Using a rule set generated from parameters that have been shown to improve safety in congested airspace, this monitor only considers the inputs and outputs of the autonomous UTM system to estimate the risk of the autonomous algorithms making poor decisions. Fuzzy rules that fire during the operation of the fuzzy assurance monitor help identify offending algorithms and their poor decisions, and thus provide a level of explainable artificial intelligence (AI) capability. The goal is to use fuzzy inference rules to evaluate the performance of strategic de-confliction algorithms in the UTM simulation. We investigate several airspace operational use cases (i.e., normal and rogue behavior in congested airspace) and several different autonomous UTM configurations (No Strategic de-confliction and Strategic de-confliction). The simulation data is analyzed with the help of the fuzzy inference system rules to help identify offending algorithms and poor decisions that lead to unsafe airspace. Our results show that the fuzzy assurance monitor is able to use the inputs and outputs of the autonomous UTM system to assign safety risks appropriately across use cases and autonomous UTM configuration. The fuzzy assurance monitor can also provide insight on the performance trade-offs of black-box algorithms.