cssi/SciSciGPT-SciSciNet huggingface dataset:
Stunted PFC activity during neuromuscular control under stress with obesity.

Objective Obesity is an established risk factor for impaired cognition, which is primarily regulated by the prefrontal cortex (PFC). However, very little is known about the neural pathways that underlie obesity-related declines in neuromuscular control, particularly under stress. The purpose of this study was to determine the role of the PFC on neuromuscular control during handgrip exertions under stress with obesity.
Defect Correction and Error Transport Discretization Error Estimation for Applications in CFD

Discretization error is usually the largest and most difficult numerical error to estimate in a Computational Fluid Dynamics (CFD) simulation. Development and evaluation of discretization error estimators ideally requires exact solutions to the PDEs which are only available for relatively simple cases. An alternative is to use numerical benchmarks which require a verified code and numerical solutions on a mesh which is sufficiently fine so that the discretization error in the benchmark solution is (essentially) negligible. The focus of this work is to use several numerical benchmark solutions to evaluate residual-based discretization error estimation methods which include defect correction and error transport equations for the Euler equations. This class of discretization error estimation methods requires accurate estimation of a residual/truncation error which will also be evaluated because the residual is the primary factor affecting the accuracy of the discretization error estimate, (i.e., an exact residual results in an exact discretization error estimate). The benchmark solutions include a supersonic inlet, a blunted hypersonic cone, and a NACA 0012 airfoil.
QUANTITATIVE GENETICS OF MORPHOLOGICAL DIFFERENTIATION IN PEROMYSCUS. II. ANALYSIS OF SELECTION AND DRIFT.

The hypothesis that the morphological divergence of local populations of Peromyscus is due to random genetic drift was evaluated by testing the proportionality of the among-locality covariance matrix, L, and the additive genetic covariance matrix, G. Overall, significant proportionality of L and Ĝ was not observed, indicating the evolutionary divergence of local populations does not result from random genetic drift. The forces of selection needed to differentiate three taxa of Peromyscus were reconstructed to examine the divergence of species and subspecies. The selection gradients obtained illustrate the inadequacy of univariate analyses of selection by finding that some characters evolve in the direction opposite to the force of selection acting directly on them. A retrospective selection index was constructed using the estimated selection gradients, and truncation selection on this index was used to estimate the minimum selective mortality per generation required to produce the observed change. On any of the time scales used, the proportion of the population that would need to be culled was quite low, the greatest being of the same order of magnitude as the selective intensities observed in extant natural populations. Thus, entirely plausible intensities of directional natural selection can produce species-level differences in a period of time too short to be resolved in the fossil record.
A New Species of Microtine from the Late Pliocene of Kansas

A new species of microtine, Pliophenacomys finneyi , is named on the basis of smaller crown height and shorter dentine tracts from the Fox Canyon local fauna of late Pliocene age. Pliophenacomys finneyi is considered to be ancestral to P. primaevus , which has a higher crown height and dentine tracts and is found in stratigraphically younger local faunas in the Great Plains area. We suggest that the absence of Pliophenacomys from the type locality of the Rexroad local fauna is due to its ecological replacement by the genus Sigmodon .
Compositional Equivalence of Barleys Differing Only in Low- and Normal-Phytate Levels

Recent breeding advances have led to the development of several barley lines and cultivars with significant reductions (50% or greater) in phytate levels. Low-phytate (LP) grain is distinguished by containing not only a reduced level of phytate P but also an increased level of inorganic P, resulting in greater bioavailability of P and mineral cations in animal diets. It is important to determine whether other nutritional characteristics are altered by breeding for the low-phytate trait. This study was designed to investigate if breeding for reduced phytate content in barleys had any effect on the contents of other attributes measured by comparing mean and range values of the levels of protein, oil, ash, total carbohydrate, starch, and β-glucan, fatty acid composition, and levels of tocopherols and tocotrienols between five LP and five normal-phytate barleys grown in three Idaho locations. Results show that only the phytate level in the LP group was substantially lower than that of the normal-phytate group and that all other attributes measured or calculated were substantially equivalent between the two groups of barleys. Therefore, the phytate level had little effect on the levels of protein, oil, ash, total carbohydrate, starch, and β-glucan, fatty acid composition, and levels of tocopherols and tocotrienols in barley seeds.
ANALYSIS OF THE STRESS OF LONGITUDINAL CORROSIVE FLAW ON OIL-PIPE WALL

Flaws on the long distance oil-pipe are one of the invisible big problems whichwill result in abnormal work. With the finite element method, the longitudinal flaws on pipe wall were analyzed in this paper, the distribution rule of stress at the flaw was obtained, and the influence of the length, width and thickness of the wall on the stress was analyzed. The results can be used to the design and safety management of the pipe.
The diagnosis of ovarian hyperstimulation (OHS): the impact of ultrasound

Eighty cycles induced by human menopausal gonadotropins in 45 women were studied with serial ultrasound examinations. The incidence of ovarian hyperstimulation (OHS) was 44%, considerably higher than in other series using similar induction protocols. This was probably due to the superior ability of ultrasound to detect ovarian enlargement and the withholding of human chorionic gonadotropin until at least one follicle had reached a minimum size of 15 mm. No difference was found between the mean urinary estrogen levels of those in whom mild or moderate OHS developed and those in whom it did not. It is concluded that the development of OHS is a frequent but acceptable result of ovulation induction.
Perioperative preservation of myocardial ultrastructure and high-energy phosphates in man.

