cssi/SciSciGPT-SciSciNet huggingface dataset:
Paleodemography: Critiques and Controversies

Recent criticism of paleodemographic methods...has centered on biases introduced by the nature of reference samples and the population-specificity of techniques for estimating age in skeletal remains. This paper examines five key arguments concerning this bias and alleged imprecision from the perspective of life table analysis. The results of...simulation and statistical analyses indicate that the criticism leveled by Bocquet-Appel and Masset is extreme. Imprecision in age indicators applied to older adults remains a problem however as does interobserver error. Data for Northern American skeletal samples are used as illustrations. (EXCERPT)
Reading and listening in people with aphasia: effects of syntactic complexity.

Purpose The purpose of this study was to compare online effects of syntactic complexity in written and spoken sentence comprehension in people with aphasia (PWA) and adults with no brain damage (NB...
High resolution brain PET with large detectors. II Performance study

For pt.I see ibid., vol.37, p.842-5, (1990). The ultimate resolution and sensitivity obtainable with a large crystal detector PET (positron emission tomography) are studied, and its performance is compared with other high-resolution systems currently under development that use small (thin) crystal detector arrays. System performance is investigated using Monte Carlo simulation. Results show that uniform high-resolution images can be obtained with the proposed system. Due to its simplicity and expected low cost, it appears that the proposed brain PET could be an ideal candidate for high-resolution brain imaging, aiming for resolution down to 2 to 3 mm full width at half maximum as well as for other high-resolution imaging applications such as animal imaging. >
Evidence of a hypermineralised calcified fibrocartilage on the human femoral neck and lesser trochanter

Femoral neck fractures are a major cause of morbidity and mortality in elderly humans. In addition to the age-related loss of cancellous bone, changes to the microstructure and morphology of the metaphyseal cortex may be a contributing factor in osteoporotic hip fractures. Recent investigations have identified a hypermineralised tissue on the neck of the femur and trochanteric region that increases in fractional area with advancing age in both males (Boyce & Bloebaum, 1993) and females (Vajda & Bloebaum, 1999). The aim of this study was to determine if the hypermineralised tissue previously observed on the proximal femur is calcified fibrocartilage. Regional variations in the fractional area of hypermineralised tissue, cortical bone, and porosity of the cortical bone along the neck of the femur and lesser trochanter were also quantified. Comparison of back scattered electron and light microscope images of the same area show that regions of hypermineralised tissue correlate with the regions of calcified fibrocartilage from tendon and capsular insertions. The hypermineralised tissue and calcified fibrocartilage had similar morphological features such as the interdigitations of the calcified fibrocartilage into the bone, lacunar spaces, and distinctly shaped pores adjacent to the 2 tissues. Regions of the neck that did not contain insertions were covered with periosteum. There were no regional differences (P > 0.05) on the superior and inferior femoral neck in terms of the percentage area of hypermineralised calcified fibrocartilage, cortical bone, or cortical bone porosity. The lesser trochanter exhibited regional differences in the fractional area of hypermineralised calcified fibrocartilage (P = 0.007) and cortical bone (P = 0.007) but not porosity of the cortical bone (P > 0.05). The effects of calcified fibrocartilage on femoral neck periosteal expansion, repair, and mechanics are unknown, but may play a role in osteoporotic fractures and intracapsular fracture healing.
Freezing of Slurry Around Piles in Permafrost

In Arctic construction, piles are frequently placed in drilled holes in permafrost and held in position while slurry of sand or silt and water is poured into space around them; analysis of method of predicting time that slurry will take to freeze in particular conditions; problem solved by computer.
Brubaker: A Guide for Viewing, Understanding, and Applying the Film

This guide is an instructional packet for viewing the full-length feature film Brubaker, starring Robert Redford and based on a true story from a prison in Arkansas. The guide allows for stopping the film at certain spots and then answering questions in the guide. A short discussion of the students' answers and then continuing the film to see what happened permits students to compare their approaches with those taken by Brubaker. The film is powerful; some may find it a bit too violent in places, but most students will find its insight into managing change compelling.
Interacciones entre los componentes de la dieta

