cssi/SciSciGPT-SciSciNet huggingface dataset:
Evaluation of Pneumatic-Tube System for Delivery of Blood Specimens

Blood specimens from normal individuals and patients (with and without blood dyscrasias) were sent through a 1,423-m pneumatic-tube system that included two monitoring devices, three switches, and 67 bends (62 with a 152-cm radius and 5 with a 76-cm radius), and then returned to the central laboratory. Each specimen was thus subjected to twice the trauma it usually would receive during transit. After transit, these specimens and duplicates kept in the laboratory were analyzed in the same manner for serum or plasma Na, K, Cl, CO2, Ca, Pi, LDH, urea, uric acid, glucose, creatinine, total protein, fibrinogen, hemoglobin, and bilirubin. Filling the tubes completely with blood and using a foam-rubber-Iined vinyl insert to hold the specimen tubes in the carrier decreased the differences attributable to transportation. Allowing the blood to clot before transport did not alter the results. Increases attributable to transport occurred only in hemoglobin, LDH, and K. Values were altered considerably less when the transported aliquot made only one leg of the trip via pneumatic tube. The alterations observed for the remaining analyses were within laboratory error. The pH of whole blood and the mean for PCO2 were not significantly altered, while the mean value for PO2, was increased 1.7 (0.5 to 4.5) mm Hg on transport.
A Meta-Analysis of Alzheimer's Disease Incidence and Prevalence Comparing African-Americans and Caucasians

Background Several studies have shown higher Alzheimer's disease (AD) incidence rates are in African-Americans (AAs) than Caucasians (CCs). If this finding is consistent across studies, it raises important etiologic questions regarding factors responsible for this discrepancy. It also affects the likely public health burden of AD in the US in the future, as the non-Caucasian population becomes the majority. Objective Estimate the AA/CC rate ratio for AD incidence across all available studies. Methods We conducted a meta-analysis of population-based studies for the rate ratio (RR) of AD incidence for AAs versus CCs, after identifying six relevant studies from the literature. We calculated an AA/CC rate ratio across all studies using inverse-variance weighting, and assessed inter-study heterogeneity. Using these incidence data, as well as data on survival after diagnosis, and on all-cause mortality, we also estimated the US prevalence of AD among AAs and CCs. Results There were six population-based studies with data comparing AD incidence between AAs and CCs, with an estimated 370 AA and 640 CC incident cases. The meta-analysis RR showed that the AD rate for AAs was 64% higher than for CCs (RR = 1.64 (95% CI 1.35-2.00)) 1.35-2.00)), with no evidence of heterogeneity. We estimated the current US AD prevalence for ages 65-90 to be 5.5% for CCs, and 8.6% for AAs (prevalence ratio 1.56). Conclusion AAs have an increased risk of incident and prevalent AD compared to CCs for reasons which are unknown, but are hypothesized to reflect biological, psychological, and socioeconomic factors.
The National Mammography Database: Preliminary Data

OBJECTIVE. The purposes of our study were to analyze screening mammography data submitted to the National Mammography Database (NMD) since its inception to confirm data collection feasibility, to draw parallels to data from the Breast Cancer Surveillance Consortium (BCSC), and to examine trends over time. We also retrospectively evaluated practice-level variation in terms of practice type, practice setting, census region, and annual volume. MATERIALS AND METHODS. Data from 90 mammography facilities in the NMD registry were analyzed. The registry receives mammography data collected as part of standard clinical practice, including self-reported demographic information, clinical findings, screening mammography interpretation, and biopsy results. Outcome metrics calculated were cancer detection rate, recall rate, and positive predictive values for biopsy recommended (PPV2) and biopsy performed (PPV3). RESULTS. The NMD successfully collected and analyzed data for 3,181,437 screening mammograms performed betwee...
Structure of Molecularly -Thin Perfluoropolyether Films on Amorphous Carbon Surfaces

Surface energies of molecularly-thin, perfluoropolyether (PFPE)-lubricated, amorphous carbon surfaces are presented as a function of the applied PFPE structure and thickness. A framework is developed to aid in the interpretation of the surface energy data. Information regarding the structure of these PFPE films adsorbed on CHx at the monolayer thickness levels is elucidated. Evidence for ordering in these polymer films is presented and interpreted to result from a combination of both, lateral cohesive interactions within the plane of the monolayer, and adhesive interactions between the PFPE monolayer and the underlying substrate.
Change in drusen area over time compared using spectral-domain optical coherence tomography and color fundus imaging.