To establish whether hypothermic crystalloid potassium cardioplegia given in multidose fashion provides adequate preservation of myocardial ultrastructure and high-energy phosphates, we studied 25 patients with an ejection fraction of 50% or higher who were undergoing cardiac procedures. Eight patients had three biopsy specimens taken from the left ventricular apex for determination of adenosine triphosphate (ATP) and creatine phosphate (CP). Specimens were taken immediately prior to aortic cross-clamping, immediately after the release of the aortic cross-clamp, and 30 minutes after the release of the cross-clamp. Seventeen patients had six specimens taken from the left ventricular apex at the above-stated times, three for ATP and CP determination and three additional specimens for electron microscopy. One patient had a small perioperative infarction and another patient died on the fifth postoperative day of an aortic dissection. The mitochondria on the electron microscopic specimens were graded on a scale from 0 to 4 (4 = severe changes). There was no significant difference in the mitochondrial scores. The preservation of high-energy phosphates was less complete. ATP was reduced to 78% (3.3/4.2) of control and CP was reduced in the immediate postclamp period to 32% (0.81/2.5) of control. The differences are particularly significant if one looks at patients whose aortic cross-clamp time was 90 minutes or more (12 patients). In this group, ATP and CP preservation were 71% of control (3.33/4.60 mmoles/kg, wet weight) and 53% of control (1.4812.81), respectively, 30 minutes after clamp removal (p ≤ 0.01). We conclude that hypothermic potassium cardioplegia gives excellent preservation of the myocardial ultrastructure in man. However, the preservation of high-energy phosphates with this technique is imperfect.
Enhancing outcomes from major depression: using antidepressant combination therapies with multifunctional pharmacologic mechanisms from the initiation of treatment.

Traditional guidelines call for treatment of major depression with a sequence of single antidepressants. Augmentation with a second agent generally only occurs when the first agent is well tolerated and when it also provides at least some symptomatic improvement on its own. Since this standard approach leads to low rates of attaining and sustaining remission by the first agent, with diminishing returns for each subsequent agent, there is growing dissatisfaction with this approach to the treatment of major depression. One new trend is to attempt to enhance the rates of sustained remission from a major depressive episode by combining two therapeutic agents from the very initiation of treatment of a major depressive episode.Traditional treatment of major depression begins with a single “first line” antidepressant, and if it does not work or is not tolerated, trying another and then another. Unfortunately, this strategy results in disappointing remission rates for the first antidepressant (Figure 1), and disappointing rates of maintaining any improvement that is attained by this first agent because of high relapse rates over the next year despite continuing treatment with the first antidepressant (Figure 2A). And that is the good news. The bad news is that with each subsequent antidepressant treatment administered remission rates are progressively reduced (Figure 1). For those patients who do improve, they are progressively less likely to sustain their therapeutic gains despite continuing to take the drug that led to their initial improvement (Figure 2).
THE UNITED NATIONS CONFERENCE ON TRADE AND DEVELOPMENT: UNCTAD IV

This chapter presents the details of the United Nations Conference on Trade and Development IV. Eight months after the Seventh Special Session of the United Nations General Assembly drew up its large prescription for global well being, UNCTAD IV met in Nairobi to try and produce some therapeutic pills for specific ailments. The conference met in the Kenyatta Centre, the round tower of which rises into the always dramatic Kenyan sky, the highest building in the country. UNCTAD IV was planned and structured for efficient decision making. Where the first three sessions had lasted anywhere from two to four months and held vociferous debates on some 40 different agenda items, the Nairobi session was only four weeks long and had only eight substantive items on its agenda. The Manila program also included a section on manufactures and semi-manufactures setting out a comprehensive strategy to expand and diversify the export trade of developing countries.
Scaling Limits, Brownian Loops, and Conformal Fields

The main topic of these lecture notes is the continuum scaling limit of planar lattice models. One reason why this topic occupies an important place in the theory of probability and mathematical statistical physics is that scaling limits provide the link between statistical mechanics and Euclidean field theory. In order to explain the main ideas behind the concept of scaling limit, we will focus on a “toy” model that exhibits the typical behavior of statistical mechanical models at and near the critical point. This model, known as the random walk loop soup, is actually interesting in its own right. It can be described as a Poisson process of lattice loops, or a lattice gas of loops since it fits within the ideal gas framework of statistical mechanics. After introducing the model and discussing some interesting connections with the discrete Gaussian free field, we will present some results concerning its scaling limit, which leads to a Poisson process of continuum loops known as the Brownian loop soup. The latter was introduced by Lawler and Werner and is a very interesting object with connections to the Schramm-Loewner Evolution (SLE) and various models of statistical mechanics. In the second part of these lecture notes, we will use the Brownian loop soup to construct a family of functions that behave like correlation functions of primary fields in Conformal Field Theory (CFT). We will then use these functions and their derivation to introduce the concept of conformal field and to explore the connection between scaling limits and conformal fields. ar X iv :1 50 1. 04 86 1v 2 [ m at h. PR ] 1 1 Fe b 20 16
Does Allograft Augmentation of Small-Diameter Hamstring Autograft ACL Grafts Reduce the Incidence of Graft Retear?:

Background:Small-diameter hamstring tendons are frequently encountered during anterior cruciate ligament (ACL) reconstructions in patients with short stature or those who are skeletally immature. T...
Gross Motor Development in Children Aged 3-5 Years, United States 2012.

