cssi/SciSciGPT-SciSciNet huggingface dataset:
Preoperative Evaluation and Preparation in the Elderly Cardiac Surgery Patient

The physiologic response of the elderly patient to cardiac surgical procedures differs substantially from their younger peers. Indeed, traditional preoperative assessment and tools which seek to estimate peri-operative risk for mortality and complications focus almost exclusively on mortality alone. Important considerations for geriatric patients who elect to undergo cardiac operations include functional mobility, quality of life, and maintenance of their independent status. The purpose of this chapter will be to review the current status of preoperative preparation and evaluation of the geriatric cardiac surgery patient. We will attempt to emphasize strategies which highlight some of the unique risk factors that are operant in the elderly patient undergoing cardiac surgery. Attention will also be directed to evaluation of risk in a manner other than evaluating traditional organ system risks. This chapter will focus on nutritional evaluation, screening for delirium, and disability before cardiac surgery, as these three entities are unique to the elderly population who undergo cardiac surgery. Lastly, emphasis on advanced directives, and the designation of a single person who will be responsible for important medical and or end-of life decisions for this group of patients will be discussed.
Examination of the Spencer-McCuen Outlier-Detection Test for Log-Pearson Type 3 Distributed Data

AbstractIdentification of outliers in flood records can be an important step in a robust flood frequency analysis procedure. Bulletin 17B includes the Grubbs-Beck test (with α=10%) as an objective criterion of whether the smallest observations in a flood record are outliers. The Spencer-McCuen test extends the Grubbs-Beck test to consider explicitly whether the three smallest observations are outliers in log-Pearson Type 3 (or equivalently Pearson Type 3) distributed samples with log-space skew coefficients between [−1,1], and three significance levels [1, 5, and 10%]. Presented here are Monte Carlo experiments evaluating the performance of the Spencer-McCuen test. When that test relies on the sample skew coefficient as an estimate of the population skew, the test generally fails to achieve the nominal significance levels. The same is true when used with a generalized (weighted) skew coefficient. Thus, the test will often be inappropriate if used as originally proposed. More fundamentally, when a proposed...
Daily Energy Expenditures of Free-Ranging Common Loon (Gavia immer) Chicks

Abstract We measured the daily energy expenditure of free-living Common Loon (Gavia immer) chicks using doubly labeled water (DLW). Average body mass of chicks during the DLW measures were 425, 1,052, and 1,963 g for 10 day-old (n = 5), 21 day-old (n = 6), and 35 day-old (n = 6) chicks, respectively, and their mean daily energy expenditures (DEE) were 686 kJ day−1, 768 kJ day−1, and 1,935 kJ day−1, respectively. Variation in DEE was not due solely to variation in body mass, but age was also a significant factor independent of body mass. Energy deposited in new tissue was calculated from age-dependent tissue energy contents and measured gains in body mass, which were 51, 54, and 33 g day−1 from the youngest to oldest chicks. Metabolizable energy (the sum of DEE and tissue energy) was used to estimate feeding rates of loon chicks and their exposure to mercury in the fish they consume. We calculated that loon chicks in Wisconsin consumed between 162 and 383 g wet mass of fish per day (depending on age), corr...
Large angle proton+ /sup 208/Pb elastic scattering at 800 MeV

A variety of nuclear structure and proton-nucleus dynamical effects are shown to significantly influence the behavior of the large angle 800 MeV p+ /sup 208/Pb elastic angular distribution. While coupled channels effects are found to be important, they are significantly smaller than recently suggested.
The appeal of Reality Television For Teen and Pre-Teen Audiences: The Power of “Connectedness” And Psycho-Demographics

ABSTRACT With the continued popularity of reality television among young viewers, it is vital to identify pre-teen and teen audiences who not only watch a reality program but have a high level of connectedness to it. Connectedness extends beyond just viewing the program and involves further engagement—posting on social networking sites, for instance, or buying products placed on the show. The authors report on a study that incorporated a national Harris Online survey of 1,098 preteens and teens in the united states to identify psycho-demographic groups that are likely to have high connectedness to reality programming. The findings will help network programmers and advertisers to make more effective decisions related to scheduling, media buying, product placements, and social-networking strategies.
Lighthouse: an automated solver selection tool

Linear algebra provides the building blocks for a wide variety of scientific and engineering simulation codes. Users of these codes face a world of continuously changing algorithms and high-performance implementations. In this paper, we describe new capabilities of our Lighthouse framework, whose goal is to match specific problems in the area of high-performance numerical computing with the best available solutions. Lighthouse's innovative strategy eliminates intensive reading of documents and automates the process for developing linear algebra software. Lighthouse provides a searchable taxonomy of popular but difficult to use numerical software for dense and sparse linear algebra while providing the user with the best algorithms for a given problem based on machine learning methods. We introduce the design of Lighthouse and show examples of its interface. We also present algorithm classification results for the preconditioned iterative linear solvers in the Parallel Extensible Toolkit for Scientific Computation (PETSc) and the Trilinos library.
Thermal Conductivity and Heat Conduction in Nanostructures: Modeling, Experiments, and Applications