Parmi les interactions decrites, un certain nombre seulement ont une influence sur la nutrition humaine, au cours de l'absorption intestinale ou de l'utilisation des nutriments. Importance des interactions avec les fibres, interactions nutriments-medicaments, selon le type d'aliment et les populations
Resistance and Power in Organizations

The article reviews the book "Resistance and Power in Organizations," edited by John Jermier, David Knights, and Walter Nord.
OUTCOMES AND RISK FACTORS FOR RE-INTERVENTION IN CHILDREN UNDERGOING RIGHT VENTRICLE DECOMPRESSION FOR PULMONARY ATRESIA INTACT VENTRICULAR SEPTUM: RESULTS FROM A MULTI-CENTER COLLABORATIVE

Outcomes following right ventricle (RV) decompression in infants with pulmonary atresia and intact ventricular septum (PA-IVS) vary widely. Descriptions of these outcomes are limited to small single-center studies. Neonates undergoing catheter (cath) pulmonary valve perforation/valvuloplasty or
Is there an Asian way of maritime war

AbstractIt would simplify matters for U.S. officials and sea-service officers enormously if there were an Asian way of maritime war. It would make Asian governments and navies more predictable. They would tend to view the strategic setting similarly, harness sea power for similar political and strategic aims, and design doctrines and forces that were roughly compatible. Unfortunately, however, disparities between Asian societies and civilizations work against any common Asian approach to sea power. There is no substitute for close study of individual societies and cultures when forging ties with seafaring Asian states.
Preparation and Anti-wear Properties of Oil-soluble MoS_2 Nanoparticles

Molybdenum disulfide nanoparticles surface-modified by Py DDP was prepared with coprecipitation method used. The composition and structures were characterized by FT-IR,TEM and elemental analysis. The dispersion was studied in the organic solvent. The results showed that the particle diameter of the prepared Mo S2 nanoparticles was in a range of 30 nm ~ 50 nm. The dispersibility in chloroform,acetone and the base oil was good. Their tribologiy behavior was evaluated with a four-ball tester. The tribology results showed that the prepared Mo S2 nanoparticles is an oil addition exhibited good friction-reduction and antiwear properties.
Severe toxemia of pregnancy.

A simple program of treatment is outlined which has proved highly successful in the management of more than 400 cases of severe toxemia of pregnancy, including 73 cases of eclampsia. A combination of cryptenamine and hydralazine is given intravenously to reduce vasospasm, and magnesium sulfate is given intramuscularly for sedation.
Khovanov–Seidel quiver algebras and Ozsváth–Szabó's bordered theory

Abstract In the 2016 preprint “Kauffman states, bordered algebras, and a bigraded knot invariant,” Ozsvath and Szabo introduced a set of algebraic constructions in the spirit of bordered Heegaard Floer homology. Their constructions can be used to compute knot Floer homology algebraically for knots in the 3-sphere. In this paper we investigate a relationship between Ozsvath–Szabo's bordered theory and the algebras and bimodules constructed by Khovanov and Seidel in “Quivers, Floer cohomology, and braid group actions” (2002). Specifically, we show that the Khovanov–Seidel quiver algebras are isomorphic to quotients of idempotent truncations of some of Ozsvath–Szabo's algebras. Furthermore, we show that the dg bimodule associated to a braid generator by Khovanov–Seidel, with the right action restricted using the quotient map, is homotopy equivalent to Ozsvath–Szabo's DA bimodule with the left action induced using the quotient map.
Molecular genetics of Marfan syndrome and Ehlers-Danlos type IV

