cssi/SciSciGPT-SciSciNet huggingface dataset:
Group Cohesion: The Therapeutic Factor in Groups

Group cohesion is the relationship among members in a group, but group cohesion is more than just a relationship (Yalom and Leszcz 2005). As shown in the opening example, sometimes students sacrifice everything just to be accepted by a group. Cohesion does not mean simply doing what someone else wants you to do or merely getting along with others. Group cohesion is a positive bond that exists between all group members. You cannot have group cohesion if one or more members of the group are ostracized or subdued into compliance. For group cohesion to be positive and constructive, it must be part of a warm supportive group ­environment, empathic understanding and acceptance must be shared by all group participants, and there must be a strong sense of attachment or feeling of belonging among ­individual participants and the group. Group cohesion provides the bond within the group which helps group members heal old wounds of negativism and pursue new pathways of success. Therefore, your program must develop and maintain constructive, positive group cohesion.
Improving Health by Reducing Stress: An Experiential Activity

Stress is a leading health issue among college students. Managing stress involves enhancing resources necessary to cope with life’s demands. Relaxation techniques are especially critical coping strategies when stress is chronic and coping resources are overused and fatigued. Methods: This article describes a research-based relaxation technique aimed to identify stress and enhance resources to cope with stress. Brainstorming, discussion, and skill practice will be utilized to meet the learning objectives. Evaluation: Process and impact evaluation will be used to assess the learning objectives. Conclusions: The implications involve reducing stress and promoting health among a priority stress population, college students.
Forensic Issues in Sexual Harassment

Publisher Summary This chapter illustrates important forensic issues related to sexual harassment, reviewing legal and psychological definitions of sexual harassment, including important federal cases, epidemiological data, characteristics of victims and perpetrators of sexual harassment, and common psychological effects on sexual harassment victims. The difference between the legal and psychological definitions of sexual harassment is that legal definitions may not account for all events that victims experience as sexually harassing. In order for judicial decisions to be made in the plaintiff's favor, it must be demonstrated that were it not for the sex of the victim, the behavior would not have occurred. Allegations of “quid pro quo” can be made based on a single incident and do not require continuous actions on behalf of the employer, as is in the case of hostile environment claims. Hostile environment sexual harassment accounts for behaviors that are unwelcome and unwanted and produce an intimidating and unfriendly work environment. It involves either verbal or nonverbal behaviors of a sexual nature that create an environment that interferes with an employee's work performance.
Negative Capacitance Behavior in a Leaky Ferroelectric

We present a simulation study of the negative capacitance effect incorporating leakage through the ferroelectric (FE) negative capacitor. The dynamics of the FE is modeled using the Landau–Khalatnikov equation. When an FE and a dielectric are simply connected in series without a metal contact between them, the stabilization of negative capacitance remains unchanged irrespective of leakage. However, when a metal is used, any finite leakage through the FE makes it impossible to stabilize negative capacitance at the steady state. Nonetheless, when a voltage is applied, the series configuration enters the negative capacitance state and as long as the gate voltage is cycled faster than the time needed by the leakage current to discharge all the capacitors, the transistor shows improved subthreshold swing. These results are expected to provide insight into understanding and analyzing recent experimental results on negative capacitance.
Distribution of Flunixin Residues in Muscles of Dairy Cattle Dosed with Lipopolysaccharide or Saline and Treated with Flunixin by Intravenous or Intramuscular Injection.

Twenty dairy cows received flunixin meglumine at 2.2 mg/kg bw, administered once daily by either the intravenous (IV) or intramuscular (IM) route for three consecutive days with either intravenous normal saline (NS) or lipopolysaccharide (LPS) providing a balanced design with five animals per group. Cows were sacrificed after a 4 day withdrawal period, and 13 muscle types were collected and assayed for flunixin by LC-MS/MS. After elimination of sample outliers, the main effects of route of administration (IV or IM), treatment (NS or LPS), and tissue type significantly (P 0.05). Intramuscular (nonlabel) flunixin administration produced greater (P < 0.05) flunixin residues in muscle than the IV (label) administration, whereas LPS resulted in lower flunixin levels. Differences among the tissue levels indicate it is necessary to specify the tissue to be used for any monitoring of drug levels for consumer protection.
Characterizing intraocular tumors with photoacoustic imaging

Intraocular tumors are life-threatening conditions. Long-term mortality from uveal melanoma, which accounts for 80% of primary intraocular tumors, could be as high as 25% depending on the size, ciliary body involvement and extraocular extension. The treatments of intraocular tumors include eye-sparing approaches such as radiotherapy and thermotherapy, and the more aggressive enucleation. The accurate diagnosis of intraocular tumors is thereby critical in the management and follow-up of the patients. The diagnosis of intraocular tumors is usually based on clinical examination with acoustic backscattering based ultrasonography. By analyzing the high frequency fluctuations within the ultrasound (US) signals, microarchitecture information inside the tumor can be characterized. However, US cannot interrogate the histochemical components formulating the microarchitecture. One representative example is the inability of US imaging (and other contemporary imaging modalities as well) in differentiating nevoid and melanoma cells as the two types of cells possesses similar acoustic backscattering properties. Combining optical and US imaging, photoacoustic (PA) measurements encode both the microarchitecture and histochemical component information in biological tissue. This study attempts to characterize ocular tumors by analyzing the high frequency signal components in the multispectral PA images. Ex vivo human eye globes with melanoma and retinoblastoma tumors were scanned using less than 6 mJ per square centimeters laser energy with tunable range of 600-1700 nm. A PA-US parallel imaging system with US probes CL15-7 and L22-14 were used to acquire the high frequency PA signals in real time. Preliminary results show that the proposed method can identify uveal melanoma against retinoblastoma tumors.
Cluster formation during aging of colloid-polymer dispersions