effects. 1-4 The past two decades have seen increasing attention to thermal conductivity and heat conduction in nanostructures. Experimental methods for characterizing the thermal conductivity of thin films and nanowires have been developed and are still evolving. Experimental data have been reported on various nanostructures: thin films, superlattices, nanowires, and nanotubes. Along the way, models and simulations have been developed to explain the experimental data. This paper summarizes some past work and the current understanding of heat conduction in nanostructures. Section II gives a brief overview on the fundamental physics that distinguishes phonon heat conduction in nanostructures from that in macrostructures. Section III discusses a few size effects in nanostructures that impact their thermal conductivity. Common techniques for characterizing thermophysical properties of nanostructures are reviewed in Sec. IV, followed by a discussion of potential applications of nanoscale heat conduction. II. Fundamental Physics Heat conduction in dielectric materials and most semiconductors is dominated by lattice vibrational waves. The basic energy quantum of lattice vibration is called a phonon, analogous to a photon which is the basic energy quantum of an electromagnetic wave. Similar to photons, phonons can be treated as both waves and particles. Size effects appear if the structure characteristic length is comparable to or smaller than the phonon characteristic lengths. Two kinds of size effects can exist: the classical size effect, when phonons can be treated as particles, and the wave effect, when the wave phase information of phonons becomes important. Distinction between these two regimes
Attitudes toward nontraditional women using IVF: The importance of political affiliation and religious characteristics.

Assisted reproductive technology (ART) has advanced in recent years and it is likely that the public’s perceptions of such technology have changed over time. The use of ART by nontraditional women (e.g., single women, lesbians) has increased; thus, it is important to assess the public’s attitudes toward in vitro fertilization (IVF), the most common ART, and the women who use such technology. The purpose of the study is to determine whether certain demographics, political and religious affiliations, and religious characteristics relate to approval of IVF use by nontraditional women. Undergraduate students were recruited from a public, medium-sized university in the western United States; 267 participants responded to multiple questions on an online survey. Using ordinary least square regression analyses, findings indicate that political affiliation is one of the strongest predictors, and that certain religious characteristics are more important in assessing attitudes than religious affiliation. Implications for assessing attitudes toward nontraditional women using IVF and inclusion of religious affiliation and characteristics in future studies are discussed.
System-wide Environmental Impact Analysis for Advanced Vehicle Concepts in the Next Generation Air Transportation System

The system-wide analysis of new vehicle technologies integrated into NextGen has been a large challenge for quite some time due to the amount of data as well as complexity involved. Since a new generation of environmental analysis tools is under development that promises to radically simplify this process, this opportunity was used to show the effects of very advanced non traditional vehicles and their environmental consequences at the system level.
Mechanosensitive properties of gastric vagal afferent fibers in the rat.

Single, teased fiber recordings were made from the decentralized right cervical vagus nerve (hyponodal) of the rat. A total of 67 afferent fibers that responded to gastric distension (GD) were stud...
Human Cancer Virology: An Historical Review

The human cancer virus story spans just over 100 years, from the demonstration by Ciuffo in 1907 of the tumor-inducing properties of a cell-free filtrate obtained from wart tissue to the discovery by Chang and Moore in 2008 of polyomavirus mRNA in Merkel cell carcinoma. In 1964, the first human cancer virus, Epstein-Barr virus, was visualized by electron microscopy in Burkitt lymphoma tissue. In 1975, the hepatitis B virus was associated with hepatocellular carcinoma. In 1980, the retrovirus HTLV-1 was discovered in the cells of adult T cell leukemia/lymphoma. In 1983, the long-anticipated discovery of a causal link between human papillomavirus and cervical cancer was made. In 1989, a second hepatitis virus, HCV, was linked to some cases of hepatocellular carcinoma. In 1994, using a sophisticated molecular technique known as representational difference analysis, a novel herpesvirus was found in Kaposi sarcoma tissue. This finding was followed 14 years later (2008) by the discovery of a novel polyomavirus in Merkel cell carcinoma.
Managing Complications Following Nephron-Sparing Procedures for Renal Masses

Small renal malignancies are commonly treated with nephron-sparing procedures including partial nephrectomy and percutaneous ablation. Although these procedures offer faster patient recovery and preserve renal function, a variety of complications can occur. Here, we review vascular and nonvascular complications associated with nephron-sparing renal mass treatments and discuss options for minimally invasive image-guided management.
PATIENT PARTICIPATION IN THE DECISION FOR REPLANTATION

It is widely accepted that medical decision making should consider the wishes of the patient. In contrast, traditional decision making in replantation has been based primarily on the expected functional outcome of the replantation as represented in the literature. Conflicts can occur when the patient seeks to exercise a positive right to replantation against the wishes of the surgeon. The field of decision science has developed a framework to study and consider this problem so that it can be applied to replantation. The concept of evidence-informed patient choice is applicable to replantation, but is tempered by several problems, including the need for decision making in an emergency situation.
Design and build of an electrical generator and load control system for a novel small-scale hybrid solar thermal collector