Two inherited disorders of connective tissue have major cardiovascular complications, Marfan syndrome and Ehlers-Danlos syndrome type IV. Major progress has been made toward understanding both the genetic defect and the molecular pathogenesis of these two disorders. Marfan syndrome results from mutations in the FBN1 gene, which encodes fibrillin-1, an extracellular matrix component found in structures called microfibrils. Histologic characterization of the effect of FBN1 mutations on fibrillin-1 cellular processing and microfibril formation has provided insights into fibrillin-1 function. Ehlers-Danlos syndrome type IV results from mutations in the COL3A1 gene, which encodes the polypeptides in type III collagen. Despite advances in the molecular genetics of these two disorders, there is not a molecular diagnostic test for these syndromes based on the identification of gene mutations. Marfan syndrome remains primarily a clinical diagnosis. Biochemical analysis of the amount of type III collagen produced by dermal fibroblasts has proven to be a powerful diagnostic test for Ehlers-Danlos syndrome type IV.
The Earth as a Gift-Giving Ancestor Nietzsche’s Perspectivism and African Animism

This article puts into conversation Friedrich Nietzsche’s perspectivism and a particular expression of “African animism,” drawn from my ethnographic fieldwork in Ghana. Nietzsche’s perspectivism ex...
New approach in lung cancer radiotherapy offers better normal tissue sparing

Abstract Purpose Medical images are more than pictures. They contain additional quantitative information which can be interrogated, quantified, and utilized. Besides anatomical information computed tomography (CT) imaging data provide electron density information. Radiotherapy use of this density information is limited to its application only in dose calculations. The direct product of dose, density, and volume forms a quantity called integral dose. The integral dose delivered to a volume of interest is the total energy deposited in that volume. Here it is hypothesized that minimization of the integral dose is advantageous in radiotherapy planning. The purpose of this work is to study the incorporation of quantitative imaging information in radiotherapy inverse optimization through total energy minimization (Energy hereafter). Design Twenty lung patient plans were studied. For each patient density was quantified on voxel-by-voxel basis through image gray value-to-density conversion curves. Energy-based objective function was used for inverse radiotherapy plan optimization. The obtained plans were evaluated in the light of current standard of care, based on dose–volume (DVH) optimization approach. Results The statistical significance analyses of the results indicated that the doses to normal tissue were between 14% and 45% lower, when Energy-based optimization was used instead of DVH-based optimization. Conclusion Incorporation of quantitative imaging information, through CT derived density, in the optimization cost function allows reduction of dose to normal tissue for NSCLC cases. Energy-based radiotherapy plans result in lower normal tissue dose and potentially lower complication rates compared to standard of care.
Regenerative Strategies for the Central Nervous System

Injury or disease to the central nervous system may result in substantial debilitating consequences for the effected patient. Current clinical treatments fall short of directly addressing the disease/injury pathology that blocks neuroregeneration to restore full functional recovery. However, recent advances in neural tissue engineering and regenerative medicine provide new avenues and approaches to tackling multi-faceted disease/injury pathology. This review highlights common barriers for regeneration in the central nervous system, the current/upcoming pharmaceutical therapies, and tissue engineering/regenerative medicine approaches.
Steric effects on complexation of bis(meta-phenylene)-32-crown-10 derivatives with paraquats

Novel 5,5′-disubstituted BMP32C10 derivatives bearing different sized substituents were designed and prepared. The stoichiometries and complexation behavior between these hosts and paraquats were studied. It was found that bulky 5,5′-substituents disfavor complexation with paraquats by hindering the formation of [2]pseudorotaxane and “taco” complexes.
Simultaneous quantification of N- and O-glycans using a solid-phase method