Objective Gross motor development in early childhood is important in fostering greater interaction with the environment. The purpose of this study is to describe gross motor skills among US children aged 3–5 years using the Test of Gross Motor Development (TGMD-2). Methods We used 2012 NHANES National Youth Fitness Survey (NNYFS) data, which included TGMD-2 scores obtained according to an established protocol. Outcome measures included locomotor and object control raw and age-standardized scores. Means and standard errors were calculated for demographic and weight status with SUDAAN using sample weights to calculate nationally representative estimates, and survey design variables to account for the complex sampling methods. Results The sample included 339 children aged 3–5 years. As expected, locomotor and object control raw scores increased with age. Overall mean standardized scores for locomotor and object control were similar to the mean value previously determined using a normative sample. Girls had a higher mean locomotor, but not mean object control, standardized score than boys (p 0.05). Conclusions In a nationally representative sample of US children aged 3–5 years, TGMD-2 mean locomotor and object control standardized scores were similar to the established mean. These results suggest that standardized gross motor development among young children generally did not differ by demographic or weight status.
Appropriateness and Parental Approval of 1920s Fashion for Small Town Women: "We pretty much all looked alike!"

While descriptions of high-end, ready-to-wear fashions of the 1920s are plentiful (Tortora & Marcketti, 2015), were everyday, small-town women wearing these same 1920s fashions? Did the dress of more ordinary women in ordinary places adopt the 1920s fashion trends associated with cosmopolitan lifestyles? To explore these issues, the author interviewed 12, small town women to record their recollections of their 1920s fashions. Data show that â€œwhatâ€ small town women wore in the 1920s and where they acquired their clothing are interdependent issues best understood within the context of the child/parent relationship. Because they were wearing clothing their mothers made for them (not ready-made fashions), their choices were 'parent-centric'. They said that being 'fashionable' was secondary; however, looking 'appropriate' was of key importance. These data provide an alternate account of the 'roaring twenties' placing 'appropriateness' and parental approval as key to fashion choices among small town women.
Association of Treatment at High-Volume Facilities With Survival in Patients Receiving Chemoradiotherapy for Nasopharyngeal Cancer

Using the National Cancer Database, this study examines the association of treatment at high-volume facilities with survival in patients receiving chemotherapy for nasopharyngeal cancer.
Proteomic analysis of the human retina reveals region-specific susceptibilities to metabolic- and oxidative stress-related diseases

Differences in regional protein expression within the human retina may explain molecular predisposition of specific regions to ophthalmic diseases like age-related macular degeneration, cystoid macular edema, retinitis pigmentosa, and diabetic retinopathy. To quantify protein levels in the human retina and identify patterns of differentially-expressed proteins, we collected foveomacular, juxta-macular, and peripheral retina punch biopsies from healthy donor eyes and analyzed protein content by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Protein expression was analyzed with 1-way ANOVA, gene ontology, pathway representation, and network analysis. We identified a mean of 1,974 proteins in the foveomacular retina, 1,999 in the juxta-macular retina, and 1,779 in the peripheral retina. Six hundred ninety-seven differentially-expressed proteins included those unique to and abundant in each anatomic region. Proteins with higher expression in each region include: heat-shock protein 90-alpha (HSP90AA1), and pyruvate kinase (PKM) in the foveomacular retina; vimentin (VIM) and fructose-bisphosphate aldolase C (ALDOC); and guanine nucleotide-binding protein subunit beta-1 (GNB1) and guanine nucleotide-binding protein subunit alpha-1 (GNAT1) in the peripheral retina. Pathway analysis identified downstream mediators of the integrin signaling pathway to be highly represented in the foveomacular region (P = 6.48 e-06). Metabolic pathways were differentially expressed among all retinal regions. Gene ontology analysis showed that proteins related to antioxidant activity were higher in the juxta-macular and the peripheral retina, but present in lower amounts in the foveomacular retina. Our proteomic analysis suggests that certain retinal regions are susceptible to different forms of metabolic and oxidative stress. The findings give mechanistic insight into retina function, reveal important molecular processes, and prioritize new pathways for therapeutic targeting.
Teaching the Basics of Negotiation in One Class.

This interactive negotiation exercise was primarily developed for situations where only one or two sessions could be devoted to teaching negotiations. The exercise, which is conducted by the instru...
Causes of Death After Nonfatal Opioid Overdose.

