cssi/SciSciGPT-SciSciNet huggingface dataset:
Development and Validation of an Instrument to Assess Social Work Students' Perceptions, Knowledge, and Attitudes about Human Trafficking Questionnaire (PKA-HTQ): An Exploratory Study.

Objective:This study sought to develop and evaluate the psychometric properties of a tool designed to assess social work students’ knowledge of and perceptions and attitudes toward human trafficking. To achieve this aim, the Perceptions, Knowledge, and Attitudes toward Human Trafficking Questionnaire (PKA-HTQ) was developed and its psychometric properties were evaluated. Specifically, the factor structure and the internal consistency of the PKA-HTQ were evaluated.Methods:Exploratory factor analysis (EFA) and a replication EFA were conducted on two independent samples of university students, an initial validation (n = 325), and cross-validation (n = 212) sample.Findings:The EFA revealed a three-factor structure, that is, self-appraisal of knowledge/skills (α = .89), worldview (α =.78), and help-seeking behavior (α =.66); this three-factor structure was supported by replication EFA.Conclusion:The PKA-HTQ questionnaire shows promise as a meaningful, potentially reliable and valid measure.
Evaluation of a Worksite Diabetes Education Program at a Large Urban Medical Center

Evidence suggests that diabetes education can be delivered at the worksite to better support employees' diabetes self-management and improve productivity and health care costs. This study was conducted to address the feasibility of a diabetes worksite education program for employees at a large urban academic health care institution. The diabetes education program was delivered in the diabetes center at the institution, a resource that was previously underutilized by employees. Through collaboration with groups in the institution, 20 employees of diverse ethnicity participated in the worksite diabetes education program with positive outcomes: improved glycemic control measured (HbA1c), attainment of self-management goals, and satisfaction with the program. Work absences trended downward, but numbers of hospitalizations and emergency department visits were unchanged in the 3 months following education. Recommendations include replication of the study with more employee participation and program evaluation over a longer period of time to continue assessment of employees' educational needs.
The Besieged Ladies in Arthurian Romance

One of the most familiar figures in Arthurian romance is the Besieged Lady, whose beleaguered castle is liberated by a young and obscure knight, and who rewards her deliverer with an offer of her love. So ubiquitous is she, in fact, that it is easy to dismiss her as an Arthurian commonplace. But even commonplaces must originate somewhere. Since the Besieged Ladies are by no means stereotyped replicas of one another, it is difficult to believe that all versions of the story derive from the earliest extant text. More probably, the story of the Besieged Lady and her troubles is a traditional narrative pattern which became a favorite with the romancers not only because of its beguiling aspects but also because of its adaptability to their concept of chivalry. A study of the more significant versions of this remarkably malleable theme will help us to discern the underlying traditions and their complex development.
INTRAVENOUS DILTIAZEM, AS COMPARED TO INTRAVENOUS METOPROLOL, FOR ATRIAL FIBRILLATION/FLUTTER IS ASSOCIATED WITH INCREASED ADMISSION FROM THE EMERGENCY DEPARTMENT

Atrial fibrillation (AF) is the most common arrhythmia encountered in the emergency department (ED). Intravenous metoprolol (IV-M) and diltiazem (IV-D) have become the most commonly used agents in their respective class for the acute treatment of atrial fibrillation/flutter with a rapid ventricular
Research Design for Mixed Methods: A Triangulation-based Framework and Roadmap

All methods individually are flawed, but these limitations can be mitigated through mixed methods research, which combines methodologies to provide better answers to our research questions. In this...
Investigation of Nosocomial Infection in a Hospital of Suizhou in 2008

Objective To understand the status concerning nosocomial infections (NI) in Suizhou City,to find problems in controlling NI,and to provide the evidence for working out monitoring measures.Methods All the cases discharged from the hospital between Jan.2008 and Dec.2008 were collected to conduct retrospective study about NI by four seasons.Cross-sectional investigation was conducted quarterly among all the inpatients,including NI,antibacterial usage,and pharmaceutical sensitive cultivation.The status of disinfection in all the departments of the hospital was simultaneously monitored.Results Totally 621 cases of NI were detected in the hospital in 2008,with the average infection rate of 5.41%,and the most common infection site was respiratory tract.The sample detection rate of the cases with NI was 33.17%,and Gram-negative bacteria were the most common pathogens,accounted for 52.35%,followed by Gram-positive bacteria and eumycete.Bacterial cultivation and drug sensitive test suggested that drug resistant rate of bacteria to cephalosporin was the lowest (62.87%).Average usage rate of antibacterial was 81.84%,among the total,the usage rate of single drug was 54.12%,and average qualified rate of disinfection was 85.53%.Conclusions The current status of NI should be investigated regularly in order to find the existing problems of NI management.Strengthening the management of NI (including using antibiotics rationally,monitoring pathogenic bacteria,etc.) may be beneficial in the prevention and control of NI.
Transitioning the Intel® next generation microarchitectures (nehalem and westmere) into the mainstream

• Intel maintains pace of innovation and execution - Next generation performance - 32nm: Another Process Technology Breakthrough • Enabling Nehalem for every segment - Delivering outstanding Nehalem performance to mainstream desktops and laptop computers • Redesigning more efficient platforms - Best performance across all segments - Low power and better power management - Higher levels of integration
Hepatic encephalopathy, GABA-ergic neurotransmission and benzodiazepine receptor ligands.