PURPOSE To investigate the relationship between drusen areas measured with color fundus images (CFIs) and those with spectral-domain optical coherence tomography (SDOCT). METHODS Forty-two eyes from thirty patients with drusen in the absence of geographic atrophy were recruited to a prospective study. Digital color fundus images and SDOCT images were obtained at baseline and at follow-up visits at 3 and 6 months. Registered, matched circles centered on the fovea with diameters of 3 mm and 5 mm were identified on both CFIs and SDOCT images. Spectral-domain OCT drusen measurements were obtained using a commercially available proprietary algorithm. Drusen boundaries on CFIs were traced manually at the Doheny Eye Institute Image Reading Center. RESULTS Mean square root drusen area (SQDA) measurements for the 3-mm circles on the SDOCT images were 1.451 mm at baseline and 1.464 mm at week 26, whereas the measurements on CFIs were 1.555 mm at baseline and 1.584 mm at week 26. Mean SQDA measurements from CFIs were larger than those from the SDOCT measurements at all time points (P = 0.004 at baseline, P = 0.003 at 26 weeks). Changes in SQDA over 26 weeks measured with SDOCT were not different from those measured with CFIs (mean difference = 0.014 mm, P = 0.5). CONCLUSIONS Spectral-domain OCT drusen area measurements were smaller than the measurements obtained from CFIs. However, there were no differences in the change in drusen area over time between the two imaging modalities. Spectral-domain OCT measurements were considerably more sensitive in assessing drusen area changes.
Abstract 2408: CD44s is required for a tumor-initiating stem-like mesenchymal phenotype in hepatocellular carcinoma via ligand-independent c-Met activation

Proceedings: AACR 103rd Annual Meeting 2012‐‐ Mar 31‐Apr 4, 2012; Chicago, IL c-Met, a high affinity receptor for hepatocyte growth factor (HGF), plays a critical role in cancer growth, invasion and metastasis. Hepatocellular carcinoma (HCC) patients with active HGF/c-Met signaling have a significantly worse prognosis. CD44, the receptor for hyaluronic acid, is utilized as a surface marker to identify mesenchymal tumor-initiating stem-like cells (TISC) in several cancers. CD44v6 (spice variant 6) has been shown to promote HGF activation of c-Met. In this work, we examine the role of CD44s as a deregulator and activator of c-Met signaling in HCC. In a transcriptome profile analysis of 149 human HCC cases, we identified a significant positive correlation (R2=0.8993) between up-regulated CD44 and c-Met expression. The human HCC cell lines MHCC97-H and Huh7 were further utilized to investigate the direct relationship between c-Met and CD44s. Metastatic MHCC97-H cells are 95% CD44+ and demonstrate ligand-independent c-Met activation. CD44+/c-Met+ MHCC97-H cells demonstrate a mesenchymal phenotype with low expression of E-cadherin, high level of tumorsphere formation, increased expression of fibronectin and Zeb2 compared to Huh7 cells, which have are CD44neg/c-Metneg. In MHCC97-H cells, a direct interaction between CD44s and c-Met was demonstrated by immunoprecipitation/immuno-blot analysis. Transient and stable inhibition of c-Met in MHCC97-H cells results in increased E-cadherin, decreased CD44s, and reduced tumor-initiating characteristics and loss of tumorsphere formation. Likewise, inhibition of CD44s demonstrates similar phenotype with increased E-cadherin, decreased tumorsphere formation, and decreased c-Met activation and loss of downstream Akt and Erk phosphorylation. CD44s knockdown recovered c-Met to a regulated HGF-dependent state. Selective inhibition of either PI3K (Ly294002) or MAPK (PD98059) pathways in MHCC97-H cells demonstrate that PI3K/Akt activation signals drive CD44s expression in a feed forward fashion. Conversely, the over-expression of CD44s in Huh7 cells demonstrates a mesenchymal phenotype with fibroblastic-like cell morphology, decreased E-cadherin, increased Zeb1, increased PI3K/Akt signaling, and increased tumorsphere formation compared to control Huh7 cells. Selective inhibition of PI3K/Akt signaling in CD44+ Huh7 cells resulted in reduced CD44s expression and decreased tumorsphere formation. In conclusion, CD44s induces a mesenchymal phenotype and tumor initiating characteristics in HCC through the deregulation of c-Met and activation of a positive feedback loop through PI3K/Akt signaling. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2408. doi:1538-7445.AM2012-2408
The Third Time Is the Charm: Proposing and Validating an Abbreviated Brand Love Scale

As anyone who has experienced it can surely attest, love is an extremely complex emotional state. Traditionally reserved for those closest to us—family, friends, significant others, or pets—recent years have witnessed the incorporation of love into the marketing discipline’s attempts to understand consumers’ experiences of brands. Empirically, brand love has been associated with important outcomes such as word-of-mouth behavior, brand loyalty, increased willingness to pay, and even forgiveness of brand failures (Batra, Ahuvia, and Bagozzi 2012). In contrast to the research that established these relationships, this manuscript seeks to address a fundamental issue related to brand love: how it should be measured.
Revisiting the Triple Helix Innovation Framework: The Case of Abengoa

The Triple Helix (TH) model is an analysis framework in which universities act as key drivers of regional innovation development in knowledge-based societies. The TH model describes interactions between three actors—university, industry, and government. Most empirical studies have addressed the role of universities, choosing to adopt a macro perspective rather than a firm perspective. Thanks to the TH model’s theoretical potential, studies using the TH framework have greatly contributed to our understanding of the dynamics and interactions among these actors. Nevertheless, this framework still contains gaps such as determining the value and practical implications of the role of firms in the TH model. This research challenges the TH literature’s traditional emphasis on the university as the main driver of innovation by addressing the following research question: Is the university really the main driver of innovation, or does each of the three helices play this role at some stage of the innovation process? Hence, this study examines the applicability and practical value of the TH model when exploring business creation, business growth, and firms’ contribution to regional innovation development. The study also explores firms’ interactions with universities and governments at the European, national, and regional levels. Specifically, this exploratory study examines the case of Abengoa, a multinational leader in renewable energy industry, specializing in innovative, sustainable biotechnology and biochemistry solutions.
Photochemical Tissue Passivation Reduces Vein Graft Intimal Hyperplasia in a Swine Model of Arteriovenous Bypass Grafting.