Importance A recent increase in patients presenting with nonfatal opioid overdoses has focused clinical attention on characterizing their risks of premature mortality. Objective To describe all-cause mortality rates, selected cause-specific mortality rates, and standardized mortality rate ratios (SMRs) of adults during their first year after nonfatal opioid overdose. Design, Setting, and Participants This US national longitudinal study assesses a cohort of patients aged 18 to 64 years who were Medicaid beneficiaries and experienced nonfatal opioid overdoses. The Medicaid data set included the years 2001 through 2007. Death record information was obtained from the National Death Index. Data analysis occurred from October 2017 to January 2018. Main Outcomes and Measures Crude mortality rates per 100 000 person-years were determined in the first year after nonfatal opioid overdose. Standardized mortality rate ratios (SMR) were estimated for all-cause and selected cause-specific mortality standardized to the general population with respect to age, sex, and race/ethnicity. Results The primary cohort included 76 325 adults and 66 736 person-years of follow-up. During the first year after nonfatal opioid overdose, there were 5194 deaths, the crude death rate was 778.3 per 10 000 person-years, and the all-cause SMR was 24.2 (95% CI, 23.6-24.9). The most common immediate causes of death were substance use–associated diseases (26.2%), diseases of the circulatory system (13.2%), and cancer (10.3%). For every cause examined, SMRs were significantly elevated, especially with respect to drug use–associated diseases (SMR, 132.1; 95% CI, 125.6-140.0), HIV (SMR, 45.9; 95% CI, 39.5-53.0), chronic respiratory diseases (SMR, 41.1; 95% CI, 36.0-46.8), viral hepatitis (SMR, 30.6; 95% CI, 22.9-40.2), and suicide (SMR, 25.9; 95% CI, 22.6-29.6), particularly including suicide among females (SMR, 47.9; 95% CI, 39.8-52.3). Conclusions and Relevance In a US national cohort of adults who had experienced a nonfatal opioid overdose, a marked excess of deaths was attributable to a wide range of substance use–associated, mental health, and medical conditions, underscoring the importance of closely coordinating the substance use, mental health, and medical care of this patient population.
Amortized Bound for Root Isolation via Sturm Sequences

This paper presents two results on the complexity of root isolation via Sturm sequences. Both results exploit amortization arguments.
Heidegger's "Authenticity" in the Psychotherapy of Adolescents

Those aspects of Heidegger’s thought culminating in his notion of “authenticity” are described, and the use of his concepts in the psychotherapy of certain adolescents is suggested. This paper offe...
Conservation laws and multiplicity evolution of spectra at energies available at the BNL Relativistic Heavy Ion Collider

Transverse momentum distributions in ultrarelativistic heavy ion collisions carry considerable information about the dynamics of the hot system produced. Direct comparison with the same spectra from $p+p$ collisions has proved invaluable in identifying novel features associated with the larger system, in particular, the ``jet quenching'' at high momentum and the apparently much stronger collective flow dominating the spectral shape at low momentum. We point out possible hazards of ignoring conservation laws in the comparison of high- and low-multiplicity final states. We argue that the effects of energy and momentum conservation actually dominate many of the observed systematics, and that $p+p$ collisions may be much more similar to heavy ion collisions than generally thought.
Theory of Absorption and Circular Dichroism of Large Inhomogeneous Molecular Aggregates

A general method to describe the spectroscopy of large, internally inhomogeneous particles is presented. The theory utilizes an approach similar to the one used by De Voe in the treatment of the optical properties of polymers. It is found that if the particle is dense the intermediate and radiation coupling mechanisms must be included in addition to the dipole-dipole coupling. Through these coupling mechanisms it is found that the excitation generated at each group in the chromophore can delocalize over regions comparable to the size of the wavelength of light. The spatially averaged equations of the absorbance for a collection of large inhomogeneous arbitrarily shaped aggregates will be presented. This theory is then applied to the polymer and salt induced Psi-type circular dichroism observed in DNA aggregates. Using the formalism developed, it is shown that the anomalously large signals observed in the circular dichroism of certain molecular aggregates result from: (a) the presence of a long-range chiral structure in the aggregate; (b) delocalization throughout the entire particle of the light-induced excitations in the chromophores. This is the first successful attempt to explain the physical origin of the psi-type CD effect. Useful information regarding the chiral structure of the aggregates can be inferred from the theory.
Control of Ciliary Activity in Aneural Organisms

Aneural organisms are subjected to many chemical and mechanical stimuli; these stimuli give rise to receptor potentials as Dr. Wood has shown. (See paper by D. Wood in this volume -- Ed.). Changes in membrane potential in turn lead to alterations in ciliary activity, which is one means of locomotion in many aneural organisms. I wish to discuss some of the mechanisms by which this ciliary activity is regulated.
Applications of Green Fluorescent Protein in Plants