We report the dynamics of aqueous dispersions of the disk-shaped colloidal clay laponite® with poly(ethylene oxide) (PEO) chains of moderate molecular weight, explored via angle-dependent dynamic light scattering (DLS) and rheology. The PEO chains adsorb onto the laponite® surfaces, causing interesting dynamic behavior, including transitions from arrested states to liquid states as the concentration and molecular weight of PEO is increased. This re-entrant behavior has been attributed to formation of particle clusters induced free PEO chains. Our DLS results are consistent with a slow diffusive dynamic process, suggesting the formation of large particle clusters, in samples at aging times <75 days. By contrast to behavior observed in laponite® dispersions with a non-adsorbing polymer, poly(acrylic acid) (PAA), diffusion coefficients of these clusters in the laponite®-PEO systems continue to decrease with aging time until samples reach an arrested state.
Bioengineering Factor VIII B-Domain Sequences Improves Function and Efficacy in Hemophilia A Models.

Abstract 2208 We previously reported that recombinant canine B-domain deleted factor VIII (FVIII) was expressed predominantly (>75%) as a single-chain protein and, upon activation with thrombin, yielded an active cofactor species with increased stability due to delayed A2 domain dissociation. We hypothesized that this could be in part due to a unique recognition sequence (HHQR) for intracellular PACE/Furin protease present in the canine FVIII, but absent in other mammals including human, porcine and murine FVIII where the sequence is RHQR. Here, we changed position 1645 from R to H in the B-domain deleted human FVIII (hFVIII-RH) and found that much more of the protein was expressed in a single chain form (3-fold) compared to hFVIII-wild type (hFVIII-WT). Importantly, the variant hFVIII-RH was biologically active exhibiting a 2-fold higher activity measured in a 2-stage activated partial thromboplastin time (p We next sought to determine the potential in vivo efficacy and safety of circulating hFVIII-RH in murine models of hemophilia A (HA) by hepatocyte-restricted transgene expression using adeno-associated viral (AAV serotype 8) vector and by exogenous administration of the recombinant protein. HA mice received varying doses (8×1012-4×1013 vg/kg) of AAV-hFVIII-WT or AAV-hFVIII-RH and exhibited a corresponding dose-dependent response of FVIII with plateau antigen levels 2–3 fold higher in hFVIII-RH than hFVIII-WT expressing mice (n = 5/group, p Laser-induced injury at microcirculation resulted in increased fibrin deposition by 2–3 fold in HA mice expressing FVIII-RH (n=4 mice, 20 injuries) compared to those expressing FVIII-WT (n=3, 10 injuries). Similar findings were obtained upon injection of recombinant protein to achieve ∼40% of normal for both FVIII-RH (n=3, 13 injuries) and FVIII-WT (n=3, 18 injuries). Moreover, we assessed the immunogenicity of hFVIII-RH by administering AAV vectors to transgenic HA mice tolerant to B-domain deleted hFVIII-WT. At 4 weeks post AAV administration all mice exhibited stable hFVIII-WT/hFVIIl-RH levels (n=5/group) with no evidence of inhibitor by Bethesda assay or by mouse specific-hFVIII-IgG titers. In summary, FVIII-RH is superior to FVIII-WT in terms of expression levels and total hemostastic function without evidence of increased immunogenicity. Therefore FVIII-RH is an attractive molecule for protein replacement and gene/cell-based strategies for HA. Disclosures: No relevant conflicts of interest to declare.
Class on Tour: An Experiential Approach to Teaching and Researching Popular Music

Teaching popular music at Vanderbilt University has provided me with the opportunity to interact with students and the city of Nashville through an immersion into the country-music tradition and the music-tourism industry. My interests in music tourism, popular music, and fandom, as well as my close proximity to the many sights and sounds associated with the birth and continuance of country music, led to my development in 2009 of a university course titled “Music City Museums and Memorabilia,” an onsite and ethnographic study of music tourism and country-music fandom in Nashville, which is offered during the summer term each year. In the class, students are given the opportunity to observe, analyze, and participate in Nashville’s active musical and fan community through onsite lectures and tours of the city’s places of performance, production, and preservation. The result is a course that covers the history of the music and tourism industries using an experiential approach and, at the same time, addresses the sociology of fandom through observation and participation. Through teaching the class, I have come to better understand the importance and meaning of country music to the many fans who make annual pilgrimages to Music City, as well as the importance of the fan community in the production and preservation of Nashville. The opening chapter will discuss my experiences in teaching the class, my acceptance of Nashville’s tourist identity, and my own placement within its multi-faceted music brand. These accounts serve as an introduction to the many topics of tradition, transformation, tourism, and fandom addressed throughout the book. This chapter also documents my own multiple roles as researcher: tourist, tour guide, music fan, local, and educator. In this introduction, I present the key themes and arguments and an explanation and analysis of my participatory fieldwork methodology.
Evaluating the atherogenic burden of individuals with a Friedewald-estimated low-density lipoprotein cholesterol <70 mg/dL compared with a novel low-density lipoprotein estimation method