Evidence compatible with increased GABAergic tone contributing to the manifestations of hepatic encephalopathy (HE) in animal models of fulminant hepatic failure (FHF) includes: (i) increased resistance to drugs which induce seizures by reducing GABAergic tone;(ii) abnormalities of visual evoked responses (VERs) which resemble those induced by drugs which augment GABAergic tone; (iii) increased sensitivity of CNS neurons to a GABA agonist; and (iv) ameliorations of the encephalopathy induced by a GABA receptor antagonist.
Direct evidence for EMIC wave scattering of relativistic electrons in space

Electromagnetic ion cyclotron (EMIC) waves have been proposed to cause efficient losses of highly relativistic (>1 MeV) electrons via gyroresonant interactions. Simultaneous observations of EMIC waves and equatorial electron pitch angle distributions, which can be used to directly quantify the EMIC wave scattering effect, are still very limited, however. In the present study, we evaluate the effect of EMIC waves on pitch angle scattering of ultrarelativistic (>1 MeV) electrons during the main phase of a geomagnetic storm, when intense EMIC wave activity was observed in situ (in the plasma plume region with high plasma density) on both Van Allen Probes. EMIC waves captured by Time History of Events and Macroscale Interactions during Substorms (THEMIS) probes and on the ground across the Canadian Array for Real-time Investigations of Magnetic Activity (CARISMA) are also used to infer their magnetic local time (MLT) coverage. From the observed EMIC wave spectra and local plasma parameters, we compute wave diffusion rates and model the evolution of electron pitch angle distributions. By comparing model results with local observations of pitch angle distributions, we show direct, quantitative evidence of EMIC wave-driven relativistic electron losses in the Earth's outer radiation belt.
Early China: Cracking the secret bones: literacy and society in late Shang

With the arrival of the late Shang with its political center relocated to the south of the Huan River in Anyang, the study of Early China has gained another footing – contemporary written evidence. We are now able to understand the past not only through the material remains it has left behind and to a limited degree through the retrospective documentation produced by later generations, but also through the eyes of the protagonists of history. The perspectives offered by such written evidence, though not without bias (as is true for all records which are the products of the human mind), are unparalleled in the sense that they are both the eyewitness record of the time they speak about, and also the least ambiguous presentation of events and institutions that are usually not directly evident in the material remains. In the case of the Shang oracle-bone inscriptions, particularly because they were the divination records of the Shang kings, they offer especially rich information about the concerns and activities of the king and the operation of the Shang royal court. But there are other areas in which we can only expect that they remain silent.
The influence of maternal energy status during mid-gestation on growth, cattle performance, and the immune response in the resultant beef progeny1

The objective of this experiment was to determine the effects of cow energy status during mid-gestation on progeny growth performance and health. To alter maternal energy status, cows (n = 151) were either fed to achieve or maintain BCS 5.0 to 5.5 (positive energy status) or fed at 80% of the energy requirements for BW maintenance (negative energy status) over the ensuing 91-d period of mid-gestation. Cows were managed as a common group beginning with the third trimester of gestation through subsequent weaning. Weaned calves (n = 71 steers and 61 heifers) were allotted to pens according to cow energy status during gestation and sex and stratified by BW to allow for live cattle performance evaluation. A subsample (n = 30) of calves was subjected to an ovalbumin challenge 19 d after entering the feedlot to compare antibody titer response. Mid-gestation dam energy status did not affect (P > 0.05) birth weight, weaning weight, or adjusted 205-d weaning weight of progeny. No differences (P > 0.05) were observed between treatments during the feeding period on ADG, DMI, and G:F. Ovalbumin results showed no interactions (P > 0.05) between treatments, days, or sexes, as well as no sex main effects. However, progeny of negative energy status cows had lower (P < 0.05) antibody titers in response to the ovalbumin challenge during the receiving period. These results suggest that differences in cow energy status applied during mid-gestation in this experiment will not affect BW or growth performance differences throughout the postnatal period in beef cattle progeny but may have an effect on the adaptive immune response during their receiving period in calves.
Longitudinal stratified liquid crystal structures to enable practical spatial light modulators in the terahertz regime