Green fluorescent protein (GFP) is increasingly being used in plant biology from the cellular level to whole plant level. At the cellular level, GFP is being used as an in vivo reporter to assess frequency of transient and stable transformation. GFP has also proven to be an invaluable tool in monitoring trafficking and subcellular localization of protein. At the organ level and up, many exciting applications are rapidly emerging. The development of brighter GFP mutants with more robust folding properties has enabled better macroscopic visualization of GFP in whole leaves and plants. One interesting example has been the use of GFP to monitor virus movement in and among whole plants. GFP is also emerging as a powerful tool to monitor transgene movement and transgenic plants in the field. In a proof-of-concept study, tobacco was transformed with a modified version of the GFP gene controlled by a constitutive (35S) promoter. GFP expression in progeny plants ranged from 0% to 0.5%, and approximately 0.1% GFP was the minimal amount needed for unambiguous macroscopic detection. GFP is the first truly in vivo reporter system useful in whole plants, and we project its usefulness will increase even further as better forms of GFP genes become available.
Systolic and Diastolic Blood Pressure Variability as Risk Factors for Adverse Events After Coronary Artery Bypass Grafting

This study assesses whether blood pressure variability is associated with adverse outcomes after coronary artery bypass grafting surgery.
Direct growth of vertically aligned carbon nanotubes on stainless steel by plasma enhanced chemical vapor deposition

Abstract Applications such as energy storage and field emission devices demand direct growth of vertically aligned carbon nanotube (VACNT) arrays on conducting metal substrates, which has remained a challenge for a long time. Here, we report a controlled growth of VACNT arrays on a stainless steel (SS) substrate via dc plasma enhanced chemical vapor deposition without the addition of a metal catalyst layer. TEM and AFM examinations revealed the occurrence of nano-hills formed on the SS surface during heating process in an NH3 environment. This is a key step for uniform growth of VACNTs. The VACNTs have uniform length and diameter, good alignment, and uniform coverage over the substrate surface, superior to reported results. The particle on the tip of most of the VACNTs was found to be single crystalline Fe metal, although a few other VACNTs were found to have an alloy of Fe, Ni, Mn, and Cr at the tips. This highlights the dominating catalytic behavior of Fe over Ni, Cr, and Mn, which are the elemental composition of the nano-hills. The high quality VACNTs may find unique applications such as electron field emitters and dense nanoscale anode materials for lithium ion batteries.
Fetal Electrocardiogram Recognition Using Multilayer Perceptron Neural Network

Fetal Electrocardiography (FECG) signal contains valuable and meaningful information that would help doctors to make decisions during pregnancy and labor. It is also an important indicator of the fetal status. However, extracting FECG from non-invasive sensors is not easy since the FECG signal is weak compared to the Maternal ECG (MECG) signal. In conventional signal processing methods, it requires an adaptive filter with the MECG signal and the mixture of Electrocardiography (ECG) signal to reveal the FECG signal. This procedure requires significant computation power and multiple sensors applied on the pregnant women. As machine learning algorithms become more and more popular, applying neural network to signal processing is widely adapted in all types of applications. This paper presents a method based on neural network to recognize the FECG signal from the abdominal ECG signal acquired by non-invasive sensors. Training and evaluation procedure are achieved in TensorFlow on a heterogeneous platform. This algorithm can precisely identify both MECG and FECG signal from the maternal abdominal ECG signal.
(Very) short proof of Rayleigh's Theorem (and extensions)

Consider a walk in the plane made of $n$ unit steps, with directions chosen independently and uniformly at random at each step. Rayleigh's theorem asserts that the probability for such a walk to end at a distance less than 1 from its starting point is $1/(n+1)$. We give an elementary proof of this result. We also prove the following generalization valid for any probability distribution $\mu$ on the positive real numbers: if two walkers start at the same point and make respectively $m$ and $n$ independent steps with uniformly random directions and with lengths chosen according to $\mu$, then the probability that the first walker ends farther than the second is $m/(m+n)$.
The impact of dupilumab on patch testing and the prevalence of comorbid allergic contact dermatitis in recalcitrant atopic dermatitis: A retrospective chart review.

Background It is unclear whether the type 2 T helper cell–specific immunosuppressive action of dupilumab interferes with patch testing. Objectives We sought to evaluate the reliability of patch testing on dupilumab and the contribution of allergic contact dermatitis (ACD) to complex dermatitis in patients with residual dermatitis on dupilumab. Methods This is a retrospective chart review of 48 patients with atopic dermatitis (AD) who were treated with dupilumab. We compare the results of patch tests performed before and after the initiation of dupilumab and the prevalence of comorbid ACD in patch-tested individuals. Results A minority of patch test reactions were “lost” on dupilumab (13/125; 10.4%). Five of 13 lost reactions occurred in individuals with documented immunodeficiency. Thirty-two of 35 patch-tested patients (91.4%) had comorbid ACD; 92.3% of individuals patch tested on dupilumab experienced further clinical improvement with allergen avoidance. Limitations This is a nonrandomized study in a small cohort of patients. The clearance of dupilumab was assessed by subjective patient reports. Conclusions Dupilumab does not appear to exert a dampening effect on patch test results. AD with comorbid ACD was highly prevalent and allergen avoidance resulted in significant improvement in residual dermatitis that had not resolved without dupilumab therapy.
Utilizing a Physician Scribe in a Pediatric Plastic Surgical Practice: A Time-driven Activity-based Costing Study.