Background A number of national and international guidelines recommend treatment to low-density lipoprotein cholesterol (LDL-C) Objectives The objectives of the study were to evaluate concordance between Friedewald-estimated LDL-C and novel-estimated LDL-C and compare with other atherogenic parameters when the estimated LDL-C is Methods Atherogenic lipid parameters were assessed in a cross-sectional analysis among participants with a Friedewald-estimated LDL-C Results Among NHANES participants not on statin therapy, 10% had LDL-C Conclusions In a nationally representative sample, a hospital laboratory, and a reference laboratory, approximately one-fifth of individuals with Friedewald-estimated LDL-C
Shakespeare Fanboys and Fangirls and the Work of Play

The term fanboy, followed by fangirl, sprang somewhat derisively out of 1970s comic book culture to denote a particularly obsessive type of fan, with its infantilizing suffix signaling a surrender to pleasure devoid of critical discernment and incessant, even age-inappropriate, play. Shakespeare fanboys/fangirls are becoming an increasingly visible online community, perhaps most legibly illustrated through the well-publicized undertakings of self-professed Shakespeare fanboys such as film director Joss Whedon and actor Tom Hiddleston. This chapter argues that fanboy/fangirl communities participate in what autonomist Marxists label a ‘social factory,’ in which the immaterial labor of communicative activity transforms social relations into commodities, or play into work, thus allowing Shakespeare fanboys and fangirls’ ‘works of play’ to actively reshape Shakespeare and notions of Shakespearean authority across various digital platforms.
Extracting Important Relationships in High Dimensions

Chapter 2 described methods to explore the relationship between two elements in a dataset. We could extract a pair of elements and construct various plots. For vector data, we could also compute the correlation between different pairs of elements. But if each data item is d-dimensional, there could be a lot of pairs to deal with, and it is hard to plot d-dimensional vectors.
Identification of the Achilles heels of the laurel wilt pathogen and its beetle vector

Ambrosia beetles harbor fungal symbionts that serve as food sources for larvae and adults. These beetles lay their eggs along tunnels in xylem sapwood, which is the substrate for fungal growth. Symbiotic fungi of the genus Raffaelea found in invasive and indigenous ambrosia beetles include the highly virulent plant pathogen Raffaelea lauricola affecting members of the Lauraceae family. R. lauricola is responsible for the deaths of > 500 million trees since 2005. Infection by as few as 100 spores can kill a healthy tree within months. Our data show that R. lauricola is cold-adapted with optimal growth between 16 and 26 °C, with little to no growth at temperatures ≥ 30 °C. The fungus is halophilic and shows a dramatic decrease in growth at pH ≥ 6.8. Fungicide resistance profiling revealed sensitivity of R. lauricola to prochloraz, dichlorofluanid, most conazoles, dithiocarbamates, and zineb (zinc fungicide), whereas the related species Raffaelea arxii showed more limited fungicide sensitivity. Entomopathogenic fungi potentially useful for beetle control were generally highly resistant to most fungicides tested. Coupling pH decreased the concentration for 95% inhibition of fungal growth (IC95) of the most potent R. lauricola fungicides by 3–4-fold. Use of avocado bark plug insect bioassays revealed that commercially available Beauveria bassiana can be used as a biological control agent capable of effectively killing the beetle vectors. These data provide simple and practical recommendations to specifically target R. lauricola while having minimal effects on other symbiotic and entomopathogenic fungi, the latter of which can be used to manage the beetle vectors.
Schwarz Lemma and Negative Curvature

In this section we prove Ahlfors’ generalization of the classical Schwarz lemma in function theory of one complex variable and its variants. For the general theory of intrinsic distances, we need only the classical Schwarz-Pick lemma in the form (2.1.7).
Nietzsche's laughter; Plato's beard

Si l'on peut dire que la postmodernite se caracterise essentiellement par le rejet de toute la tradition metaphysique, l'A. tient a placer Nietzsche comme le premier a en avoir ri. Ce rire, il l'analyse essentiellement a travers le recit dans «La naissance de la tragedie» de la comparaison de Socrate a un silene, et il presente sa pensee comme un mouvement de depassement des categories objectives de la verite
Protestant Bible Institutes in the United States