Background Bypass grafting remains the standard of care for coronary artery disease and severe lower extremity ischemia. Efficacy is limited by poor long‐term venous graft patency secondary to intimal hyperplasia (IH) caused by venous injury upon exposure to arterial pressure. We investigate whether photochemical tissue passivation (PTP) treatment of vein grafts modulates smooth muscle cell (SMC) proliferation and migration, and inhibits development of IH. Methods and Results PTP was performed at increasing fluences up to 120 J/cm2 on porcine veins. Tensiometry performed to assess vessel elasticity/stiffness showed increased stiffness with increasing fluence until plateauing at 90 J/cm2 (median, interquartile range [IQR]). At 90 J/cm2, PTP‐treated vessels had a 10‐fold greater Young's modulus than untreated controls (954 [IQR, 2217] vs 99 kPa [IQR, 63]; P =0.03). Each pig received a PTP‐treated and untreated carotid artery venous interposition graft. At 4‐weeks, intimal/medial areas were assessed. PTP reduced the degree of IH by 66% and medial hypertrophy by 49%. Intimal area was 3.91 (IQR, 1.2) and 1.3 mm2 (IQR, 0.97; P ≤0.001) in untreated and PTP‐treated grafts, respectively. Medial area was 9.2 (IQR, 3.2) and 4.7 mm2 (IQR, 2.0; P ≤0.001) in untreated and PTP‐treated grafts, respectively. Immunohistochemistry was performed to assess alpha‐smooth muscle actin (SMA) and proliferating cell nuclear antigen (PCNA). Objectively, there were less SMA‐positive cells within the intima/media of PTP‐treated vessels than controls. There was an increase in PCNA‐positive cells within control vein grafts (18% [IQR, 5.3]) versus PTP‐treated vein grafts (5% [IQR, 0.9]; P =0.02). Conclusions By strengthening vein grafts, PTP decreases SMC proliferation and migration, thereby reducing IH.
How Do US Pediatric Residency Programs Teach and Evaluate Community Pediatrics and Advocacy Training

Abstract Objective In 2013, the Accreditation Council for Graduate Medical Education updated requirements for training in community pediatrics and advocacy in pediatric residency programs. In light of this update, the aim of this study was to better understand how community pediatrics is being taught and evaluated in pediatric residency programs in the United States. Methods Cross-sectional exploratory study using a Web-based survey of pediatric residency program directors in September 2014. Questions focused on teaching and evaluation of 10 community pediatrics competencies. Results Of 85 programs (43% response rate), 30% offered a separate training track and/or 6-block individualized curriculum in community pediatrics or advocacy. More than 75% required all residents to learn 7 of 10 competencies queried. Respondents in urban settings were more likely to teach care of special populations ( P = .02) and public speaking ( P P = .04) and evaluate ( P = .02) community-based research. Experiential learning and classroom-based didactics were the most frequent teaching methodologies. Many programs used multiple teaching methodologies for all competencies. Observation was the most frequent evaluation technique used; portfolio review and written reflection were also commonly reported. Conclusions Our findings show a strong emphasis on community pediatrics and advocacy teaching among responding US pediatric residency programs. Although respondents reported a variety of teaching and evaluation methods, there were few statistically significant differences between programs.
Linoleic acid causes greater weight gain than saturated fat without hypothalamic inflammation in the male mouse

A significant change in the Western diet, concurrent with the obesity epidemic, was a substitution of saturated fatty acids with polyunsaturated, specifically linoleic acid (LA). Despite increasing investigation on type as well as amount of fat, it is unclear which fatty acids are most obesogenic. The objective of this study was to determine the obesogenic potency of LA vs. saturated fatty acids and the involvement of hypothalamic inflammation. Forty-eight mice were divided into four groups: low-fat or three high-fat diets (HFDs, 45% kcals from fat) with LA comprising 1%, 15% and 22.5% of kilocalories, the balance being saturated fatty acids. Over 12 weeks, bodyweight, body composition, food intake, calorimetry, and glycemia assays were performed. Arcuate nucleus and blood were collected for mRNA and protein analysis. All HFD-fed mice were heavier and less glucose tolerant than control. The diet with 22.5% LA caused greater bodyweight gain, decreased activity, and insulin resistance compared to control and 1% LA. All HFDs elevated leptin and decreased ghrelin in plasma. Neuropeptides gene expression was higher in 22.5% HFD. The inflammatory gene Ikk was suppressed in 1% and 22.5% LA. No consistent pattern of inflammatory gene expression was observed, with suppression and augmentation of genes by one or all of the HFDs relative to control. These data indicate that, in male mice, LA induces obesity and insulin resistance and reduces activity more than saturated fat, supporting the hypothesis that increased LA intake may be a contributor to the obesity epidemic.
Reducing obesity stigma via a brief documentary film: A randomized trial.