The primary goal of this research was to design the electrical generation and control system for a small-scale solar-thermal collector, which was optimized for the Pacific Northwest. The project team collected data on the existing solar-thermal system and worked to design a power conversion system to generate electricity. Design and implementation of the generator, prime mover, and electric load controller are discussed in the paper.
Care of Patients with Burns and Traumatic Brain Injury

The combination of thermal injury and traumatic brain injury (TBI) poses a significant resuscitation challenge. Limited data exist on the effect of severe burns (>20 % of the total body surface area) on the brain. These data suggest that even in the absence of TBI, burns may cause disruption of the blood–brain barrier (BBB). Burn patients require large volumes (2–4 ml/kg/% burn) of fluid for resuscitation during the first 24 h postburn. This, combined with loss of BBB integrity, may cause cerebral edema during the early postburn period. In patients with TBI and burns, close attention to parsimonious fluid management; liberal use of intracranial pressure monitoring during resuscitation; and careful consideration of alternative approaches to include hypertonic saline or mannitol infusion may be required.
Quantitative NMR Analysis of Concurrent Phosphorylation Events and Phosphorylation-Related Structural Changes in Unstructured Cytoplasmic Domain of T-Cell Receptor CD3γ Subunit

NMR spectroscopy has a unique ability to describe concurrent molecular events, such as phosphorylation, which cannot be characterized individually by other methods. By combining heteronuclear NMR methods and selective protein labelling we aim to build a quantitative approach for the analysis of multi-site phosphorylation and related structural changes in proteins. Particularly, we are studying kinetics of phosphorylation, order of the phosphorylation events, and related structural changes within immunoreceptor tyrosine-based activation motifs (ITAM) at the mostly unstructured cytosolic domains of signal-propagating CD3 subunits of T-cell receptor (TCR) complex.
Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis.

Importance The public health implications of e-cigarettes depend, in part, on whether e-cigarette use affects the risk of cigarette smoking. Objective To perform a systematic review and meta-analysis of longitudinal studies that assessed initial use of e-cigarettes and subsequent cigarette smoking. Data Sources PubMed, EMBASE, Cochrane Library, Web of Science, the 2016 Society for Research on Nicotine and Tobacco 22nd Annual Meeting abstracts, the 2016 Society of Behavioral Medicine 37th Annual Meeting & Scientific Sessions abstracts, and the 2016 National Institutes of Health Tobacco Regulatory Science Program Conference were searched between February 7 and February 17, 2017. The search included indexed terms and text words to capture concepts associated with e-cigarettes and traditional cigarettes in articles published from database inception to the date of the search. Study Selection Longitudinal studies reporting odds ratios for cigarette smoking initiation associated with ever use of e-cigarettes or past 30-day cigarette smoking associated with past 30-day e-cigarette use. Searches yielded 6959 unique studies, of which 9 met inclusion criteria (comprising 17 389 adolescents and young adults). Data Extraction and Synthesis Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale and the Risk of Bias in Non-randomized Studies of Interventions tool, respectively. Data and estimates were pooled using random-effects meta-analysis. Main Outcomes and Measures Among baseline never cigarette smokers, cigarette smoking initiation between baseline and follow-up. Among baseline non–past 30-day cigarette smokers who were past 30-day e-cigarette users, past 30-day cigarette smoking at follow-up. Results Among 17 389 adolescents and young adults, the ages ranged between 14 and 30 years at baseline, and 56.0% were female. The pooled probabilities of cigarette smoking initiation were 23.2% for baseline ever e-cigarette users and 7.2% for baseline never e-cigarette users. The pooled probabilities of past 30-day cigarette smoking at follow-up were 21.5% for baseline past 30-day e-cigarette users and 4.6% for baseline non–past 30-day e-cigarette users. Adjusting for known demographic, psychosocial, and behavioral risk factors for cigarette smoking, the pooled odds ratio for subsequent cigarette smoking initiation was 3.50 (95% CI, 2.38-5.16) for ever vs never e-cigarette users, and the pooled odds ratio for past 30-day cigarette smoking at follow-up was 4.28 (95% CI, 2.52-7.27) for past 30-day e-cigarette vs non–past 30-day e-cigarette users at baseline. A moderate level of heterogeneity was observed among studies ( I2 = 56%). Conclusions and Relevance e-Cigarette use was associated with greater risk for subsequent cigarette smoking initiation and past 30-day cigarette smoking. Strong e-cigarette regulation could potentially curb use among youth and possibly limit the future population-level burden of cigarette smoking.
A New Species of Styrax (Styracaceae) from Peru