Electro-optic (EO) modulation of the amplitude and phase of electromagnetic waves using liquid crystals (LCs) is commonplace in the optical and infrared regions. This effort has led to commercially available components used in spectral filtering, polarization management, beam steering, transmitters, displays, etc. However, electro-optic techniques have had limited success in the terahertz (THz) region due to several practical design challenges. The growth in applications has led to an interest in the development of a spatial light modulator (SLM) for the terahertz region. In the visible region, the most common SLMs use electro-optic materials such as liquid crystals to spatially modulate a beam. However, this approach to achieve a practical SLM in the terahertz regime has been difficult. The primary barrier for components is the long interaction lengths required to modulate a THz wave. Since the EO modulation depth is directly proportional to the multiplication of the change of permittivity and the ratio of interaction length over wavelength, THz systems with wavelengths ranging from 150 μm to 1mm pose a challenge. To overcome this barrier, longitudinal stratified sub-wavelength liquid crystal structures have been engineered and fabricated. The stratified structures introduce the challenge in the selection and design of the electrodes. By using multiple layers the tunable films can be maintained at manageable thicknesses (25 to 200 μm). The reduced individual film thickness will significantly improve the requisite drive voltage and response time. However, the layered structure with multiple conducting layers adds considerable challenges to the design of the transparent electrode. Both simulation and experimental data will be presented.
Multilayer transducer for nonlinear imaging with application to targeting and monitoring of therapeutic ultrasound

Nonlinear acoustic wave propagation can improve the resolution of ultrasound imaging, and could be used to dynamically estimate the physical properties of tissue. However, transducers capable of launching a wave that becomes nonlinear through propagation can typically detect only the fundamental and second harmonic. Here we present the design and characterization of a multilayer transducer with a high power transmit layer to generate nonlinear waves and a broadband receive layer to detect nonlinear scatter. The transmit array was made from a narrow-band PZT, with nominal frequency of 2.0 MHz, that was diced into an array of 32 elements. Elements had 0.300 mm width and 6.3 mm elevation, and the pitch was 0.400 mm. The receive array, placed directly above the transmit array, was made from PVDF elements that were patterned by flex circuit pads that replicated the PZT element dimensions. The PZT and PVDF elements had identical apertures. Simulations were performed to guide the selection of the transducer materials and thicknesses. Characterization of electrical parameters and acoustic output were performed per standard methods, in which transmit and receive events were driven by a software-controlled ultrasound system. Nonlinear waveforms with peak positive pressure up to 2.14 MPa were measured by a calibrated hydrophone. Echo data, collected from ex vivo tissue and digitized at 45 MS/s, exhibited frequency content up to the 4th harmonic of the 2 MHz transmit frequency.
Development of a cerebral mycotic aneurysm within 5 days

A 35-year-old man with a history of IV drug abuse and endocarditis underwent a surveillance digital subtraction angiography (DSA) after completing a prolonged course of IV antibiotics. The DSA did not show mycotic aneurysms (MA). A transesophageal echocardiogram did not demonstrate the presence of any vegetation. The patient relapsed after these diagnostic tests and used IV drugs.
Innovation, firm size, and firm age

This paper uses a new data set on innovation output to assess the degree to which the level of innovation in manufacturing firms is influenced by firm size and firm age. Indicators of innovation output used are the number of new products introduced as a function of firm sales and the proportion of firm sales obtained from products first introduced in the previous five years. While the evidence is mixed, the results tend to indicate that it is possible to separate the effects of age and size in assessing the level of innovation. Both firm size and firm age tend to be inversely related to innovative output.
Dynamics influences of Tobin’s Q and CEO compensation on US stocks

This paper aims to empirically explore the influences of Tobin’s Q and CEO compensation of 249 US companies on their stock returns.,Heterogeneous panel data for these companies over 2004-2012 are used invoking panel cointegration techniques.,Panel unit root tests and Pedroni cointegration tests confirm nonstationarity of each variable and cointegration among the above three variables. The panel vector error-correction model (VECM) estimates reveal long-run convergence with tepid adjustment. The short-run net interactive feedback effects are positive. The panel generalized method of moments estimates lend further support to the panel VECM inferences.,The topic is unique and the existing literature on this topic is scant. Relatively new econometric techniques have been applied for estimation using panel data. The results are quite insightful, in the authors’ view.
Universal scaling of transverse wave attenuation in polycrystals

Abstract A single mode approximation for the transverse attenuation coefficient in polycrystals is obtained from the far field approximation model (Rokhlin et al., 2015). The model is applicable in all frequency ranges to polycrystals with ellipsoidal grains of triclinic symmetry and is shown to be in favorable agreement with other second order models. In the frame of this model, the transverse wave attenuation coefficient depends on a single elastic scattering factor only (it solely encompasses dependence on the crystallite elastic moduli and the elastic covariance). Therefore in this approximation the attenuation coefficient can be scaled with this factor (normalized), obtaining the universal (master) curve. The admissibility of scaling is supported by the use of the second order model (the type of Stanke-Kino) for a large number of material systems with different grain anisotropies. Within the second order model, the behavior of the scaled transverse wave attenuation coefficient versus frequency is nearly independent of the material system and is a function of the grain geometrical characteristics only. The scaling of the transverse wave attenuation coefficient is tested on the measurements for Ti alloy samples performed in this work and a large set of experimental data obtained for different material systems available in the literature. The results confirm the scaled coefficient independence of the material and good agreement between the data and the universal attenuation curve.
Everyday Encounters with Activist Scholarship

In light of the grave challenges ahead under the Trump administration and the rise of right-wing populism in the West, it is critical that geographers across subdisciplines embrace activist and eng...
An enigmatic heteronemertean from the Gulf of Mexico