Glycosylation has a pivotal role in a diverse range of biological activities, modulating the structure and function of proteins. Glycogens coupled to the nitrogen atom (N-linked) of asparagine side chains or to the oxygen atom (O-linked) of serine and threonine side chains represent the two major protein glycosylation forms. N-glycans can be released by glycosidases, whereas O-glycans are often cleaved by chemical reaction. However, it is challenging to combine these enzymatic and chemical reactions in order to analyze both N- and O-glycans. We recently developed a glycoprotei n immobilization for glycan extraction (GIG) method that allows for the simultaneous analysis of N- and O-glycans on a solid support. GIG enables quantitative analysis of N-glycans and O-glycans from a single specimen and can be applied to a high-throughput automated platform. Here we provide a step-by-step GIG protocol that includes procedures for (i) protein immobilization on an aldehyde-active solid support by reductive amination; (ii) stabilization of fragile sialic acids by carbodiimide coupling; (iii) release of N-glycans by PNGase F digestion; (iv) release of O-glycans by β-elimination using ammonia in the presence of 1-phenyl-3-methyl-5-pyrazolone (PMP) to prevent alditol peeling from O-glycans; (v) mass spectrometry (MS) analysis; and (vi) data analysis for identification of glycans using in-house developed software (GIG Tool; free to download via http://www.biomarkercenter.org/gigtool). The GIG tool extracts precursor masses, oxonium ions and glycan fragments from tandem (liquid chromatography (LC)-MS/MS) mass spectra for glycan identification, and reporter ions from quaternary amine containing isobaric tag for glycan (QUANTITY) isobaric tags are used for quantification of the relative abundance of N-glycans. The GIG protocol takes ∼3 d.
Electrospun Nanofibers in Drug Delivery: Fabrication, Advances, and Biomedical Applications

Abstract Nanotechnology is an expanding and exciting technology. It has emerged as a vital scientific and commercial engine providing global economic benefits. With expanding knowledge of nanomaterials manufacturing techniques, research groups around the globe are focused more on the preparation of novel nanomaterials for various applications. Among the various techniques reported in the literature, electrospinning has gathered significant momentum due to its ability to fabricate nanostructures with unique properties such as a high surface area and inter/intrafibrous porosity. Electrospinning has been the most widely used technique in the 20th and early 21st centuries. Since its first application in the early 20th century, significant improvements have been made in the design, fabrication, and utility of the nanomaterials. The production of nanofibers via electrospinning is dependent on many operating parameters. This chapter provides an overview of the electrospinning (applied electric field, distance between the needle and collector, as well as flow rate and needle diameter), solution (polymer concentration, viscosity, solvent and solution conductivity), and environmental (relativity humidity and temperature) parameters. All of these parameters are crucial for the application of nanofibers in tissue engineering, drug delivery systems, wound dressings, antibacterial study, filtration, biosensors, and immunoassay.
Techno-economic analysis of an integrated gasification direct-fired supercritical CO2 power cycle

Abstract This study describes recent systems analyses of coal-fueled, oxy-fired direct supercritical CO2 (sCO2) power cycles, which are inherently amenable to carbon capture and storage (CCS) processes. In this plant, coal is gasified in an entrained flow gasifier, cleaned of sulfur and particulate matter, and supplied to the sCO2 cycle’s oxy-combustor, where it burns with oxygen in a high pressure, heavily diluted sCO2 environment. Following expansion of the combustion products through a turbine and recuperation of its thermal energy, water is condensed from the working fluid, which is recompressed for return to the combustor, with a portion of the CO2 exhausted from the cycle for CCS. The conceptual designs for two coal-fueled direct-sCO2 power plants are included in this study, one as a baseline sCO2 plant, and another which includes improved thermal integration between the sCO2 cycle and the gasifier. Parametric analyses are used to optimize the overall plant configuration and operating conditions, from which the capital cost and operating expenses of the plant are estimated, and the cost of electricity (COE) calculated. The study results yield plant thermal efficiencies of 37.7% (HHV) and 40.6% for the baseline and improved sCO2 cases, including CCS. These efficiencies are a significant improvement on the 31.2% efficiency of the same gasifier in an integrated gasification combined cycle (IGCC) plant configuration with CCS, and are also shown to be comparable to more advanced IGCC systems and other coal-fueled direct sCO2 plants with CCS. Detailed economic analyses yield COE results of $137.3/MWh and $122.7/MWh for the baseline and thermally integrated sCO2 plants, respectively, representing 10% and 20% improvements on the reference IGCC COE of $152.6/MWh, with CCS. Recommendations are made for alternative gasification systems and modifications to the thermal integration between the gasifier and direct sCO2 system, which should further improve plant performance relative to alternative systems.
The Measurement of Individual Congestion Costs: An Economic Application to Wilderness Recreation