Despite the fact that theological education was the initial inspiration behind establishing institutions of higher learning in what became the United States, few formal studies exist concerning what may best be identified as Bible colleges or, as will be employed in what follows, Bible institutes. For example, the literature generated by higher education scholars makes almost no reference to Bible institutes. The literature generated in recent years concerning Christian colleges and universities also makes almost no reference to these same schools. However, given the sheer number of Bible institutes operating in North America alone, considerable scholarly work needs to be done. Perhaps what follows can thus provide not only an overview of these schools but also a framework for the beginnings of further study. This chapter opens with some speculative remarks concerning why research concerning Bible institutes is so difficult to find. A history of these schools will then be provided. The remaining portion will then provide an overview of these schools as they exist today through both data and some brief cases studies. Although perhaps needing revision by subsequent scholars, the brief case studies are divided into four ways. First, some schools have chosen to remain what is generally referred to as 2-year institutions while others have become 4-year institutions. Some even offer graduate programs. The chosen examples come from the Mennonite tradition. Second, some schools are intentionally interdenominational schools while other schools are intentionally denominational. Examples of these schools include an interdenominational school in the Midwest and a school in the Church of Christ or Restoration tradition. Third, an overview of an organization that is not a formal institute but provides an ever-increasing array of opportunities for Bible instruction, Youth with a Mission or YWAM, is offered. Finally, perhaps the most recent additions to this list of schools include schools being started by individual churches. One example is from an interdenominational school while the other is from the Baptist tradition. While this typology and the case studies cannot do justice to the full range of Bible institutes presently in operation, the hope is that it can give rise to a body of work that does.
Target detection assessment of the SHARE 2010/2012 hyperspectral data collection campaign

It has been over four years since the first SpecTIR Hyperspectral Airborne Rochester Experiment (SHARE) was conducted in 2010. As such, a second SHARE experiment was performed in 2012 using the same deployed target panels and HSI sensor (i.e., specifically related to the target detection experiment"). A suite of sensors were own over the target areas including multi- and hyperspectral imagers, as well as a LADAR sensor. Experiments were conducted to examine topics such as pixel unmixing, subpixel detection, forest health, and in-water target detection, to name a few. This paper's focus is on target detection of different colored panels deployed on different backgrounds viewed under different illumination conditions collected two years apart. Additionally, the calibration and reflectance retrieval of the data is also examined. Detection is on the standard reflectance product provided by the acquisition company. Results are illustrated in the form of ROC curves. Analysis was performed on (many) red and blue panels on backgrounds such as grass, gravel, and roof tar paper. The targets were in the open (i.e., fully illuminated), as well as heavy and light shadow, which were harder to discover than their open counterparts. Calibration of the 2012 data is good with some issues related to the 2010 data. Adjustments and corrections are discussed. Finally, discussion of where to obtain the free HSI and co-registered LADAR data set is discussed.
Advanced Nutrition : Macronutrients, Second Edition

The explosion of knowledge about satiety and hunger has given new meaning to our understanding of the genetics of obesity. New interest in gene expression as related to nutrition and advances in the field of macronutrients has made the latest nutrition research intriguing. Advanced Nutrition: Macronutrients adopts an integrated approach to the understanding of macronutrient nutrition. It provides scientific foundations of the current findings on energy balance, protein need, gene expression, and carbohydrate and lipid use, and maintains emphasis on the biochemical and physiological basis for nutrient need.
Epistemic Humility, Defeat, and a Defense of Moderate Skepticism

This chapter will argue for a moderate form of skepticism. Moderate skepticism is the view that human beings know far less than is normally credited to them. Although I believe Peter Klein has refuted a radical form of skepticism that serves as familiar fodder for philosophical debate, the moderate form of skepticism I defend here is immune to Klein’s objections. This form of skepticism is not only plausible and interesting, but I believe it is supported by an argument with premises Klein ought to accept. My argument for moderate skepticism will rely on a defeasibility analysis of knowledge, an evidentialist theory of epistemic justification, the fact that we all suffer from epistemic limitations, and the claim that epistemic humility is a virtue. The argument maintains that when it comes to the important and interesting questions human beings ponder, we all suffer from epistemic limitations including insufficient evidence, imperfectly reliable memories, cognitive biases, epistemic peers who disagree with us, and underdeveloped cognitive skills. For the vast majority of human beings, these limitations serve as defeaters that undermine our capacity to know many of the things we wonder about and investigate. The virtue of epistemic humility requires us to be honest about our epistemic shortcomings and to embrace moderate skepticism and all that it suggests about learning, teaching, communicating, civil discourse, and the pursuit of wisdom.
Edge Effects in Benzenoid and Total Resonant Sextet Benzenoid Hydrocarbons and Clar's Sextet Principle.

Because the effect of a benzenoid perimeter edge on a sextet pattern is of paramount importance, trends in the degree of sextet aromaticity are determined. The spectacular structural isomorphism be...
Cellular effects in perennial ryegrass (Lolium perenne L.) associated with the root inhibiting compound alaninyl-alanine