A new species of Styrax L. from the region of Cusco, Peru, is described and illustrated. Styrax excelsus P. W. Fritsch belongs to Styrax subser. Foveolaria (Ruiz & Pav.) P. W. Fritsch through its flowers shorter than or up to 10 mm; number of stamens equal to the number of petals (five); near-basal placentation; three ellipsoid ovules per flower (i.e., one per carpel); and presence of only female flowers, which suggests a gynodioecious breeding system. It is similar to S. maninul B. Walln. but differs by its taller habit; abaxial surface of the leaf blade with ferruginous, stellate trichomes that are generally smaller but with more arms and prominent reticulate tertiary veins; acute or slightly acuminate leaf apex; shorter inflorescences with fewer flowers; a longer corolla; and narrower staminodial pseudoanthers. The new species is only known from the type.
Nanoscale Metal–Organic Layers for Deeply Penetrating X-ray-Induced Photodynamic Therapy

We report the rational design of metal-organic layers (MOLs) that are built from [Hf6 O4 (OH)4 (HCO2 )6 ] secondary building units (SBUs) and Ir[bpy(ppy)2 ]+ - or [Ru(bpy)3 ]2+ -derived tricarboxylate ligands (Hf-BPY-Ir or Hf-BPY-Ru; bpy=2,2'-bipyridine, ppy=2-phenylpyridine) and their applications in X-ray-induced photodynamic therapy (X-PDT) of colon cancer. Heavy Hf atoms in the SBUs efficiently absorb X-rays and transfer energy to Ir[bpy(ppy)2 ]+ or [Ru(bpy)3 ]2+ moieties to induce PDT by generating reactive oxygen species (ROS). The ability of X-rays to penetrate deeply into tissue and efficient ROS diffusion through ultrathin 2D MOLs (ca. 1.2 nm) enable highly effective X-PDT to afford superb anticancer efficacy.
Accommodations to Weightlessness

Unlike the anatomical and physiological changes necessary to adapt to weightlessness covered in the previous ten chapters, there are other significant changes that the body makes that are within its existing 1-g capacity to accommodate the new force environment [1]. Our bodies are elastic and plastic, and although seldom noted, they are constantly changing size, shape and posture under the influence of their varying orientation to the 1-g weight vector. These accommodations are transient and rapidly removed with cessation of stress, and except for posture are small (Fig. 11.1).
Do we consider paid sick leave when deciding to get vaccinated

This study investigated the effect of paid sick leave on workers' decisions to obtain vaccinations for the seasonal flu. Our vaccination decision model suggested that the marginal effect of paid sick leave depended on the reduced cost of obtaining a vaccination now and the expected income benefit from claiming paid sick leave after flu infection. Our hypothesis was that these effects vary according to workers' income levels. To confirm this hypothesis, we examined 11,702 participants in the National H1N1 Flu Survey (NHFS) conducted in late 2009 to early 2010 and measured the marginal effect using a Bayesian endogenous covariates regression model. The results of our estimation indicate that having paid sick leave did affect workers' vaccination decisions differently based on their income levels. Low-income workers were willing to be vaccinated because of the positive expected income benefit. High-income workers were willing to be vaccinated because the positive cost effect dominated the negative expected income benefit.
miR-466a Targeting of TGF-β2 Contributes to FoxP3+ Regulatory T Cell Differentiation in a Murine Model of Allogeneic Transplantation.

The promise of inducing immunological tolerance through regulatory T cell (Treg) control of effector T cell function is crucial for developing future therapeutic strategies to treat allograft rejection as well as inflammatory autoimmune diseases. In the current study, we used murine allograft rejection as a model to identify microRNA (miRNA) regulation of Treg differentiation from naive CD4 cells. We performed miRNA expression array in CD4+ T cells in the draining lymph node (dLN) of mice which received syngeneic or allogeneic grafts to determine the molecular mechanisms that hinder the expansion of Tregs. We identified an increase in miRNA cluster 297-669 (C2MC) after allogeneic transplantation, in CD4+ T cells, such that 10 of the 27 upregulated miRNAs were all from this cluster, with one of its members, mmu-miR-466a-3p (miR-466a-3p), targeting transforming growth factor beta 2 (TGF-β2), as identified through reporter luciferase assay. Transfection of miR-466a-3p in CD4+ T cells led to a decreased inducible FoxP3+ Treg generation while inhibiting miR-466a-3p expression through locked nucleic acid resulting in increased Tregs and a reduction in effector T cells. Furthermore, in vivo inhibition of miR-466a-3p in an allogeneic skin-graft model attenuated T cell response against the graft through an increase in TGF-β2. TGF-β2 was as effective as TGF-β1 at both inducing Tregs and through adoptive transfer, mitigating host effector T cell response against the allograft. Together, the current study demonstrates for the first time a new role for miRNA-466a-3p and TGF-β2 in the regulation of Treg differentiation and thus offers novel avenues to control inflammatory disorders.
Patterns of Orofacial Clefting in New York City From 1983 to 2010: Trends by Racial Background, Birthplace, and Public Health Strategies