Background To use time-driven activity-based costing methodology to compare the costs of routine pediatric plastic surgical patient visits with and without a physician scribe. Methods Pediatric plastic surgical clinic visits at a tertiary care facility with the following diagnoses were studied: skin lacerations, skin lesions, and plagiocephaly. Two plastic surgeons saw patients individually either with or without a scribe over a 10-month period. The time that the scribe and physician spent on the patient was recorded, including the duration of the clinic visit and time spent creating, dictating, reviewing, and signing the note. An average appointment activity time for each measurement component was produced, and a capacity cost rate was introduced to derive the cost per minute for a scribe and physician. Sensitivity analysis and paired t-test were conducted to analyze the results. Results A total of 45 cases with a physician scribe were observed with an average appointment activity time of 12.83 minutes (4.97 min for the scribe, 0.92 min for the physician, and 6.95 min combined). A total of 72 cases without a physician scribe were observed with an average appointment activity time of 12.01 minutes. The total attributable cost saving per appointment was $13.82 when a physician scribe was utilized. Conclusion Time-driven activity-based costing methodology showed that the use of a physician scribe reduced cost per office visit by substituting physician time for a less expensive resource.
MEALS OF THE BOUNDARIES COMMISSION IN LVIV (1578, 1579, 1581) ON THE EXAMPLE OF A SOURCE - THREE FRAGMENTS FROM THE LVIV WEEKLY-EXPENDITURES BOOKS. TRANSLATION. COMMENTS

In the second half of the 16th century in Lviv were conducted meeting of the Border Commission. The Commissionresolved the controversial questions related to the land issue and ordering its boundaries. During its implementation,city delegates and commissioners often stopped for rest and lunch. Meat, fish, bread, various spices and wine wereaccompanied participants of the Borders Commission during joint meetings, whether at the City Hall or outside it.This and other information is vividly illustrated by a source such as the Lviv weekly-expenditures book for 1572–1582. This source has big information potential. In the Lviv weekly-expenditures books you can find informationabout the activities of the city authorities (councils and benches of the city of Lviv); the acomplishment of functions by city officials (such as the executioner); routine affairs in the city, etc. This publication provides three fragments ofthe source of the Boundary Commission meeting for 1578, 1579, 1581.The Boundary Commission of 1578 was held on the eve of the Birthday of John the Baptist (June 24) and lasted fromJune 20 to June 23, 1578. The source does not provide specific details of the dispute, but it can be assumed that a soildispute arose between a monastic order of Lviv Dominicans and Bryukhovychi peasants. During the joint lunchesand dinners in the suburban tavern in Bryukhovychi, for four days, the commissioners drank three barrels of beer, 22jugs (85 liters) of Hungarian wine, consumed veal; fish and herrings (most likely eaten on Friday June 22); breadand other dishes cooked for them.In 1579, the Commission resolved the disputed issues between the city and Lviv’s podstoli, Joakim Samp. During itsmeeting on the second Sunday of Lent in 1579, were present Lviv’s castellans Stanislav Herburth and Lviv starostaMykola Herburth. Each of them was presented with 8 jugs of Malvasia for greetings. To feed the delegates werepurchased variety of fish, bread, spices, vegetables, condiments and 27 jugs of Malvasia. It is interesting that theCommissioners did not consume meat under the Border Commission because it took place during Lent.The Borders Commission, in October 1581, was also involved in resolving the dispute between Joachim Samp and thecommunity of Lviv. The meetings of the Commission were followed by lavish dinners. In particular, to the borders thatwere checked was bought 2 barrels of beer, two-quarters of meat, 5 chickens, bread, various roots. On Tuesday, October13, 1581, all the commissioners and guests, including Mykola Herburt, the Lviv starosta and Mykola Meletsky,the Podolsk voivode, and all their servants were gratulated in Sikhiv Korchma. For festive supper was bought twocalves, four quarters of meat, 2 barrels of beer, rye and white bread, vegetables, lemons, raisins, sugar, 4 vessels ofjam, 35 ½ jugs of wine and 6 jugs of alicakantu.
Deadman anchoring design for cable logging: a new approach

Cable yarding is still a common system for transporting wood in steep terrain. In the Pacific Northwest, United States, and other regions of high-productivity forestry, reduced rotation ages for ha...
On Meaningful, Researchable, and Generative Questions

This essay focuses on a particular subset of educational research, questions that are researchable and that, ultimately, will make a positive difference for the educational enterprise. It argues that to be researchable, tasks need to be addressable in operational terms – that questions that hinge on values (e.g. “are large small classes better than large classes?”) are inherently unaddressable until the values undergirding the questions are specified in clear and meaningful ways. Key claims of this paper are that in addition to being addressable, to advance the field, research questions should be meaningful and generative. What is meant by meaningful is that the answer to the questions posed should matter to either practice or theory in some important way. What is meant by generative is that working on the problem, whether it is “solved” or not, is likely to provide valuable insights. Interestingly, time is not necessarily an issue – a problem that takes a century to solve may still be extremely valuable – if the subproblems it spawns are rich, interesting, and addressable. From this author’s perspective, for a problem to be researchable (in effect, answerable) is only a first step. What makes problems valuable to the field is their potential importance and their fruitfulness in producing ongoing insights and meaningful questions. A range of examples including design experiments, assessments, and the evolution of an extended research program are discussed as illustrations of the above claims.
Abstract TP296: Telestroke Associated With Increased Levels of Acute Stroke Care

Introduction/Hypothesis: Telestroke may be used to augment hospitals’ acute stroke services. The Department of Veterans Affairs launched a National TeleStroke Program (NTSP) in September 2017 that ...
Intermittent hypercapnic hypoxia induces respiratory hypersensitivity to fentanyl accompanied by tonic respiratory depression by endogenous opioids.