Corn gluten meal (COM), a byproduct of corn {Zea mays L.) wet-milling, has been shown to be an effective natural preemergence herbicide and fertilizer for various plant production systems. Alaninyl-alanine (Ala-Ala), along with four other dipeptides were isolated from CGM and identified as being the inhibitory compounds. The herbicidal effects of these natural compounds are seen as growth-regulating, root inhibitors that have minimal effect on shoot growth at low concentrations. However, little is known about the precise inhibitory action of CGM or Ala-Ala. The objective of this research was to elucidate morphological and anatomical differences in perennial ryegrass {Lolium perenne 'j. B. Unruh and N. E. Christians, Dep. of Hort., 105 Horticulture Hall, Iowa State Univ., Ames, lA 50011-1100; and H. T. Horner, Dep. of Bot., 3A Bessey Hall, Iowa State Univ., Ames, lA 50011-1020 Received for publication . Journal Paper No. h. of the Iowa Agriculture and Home Economics Experiment Station, Ames, Iowa, USA. Project No. 3149. ^Corresponding Author. Abbreviations: CGM, Corn Gluten Meal; Ala-Ala, Alaninyl-alanine, LM, Light Microscopy; TEM, Transmission Electron Microscopy.
Grundbegriffe der Graphentheorie

Ein Graph ist ein Paar (V, E), bestehend aus einer nichtleeren endlichen Menge V von Knoten (vertices) und einer Menge E von Kanten (edges), d.h. ungeordneten Paaren von (nicht notwendig verschiedenen) Elementen von V. Zu jeder Kante e ∈ E gibt es also Knoten \( u,v \in V mit e = \overline {uv} . \)
A Pragmatic Trial of Symptom-Based Inhaled Corticosteroid Use in African-American Children with Mild Asthma

Background Symptom-based adjustment (SBA) of inhaled corticosteroids may be an alternative patient-centered approach in which day-to-day inhaled corticosteroid use is adjusted by symptoms and short-acting β-agonist need. Objective To evaluate the effectiveness of SBA in the primary care setting. Methods We conducted a randomized, open-label, pragmatic equivalence trial in African-American children (6-17 years old) with mild asthma managed by 12 primary care providers (PCPs). A total of 206 participants were randomized to SBA (as-needed beclomethasone 80 μg with rescue short-acting β-agonist) or provider-based guideline-directed adjustment (PBA): maintenance beclomethasone 80 μg/d (6-11 years old), 160 μg/d (12-17 years old), with subsequent guideline-based dose adjustment by PCPs. PCPs implemented both treatment assignments, with outcomes measured by blinded staff. All participants received symptom recognition and albuterol use education from peer educators. Primary outcome was change in asthma control (measured by Asthma Control Test [ACT]/childhood ACT [cACT]) over 12 months. Results Participants had adequately controlled asthma (mean ACT or cACT score = 21.6 ± 2.8) at baseline. After 1 year, there was no significant between-group difference in change in ACT scores (SBA − PBA): ACT: −0.88 (95% CI, −2.19 to 0.42), cACT: −0.73 (−2.09 to 0.62), or combined ACT and cACT (P = .10), and was within the predefined statistical clinical equivalence. The proportion with an exacerbation and measures of lung function were similar between groups. Compared with PBA, SBA led to less beclomethasone use (SBA: 526 μg/mo [95% CI, 412-639 μg] vs PBA: 1961 μg/mo [95% CI, 1681-2241]; P Conclusions SBA in African-American children with mild asthma was similar to PBA in asthma control and events when implemented by PCPs with lower inhaled corticosteroid exposure.
Automated extraction of ophthalmic surgery outcomes from the electronic health record

Abstract Objective Comprehensive analysis of ophthalmic surgical outcomes is often restricted by limited methodologies for efficiently and accurately extracting clinical information from electronic health record (EHR) systems because much is in free-text form. This study aims to utilize advanced methods to automate extraction of clinical concepts from the EHR free text to study visual acuity (VA), intraocular pressure (IOP), and medication outcomes of cataract and glaucoma surgeries. Methods Patients who underwent cataract or glaucoma surgery at an academic medical center between 2009 and 2018 were identified by Current Procedural Terminology codes. Rule-based algorithms were developed and used on EHR clinical narrative text to extract intraocular lens (IOL) power and implant type, as well as to create a surgery laterality classifier. MedEx (version 1.3.7) was used on free-text clinical notes to extract information on eye medications and compared to information from medication orders. Random samples of free-text notes were reviewed by two independent masked annotators to assess inter-annotator agreement on outcome variable classification and accuracy of classifiers. VA and IOP were available from semi-structured fields. Results This study cohort included 6347 unique patients, with 8550 stand-alone cataract surgeries, 451 combined cataract/glaucoma surgeries, and 961 glaucoma surgeries without concurrent cataract surgery. The rule-based laterality classifier achieved 100% accuracy compared to manual review of a sample of operative notes by independent masked annotators. For cataract surgery alone, glaucoma surgery alone, or combined cataract/glaucoma surgeries, our automated extraction algorithm achieved 99–100% accuracy compared to manual annotation of samples of notes from each group, including IOL model and IOL power for cataract surgeries, and glaucoma implant for glaucoma surgeries. For glaucoma medications, there was 90.7% inter-annotator agreement. After adjudication, 85.0% of medications identified by MedEx determined to be correct. Determination of surgical laterality enabled evaluation of pre- and postoperative VA and IOP for operative eyes. Conclusion This text-processing pipeline can accurately capture surgical laterality and implant model usage from free-text operative notes of cataract and glaucoma surgeries, enabling extraction of clinical outcomes including visual acuities, intraocular pressure, and medications from the EHR system. Use of this approach with EHRs to assess ophthalmic surgical outcomes can benefit research groups interested in studying the safety and clinical efficacies of different surgical approaches.
Historical Perspectives: Berry Brazelton: Le Magnifique.