The stigma of obesity impacts individuals across numerous life domains, and people with obesity are offered little legal protection against discrimination based on their body type. While a number of experiments have shown that stigmatizing attitudes toward obesity are somewhat malleable, fewer studi
DNA fragile site breakage as a measure of chemical exposure and predictor of individual susceptibility to form oncogenic rearrangements

Chromosomal rearrangements induced by non-radiation causes contribution to the majority of oncogenic fusions found in cancer. Treatment of human thyroid cells with fragile site-inducing laboratory chemicals can cause preferential DNA breakage at the RET gene and generate the RET/PTC1 rearrangement, a common driver mutation in papillary thyroid carcinomas (PTC). Here, we demonstrate that treatment with non-cytotoxic levels of environmental chemicals (benzene and diethylnitrosamine) or chemotherapeutic agents (etoposide and doxorubicin) generates significant DNA breakage within RET at levels similar to those generated by fragile site-inducing laboratory chemicals. This suggests that chronic exposure to these chemicals plays a role in the formation of non-radiation associated RET/PTC rearrangements. We also investigated whether the sensitivity of the fragile RET region could predict the likelihood of rearrangement formation using normal thyroid tissues from patients with and without RET/PTC rearrangements. We found that normal cells of patients with thyroid cancer driven by RET/PTC rearrangements have significantly higher blunt-ended, double-stranded DNA breaks at RET than those of patients without RET/PTC rearrangements. This sensitivity of a cancer driver gene suggests for the first time that a DNA breakage test at the RET region could be utilized to evaluate susceptibility to RET/PTC formation. Further, the significant increase of blunt-ended, double-stranded DNA breaks, but not other types of DNA breaks, in normal cells from patients with RET/PTC-driven tumors suggests that blunt-ended double-stranded DNA breaks are a preferred substrate for rearrangement formation, and implicate involvement of the non-homologous end joining pathway in the formation of RET/PTC rearrangements.
Allogeneic Transplantation (HCT) for Myelodysplastic Syndrome:Recent MDACC Experience.

Abstract BACKGROUND: Many recent advances have occurred in the field of MDS including hypomethylating agents, lenalidomide, and WHO classification. Likewise the field of HCT has also undergone major new developments including non ablative conditioning, better supportive care, better HLA typing, selection of unrelated donors and development of reduced toxicity ablative regimens like Busulfan and Fludarabine. The role of HCT therefore needs to be redefined in light of these developments. The purpose of this study is to report our recent results. PATIENTS AND METHODS: 89 consecutive patients with MDS as defined by WHO criteria treated at our institution between Jan 2002 and April 2008 are included in this report. There were 60 males and 29 female with a median age of 54 (23–67). There were 5(6%) patients with RA, 1(1%) RARS, 9(10%) RCMD, 22(25%) RAEB 1, 17(19%) RAEB 2, and 35(39%) therapy related MDS(t MDS). Their IPSS scores were 25(28%) patients with Intermediate 1, 49(55%) Intermediate 2, 15(17%) high. Their WPSS categories were 5(6%) patients Low, 9(10%) Intermediate, 49(55%) high, and 26(29%) very high. 51(57%) patients had a matched related donor and 38(43%) had an unrelated donor. Conditioning regimen were Flu/Bu in 56(63%) patients, Bu/Cy 1(1%), Flu/Mel 32(36%). According to HCT-CI index, the comorbidity scores were 0 in 16(18%) patients, 1 or 2 in 19(21%) and greater then 2 in 54(61%). Median time from diagnosis to transplant was 8 months (range 1–51 months). RESULTS: With a median follow up of 28 (3–73) months, 2 year overall(OS) and disease free survival were 54%(95% CI; 42%–66%) and 52%(95% CI; 40%–64%) respectively. Cumulative incidence of non relapse mortality at 2 years was 23% (95% CI; 16%–35%). Cumulative incidence of relapse mortality at 2 years was 23% (95% CI; 15%–34%). As per WHO grouping, OS was 63%, 60%, 46% and 48% in patients with Low blast count (RA, RARS, RAMD), RAEB1, RAEB2 and t MDS( p=0.46) respectively. WPSS score was significantly(P=0.01) predictive of overall survival (see fig): 27% surviving in very high risk group, 61% in high risk group and 78% in Low and intermediate risk group. Likewise cytogenetic risk group and IPSS were significantly predictive of survival. Donor type or graft source did not predict outcome. Five patients developed primary(3) or secondary(2) graft failure. Median time to neutrophil engraftment was 13 days (8–26 days) and to platelet engraftment was 16 days (9–89 days). CONCLUSION: These results in patients with comorbidities and with a median age of 54 years are promising. Cytogenetics and prognostic scores based on cytogenetics predict outcome after HCT. Download : Download high-res image (102KB) Download : Download full-size image
MOCing Framework for Local Reduction