Heteroenopleus enigmaticus gen. nov., sp. nov. isdescribed from the northwestern Gulf of Mexico. Itoccurs both in the nearshore Gulf and in high salinityestuarine areas. Body wall musculature conforms tothe general plan of heteronemerteans, i.e. outerlongitudinal, middle circular and inner longitudinalmuscle layers. The head bears a pair of horizontallateral slits, characteristic of the lineids. Theproboscis musculature is of the heteronemertean‘palaeotype’ with two muscle layers, outer circularand inner longitudinal. Other morphologicalcharacters agree with those of heteronemerteans withone major exception: the proboscis is armed with tworows of structures, herein named parastylets. Thisarmature has no morphological similarity to either themicrovillar proboscideal spines of heteronemerteans orto the stylets of mono- or polystiliferans. A newsubfamily Heteroenopleinae is erected to contain theapomorphic character of an armed proboscis.
Reducing landslide risk in urban areas - experience in the united states

Publisher Summary This chapter discusses the need for reducing social and economic losses due to landslides by means of effective planning and management. The concepts that have ben presented and the examples of this use are based primarily on experience in the United States. Reducing the landslide risk in urban areas and mitigating economic and social losses due to landslides can be achieved by different methods: by restricting development in landslide-prone areas (i.e., avoidance); by using codes in excavation, grading, landscaping, and construction; by using engineered physical measures (drainage, slope-geometry, modification, structures, and vegetation) to prevent or control landslides; and by developing landslide warning systems. Optimal approaches to reduction of landslide risk usually involve a carefully assembled mix of the above hazard-reduction strategies and techniques. Excavation, grading, and construction ordinances have been developed to ensure that construction in landslide-prone areas is planned and conducted in a manner that will not impair the stability of hillside slopes. In addition, landslide insurance can provide financial protection to individual property owners.
LATERAL AND MEDIAL EPICONDYLITIS

Lateral and medial epicondylitis (tennis elbow) are common pain complaints about the elbow in the adult. Disability from persistent pain and weakness at the elbow lead to surgical correction of the disorder. Complications of surgery arise from the improper diagnosis of the origin of the pain, failure to correct the pathology with the surgical procedure, and resultant profound forearm weakness or elbow instability. Rehabilitation during the postoperative period is critical for successful return to work or sports activity.
Pre-existing symptoms, resource utilization, and healthcare costs prior to diagnosis of neuroendocrine tumors: A SEER-Medicare database study.

4092Background: The incidence and prevalence of neuroendocrine tumors (NETs) are continually increasing. While it is known that NET symptoms often predate diagnosis, the prevalence of these symptom...
Thermal Noise Metrology with Time-Based Synthesis

We present a new measurement technique for quantifying noise temperature based On temperature and time. A single-pole, double-throw (SPDT) ultra-fast switch combines signals from outputs of two synchronized electromechanical (EM) switches. The input ports of EM switches are terminated by one unknown noise source, one known cold noise source, and two known noise references at ambient temperature. The magnitude of the combined noise signal can be adjusted by the duty cycle of the transistor-transistor logic (TTL) pulse that controls the fast switch. The measurement approaches the balanced mode by regulating the TTL duty cycle in order to minimize the difference between the combined noise signal and the ambient noise reference. In comparison to conventional total-power radiometers, this new instrumentation is more efficient and potentially provides a wider dynamic range.
What Is My Patient’s Risk of Cancer from Radiation Exposure with Computed Tomography of the Abdomen and Pelvis? What Do I Tell My Patient?

Since the invention of and advancements made in computed tomography (CT), physicians have increased its use dramatically to assist with diagnosis and treatment of patients. The surge in CT use and patient exposure to medical radiation can result in a potential increase in the risk of developing cancer. This increased risk and mortality of cancer to the individual is small, but the exponential growth in use of CT can result in a significant increase in cancer rates in the US population, which may have considerable public health impacts. Therefore, it is important to consider strategies to help reduce radiation exposure when possible.
Expression Graphs

Factor graphs are a very general knowledge representation, subsuming many existing formalisms in AI. Sum-product networks are a more recent representation, inspired by studying cases where factor graphs are tractable. Factor graphs emphasize expressive power, while sum-product networks restrict expressiveness to get strong guarantees on speed of inference. A sum-product network is not simply a restricted factor graph, however. Although the inference algorithms for the two structures are very similar, translating a sum-product network into factor graph representation can result in an exponential slowdown. We propose a formalism which generalizes factor graphs and sum-product networks, such that inference is fast in cases whose structure is close to a sum-product network.
Structurally bound S2−, S1−, S4+, S6+ in terrestrial apatite: The redox evolution of hydrothermal fluids at the Phillips mine, New York, USA