Objective:To determine the role of racial background, public health initiatives, and residence on the prevalence of orofacial clefts (OFCs) in New York City (NYC).Design/Methods:Retrospective review of OFC cases from the New York State Congenital Malformations Registry.Patients/Participants:Patients born with an OFC and all live births to mothers residing in NYC between 1983 and 2010.Main Outcome Measures:Orofacial cleft birth prevalence by cleft type, race, and borough of maternal residence for each year and by time period around the implementation of public health interventions including folate supplementation.Results:A total of 3557 cases were reviewed. The prevalence remained stable for cleft palate and cleft lip with or without cleft palate (CL ± P) in sequential time periods of the study. Among CL ± P cases, cleft lip prevalence decreased early in the study compared to increases in cleft lip and palate prevalence. For most years, the prevalence of OFCs was lower among African Americans than whites. ...
Isolation of an acetylide-CuI3-tris(triazolylmethyl)amine complex active in the CuAAC reaction

Abstract The CuAAC click reaction is greatly accelerated by tris(triazolylmethyl)amine ligands ( TL ). Using mass spectrometry, we found a trinuclear TL –Cu I 3 –acetylide complex formed in the reaction. Under catalytic conditions, the trinuclear complex is more active than the proposed dinuclear complex, whereas in a single-turnover reaction, the dinuclear complex is more reactive. Here, this finding is rationalized by analysis of the first single-crystal X-ray structure of a trinuclear TL –Cu I 3 –acetylide complex and DFT calculation, revealing how TL stabilizes the trinuclear complex, which may accelerate the reaction by promoting coordination with an azide followed by dissociation of a Cu I to form a more favorable dinuclear transition state.
4. Computers and Espionage

It was 1959 and the Cold War was escalating steadily, moving from a state of palpable sustained tension toward the overt threat to global peace to be posed by the 1962 Cuban Missile Crisis – the closest the world has ever come to nuclear war. Quite by chance, I found myself thrust into this vortex, involved in top-level espionage work. I would soon write the software for the world’s first spy satellite.
Through the Physician's Eyes: The Despair of Health Disparities.

A physician discusses potential factors underlying disparities in health care and health outcomes and advocates for standards to improve cultural competence, improve health literacy, and reduce disparities. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.
Kinematics of Sea Ice

Kinematics is that branch of physical science dealing with motion itself and not with the causes of the motion. Attention is focused, in this chapter, on how sea ice moves. The deeper question of why sea ice moves as it does is addressed in the chapter on sea ice dynamics. For some scientific and practical applications, knowledge of the ice kinematics (as opposed to the dynamics) is sufficient. As examples, consider gouging of the sea floor in shallow water, the transport of natural debris or pollutants, the impact loads on structures, navigability in ice regions, and the movement of the ice edge. Aside from these applications, the study of kinematics is a basic step toward understanding the dynamics.
Mineworkers’ Perceptions of Mobile Proximity Detection Systems

Accident data indicates that mobile haulage poses a significant pinning, crushing, and striking risk. Proximity detection systems (PDSs) have the potential to protect mineworkers from these risks. However, unintended consequences of mobile PDSs can undermine the safety benefit they provide. Soliciting iterative user input can improve the design process. Users help provide a critical understanding of how mobile PDSs may hinder normal operation and endanger mineworkers. Researchers explored users’ perspectives by conducting interviews with mineworkers from seven mines that have installed mobile PDSs on some of their haulage equipment. Mineworkers reported that mobile PDSs affect loading, tramming, section setup, maintenance, and general work on the section. Mineworkers discussed the operational effects and increased burden, exposure, and risk. Mineworkers also suggested that improved task compatibility, training, logistics, and PDS performance might help address some of these identified issues. This paper also gives additional insights into mobile PDS design and implementation.
Subtilisin BPN': Tertiary Structure and Inhibitor Binding

ABSTRACT The structure of subtilisin BPN' at a resolution of 2.5 A reveals an interesting active-site hydrogen-bond network involving the side chains of Asp 32, Ser 33, His 64, and reactive Ser 221. This network becomes of even greater interest when it is compared with the corresponding region in another serine protease, α-chymotrypsin. Although the two enzymes have entirely different three-dimensional structures, their active-site regions are remarkably similar. Recently, studies designed to show the binding sites and stereochemical effects of a number of inhibitors on the native enzyme have been undertaken. Difference-Fourier maps for the following inhibitors have been computed: phenylmethanesulfonyl fluoride, N-benzoyl-L-arginine, lysyl-tyrosine, and N-trans-cinnamoylimidazole. It is apparent from these maps that only the phenylmethanesulfonyl derivative shows any appreciable structural alteration. In this case, the side-chain of His 64 is displaced by about 4 A. Conversion of the active-site Ser 221 to a cysteine residue also produces no noticeable changes, but at present there remains some possibility that the thiol group of Cys 221 may have been oxidized in our crystals.
The role of ministernotomy in aortic valve surgery-A prospective randomized study.