In sensory neuroscience, the neural and perceptual levels of investigation are commonly related through a reductive research strategy based in psycho-neural isomorphisms. Davida Teller’s “linking propositions” are a particularly vivid illustration of this epistemology in the context of vision science. For Teller, linking propositions guide the core epistemological practices of vision science by expressing the criteria for acceptable explanations of perceptual phenomena by neural processes and by articulating heuristics for discovering neural properties on grounds of perceptual ones, and vice versa. Furthermore, linking propositions create a uniform discourse in which ontological identity statements can be formulated on the basis of structural terms applicable to both the neurophysiological and perceptual domains.
Consideration of the Validity of Debris-flow Bulking Factors

Compilation of a database of debris-flow peak discharges (Q) allowed for a comparison with the expected basin discharge as computed using the rational equation, Q=CIA. The observed values of Q for debris flows in unburned and burned areas were divided by the computed Q values of runoff using the rational method. This ratio is the bulking factor for that debris-flow event. Unburned and burned basins constitute two distinct populations, analysis shows that the bulking factors for burned areas are consistently higher than unburned basins. Previously published bulking factors for unburned areas fit the dataset in about 50% of the observed cases in our compiled dataset. Bulking factors for burned areas that were found in the published literature were well below the observed increases in peak discharge in over 50% of the cases investigated. If used for design purposes , these bulking factors would result in a significant underestimation of the peak discharge from a burned basin for the given rainfall intensity. Peak discharge bulking rates were found to be inversely related to basin area.
Knowledge, Dexterity, and Attention : A Theory of Epistemic Agency

Contemporary cognitive science clearly tells us that attention is modulated for speech and action. While these forms of goal-directed attention are very well researched in psychology, they have not been sufficiently studied by epistemologists. In this book, Abrol Fairweather and Carlos Montemayor develop and defend a theory of epistemic achievements that requires the manifestation of cognitive agency. They examine empirical work on the psychology of attention and assertion, and use it to ground a normative theory of epistemic achievements and virtues. The resulting study is the first sustained, naturalized virtue epistemology, and will be of interest to readers in epistemology, cognitive science, and beyond.
Antibacterial effect and toxicity pathways of industrial and sunscreen ZnO nanoparticles on Escherichia coli

Abstract There has been an unprecedented increase in the production and consumption of metal oxide nanoparticles (NPs) due to their physicochemical properties. While NPs are advancing the frontiers of science, technology, medicine, and consumer products, their toxicity to human health and the environment remains an emerging concern. Since we are exposed to NPs largely through consumer products, this paper compares the toxicity of sunscreen lotion extracted ZnO NPs with industrial-grade ZnO NPs. E. coli was exposed to different concentrations of ZnO NPs for different durations. Our analysis suggests that E. coli growth and reactive oxygen species (ROS) varied according to type and size of particles, as well as level and duration of exposure to ZnO NPs. ROS generation was higher at the growth phase than at the stationary phase. Industrial ZnO NPs with smaller particle size were more toxic than those extracted from the sunscreen with larger particle size. The smaller particle size with homogenous distribution could be one of the underlying causes of their high toxicity. Our findings have implications for guiding policies to manage exposure to NPs in consumer products and the environment.
Explaining All Possible Paired Comparison Problems

For centuries, cycles and other anomalies have hindered the use of paired comparisons, whether it be in decision theory, voting, economics, engineering, statistics, and on and on. It is shown here how all of these problems, along with ways to find solutions, can be completely understood in terms of what is called a “ranking wheel.”
Searching for the variables that control human rule‐governed “insensitivity”

Verbal rules or instructions often exert obvious and meaningful control over human behavior. Sometimes instructions benefit the individual by enabling faster acquisition of a skill or by obviating an aversive consequence. However, research has also suggested a clear disadvantage: “insensitivity” to changing underlying contingencies. The two experiments described here investigated the variables that control initial rule-following behavior and rule-following insensitivity. When the initial rule was inaccurate, behavior was consistent with the rule for approximately half of participants and all participants' behavior was mostly insensitive to changing contingencies. When the initial rule was accurate, behavior of all participants was consistent with it and behavior for nearly all participants was insensitive to changes in underlying contingencies. These findings have implications for how best to establish and maintain rule-following behavior in applied settings when deviant behavior would be more reinforcing to the individual.
Recognition of Impending Systemic Failure