Abstract The oxidation state of sulfur (S) plays a critical role in the formation of igneous and hydrothermal mineral systems. Constraining the oxidation state of S during mineralization and alteration is a valuable tool for understanding primary versus secondary processes that affect mineral systems. Recent experimental studies demonstrate that apatite, which is a ubiquitous accessory mineral in igneous and hydrothermal ore-forming systems, structurally incorporates multiple oxidation states of S (i.e., S6+, S4+, S2−), and that the abundance of reduced versus oxidized S in apatite is systematically related to oxygen fugacity. In this study, we used micro X-ray absorption near edge structure (μ-XANES) spectroscopy at the S K-edge to measure the oxidation states of S in natural apatite from the Phillips mine magnetite-sulfide mineral deposit (Putnam County, New York). Micro-XANES transects were collected within two apatite grains, starting near the edge of (1) a pyrrhotite inclusion, and (2) an inclusion assemblage consisting of pyrite, ferroan carbonate, pyroxene, and magnetite. Significant compositional and textural variations within the apatite were observed by electron probe micro-analysis (EPMA), wavelength dispersive (WDS) spectroscopy element mapping, and cathodoluminescence (CL) imaging, and used in combination with the μ-XANES data to discuss the formation of the Phillips mine apatite. The μ-XANES analyses reveal that apatite contains variable proportions of S6+, S4+, S1− and S2−, with corresponding peak absorption energies of 2481.7 ± 0.3 eV, 2477.9 ± 0.4 eV, 2471.8 ± 0.1 eV, and 2469.8 ± 0.04 eV, respectively. Notably, this marks the first observation of reduced S species (S2−, S1−) in terrestrial apatite. Peak areas ratios (S6+/∑S) demonstrate systematic variations in the oxidation state of S within the apatite grains. Elevated S6+/∑S peak area ratios typically coincide with higher concentrations of S and rare earth elements within the apatite grains. Several observations, including the presence of multiple oxidation states of S in apatite, and monazite inclusions that record secondary, fluid-mediated dissolution-reprecipitation of apatite, indicate differences in the oxidation of S, thus oxygen fugacity, during primary mineralization and secondary alteration (i.e., metasomatism). We propose a model for the formation of the Phillips mine apatite wherein the primary apatite grains crystallized from a reduced, S-bearing hydrothermal fluid characterized by a low SO2/H2S ratio. Subsequently, metasomatism of apatite in the presence of an oxidized fluid, which contained an elevated SO2/H2S ratio, resulted in the exsolution of rare earth elements from apatite and concomitant growth of monazite, and the structural incorporation of oxidized S (S6+ and S4+) in apatite. This study demonstrates that the oxidation states of S in apatite provide valuable geochemical information regarding the redox evolution of mineralized systems.
Influence of transient operating parameters on the mechanical behavior of fuel cells

Abstract Transient operating parameters of polymer electrolyte membrane fuel (PEM) cells significantly influence their performance and durability by affecting the water content of the membrane. Towards understanding the factors contributing to mechanical degradation, this paper presents numerical simulations on the effects of operating conditions on the stress and strain induced in the membrane constrained by bipolar plates and subjected to changing humidity levels. The fuel cell is subjected to dynamic changes in load to capture the water content values in the membrane using detailed three-dimensional (3D) computational fluid dynamics simulations. Using the information from the three-dimensional simulations, two-dimensional (2D) finite element (FE) analysis is used to predict the mechanical response of the membrane at various planar sections for hygral (water) loading and unloading cycles. The effects of operating parameters (anode and cathode pressure, stoichiometry and relative humidity at cathode inlet) on evolution of stresses and plastic deformations in the membrane are analyzed for cyclic changes in operating load.
Minimally Invasive Lateral Retropleural Approach to the Thoracic Spine for Salvage of a Subsided Expandable Interbody Cage.

Background Cylindrical expandable cages are commonly used as interbody grafts after cervical, thoracic, or lumbar corpectomy in patients with osteomyelitis. Unfortunately, there is a high incidence of hardware subsidence due to small-diameter footplates. Newer expandable intervertebral cages with large rectangular endcaps use the anatomic strength of the vertebral epiphyseal ring to prevent subsidence. Case Description A 67-year-old man with medically refractory thoracic osteomyelitis and discitis presented to our service for further management of debilitating back pain secondary to a persistent infection and associated progressive spinal kyphotic deformity. He underwent a transpedicular T9-10 corpectomy, placement of an expandable interbody cage, and posterior instrumented spinal fusion from T7 to T12. On postoperative day 2, upright thoracic radiographs demonstrated cage subsidence of >50% into the T8 vertebral body. The patient was returned to the operating room for hardware revision and placement of an expandable intervertebral cage with rectangular endcaps through a minimally invasive lateral retropleural approach to the thoracic spine. The patient tolerated the procedure well, and no evidence of subsidence occurred after the revision after 2 years of follow-up. Conclusions Expandable intervertebral cages with rectangular endcaps can be used to prevent and/or correct preexisting cage subsidence in patients in need of anterior column instrumentation, especially in those with bone-weakening pathologies. Prospective studies should be entertained to evaluate subsidence rates in cages with cylindrical versus rectangular endcaps.
Unknowing Fanaticism: Reformation Literatures of Self-annihilation: by Ross Lerner, New York, Fordham University Press, 2019, 224 pp., $105.00 (hb.), ISBN-13: 9780823283873, $30.00 (pb.), ISBN-13: 9780823283866