I was privileged to have worked with Berry Brazelton (Fig) for over 40 years. In 1978, as a new graduate student from Ireland, I first looked over his shoulder in the company of his pediatric fellows, as he used the scale he had just developed—the Neonatal Behavioral Assessment Scale (NBAS)—to examine a less than 1-day-old female newborn in the old Boston Lying-In Hospital. Even as he examined the baby’s reflexes, I was immediately struck by his—what could only be called gentleness, even tenderness—in the way he both held and spoke to the baby. He called her by her first name. “You are so alert, Sarah. Your mother must be very proud of you.” When he took a red ball out of his kit and moved it slowly from 1 side to the other, the baby began to track the ball and locked on to it, as if she did not want to release it from her gaze. “She can see,” blurted her mother, shaking her head in disbelief. When he began to talk to her in lilting, melodic phrases, Sarah’s face relaxed and her eyes widened and brightened. They were now interacting with each other—in a give-and-take, back-and-forth cyclical rhythm that had all the hallmarks of true conversation. Figure. Berry Brazelton (courtesy of Insieme photo by Fulvia Farassino). That babies could see and hear and had a wide repertoire of behavioral endowments at birth was a revelation to me, but Berry Brazelton had just demonstrated that this less than 1-day-old baby also had her own well-defined personalized behavioral style and was already shaping and leaving her mark on the world. She and Berry Brazelton left their mark on me and on all the pediatric fellows who were present on that August day, many years ago. In this clinical newborn encounter, we …
New Alternative Treatments for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

Urinary obstruction as a result of benign prostatic disease has been recognized since the earliest days of medicine. Early treatments for benign prostatic hyperplasia (BPH) centered on open procedures; however these were often bloody and lead to unacceptable mortality and morbidity. The transurethral resection of the prostate (TURP) offered another option between watchful waiting and open prostatectomy, though this procedure continued to have an elevated morbidity and even mortality.
Guidance Program Evaluation: A Follow-Up of Effectiveness and Value.

In 1968, the Division of Guidance and Testing, Ohio Department of Education, developed a series of instruments to evaluate secondary school guidance programs. The evaluation procedures and instrume...
Abstract TP238: Encephalopathy Only Stroke Codes (EoSC) Do Not Result in rt-PA Treatments

Background: Isolated mental status changes as presenting sign (EoSC+), are not uncommon stroke code triggers. As stroke alerts, they still require the same intensive resources be applied. We previo...
Unemployed at Midlife: Coping Strategies that Safeguard Well-Being

There is extensive research on the theory of unemployment which posits that job loss and longer-term unemployment have a profound and detrimental effect on well-being. The impacts are severe, and the stakes are higher, for older adults who experience longer durations of unemployment and have less time to recover from financial losses. Despite widespread research, less is known about the multi-faceted phenomenon of coping with long-term job loss at midlife. This study identifies new aspects of complementary coping strategies used by the midlife, long-term unemployed to safeguard their well-being. Qualitative data were collected from a sample of long-term unemployed age 47–59 from the Workforce Investment Act dislocated worker program (N = 16) who reported positive well-being on the General Health Questionnaire (GHQ-12). Structured interview questions generated detailed data on coping strategies. Data were analyzed using MAXQDA10 software. Key coping strategies associated with positive well-being included productive use of time on meaningful activities, conserving financial resources, social supports, and cognitive maneuvers. These findings suggest that employing certain behavioral coping strategies together safeguards subjective well-being during long-term unemployment and enables midlife individuals to remain active in their job search.
Improving Chronic Obstructive Pulmonary Disease (COPD) Symptoms Using a Team-Based Approach.

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States (US), with West Virginia bearing a disproportionate disease burden. Complex COPD cases can be difficult to manage during a standard primary care provider (PCP) visit, and pharmacological treatment regimens should be individually tailored to each patient. Methods: To address these needs, the West Virginia University Department of Family Medicine created an interdisciplinary COPD specialty clinic that uses a team-based approach to treat patients with COPD. In order to evaluate the effectiveness of the specialty clinic, we conducted a retrospective chart review to examine the impact of the clinic on patient hospitalizations, emergency department visits, and urgent care visits six months and one year before and after initiating care at the clinic. We also examined the impact of the clinic on patients’ self-reported nicotine dependency, COPD symptoms, and tobacco use behavior. Patients referred to the clinic and having at least one visit from February 2015 to February 2019 were included in this study (n = 149). Results: Patients treated at the COPD specialty clinic had significantly fewer hospital admissions and ED visits six months after and one year after initiating care at the clinic as compared to six months before and one year before, respectively. Patients at this clinic also reported smoking significantly fewer cigarettes per day with significantly fewer self-identifying as smokers and experiencing significantly reduced COPD symptoms. Conclusion: An interdisciplinary, team-based approach was effective for improving the health of COPD patients in an Appalachian academic primary care practice.
Incorporating TeamSTEPPS training to improve staff collaboration in an academic level I emergency and trauma center