1. Saul Flores, MD* 2. Paul A. Checchia, MD, FCCM, FACC* 1. *Section of Critical Care Medicine, Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX * Abbreviations: AKI: : acute kidney injury ARDS: : acute respiratory distress syndrome ECMO: : extracorporeal membrane oxygenation ICU: : intensive care unit IV: : intravenous MH: : malignant hyperthermia NIRS: : near-infrared spectroscopy PALS: : pediatric advanced life support PEWS: : pediatric early warning score RRT: : rapid response team SF: : systemic failure Early recognition of impending systemic failure is critical for timely interventions. However, some evidence demonstrates lower identification rates of impending systemic failure by primary care and emergency department physicians. After completing this article, readers should be able to: 1. Discuss how impending systemic failure (SF) presentation varies by age. 2. Delineate the epidemiological risk factors for the development of impending SF. 3. List the signs and symptoms of impending SF. 4. Recognize the laboratory findings associated with impending SF. 5. Define the various types of SF. 6. Describe the physiological parameters used to monitor critically ill patients at risk for impending SF. 7. Plan the management of impending SF. 8. Describe measures to prevent the development of SF. 9. Describe the implementation of rapid response teams. 10. Identify irreversible systemic failure (eg, brain death, hepatic failure, cardiogenic shock). You are the senior resident on call and part of the rapid response team (RRT) this evening. You are about to evaluate a 10-month-old infant in the pediatric inpatient ward after the parents activated the RRT. The patient’s bedside nurse informs you that for the past hour, the patient is more tachycardic and tachypneic and is febrile to 101.3°F (38.5°C) with increase of the pediatric early warning score (PEWS). In addition, the patient’s mother discloses that she has not had to change any diapers in the past 3 hours, and she also noticed the patient’s abdomen becoming more enlarged. The infant’s physical examination findings are a gallop, intermittent wheezing, and hepatosplenomegaly. The infant’s laboratory findings are creatinine level of 0.9 mg/dL (79.56 μmol/L), …
A multi-grid method for variational inequalities in contact problems

The convergence of the method is proved and it is shown that the objective function corresponding to the quadratic programming problem is monotonically decreasing. The results of numerical tests for an elasticity contact problem are presented.
Nonlinear Viscoelastic and Viscoplastic Constitutive Equations Based on Thermodynamics

An approach to modeling the mechanical behavior of fiber reinforced and unreinforced plastics with an evolving internal state is described. Intrinsic nonlinear viscoelastic and viscoplastic behavior of the resin matrix is taken into account along with growth of damage. The thermodynamic framework of the method is discussed first. The Gibbs free energy is expressed in terms of stresses, internal state variables (ISVs), temperatureand moisture content. Simplifications are introduced based on physical models for evolution of the ISVs and on experimental observations of thedependence of strain state on stress state and its history. These simplifications include use of master creep functions that account for multiaxial stresses, environmental factors and aging in a reduced time and other scalars. An explicit representation of the strains follows, which isthen specialized to provide three-dimensional homogenized constitutiveequations for transversely isotropic, fiber composites. Experimentalsupport for these equations is briefly reviewed. Finally, physicalinterpretation of some of the constitutive functions is discussed usingresults from a microcracking model as well as molecular rate process andfree volume theories. It is shown that the present thermodynamicformulation leads to a generalized rate process theory that accounts for abroad distribution of thermally activated transformations in polymers.
The Role of Grain Boundaries and Interfaces on Superconductivity

The influence of grain boundaries and interfaces on critical current density in both high-temperature, cuprate superconductors and conventional superconductors is discussed. Recent measurements of the critical current density of individual grain boundaries in yttrium barium cuprate are also reviewed.
Developing an SBIRT Curriculum in Advanced Practice

Social work has a unique opportunity to integrate evidence-based substance abuse screening interventions such as screening, brief intervention, and referral to treatment (SBIRT) into master-level MSW education. Development of curricula for teaching for MSW students provides students with a language and a model to assess clients for substance abuse across populations. This chapter focuses on presenting the model, its theoretical underpinnings in motivational interviewing, and identifying challenges in teaching SBIRT to advanced practice MSW students. Challenges addressed include the adequate training of faculty, student’s preconceived notions about substance abuse and substance abusers, countertransference, the timing of SBIRT within the curriculum, agency obstacles, and field instructor buy-in. Inclusion of an evidence-based protocol such as SBIRT in teaching curricula requires buy-in from the school, the faculty, the agency, and the field instructor making this a complicated endeavor which needs to be well thought out and planned.
Temperature sensitivity of metabolism in offshore and intertidal onuphid polychaetes

Acclimated metabolism-temperature curves have been constructed for 4 populations of the intertidal onuphid Diopatra cuprea, and for the 2 offshore species Hyalinoecia tubicola and H. artifex. The intertidal species shows greater temperature sensitivity than its offshore relative, despite its presumed adaptation to thermally unstable habitats. Temperature changes considerably in excess of natural fluctuations do not greatly alter metabolic rates in Hyalinoecia. However, the range of thermal tolerance in these two species is considerably reduced.
Synergy between Defects, Photoexcited Electrons, and Supported Single Atom Catalysts for CO2 Reduction

Dispersed atomic catalysts can achieve high catalytic efficiency and have the potential to enable chemical transformation of inert molecules like CO2. The effect of surface defects on photocatalytic reduction of CO2 using supported single atom catalysts however requires clarification. Using density functional theory and experimental techniques, we have investigated the role of surface oxygen vacancies (Ov) and photoexcited electrons on supported single atom Cu catalysts and CO2 reduction. Adsorption of Cu was strong to the TiO2 surface, and charges of the Cu atoms were highly dependent on whether surface defects were present. Cu atoms with Ov aided in the adsorption of activated bent CO2, which is key to CO2 reduction. Our results also show that CO2 dissociation (CO2* → CO* + O*), which is a proposed initial step of CO2 reduction to hydrocarbon products, occurs very readily for a single Cu atom in an Ov, with barriers of ∼0.19 eV. Such low barriers do not occur with Cu over a stoichiometric surface. Furth...
Personal Exposure to PM2.5 in the Various Microenvironments as a Traveler in the Southeast Asian Countries