Publisher Summary This chapter presents a general methodology for accommodating and measuring congestion-related quality deterioration. The model presented in the chapter is a straightforward extension of Lancaster's framework. In this scheme, an individual is assumed to have a utility function expressed in terms of attributes or characteristics. Each good or service is assumed to provide few or all of these attributes in various proportions, and the consumer's choice problem is to maximize utility subject to an income constraint and the attributes' relationships to these goods and services. Within this model, congestion and the attendant quality deterioration of a particular service flow becomes a reduction (perhaps elimination) of the service's attributes. The value of the good to the individual is directly related to which attributes it possesses. The chapter discusses the effects of congestion in terms of the reductions of each individual's willingness to pay.
2 Laceration of the anterior mitral valve leaflet to prevent left ventricular outflow tract obstruction (lampoon)

Background Left ventricular outflow tract (LVOT) obstruction is a life-threatening complication of transcatheter mitral valve implantation (TMVI), caused by septal displacement of the anterior mitral leaflet (AML). We used a new catheter technique to split the AML. Methods Eighteen patients with severe mitral valve disease, prior surgical ring or mitral annular calcification, and prohibitive surgical risk were offered LAMPOON and TMVI on a compassionate basis. Iatrogenic LVOT obstruction was predicted in all based on echocardiography and CT. Transfemoral guiding catheters directed an electrified guidewire across the AML towards a snare in the left atrium. The externalised guidewire loop was electrified to lacerate the AML along the centreline from base to tip, sparing chordae, immediately before transseptal TMVI (figure 1). Results All patients had successful laceration of the AML. Following TMVI, the transcatheter heart valves spanned the LVOT but with Doppler flow through the open cells. In one patient, the valve missed the anterior landing zone and deployed into the LVOT, causing obstruction despite LAMPOON. All other patients had no or tolerable gradients. Conclusions This novel catheter technique, which resembles surgical chord-sparing AML resection, may enable TMVI in patients with prohibitive risk of LVOT obstruction. An early feasibility trial of LAMPOON is underway in the United States.
Open-source speech-processing platforms: An application example

Speedy assessment of frequency-importance functions for a variety of speech materials is possible with an Open-source Speech-Processing (OSP) platform. One such platform is that developed at the University of California San Diego. It provides real-time, six-band, processing of microphone input from ear-level transducer assemblies. This platform was used to provide normative data on a new consonant-contrast test developed for use in studies of hearing-aid self-fitting. Performance of young normally hearing adults was measured under various conditions of low-pass filtering. Because the UCSD system includes two sets of filters whose center and crossover frequencies differ by half an octave, it was possible to test with cut-off frequencies at half-octave intervals from 250 through 8000 Hz. Group mean composite contrast score, after correction for chance, fell to around 50% at a (6 dB) cut-off frequency of 660 Hz. With a cut-off frequency of 1 kHz, group-mean contrast scores were in the region of 30 to 35% for place and clustering, 70% for continuance, and over 90% for voicing. Determining the frequency-importance functions of various speech materials and speech features is just one example of the potential value of OSPs in hearing-science and hearing-aid research.Speedy assessment of frequency-importance functions for a variety of speech materials is possible with an Open-source Speech-Processing (OSP) platform. One such platform is that developed at the University of California San Diego. It provides real-time, six-band, processing of microphone input from ear-level transducer assemblies. This platform was used to provide normative data on a new consonant-contrast test developed for use in studies of hearing-aid self-fitting. Performance of young normally hearing adults was measured under various conditions of low-pass filtering. Because the UCSD system includes two sets of filters whose center and crossover frequencies differ by half an octave, it was possible to test with cut-off frequencies at half-octave intervals from 250 through 8000 Hz. Group mean composite contrast score, after correction for chance, fell to around 50% at a (6 dB) cut-off frequency of 660 Hz. With a cut-off frequency of 1 kHz, group-mean contrast scores were in the region of 30 to 35% for...
Lessons learned in generating stereoscopic images