Unknowing Fanaticism investigates the role that Christian fanatical experience plays in the work of four widely read early modern authors: Spenser, Donne, Hobbes, and Milton. In the Reformation, Ch...
Utility of Optical Coherence Tomography in the Diagnosis and Management of Optic Neuropathy in Patients with Fibrous Dysplasia

Optic neuropathy (ON) is a highly disabling complication of fibrous dysplasia (FD). The optimal test for identifying and monitoring ON in FD is unknown. Optical coherence tomography (OCT) is an imaging modality that detects retinal nerve fiber layer (RNFL) thinning, a sign of optic nerve atrophy. The purpose of this study was to (i) assess the ability of OCT RNFL thickness measurements to identify ON in FD; (ii) compare the performance of RNFL thickness to computed tomography measurements; and (iii) examine changes in RNFL thickness over time to assess disease progression. A retrospective cohort study was performed to assess subjects (n = 70) who underwent neuro-ophthalmologic examination, including OCT. The diagnostic utility of RNFL thickness was determined using receiver operator characteristic (ROC) curve analysis, and the accuracy was compared with computed tomography measurements. The relationship between RNFL thickness and age was assessed cross-sectionally, using generalized estimating equation methodology, and longitudinally, using a generalized mixed model. Eleven subjects were identified with ON. RNFL thickness identified ON (area under curve = 0.997, p < 0.0001) with sensitivity and specificity of 100% and 95%, respectively, when using the diagnostic criterion of ≤71 μm. RNFL thickness outperformed computed tomography measurements of optic canal narrowing and optic nerve stretch. Subjects with ON exhibited a greater decrease in RNFL thickness with each year of age (-0.70 μm/year, p < 0.001) than subjects with normal vision (-0.16 μm/year, p < 0.05). When assessed longitudinally, subjects with normal vision demonstrated an increase in RNFL thickness until approximately age 20 years that decreased thereafter. In contrast, subjects with ON exhibited an earlier decrease in RNFL thickness during adolescence. In conclusion, RNFL thickness of ≤71 μm accurately identified ON in this population. By establishing the difference in rate of RNFL thinning in patients with and without ON, clinicians may distinguish between patients at risk for ON and intervene before irreversible damage. © 2020 American Society for Bone and Mineral Research.
Multiscale modeling of tensile fracture in fiber reinforced composites

Abstract Intralaminar fiber-matrix fracture, also known as splitting, is encountered frequently during the tensile failure of fiber reinforced polymer matrix composites (FRPMCs). The prediction of this failure mode and its influence on a macroscopically homogenized model brings associated challenges in numerical modeling. An efficient two-scale model is presented, based on the micromechanics 2-concentric cylinder (2CYL) [1] analytical method for pre-peak nonlinearity, interfaced with the 3D orthotropic smeared crack approach (SCA) [2] , [3] for post-peak softening behavior. A homogenized ply is modeled using standard 3D finite elements, such that a matrix crack can be captured explicitly with respect to the orientation of the ply angle. The capability of the proposed method is demonstrated by predicting the grip-to-grip longitudinal split in a 00 ply, mixed-mode matrix cracking in 450 ply, the transverse matrix cracking in 900 ply and the failure of laminate containing these plies. The predictions of the proposed method are found to be in very good agreement with corresponding experimental data [4, 5].
Sex differences in circulating leptin as a marker of adiposity in obese or overweight adolescents with type 1 diabetes.

INTRODUCTION We aimed to test whether the serum adipokines leptin and adiponectin are more strongly associated with body fat percentage (BF%) than body mass index (BMI) in adolescents with type 1 diabetes (T1D) and overweight/obesity. RESEARCH DESIGN AND METHODS We studied all participants in the T1D Exchange Metformin Study (n=122, median age 12.9 years, range 12-19.5; 32% males; 77% non-Hispanic whites, 100% overweight or obesity; median diabetes duration 6.7 years, range 1.4-15) with a baseline serum sample where we measured leptin and adiponectin concentrations. Anthropometric, clinical, laboratory and dual-energy X-ray absorptiometry (DEXA) scan measurements were analyzed. We compared correlation coefficients between variables of interest. RESULTS BF% by DEXA was significantly correlated with BMI Z-score (r=0.38, p<0.0001), BMI per cent of the 95th percentile (BMI%95) (r=0.45, p<0.0001), waist circumference (r=0.46, p<0.0001), leptin (r=0.58, p<0.00001) and leptin/adiponectin ratio (r=0.36, p<0.0001), while it was not significantly correlated with absolute body weight, adiponectin or insulin dose (total or basal). BF% was significantly more strongly correlated with leptin than with BMI Z-score in the overall group (p=0.022). However, there were sex-based differences. Among the significant correlations in the overall group, BF% was most strongly associated with leptin (r=0.75) in boys (n=39) but with waist circumference (r=0.58) in girls (n=83) (all p<0.0001). CONCLUSIONS Serum leptin could be used as a surrogate convenient marker of adiposity in overweight/obese adolescent boys with T1D, equivalent to BMI Z-score or BMI%95. In girls, waist circumference was the best performing marker overall, and was also strongly correlated with %BF in boys.
Covalency in Actinide Compounds