Abstract Background Seamless communication and coordinated teamwork is paramount in high stakes clinical practice settings, such as the emergency department (ED), to prevent medical errors and ensure high quality patient care delivery. Ineffective communication in this fast-paced environment can be detrimental for patient outcomes and staff collaboration. Purpose The purpose of this project was to evaluate the effect of TeamSTEPPS® training (Team strategies and Tools to Enhance Performance and Patient Safety), an evidenced based communication-training toolkit, on staff perception of teamwork and communication in an academic Level I Emergency and Trauma Center. Methods A prospective, single group, pre-post design with a convenience sample was employed. The sample consisted of thirty-five clinical staff members, including registered nurses (RNs) and patient care technicians (PCTs), recruited from an academic Level I Emergency and Trauma Center. A pre-intervention T-TPQ (TeamSTEPPS® teamwork and Perceptions Questionnaire) measuring staff perception of teamwork and collaboration was administered followed by a one-hour TeamSTEPPS® education session from freely-available published materials. Three weeks later, a post-intervention T-TPQ was administered. A paired samples t-test and Wilcoxon signed-rank test was used to analyze changes in scores from pre-post-test for outcome measures. Results 23 females and 12 males with a mean age of 30 years and 9 years of experience participated. T-TPQ scores showed a mean of 121.4 pre-training and mean of 128.2 after training. Paired t-test demonstrated overall pre-intervention (mean = 3.52, SD ± 0.5) and post-intervention (mean = 3.78, SD = 0.4) scores were significantly improved overall (-0.29 to −0.13, p Conclusion TeamSTEPPS® was an effective communication collaboration program to improve teamwork and communication perceptions in the ED suggesting that an evidence-based multifaceted, multimedia instructional toolkit may promote a collaborative culture of effective communication and teamwork. Long term effects of TeamSTEPPS® training in the ED requires further study.
Primary Care in the COVID-19 Pandemic: Essential, and Inspiring.

> You may encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter defeats…so you can know who you are, what you can rise from, how you can still come out of it. > —Maya Angelou Spurred by a novel coronavirus pandemic, 2020 will undoubtedly stand out in
When too many hits breaks the heart: A case of Radiation Induced Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy (TCM), or stress induced cardiomyopathy is being increasingly recognized as a cause of acute heart failure. Often seen in women and older individuals with acute stressors, it can cause significant hemodynamic compromise. Here we report a case of a 78 year old woman who developed sudden chest pain following radiation therapy for B-Cell lymphoma. Echocardiogram revealed newly reduced ejection fraction and cardiac catheterization showed non obstructive coronary disease. Left ventriculogram revealed apical ballooning, characteristic of TCM. Often linked to physical and emotional stressors, TCM has been found to be more prevalent in patients with malignancies.
Multiobjective Optimization of Relief Well Operations to Improve Levee Safety

AbstractThe factor of safety (FS) of levees and floodwalls with relief wells to underseepage is predicated on the blanket thickness and relief well performance. In urban environments with limited r...
Reconstitution of the Rous sarcoma virus transforming protein pp60v-src into phospholipid vesicles.

Abstract An artificial membrane system was developed to study the molecular basis for interaction of pp60v-src, the Rous sarcoma virus transforming protein, with lipid bilayers. pp60v-src was extracted from cell membranes by detergent solubilization and reincorporated into phospholipid vesicles. Reconstituted pp60v-src retained tyrosine kinase activity and was integrally associated with the liposome through a 10-kilodalton (kDa) amino-terminal domain. The same 10-kDa domain was shown to anchor pp60v-src to the plasma membrane of transformed cells. Reconstitution experiments performed with nonmyristylated pp60v-src proteins revealed that these polypeptides did not interact with phospholipid vesicles. In contrast, myristylated, soluble pp60v-src molecules (including a highly purified pp60v-src preparation) could be reconstituted into liposomes, but their interaction with the liposomal bilayer was not mediated by the 10-kDa amino-terminal domain. When membrane proteins were included during reconstitution of purified pp60v-src, binding through the 10-kDa anchor was restored. A model is presented to accommodate the different types of interactions of pp60v-src with liposomes; the model postulates the existence of an additional membrane component that anchors the pp60v-src polypeptide to the phospholipid bilayer.
Crystallinity engineering of stoichiometric TiO 2 : transition from insulator to semiconductor

Over decades, the electrical properties of metal oxides have been a myth, stimulating rigorous debate and research. It is commonly accepted that the oxygen vacancy, working as shallow donors, gives rise to the n-type semiconductor behavior in these metal oxides. However, the function of the oxygen vacancy has been doubted, the energy level of which is reported to be far below conduction band to be responsible for the n-type conductivity [1] . In addition, metal oxides with oxygen deficiency in nature is susceptible to the spurious oxidation from the environment, resulting in stability and reliability issue in electronic device. In this work, we observe the conductivity transition from insulator to semiconductor of the stoichiometric TiO 2 films via judicious control of the crystallinity, highlighting the important role of crystallinity in the electrical properties of metal oxide. Based on this observation, high-performance thin film transistors (TFTs) with polycrystalline TiO 2 (poly-TiO 2 ) as the active channel and InAlN/GaN metal-insulator-semiconductor high-mobility-electron-transistors (MISHEMTs) with amorphous TiO 2 (a-TiO 2 ) as the gate dielectrics are demonstrated, indicating the full potential of stoichiometric TiO 2 films as functional electronic materials in device applications.
Assessing the Risks Versus Benefits of Conducting Research with Adolescents in Foster Care