BACKGROUND AND AIMS The purpose of this prospective randomized study was to compare the early and midterm outcomes of aortic valve replacement (AVR) through upper ministernotomy with conventional AVR through median sternotomy. METHODS One hundred patients undergoing elective AVR were randomized into two groups: the M group (upper ministernotomy group, n = 50) and the C group (conventional sternotomy group, n = 50). The operative data, major adverse outcomes, and postoperative variables were compared between the two groups of patients. A cross-sectional follow-up was performed 24.9 ± 5.8 months after surgery. RESULTS The aortic cross-clamp time and cardiopulmonary bypass time were significantly longer in the M group. Similar incidences of major cardiac, neurologic and renal complications were recorded in both groups. Two patients (4%) in the C group developed wound infections. The length of ICU stay was similar in both groups. The patients in the M group had a shorter hospital stay compared with the patients in the C group (7.6 ± 2 days vs 9.3 ± 4.8 days; P = 0.022). Follow-up revealed that the time period needed to reach full recovery was significantly shorter in the ministernotomy group (1.7 ± 1.2 months vs 2.8 ± 1.6 months; P = 0.001). Morbidity and mortality data did not differ between the two groups. CONCLUSIONS There was no difference in the major outcomes between the patients who underwent upper ministernotomy and those who underwent full sternotomy. The benefits of the minimally invasive approach were the shorter hospital stay and significantly faster recovery of patients after discharge from the hospital.
Statistical considerations for occupational and environmental physiology.

In this issue of Temperature, Caldwell and Cheuvront summarize what they consider to be basic statistical considerations for occupational and environmental physiology [1]. In their Comprehensive Re...
Electrical modulation of degenerate semiconductor plasmonic interfaces

We demonstrate electrical modulation of plasmonic interfaces in semiconductor p-n++ junctions fabricated from both III–V and Si materials. Junction diodes are grown/fabricated, consisting of degenerately doped n-type material and heavily doped p-type material, where the n++ semiconductor acts as a plasmonic material capable of supporting infrared propagating surface plasmon polaritons. Devices were characterized electrically and optically, and we achieved tuning of the reflectivity under applied bias with amplitude reaching 1.5% in mid-IR wavelengths. We developed a model of electrical carrier injection at the degenerately doped interface, which we used to model the bias-dependent optical properties of the system. A strong agreement between our model and experimental results is demonstrated. The presented devices offer the opportunity for electrical modulation of propagating plasmonic modes in an all-semiconductor system.
Adolescent male chimpanzees (Pan troglodytes) form social bonds with their brothers and others during the transition to adulthood.

Social relationships play an important role in animal behavior. Bonds with kin provide indirect fitness benefits, and those with nonkin may furnish direct benefits. Adult male chimpanzees (Pan troglodytes) exhibit social bonds with maternal brothers as well as unrelated adult males, facilitating cooperative behavior, but it is unclear when these bonds develop. Prior studies suggest that social bonds emerge during adolescence. Alternatively, bonds may develop during adulthood when male chimpanzees can gain fitness benefits through alliances used to compete for dominance status. To investigate these possibilities and to determine who formed bonds, we studied the social relationships of adolescent and young adult male chimpanzees (N = 18) at Ngogo in Kibale National Park, Uganda. Adolescent male chimpanzees displayed social bonds with other males, and they did so as often as did young adult males. Adolescent and young adult males frequently joined subgroups with old males. They spent time in proximity to and grooming with old males, although they also did so with their age peers. Controlling for age and age difference, males formed strong association and proximity relationships with their maternal brothers and grooming relationships with their fathers. Grooming bonds between chimpanzee fathers and their adolescent and young adult sons have not been documented before and are unexpected because female chimpanzees mate with multiple males. How fathers recognize their sons and vice versa remains unclear but may be due to familiarity created by relationships earlier in development.
Mitral and tricuspid stenosis caused by light chain cardiac amyloid deposition

Cardiac amyloidosis results in an infiltrative restrictive cardiomyopathy, with a number of characteristic features: biventricular hypertrophy, abnormal myocardial global longitudinal strain with relative apical sparing, biatrial dilation, and small pericardial effusion along with conduction abnormalities. Amyloid deposits leading to hemodynamically significant valvular heart disease are very rare. We describe a rare case of concomitant moderately severe tricuspid and mitral valve stenosis because of ongoing amyloid deposition in a patient with progressive multiple myeloma and fat pad biopsy-proven light chain amyloidosis. Worsening infiltrative cardiomyopathy and valvulopathy despite evidence-based chemotherapy and heart failure pharmacotherapy led to end-stage disease and death. Valvular involvement in cardiac amyloidosis requires early recognition of the underlying disease condition to guide directed medical therapy and prevent its progression. In this instance, valvuloplasty or valve replacement is not a viable option.
A chronicle on genetics and the March of Darwinian and Mendelian Medicine

Ken Burns, a well-known documentarian has produced a film titled, “The Gene: An Intimate History” based on Siddhartha Mukherjee’s book by the same name. The film focuses sharply on the history of genetics, the science of inheritance and variation, in particular, the gene, the central player in genetics, its discovery, structure and function as well as its myriad influence on development, growth, health, disease and evolution of all organisms. Importantly, he has shown how geneticists, physicians, patients and their families as well as society at large must cooperate, develop mutual trust and share ethical responsibilities in order to predict, prevent, manage and cure many inherited disorders. Mr. Burns has reinforced these ideas beautifully with illustrations, archived film footage, location filming and commentaries. The film also hints at the need for taking a unified Darwinian-Mendelian and Hippocratic approach toward building a healthier human society. In short, this is a beautiful and engrossing documentary on the future of Genetic Medicine.
TALKING TOGETHER: USING INTERCOLLEGIATE PODCASTS FOR INCREASED ENGAGEMENT IN MARKETING EDUCATION