An application can generate Stereoscopic 3D images by rendering the same image from two slightly offset viewing angles to produce a left and right eye image. When the scene is displayed, the left and right eye images are interlaced producing what appears to be a fuzzy shaking object to a viewer. Yet, if the viewer is wearing 3D glasses that are synched with the graphics card as it generates the left and right eye images, the 3D glasses will alternately obscure one eye from being able to see. Thus only the right eye will see the right eye image and only the left eye will see the left eye image. The brain will combine the interlaced images making one image which appears to stand out from the screen. Because the human viewer is looking through the 3D glasses at the display, they can see not only the Stereoscopic 3D image but other real objects around them, such as the mouse, keyboard, and their own hands. OpenGL is an Open Source library which allows complex cross platform 3D graphics applications to be developed using C/C++. During the process of converting existing OpenGL application to create Stereoscopic 3D images, it was discovered that GPU vendor NVIDIA only offers limited support for Stereoscopic 3D images when OpenGL is being used. As a result the authors have been forced to convert existing OpenGL applications to Direct3D so as to be able to make these applications support Stereoscopic 3D images. This paper will cover our experience in porting an OpenGL application to Direct3D and the additional features that must be added to support Stereoscopic 3D images.
VLSI architectures for recognition of context-free languages

This paper presents two VLSI architectures for the recognition of context-free languages based on Cocke-Younger-Kasami’s and Earley’s algorithms. By restricting the context-free grammar to be free of null rule, it is possible to implement the two algorithms on triangular shape VLSI systems. For both parsing algorithms, the designed VLSI systems are capable of recognizing a string of length n in 2n time units. Extensions to the recognition of regular tree languages and finite-state languages are also discussed.
Basic Sentence Patterns and Major Variations

This chapter reviews sentence constituents and basic sentences, and then investigates variations on basic sentences. The chapter is divided into four sections. Section 8.1 reviews basic sentences; Sect. 8.2 explores different types of questions; Sect. 8.3 considers passive constructions; and Sect. 8.4 looks at sentence substitutions.
Manufacturing Scheduling for Reduced Energy Cost in a Smart Grid Scenario

This paper explores the feasibility of including manufacturing facilities in smart grid. A microgrid in a suburban region in Indiana serving 150 single-family homes, 4 medium-sized office buildings, and 1 flow shop is simulated using GridLAB-D. For residential and commercial buildings, passive controllers are implemented on thermostatically controlled devices. For the factory, Drum-Buffer-Rope (DBR) methodology is used to schedule processes to minimize impact on productivity while reducing power consumption during peak hours. Results suggest that it is possible for an industrial facility to become an integrated part of a smart grid. Future research opportunities related to smart factories are discussed.
E-173 Peri-infarct acid/base and electrolyte alterations in acute large vessel occlusion stroke

Introduction In the setting of mechanical thrombectomy for emergent large vessel occlusion (ELVO), we have for the first time developed a protocol to collect and evaluate blood immediately distal and proximal from the removed intracranial thrombus. These samples provide a unique resource in evaluating acute changes in acid/base and electrolyte concentrations at the time of ischemic stroke. The purpose of this study is to compare acid/base and electrolyte differences obtained proximal and distal to the occluded intracranial thrombus in acute ischemic stroke patients. Methods We developed the BACTRAC protocol: an IRB-approved tissue banking strategy for ELVO (clinicaltrials.gov NCT03153683). We compared arterial blood gases (ABG) of blood distal versus proximal to the thrombus during thrombectomy. Comparisons were evaluated by Paired Samples T-Tests (p Results We analyzed the first 24 subjects (age=65±0.54, 11 males) in the BACTRAC registry. Preliminary results demonstrate that, while pH is nonsignificant, distal blood in relation to proximal blood showed significantly lower oxygen (p=0.010), carbon dioxide (p=0.001), bicarbonate (p=0.002), ionized calcium (p=0.001), and potassium (p=0.001). Sodium concentration was significantly higher (p=0.002) in distal blood. These results suggest alterations occurring intravascularly during ischemia. Conclusion These findings provide a novel insight into the pathology of large vessel stroke in humans, particularly in regard to identifying acute changes in acid/base balance and electrolyte concentrations that occur during stroke. Disclosures J. Fraser: None. S. Martha: None. L. Collier: None. S. Davis: None. A. Abdulnasser: None. S. Grupke: None. K. Pennypacker: None.
Resource Utilization for Prenatally Diagnosed Single-Ventricle Cardiac Defects: A Philadelphia Fetus-to-Fontan Cohort Study.