Covalency in actinides has emerged as a resounding research topic on account of the technological importance in separating minor actinides from lanthanides for spent nuclear fuel processing, and utilization of their distinct bonding properties has been realized as a route towards overcoming this challenge. Because of the limited radial extent of the 4f orbitals, there is almost no 4f electron participation in bonding in lanthanides; this is not the case for the actinides, which have extended 5f orbitals that are capable of overlapping with ligand orbitals, although not to the degree of overlap as in the d orbitals of transition metals. In this concept paper, a general description of covalency in actinide compounds is provided. After introducing two main approaches to enhance covalency, either by exploiting increased orbital overlap or decreasing energy differences between the orbitals causing orbital energy degeneracy, the current state of the field is illustrated by using several examples from the recent literature. This paper is concluded by proposing the use of actinide chalcogenides as a convenient auxiliary tool to study covalency in actinide compounds.
Economic Dispatch with Unit Deactivation: Model and Solution

The conventional economic dispatch (ED) model does not consider the case that some units are allowed to be deactivated. In this paper, the significance of this case is discussed first. Then a new ED model is proposed to incorporate unit deactivation. In this model, the integer variables are controlled by continuous variables. An algorithm is developed to solve the new model, taking into account the transmission loss. This algorithm is implemented in a computer program. Two systems are tested. It is shown that the objective function can be further optimized, up to 12.9% compared to the conventional ED model.
The Role of Medical Therapy for Menigniomas

Surgical resection and radiotherapy form the backbone of effective treatments for meningioma. The majority of patients have WHO Grade I tumors that can be successfully treated with local therapies, with low relapse rates. However, patients with Grade II and III tumors have higher rates of relapse despite surgery and radiation. Repeat surgeries and radiotherapy can be used for salvage, but when such options have been exhausted, systemic treatments are considered. Unfortunately, there have been no systemic therapies to date that are definitively proven to prolong survival. Small patient populations, varied outcome measures, and lack of control populations have limited the evaluation of systemic therapies in recurrent and refractory meningiomas. Given the slow-growing nature of these tumors, it is often difficult to determine whether a given systemic therapy has changed the natural history of the disease. Multiple cytotoxic, hormonal, immunologic, and antiangiogenic agents have been trialed in small, prospective single arm studies, but no agent has received FDA approval to date. Current NCCN guidelines recommend considering three of these agents: interferon-alpha-2 beta, somatostatin analogues, and sunitinib in patients who require systemic therapy. However, providers should be aware that the activity and impact of such agents on the natural history of the disease is unclear. In this chapter we will review the available data on the use of systemic therapy in patients with meningiomas who have exhausted radiotherapy and surgical options.
Counter-Intuitive Climate Forcing: Post Paris Agreement Corporate Incentives

This article applies a micro-level lens to details of disincentives embodied in the new U.S. tax law effective in 2018, affecting corporate action to address climate change, and applies a macro-level assessment of how corporate action is affecting U.S. realization of its climate change goals and requirements. The article examines and offers several state law options that can substitute as alternative incentives, and an unrelated ‘Opportunity Zone’ provision in the new federal tax law, all of which can provide alternative legal paths.
Experimental study of double-steel encased transfer beam and SRC column connections

Based on a high-rise building in Guangdong Province and its large-span transfer structure,this paper put forward new constructional composite form with the double-steel reinforced concrete transfer( DSRCT) beam-column joint,and two low-cyclic reversed loading tests were conducted on the joints of two DSRCT beams under vertical and horizontal loads. The failure pattern,bending strength,stiffness,hysteretic characteristics,ductility,and energy dissipation capacity of the joints,and strain of reinforcements and shape steel at critical positions were all studied.Experimental results reveal: transfer beam with a built-in double steel web form a closed space constraints for concrete can improve the node region concrete shear capacity; hysteresis curves of double steel reinforced concrete transfer beam of are full; the deformation capacity,bearing capacity,stiffness,ductility and energy dissipation capacity are also improved; the end plate bolted connection for the converted column and double steel reinforced concrete beam can result in the development of plastic hinge at bottom of the converted column first,ensuring the mechanisms of‘strong beam and column and stronger joints' and‘strong transfer structure'in the seismic design.
Variation in Medication Adherence Across Patient Behavioral Segments: AMulti-country Study in Hypertension