Podcasts are an increasingly popular form of entertainment and education. To encourage communication and interactivity and to engage students in experiential learning in a remote setting, marketing...
Sour Grapes in the Lab and Field: A Test of Access-Based Beliefs

Standard economic theory holds that beliefs about an alternative’s value are independent of the probability of it being in the choice set. Using data from two lab experiments (conducted in the US and India) and one field experiment (conducted in the US), I find consistent evidence that agents have systematically lower beliefs of the value of alternatives that they have a low probability of accessing. Such access-based beliefs are at odds with prominent models of decision under uncertainty, but are compatible with models of motivated cognition. Additionally, the effects appear larger for poorer individuals, suggesting that access-based beliefs may partially explain low levels of investment amongst the poor.
Texture evolution as a function of scan strategy and build height in electron beam melted Ti-6Al-4V

Abstract Metal additive manufacturing (AM) enables customizable, on-demand parts, allowing for new designs and improved engineering performance. Yet, the ability to control AM metal alloy microstructures (i.e., grain morphology, crystallographic texture, and phase content) is lacking. This work performs corroborative neutron diffraction and large-scale electron backscatter diffraction (EBSD) measurements to assess crystallographic texture in electron beam melted (EBM) Ti-6Al-4V as a function of scan strategy and build height. Texture components for one raster and two spot melt scan strategies were evaluated using a triclinic specimen symmetry to capture all possible texture components, which were found to be considerably different than previously reported values from studies employing orthotropic specimen symmetry. This finding highlights the importance of a standard method and best practice for assessing textures produced by AM. Texture was found to vary between scan strategies, but changed minimally as a function of build height. Parent phase β-Ti reconstructions obtained from as-built crystallographic orientations revealed spot melt scan strategies produced finer equiaxed/columnar grains with clear { 001 } β build direction fiber textures, whereas the raster scan strategy produced large columnar grains and a weaker { 001 } β build direction fiber texture. The observed grain morphologies agree with those predicted by solidification theory for the thermal gradients and solidification velocities experienced during the build process. The presence of a strong { 001 } β fiber orientation (typical of cubic solidification) produced by spot melting was found to correlate with a previously unreported { 01 1 2 } α fiber texture in the as-built condition and colony microstructures. The { 01 1 2 } α fiber texture was weakly observed for the raster scan strategy, and { 001 } β oriented grains preferentially transformed into α ′ martensite with orientations between { 1 1 00 } α and { 11 2 0 } α . This shift in product α -Ti orientations has not yet been reported, and further work is recommended to understand these crystallographic signatures in the context of solid-state phase transformations. The presence of the { 01 1 2 } α fiber texture is proposed as a useful diagnostic for evaluating the solidification or transformed microstructure condition (e.g., grain morphology and texture) of Ti-6Al-4V AM builds via accessible techniques like laboratory X-ray diffraction.
Intranasal local anesthetic application: possible mechanisms of action.

I would like to thank Dr de Leon Casasola for his interest in our daring discourse report on intranasal local anesthetic (INLA) application.[1][1] I feel like we are more in agreement than not. It is clear from my previous report that intranasal application of local anesthetic is not a true
Subgrid-scale Horizontal and Vertical Variations of Cloud Water in Stratocumulus Clouds: A case study based on LES and comparisons with in-situ observations

Abstract. Stratocumulus clouds in the marine boundary layer cover a large fraction of ocean surface and play an important role in the radiative energy balance of the Earth system. Simulating these clouds in Earth system models (ESMs) has proven to be extremely challenging, in part because cloud microphysical processes such as the autoconversion of cloud water into precipitation occur at the scales much smaller than typical ESM grid sizes. An accurate autoconversion parameterization needs to account for not only the local microphysical process (e.g., the dependence on cloud water content qc and cloud droplet number concentration Nc), but also the sub-grid scale variability of the cloud properties the determine the process rate. Accounting for subgrid-scale variability is often achieved by the introduction of a so-called enhancement factor E. Previous studies of E for autoconversion focused more on its dependence on cloud regime and ESM grid size, but largely overlooked the vertical dependence of E within the cloud. In this study, we use a large-eddy simulation (LES) model, initialized and constrained with in situ and surface-based measurements from a recent airborne field campaign, to characterize the vertical dependence of the horizontal variation of qc in stratocumulus clouds and the implications for E. Similar to our recent observational study (Zhang et al., 2021), we found that the inverse relative variance of qc, an index of horizontal homogeneity, generally increases from cloud base upward through the lower 2/3 of the cloud, and then decreases in the uppermost 1/3 of the cloud. As a result, E decreases from cloud base upward, and then increases towards the cloud top. We apply a decomposition analysis to the LES cloud water field to understand the relative roles of the mean and variances of qc in determining the vertical dependence of E. Our analysis reveals that the vertical dependence of the horizontal qc variability and enhancement factor E is a combined result of condensation growth throughout the lower portion of the cloud and entrainment mixing at cloud top. The findings from this study indicate that a vertically dependent E should be used in ESM autoconversion parameterizations.
The Ubiquity of Prophylactic Rules