For researchers and designers to produce better design solutions for promoting adolescent online safety, we need access to study adolescent populations. While HCI research has moved in the direction of engaging directly with teens, this progress does not come without costs. Further, it also does not take into account the needs of particularly vulnerable teen populations. For instance, teens in foster care face higher levels of risk in general and, thus, have a greater need for protection beyond typical teens. Yet, when studying this population, many ethical challenges arise concerning a teen’s privacy and eligibility to participate in research when they are part of the foster system. These challenges include: 1) Consent and Assent, 2) Confidentiality and Privacy, and 3) Sensitive Data. The goal of this paper is to present situations in which a researcher must evaluate the tradeoffs between privacy and advancing knowledge to benefit vulnerable populations, such as youth in foster care.
A Cost Effectiveness Analysis of Intravitreal Aflibercept for the Prevention of Progressive Diabetic Retinopathy

Abstract Purpose To calculate costs required to prevent center-involved diabetic macular edema (CI-DME) or proliferative diabetic retinopathy (PDR), and to improve the diabetic retinopathy severity score (DRSS) with intravitreal anti-VEGF injections as reported for aflibercept in two randomized control trials. Design Cost-effectiveness analysis modeling based on published data Subjects None Methods Results from PANORAMA and the Diabetic Retinopathy Clinical Research Network ( DRCR.net ) Protocol W were analyzed. Parameters collected included DRSS score, risk reduction of PDR, risk reduction of CI-DME, and number of treatments required. Costs were modeled based on 2020 Medicare reimbursement data practice settings of hospital-based facility and non-facility. Main Outcome Measure Cost to prevent case of PDR and CI-DME, and to improve DRSS stage Results Over 2 years in Protocol W, the cost required to prevent 1 case of PDR was $83,000 ($72,400) in the facility (non-facility) setting; in PANORAMA, the corresponding 2 year costs were $89,400 ($75,000) for the 2Q16 arm, and $91,200 ($89,900) for the 2Q8PRN arm. To prevent 1 case of CI-DME with vision loss in Protocol W, the cost was $154,000 ($133,000). For all CI-DME, with and without vision loss; in PANORAMA, the costs to prevent a case were $70,900 ($59,500) for the 2Q16 arm, and $90,000 ($88,800) for the 2Q8PRN arm. In Protocol W, the overall accumulated total for cost /DRSS unit change at the 2 year point for facility (non-facility) setting was $2700 ($2400)/DRSS. In the first year alone, it was $2100 ($1800)/DRSS and in the second year alone, $6100 ($5300)/DRSS. Conclusion There is a considerable cost associated with the prevention of PDR and CI-DME with intravitreal aflibercept injections. A price per unit of change in diabetic retinopathy severity score is a new parameter which might serve as a benchmark in future utility analyses that could be used to bring perspective to cost-utility considerations.
ED syphilis and gonorrhea/chlamydia cotesting practices before and after the implementation of an electronic health record-based alert.

BACKGROUND The prevalence of syphilis is increasing in many countries, including the USA. The ED is often used by underserved populations, making it an important setting to test and treat patients who are not evaluated in outpatient clinical settings. We aimed to assess the utility of an ED-based syphilis and gonorrhoea/chlamydia cotesting protocol by comparing testing practices before and after its implementation. METHODS We implemented an electronic health record (EHR) alert that prompted clinicians to order syphilis testing in patients undergoing gonorrhoea/chlamydia testing. We performed a retrospective cohort analysis that compared outcomes between the preimplementation period (January-November 2018) and the postimplementation period (January-November 2019). Patients were tested for Treponema pallidum antibody (TPA) using a multiplex flow immunoassay (MFI), and positive results were confirmed by rapid plasma reagin (RPR). The primary implementation outcome was the number of syphilis tests/month, and the primary clinical outcome was the number of syphilis diagnoses/month (defined as positive TPA MFI and RPR). We performed an interrupted time-series analysis to evaluate the effect of implementing the alert over time. RESULTS Four-hundred and ninety-four and 1106 unique patients were tested for syphilis in the preimplementation and postimplementation periods, respectively. Syphilis testing increased by 55.6 tests/month (95% CI 45.9 to 65.3, p<0.001) following alert implementation. Patients tested in the postimplementation period who were tested using the alert were much younger (difference: 14 years (95% CI 12 to 15)) and were more likely to be female (difference: 15% (95% CI 8 to 21)) and African-American (difference: 11% (95% CI 5 to 17)) than patients tested by clinician-initiated testing. Presumptive syphilis diagnoses increased from 3.4 diagnoses/month to 7.9 diagnoses/month (difference, 4.5 (95% CI 2.2 to 6.9), p<0.001). CONCLUSIONS Our study demonstrates that use of a targeted EHR alert testing protocol can increase syphilis testing and diagnosis and may reduce clinician bias in testing.