Air pollution has become a pressing issue in today’s society because of its significant effects on humans, animals, plants, air quality, climate and the wider environment. Most urban areas are associated with one or more air pollutants which are emitted from local or regional pollution sources including vehicle exhausts, fossil fuels using in energy production, emissions from industrial and mining activities, agricultural and construction operations, household usage of chemicals and materials and natural causes. Most personal exposure studies are focused on local environments and short-term periods. Previous controlled experiments and studies were done in a small number of designated areas in cities. Our research study used time-based activity data; 3 main and 17 sub-microenvironments were applied over 37 days-long research while traveling through Southeast Asian countries. In this study, personal exposure of PM2.5 for a traveler was monitored using an assembled low-cost monitor with Plantower PMS 3003 PM2.5 sensor which has a light-scattering principle. All time-based activity data was recorded with a smartphone whenever microenvironments changed during the study period. The goal of this study was to understand more about the personal exposure to PM2.5 related air pollution in the global travel environment as a traveler and to understand how an individual’s activity and location impact PM2.5 exposure. According to the results from the Southeast Asia study, the personal PM2.5 exposure varied in the categorized microenvironments. Port/Station (outdoor) and Cafe/Pub/Restaurant (indoor-outdoor) were the most polluted microenvironments with 32.8 and 29.6 µg/m3 1-h mean PM2.5 concentration, respectively. Market/Shopping Mall (indoor), Street (outdoor) and Cable Car/Metro/Tram (vehicle) were also concerning microenvironments with 19.3, 19.3 and 18.9 µg/m3 1-h mean PM2.5 concentrations, respectively. Passenger Car microenvironment had the lowest 1-h mean PM2.5 concentration of 2.3 µg/m3 which agrees with some other studies on transportation microenvironments in the literature.
Magnetic skyrmions in nanostructures of non-centrosymmetric materials

Magnetic skyrmions are a new form of magnetic ordering with whirlpool-like spin arrangements. These topologically protected particlelike spin textures were first discovered a decade ago in noncentrosymmetric magnetic materials. Confining magnetic skyrmions in nanostructures leads to interesting fundamental insights into skyrmion stability and could provide convenient platforms for potential practical applications of skyrmions in information storage technology. In this research update, we summarize the recent advances on studying magnetic skyrmions in nanostructures of skyrmion hosting noncentrosymmetric materials (especially the B20 materials) made via bottom-up synthesis or top-down fabrication methods. We discuss various real space imaging (such as Lorentz transmission electron microscopy or electron holography) or physical property measurement (such as magneto-transport) techniques that have been used to observe and detect these exotic magnetic domains in both nanostructure and bulk samples, which have proven to be critical to fully understanding them. We examine the importance of morphology and dimensionality of skyrmion hosting materials in stabilizing isolated magnetic skyrmions in confined geometry and their benefits for implementation in magnetic memory applications. We further highlight the need for experiments that allow the skyrmion research to move from the fundamental physics of skyrmion formation and dynamics to more applied device studies and eventual applications, such as the all-electrical writing and reading of skyrmions needed for skyrmion-based high density magnetic memory storage devices.
The Burden of Cost in Inflammatory Bowel Disease: A Medical Economic Perspective and the Future of Value-Based Care

To examine the quantifiable economic impact of inflammatory bowel disease (IBD), key cost drivers and determinants, and the impact of value-based care in IBD. Finally, we prognosticate on future directions and opportunities on healthcare economics in IBD. New value-based initiatives, technologically driven interventions, and quality improvement programs have demonstrated reductions in healthcare utilization and enhanced patient outcomes, and several have realized cost of care reductions. IBD is a costly, chronic illness with unbalanced spending by a small proportion of individuals. Pharmaceutical costs are overtaking inpatient expenses as the primary cost driver. Value-based care initiatives including the IBD medical home, remote monitoring platforms such as myIBDcoach and Project Sonar, and learning healthcare networks exemplified by ImproveCareNow have all demonstrated successes in improving care quality, patient outcomes, and reduced healthcare spending in some populations. The future of value-based care in IBD is bright, with ample opportunities for model refinement, collaboration, and growth.
Numerical Simulations of 3D Tool Geometry Effects on Deposition Stresses in Diamond Coated Cutting Tools