The Supreme Court's opinion in Miranda v. Arizona' does not even look like an ordinary opinion. As many critics have commented, it reads more like a legislative committee report with an accompanying statute.2 As if that were not enough, the Court has, since Miranda, repeatedly said that the Miranda rules are not required by the self-incrimination clause of the fifth amendment but are judge-made rules designed to implement that provision.3 Against this background, it is not surprising to find Miranda under attack not just as wrong but as "illegitimate." Professor Grano, for example, argues that "prophylactic rules" like Miranda's always raise questions of legitimacy; and that even if prophylactic rules are sometimes legitimate, Miranda's prophylactic rule is not.4 I want first to suggest that Professor Grano is mistaken in his argument that what the Court did in Miranda is different from, and less legitimate than, what it does when it prescribes the kind of prophylactic rules that he finds legitimate. Then I will make a broader argument-that "prophylactic" rules are not exceptional measures of questionable legitimacy but are a central and necessary feature of constitutional law. Indeed, constitutional law consists, to a significant degree, in the elaboration of doctrines that are universally accepted as legitimate, but that have the same "prophylactic" character as the Miranda rule."
The Welfare Eects of Supply-Side Regulations in Medicare Part D

We study the regulatory mechanisms through which the government currently administers subsidies in Medicare Part D, a large prescription drug program for US seniors. Using the data from the rst six years of the program, we estimate an econometric model of supply and demand that incorporates the regulatory pricing distortions in the insurers’ objective functions. We have four primary results: consumers have low willingness-to-pay for the products oered in Medicare Part D; competition among insurers is fairly eective in lowering prices towards marginal cost; the primary driver of welfare gains in Medicare Part D is the substitution of enrollees into Part D from Medicare Advantage; and the current mechanism achieves a level of total welfare close to that obtained under an optimal voucher scheme, but is far from the social planner’s rst-best solution.
Computational evaluation of metal foam orbital debris shielding

Aluminum honeycomb sandwich structures are widely used in aerospace applications, and are generally favored for their high specific strength and stiffness. However, experimental studies of their orbital debris shielding performance have shown an undesirable tendency to channel impact debris from a front face sheet impact, towards the back face sheet, inhibiting lateral debris dispersion. Hence published experimental research has evaluated the orbital debris shielding performance of aluminum foam sandwich panels, as a potential structural alternative. The limitations of light gas gun technology mean that experimental studies of this type can only investigate the lower half of the impact velocity regime of interest in low earth orbit applications. Recent research has conducted a series of 49 impact simulations, employing a hybrid-particle element method, in order to estimate the orbital debris shielding performance of aluminum foam sandwich panels for impact conditions which cannot be duplicated in the laboratory. The simulation results suggest that published scaling laws which extrapolate the experimental data base outside the testable range provide an accurate estimate of metal foam shielding performance over the full impact velocity range of interest for spacecraft operating in low earth orbit.
Boundary Value Problems

When a person begins the study of ordinary differential equations, he is usually confronted first by initial value problems, i.e. a differential equation plus conditions which the solution must satisfy at a given point x = x0.
Lifecode: An Examination of the Shape, the Nature, and the Usage of the Oikoscode, a Replicative Nonformal Learning Pattern of Ethical Education for Leadership and Community Groups

LIFECODE: AN EXAMINATION OF THE SHAPE, THE NATURE, AND THE USAGE OF THE OIKOSCODE, A REPLICATIVE NONFORMAL LEARNING PATTERN OF ETHICAL EDUCATION FOR LEADERS AND COMMUNITY GROUPS
High atrioventricular phase index on near-field intracardiac electrogram is associated with risk of ventricular arrhythmia

The purposes of this study were to characterize and quantify concordance between consecutive atrial and ventricular activation time points through analysis of phases and to explore its association with outcomes in patients with implantable cardioverter-defibrillator (ICD). Patients with structural heart disease and dual-chamber ICDs underwent 5min baseline right ventricular (V) near-field and atrial (A) electrogram (EGM) recording. The cross-dependencies of phase dynamics of the changes in consecutive A (AA') and V (VV') were quantified and the AV phase dependency index was determined. In Cox regression analysis, a high AV phase index (in the highest quartile, >0.259) was significantly associated with higher risk of ventricular tachyarrhythmias (HR 2.84; 95% CI 1.05-7.67; P=0.04). In conclusion, in ICD patients with structural heart disease, high sinus AV phase dependency index on EGM is associated with the risk of ventricular arrhythmia.