Background Healthcare resource utilization is substantial for single‐ventricle cardiac defects (SVCD), with effort commencing at time of fetal diagnosis through staged surgical palliation. We sough...
Everyday Leadership: A Combined Resident and Faculty Workshop.

Objectives Historically, physicians have always been viewed as leaders in the healthcare field. Whether they embrace this role, physicians often find themselves in a leadership role, from the clinical setting to an institutional setting. In most cases, this leadership role is taken on without prior training on even the most basic concepts required for effective leadership. Methods We created a combined leadership workshop for both faculty members and residents in training. The topics included an introduction to leadership styles, emotional intelligence, and negotiation skills. The leadership workshop was conducted as an interactive training session for faculty and resident physicians and was embedded during routinely scheduled teaching time for residents. Results We present survey data from two annual workshops, demonstrating a clear improvement in participants' perceived understanding of leadership skills in the areas of leadership style, emotional intelligence, and negotiation skills. We have found that fairly simple measures may be taken to embed this training into the busy schedules of medical faculty and residents in training and that tapping into local expertise was an effective and efficient approach to this. Conclusions We believe the results from our experience can help inform other programs about practical approaches to teaching leadership skills.
Characteristics of nursing homes with comprehensive antibiotic stewardship programs: Results of a national survey.

Background Antibiotic stewardship in nursing homes (NHs) is a high priority owing to intense antibiotic use and increased risk of adverse events. Updated Centers for Medicare and Medicaid Services regulations required NHs to establish antibiotic stewardship programs (ASPs). This study describes the current state of NH ASPs. Methods A nationally representative survey of NHs was conducted in 2018. ASP comprehensiveness, infection preventionist (IP) training, participation in Quality Innovation Network-Quality Improvement Organization (QIN-QIO) activities, and facility and staff characteristics were analyzed using weighted descriptive statistics and multinomial regression models. Results Of 861 NHs, 33.2% (6-7) had “comprehensive” ASP policies, 41.1% (4-5) had “moderately comprehensive” ASP policies, and 25.6% (≤ 3) had “not comprehensive” ASP policies. Data collection on antibiotic use was most reported (91.4%), and restricting use of specific antibiotics was least reported (19.0%). Comprehensive ASPs were associated with QIN-QIO involvement; moderate and comprehensive ASPs were associated with IP training and high occupancy. Discussion Immediately following Centers for Medicare and Medicaid Services regulation changes, a majority of NHs had moderately comprehensive or comprehensive ASPs. Rates for each policy and infection control-trained IPs increased from previous studies. Conclusions NH ASPs are becoming more comprehensive. Infection control training and partnerships with QIN-QIOs can support NHs to increase ASP comprehensiveness.
Structuring Culture for Change: Strategy, Participation, and Collective Purpose in a Japanese Factory

Organizational culture in Japanese firms has often been used as an independent variable to explain both economic success and, more recently, economic troubles. The Japanese work ethic and lifetime employment stand in for culture in the former case and Japanese reliance on rigid traditions and hierarchy stand in for culture in the latter. This article examines a Japanese factory campaign designed to prepare for recent and ongoing challenges to employment practices and business strategies by “strengthening culture” and “creating new values.” Factory managers worked to create support for their goals in face of department, section, and worker responses ranging from enthusiasm to apathy or opposition. An analysis of this campaign shows that culture is a social process, not a given body of knowledge and practice. It also shows how that process is carried out within a particular economic institution by particular actors.
A Pharmacist-Led Program to Taper Opioid Use at Kaiser Permanente Northwest: Rationale, Design, and Evaluation.