KEY POINTS Sleep apnoea increases susceptibility to opioid-induced respiratory depression (OIRD). Endogenous opioids are implicated as a contributing factor in sleep apnoea. Rats exposed to sleep-phase chronic intermittent hypercapnic hypoxia (CIHH) for 7 days exhibited exaggerated OIRD to systemic fentanyl both while anaesthetized and artificially ventilated and while conscious and breathing spontaneously, implicating heightened CNS inhibitory efficacy of fentanyl. CIHH also induced tonic endogenous opioid suppression of neural inspiration. Sleep-related episodes of hypercapnic hypoxia, as in sleep apnoea, promote hypersensitivity to OIRD, with tonic respiratory depression by endogenous opioids implicated as a potential underlying cause. ABSTRACT Sleep apnoea (SA) increases opioid-induced respiratory depression (OIRD) and lethality. To test the hypothesis that this results from chronic intermittent bouts of hypercapnic hypoxia (CIHH) accompanying SA, we compared OIRD across continuously normoxic control rats and rats exposed to sleep-phase (8 h/day) CIHH for 1 week. OIRD sensitivity was first assessed in anaesthetized (urethane/α-chloralose), vagotomized and artificially ventilated rats by recording phrenic nerve activity (PNA) to index neural inspiration and quantify PNA burst inhibition to graded doses (0, 2, 20, 50 μg kg-1 , i.v.) of the synthetic opioid fentanyl. Fentanyl dose-dependently reduced PNA burst frequency (P = 0.0098-0.0001), while increasing the duration of burst quiescence at 50 μg kg-1 (P < 0.0001, n = 5-6/group/dose). CIHH shifted the fentanyl dose-phrenic burst frequency response curve to the left (P = 0.0163) and increased the duration of burst quiescence (P < 0.0001). During fentanyl recovery, PNA burst width was increased relative to baseline in normoxic and CIHH rats. Systemic naloxone (1 mg kg-1 , i.v.) reversed fentanyl-induced PNA arrest in both groups (P = 0.0002), and increased phrenic burst amplitude above baseline (P = 0.0113) in CIHH rats only. Differential sensitivity to anaesthesia as a cause of CIHH-related OIRD hypersensitivity was excluded by observing in conscious spontaneously breathing rats that fentanyl at 20 μg kg-1 (i.v.), which silenced PNA in anaesthetized rats, differentially increased breathing variability in normoxic versus CIHH rats (P = 0.0427), while significantly reducing breathing frequency (P < 0.0001) and periodicity (P = 0.0003) in CIHH rats only. Findings indicate that CIHH increased OIRD sensitivity, with tonic inspiratory depression by endogenous opioids as a likely contributing cause.
Getting Away With Murder: Homicide Clearance by Arrest in Chicago and Its Community Areas:

This work explores the decline in murder clearances through arrest in Chicago from 1965 through 2015, specifically focusing on the most recent time period since 2001. The findings suggest that clea...
No More Surprises - New Legislation on Out-of-Network Billing

New Legislation on Out-of-Network Billing The passage of the federal No Surprises Act — which banned “surprise billing” in many scenarios — was an unexpected step forward. The new legislation will ...
Layoffs and Duration Dependence in a Model of Turnover

A semi-Markov model of turnover, resulting from optimizing behavior on the part of workers, is developed. Duration dependence in the transition out of employment is modelled as resulting from a layoff probability which decreases with tenure. Some preliminary results, based on DIME data, are presented. These indicate that a declining hazard rate in the transition out of employment is a significant feature of the data.
The Effect of Urine Collection with a Novel External Catheter Device on Common Urine Chemistry and Urinalysis Results.

INTRODUCTION: Urine collection from incontinent individuals can be challenging. Various methods have been devised to collect the sample without catheterization. Recently the PureWick external catheter was developed to draw the sample gently away from external female genitalia. While the primary purpose of the device is to prevent moisture and maintain skin integrity, the urine that is collected may be sent for laboratory analysis. We sought to validate the use of this collection method for common urine chemistry assays and urinalysis. METHODS: Twenty pools of residual urine samples were separated into "control" and "PureWick" treated samples. The control samples were maintained at room temperature while 15 mL of urine was added to the PureWick device which was connected to a vacuum line through a collection canister. The urine collected in the canister and the controls samples were all subject to urine chemistry strip, microscopic, and automated urine chemistry analysis. Results were compared between pairs of treated and control samples. RESULTS: No clear affect was noted on urine strip semi-quantitative or automated chemistry analysis from the PureWick collection. There was a statistically significant decrease in microscopic measurements of white blood cells and crystals in the PureWick urine samples. DISCUSSION: This study supports the use of the PureWick external catheter for collection of samples for most urinalysis and urine chemistry tests.
Politics and Prejudice: Using the Term “Undocumented Immigrant” over “Illegal Immigrant”