Objectives This study determines the following for a hypertensive patient population: 1) the prevalence of patient worldview clusters; 2) differences in medication adherence across these clusters; and 3) the adherence predictive power of the clusters relative to measures of patients’ concerns over their medication’s cost, side effects, and efficacy. Methods Members from patient panels in the UK, Germany, Italy, and Spain were invited to participate in an online survey that included the Medication Adherence Report Scale5 (MARS5) adherence instrument and a patient segmentation instrument developed by CoMac Analytics, Inc, based on a linguistic analysis of patient talk. Subjects were screened to have a diagnosis of hypertension and treatment with at least one antihypertensive agent. Results A total of 353 patients completed the online survey in August/September 2011 and were categorized against three different behavioral domains: 1) control orientation (n=176 respondents [50%] for I, internal; n=177 respondents [50%] for E, external); 2) emotion (n=100 respondents [28%] for P, positive; n=253 respondents [72%] for N, negative); and 3) agency or ability to act on choices (n=227 respondents [64%] for H, high agency; n=126 [36%] for L, low agency). Domains were grouped into eight different clusters with EPH and IPH being the most prevalent (88 respondents [25%] in each cluster). The prevalence of other behavior clusters ranged from 6% (22 respondents, INH) to 12% (41 respondents, IPL). The proportion of patients defined as perfectly adherent (scored 25 on MARS5) varied sharply across the segments: 51% adherent (45 of 88 respondents) for the IPH vs 8% adherent (2 of 25 respondents) classified as INL. Side effects, being employed, and stopping medicine because the patient got better were all significant determinants of adherence in a probit regression model. Conclusion By categorizing patients into worldview clusters, we identified wide differences in adherence that can be used to prioritize interventions and to customize adherence messages. Also, the predictive power of segments was greater than that for variables measuring concerns over cost, side effects, and efficacy.
Antineutrophil cytoplasmic antibody positivity and cutaneous IgA vasculitis in a patient with antisynthetase syndrome.

Vasculitis is a disease process that results from inflammation of blood vessel walls. The clinical presentation is variable and dependent upon the size and location of the vessels involved.1 Cutaneous vasculitis refers to a vasculitis that results in skin manifestations, often due to involvement of small- and medium-sized vessels. The incidence of cutaneous vasculitis ranges from 15.4 to 29.7 cases per 1 million people every year.2 Clinical presentations vary and can include petechiae, purpura, purpuric papules, hemorrhagic vesicles, and bullae.1 Biopsy is the gold standard for making a diagnosis of cutaneous vasculitis.2 The collection of histopathologic findings in cutaneous small-vessel vasculitis are referred to as leukocytoclastic vasculitis (LCV) and include a polymorphonuclear neutrophilic infiltrate, primarily in postcapillary venules, with fibrinoid deposits in and around the vessel wall and extravasation of red blood cells.3 Although LCV is often idiopathic, it may occur secondary to infection, drugs, malignancy, or autoimmune processes, such as antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).4 The following case report describes a patient with a history of antisynthetase syndrome (ASS) who subsequently developed IgA vasculitis with copositive ANCA.
Mining Multi-variant Process Models from Low-Level Logs

Process discovery techniques are a precious tool for analyzing the real behavior of a business process. However, their direct application to lowly structured logs may yield unreadable and inaccurate models. Current solutions rely on event abstraction or trace clustering, and assume that log events refer to well-defined (possibly low-level) process tasks. This reduces their suitability for logs of real BPM systems (e.g. issue management) where each event just stores several data fields, none of which fully captures the semantics of performed activities. We here propose an automated method for discovering an expressive kind of process model, consisting of three parts: (i) a logical event clustering model, for abstracting low-level events into classes; (ii) a logical trace clustering model, for discriminating among process variants; and (iii) a set of workflow schemas, each describing one variant in terms of the discovered event clusters. Experiments on a real-life data confirmed the capability of the approach to discover readable high-quality process models.
Characterization of PC12 cell proliferation and differentiation-stimulated by ECM adhesion proteins and neurotrophic factors

Among the various elements which influence axonal outgrowth in vivo is the physicochemical interaction of actively outgrowing nerve fibers with the various substrata they encounter during differentiation. Several experiments have explored the role of the extracellular matrix (ECM) in the control of neuronal differentiation. The nature, however, of the interactions between neurons and components of the ECM during regeneration and development are largely a matter of speculation. Although previous studies have already explored the influence of a number of ECM adhesion proteins and neurotrophic factors on neurite outgrowth, none have been carried in a systematic approach that allows for the simultaneous comparison of different surface conditions in relation to different neurotrophic factors. Motivated by the necessity of establishing controlled environments that allow for the rational design of stable neuronal/biomaterial interfaces, the long-term effects of NGF and FGF-2 on the behavior of PC12 cells plated on collagen and laminin modified surfaces were evaluated. A pheochromocytoma cell line derived from transplantable rat adrenal medulla, PC12 cells have been commonly employed as an instructive model for studying the underlying mechanisms of neuronal differentiation. Long-term characterization of PC12 proliferation and neuronal differentiation for an experimental duration of 7–22 days was achieved by both qualitatively and quantitatively assaying for cell count, neurite number, neurite mean length, and neurite stability. Neurite stability was determined in terms of resistance to loss after neurotrophic factor (NGF/FGF-2) withdrawal. The present findings demonstrate that ECM adhesion proteins collagen and laminin are equally effective in promoting PC12 proliferation. It was noted as well that NGF supplemented collagen cultures are significantly more efficient in providing long-term support to PC12 differentiation in terms of neurite number, mean length, and stability.