Diamond-coated cutting tools are attractive alternatives to polycrystalline diamond tools for machining lightweight, high-strength components made of advanced materials such as composites. However, residual stresses induced by the diamond deposition process, due to thermal mismatch between diamond and the substrate, significantly impact the coating-substrate adhesion, and thus, the tool performance in machining. Moreover, the tool geometry, particularly at the very tip, complicates the stress fields because of the sharp geometry changes. The objective of this research is to investigate the effects of critical tool geometry parameters on the residual stress augmentations in diamond coated cutting tools. In this study, computer-aided design (CAD) software was used to create the solid model of various tool geometries. It was used to create an accurate model of the tool, which emulates each aspect of the tool geometry, e.g., as small as 5-micron edge radius on a 12.7-mm tool. The solid model was then exported to finite element analysis (FEA) software for 3D simulations of residual stresses generated in the tool with given deposition conditions. The obtained stress data was transformed to evaluate the interface stress profiles around the tool edges. To systematically investigate the tool geometry effects, a test matrix, determined using the design of experiments approach, includes 4 factors (edge radius, relief angle, corner radius, and corner angle) and 2 levels with a full factorial design. Analysis of variance was performed to quantitatively reveal the significant factors and interactions between the factors that dominate the stress concentrations. Results are summarized as follows. (1) The cutting edge radius is the most significant factor to the interface stresses. (2) For a 5 μm edge radius, the radial normal stress (σΓ ) increases from 0 at the top uniform surface to about 1.5 GPa in tension, and the circumferential normal stress (σθ ) increases from around 3.0 GPa in compression to over 3.7 GPa. (3) The corner radius is of secondary importance to σΓ , and the relief angle is of secondary importance to σθ .Copyright © 2008 by ASME
COST: Distraction or Progress?

This chapter examines how the political struggle over the British European Community membership transformed the Community’s plans of a common research policy into a rather unexpected arrangement: COST saw the daylight as a loose intergovernmental enterprise outside the EC’s structures. The story of COST shows how, in the EC, different policy issues easily became interlinked, and consequently, even powerful initiatives could be overrun by disputes in other sectors. At the same time, rather than failure, COST should be seen as an excellent showcase for the flexibility, variety, and innovativeness of European integration.
ANAVIP® interaction with western pygmy rattlesnake venom: In vitro assesment of reactivity using SE-HPLC

Abstract Every year large numbers of venomous snake bites occur around the world, especially in tropical areas. The World Health Organization classifies venomous snake bites as one of their highest priority neglected tropical diseases, one of the reasons being the short supply of antivenom compared to the number of snake envenomations. The standard of care for snake envenomation is administration of antivenom. Many antivenoms are polyvalent, which are produced using venoms from multiple species of snakes. The polyvalent antivenoms can treat envenomation from snake venoms used in the production, but also show cross-reactivity against snake venoms with similar composition. Determining cross-reactivities of antivenoms could help improve the quality of treatment and provide a better understanding of venom-antivenom binding. One antivenom only has been available in the United States for treatment of North American Crotaline envenomation, with the recent introduction of an F(ab’)2 antivenom (ANAVIP®). Size-exclusion high performance liquid chromatography (SE-HPLC) was used to assess cross-reactivity of the western pygmy rattlesnake, Sistrurus miliarius streckeri (S. m. streckeri), against ANAVIP®. Estimates of venom-antivenom reactivity was measured in reaction mixtures based on the increase in elution profile area of higher molecular weight complexes (region 1) and on the decrease in elution profile area of reactants (region 2). Reaction mixtures contained ANAVIP® (1.0 mg/ml) and S. m. streckeri venom (0.125, 0.25, 0.5, or 1.0 mg/ml). Controls were ANAVIP® and S. m. streckeri (1.0 mg/ml). Mixtures were incubated at 37 °C for 30 min, then stored at 4 °C (5 min) prior to SE-HPLC. Relative binding, estimated from the increase in region 1 (immune complexes) and decrease in region 2 (reactants) region areas, suggested saturation of reactive antivenom binding sites at 0.125 (and above) mg venom/mg antivenom. SE-HPLC data indicate that binding of ANAVIP® to S. m. streckeri venom does occur, consistent with protective effects observed clinically. Further studies are needed to compare the binding of S. m. streckeri venom to other commercially available antivenoms, and the binding of ANAVIP® to other venoms of clinical significance.
Retinal injury from handheld lasers: a review

Retinal photic injury induced by handheld lasers is a burgeoning public health concern due to the wider accessibility of high-powered devices. Retinal damage from thermal energy can cause potentially severe and permanent vision loss in children and young adults who are particularly vulnerable because of comorbid behavioral, learning, and psychiatric impairments. Understanding the spectrum of specific clinical and imaging features of such laser injuries aids in prompt and accurate diagnosis. Multimodal retinal imaging is important for the identification of the outer retinal abnormalities that characterize this condition. We reviewed 171 reported cases in the English and non-English language literature published from 1999, when handheld laser injury was first described, to December, 2018. Risk factors, demographic and clinical characteristics, as well as multimodal imaging findings, were collected and summarized. These findings both provide insights for public health awareness and guide areas of future investigation.
Teaching NeuroImages: Diffuse intrinsic pontine glioma in white matter

We present an image of diffuse intrinsic pontine glioma (DIPG) showing its relationship to white matter structures based on reconstructed tractography (figure). An 8-year-old girl presented with diplopia, right abducens nerve palsy, and mild ataxia. Reconstruction showed at the level of the pontine decussation a right-sided disruption of the pontocerebellar fibers anterior to the descending corticospinal fibers involving the pontine nuclei region. Understanding the white matter tract anatomy of DIPG in relation to surrounding structures critical for function by this method may have the potential to assist in minimizing functional deficit risk during biopsy, but requires future validation.