The presidency of Donald Trump and subsequent interest in issues related to immigration have created controversy regarding how to refer to immigrants living in the USA without documentation. The first part of this paper acts as an analysis of the growing use of the term “illegal immigrant” and the controversy around this term. Given the current debate over using the term “illegal immigrant” versus “undocumented immigrant,” we test the claim that the term “illegal immigrant” causes Americans to support more restrictive immigration policies and view immigrants less favorably. Using Amazon Turk, we distributed two sets of opinion surveys regarding unlawful immigrants. These surveys were identical except that one set used the term “illegal immigrant” and the other used “undocumented immigrant.” The differences in responses between these two survey sets were analyzed. While the term “illegal immigrant” is generally used in more negative contexts than the term “undocumented immigrant,” using one term over the other had little to no effect on how our study participants viewed immigration policy and immigrants themselves. Given prior research about the usage of the two terms, these results suggest that while the decision to use one term over the other is an indication of political ideology, attempts to sway opinion about immigration policy using only terminology may be less effectual than normally believed.
Mini review: Biomaterials in repair and regeneration of nerve in a volumetric muscle loss.

Abstract Volumetric muscle loss (VML) following a severe trauma or injury is beyond the intrinsic regenerative capacity of muscle tissues, and hence interventional therapy is required. Extensive muscle loss concomitant with damage to neuromuscular components overwhelms the muscles’ remarkable regenerative capacity. The loss of nervous and vascular tissue leads to further damage and atrophy, so a combined treatment for neuromuscular junction (NMJ) along with the volumetric muscle regeneration is important. There have been immense advances in the field of tissue engineering for skeletal muscle tissue and peripheral nerve regeneration, but very few address the interdependence of the tissues and the need for combined therapies to repair and regenerate fully functional muscle tissue. This review addresses the problem and presents an overview of the biomaterials that have been studied for tissue engineering of neuromuscular tissues associated with skeletal muscles.
Effects of adolescent substance use disorders on central cholinergic function.

Abstract Adolescence is a transitional period between childhood and adulthood, in which the individual undergoes significant cognitive, behavioral, physical, emotional, and social developmental changes. During this period, adolescents engage in experimentation and risky behaviors such as licit and illicit drug use. Adolescents' high vulnerability to abuse drugs and natural reinforcers leads to greater risk for developing substance use disorders (SUDs) during adulthood. Accumulating evidence indicates that the use and abuse of licit and illicit drugs during adolescence and emerging adulthood can disrupt the cholinergic system and its processes. This review will focus on the effects of peri-adolescent nicotine and/or alcohol use, or exposure, on the cholinergic system during adulthood from preclinical and clinical studies. This review further explores potential cholinergic agents and pharmacological manipulations to counteract peri-adolescent nicotine and/or alcohol abuse.
Nonoperative treatment of distal humerus fractures in the elderly yields satisfactory functional outcomes and low conversion to delayed surgery: a systematic review

Abstract: Background Distal humerus fractures (DHF) pose a treatment challenge in elderly patients. We sought to systematically review and report the clinical outcomes of the nonoperative approach (e.g., “bag of bones”) for the treatment of these injuries, and the rate of conversion to delayed surgery. Methods A comprehensive review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was conducted. Studies involving outcomes following nonoperative treatment of DHF in patients >65 years of age were included from 1985 to present. Data regarding patient age, DHF type, nonoperative treatment method, complications, conversion to delayed surgery, range of motion, union rate, and surgeon and patient reported outcome measures were extracted. Results A total of five studies met inclusion criteria (all level IV evidence), yielding a total of 143 patients (mean age: 73.5 years to 87.4 years) with 7.1 months to 55 months of follow-up. The mean Mayo Elbow Performance Index (MEPI) scores were good to excellent across several studies (range 83 - 93.1). Multiple studies reported good range of motion (mean arc of motion: 81 to 106 degrees) and low levels of upper extremity disability (mean Quick Disability of the Arm-Shoulder-Hand (Q-DASH) scores: 31.3 to 38.5) at final follow-up. The rate of conversion to total elbow arthroplasty and operative fixation ranged from 0% to 7.5% and 0% to 5%, respectively. Conclusion Nonoperative management of distal humerus fractures in the elderly seems to be associated with acceptable functional outcomes and low rates of delayed surgery. This information is important for patient counseling and treatment decision-making.
Presynaptic Nicotinic Acetylcholine Receptors and the Modulation of Circuit Excitability

Cholinergic modulation of circuit excitability by activation of nicotinic acetylcholine receptors (nAChRs) is involved in essential aspects of motivated behaviors, attention, and affect. In this review we focus entirely on the contribution of presynaptic nAChRs to the regulation and dysregulation of synapses and circuits in the CNS. In particular we highlight recent insights into the regulation of presynaptic nAChR targeting and advances into discerning the mechanisms by which presynaptic nAChRs regulate neurotransmitter release and synaptic transmission in the brain.