Introduction Primary care practitioners (PCPs) are concerned about adverse effects and poor outcomes of opioid use but may find opioid tapering difficult because of a lack of pain management training or time constraints limiting patient counseling. In 2010, Kaiser Permanente Northwest implemented a pharmacist-led opioid tapering program-Support Team Onsite Resource for Management of Pain (STORM)-to address high rates of opioid use, alleviate PCPs' workload demands, and improve patient outcomes. Objective To describe the rationale, structure, and delivery of this unique pharmacist-led program, which partners with PCPs and provides individualized care to help patients reduce opioid use, and the Facilitating Lower Opioid Amounts through Tapering study, which examines the program's effectiveness, cost-effectiveness, and implementation. Results The STORM program includes a pain medicine physician, a social worker or nurse, and pharmacists who have received specialized clinical and communications training. The program has a 2-fold role: 1) to provide PCP education about pain management and opioid use and 2) to offer clinician and patient support with opioid tapering and pain management. After program training, PCPs are equipped to discuss the need for tapering with a patient and to refer to the program. Program pharmacists provide a range of services, including opioid taper plans, nonopioid pain management recommendations, and taper-support outreach to patients. Discussion The STORM program provides individualized care to assist patients with opioid tapering while reducing the burden on PCPs. Conclusion The STORM program may be a valuable addition to health care systems and settings seeking options to address their patients' opioid tapering needs.
Colin S. Gray and his contribution to the study of geopolitics: An appreciation

Colin Gray has made extraordinary contributions to modern strategic thought. His clear thinking and evidence-based argumentation help understand why he has been such an influential commentator on i...
Effect of Virtual Reality Perspective-Taking on Related and Unrelated Contexts.

Virtual reality perspective-taking (VRPT) experiences effectively increase both empathy and prosocial behaviors toward related social targets (e.g., cutting down a tree in virtual reality increases...
The Clinicopathological Features of Mediastinal Tuberculous Lymphadenitis in Cancer Patients and the Diagnostic Role of Endobronchial Ultrasound.

Introduction Mediastinal lymphadenopathy in cancer patients can be of both malignant and non-malignant (including infectious) etiology. Tuberculosis (TB) is an important differential in this regard, particularly in regions with high TB endemicity. Objectives To determine the incidence and clinical characteristics of mediastinal tuberculous lymphadenitis (MTBLA) in cancer patients of a TB-endemic region, and the diagnostic role of endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) in such patients, utilizing both cytopathological and microbiological parameters for diagnosing TB. Materials and methods We retrospectively analyzed the relevant clinical data of all cancer patients diagnosed with MTBLA after undergoing EBUS-TBNA at our center, between July 2013 till July 2018 (total five years). The diagnostic yield, sensitivity and specificity of cytopathological and microbiological investigations (including TB culture and Mycobacterium tuberculosis Gene Xpert assay) for diagnosis of MTBLA were determined. Results Of the total 493 cancer patients, MTBLA was diagnosed in 54 (11%), with mean age of 48 ± 12 years, and predominantly male gender (59.3%). Thirty-three (61.1%) patients were clinically asymptomatic at the time of presentation, while cough was reported by 13 (24.7%) patients and weight loss, shortness of breath and fever by only six (11.1%), six (11.1%) and five (9.2%) patients, respectively. Total 53% had an underlying gastrointestinal malignancy. Chest imaging revealed bilateral versus unilateral hilar lymph node enlargement in 32 (59.3%) against 22 (40.7%) patients, respectively, while only 14 (25.9%) had accompanying lung parenchymal findings. Granulomatous TBNA cytology was detected in 41 (77.3%) patients, giving a diagnostic yield of 70.3% for MTBLA, with an estimated sensitivity and specificity of 79.2% and 99%, respectively. TB culture and Gene Xpert had a respective sensitivity of 48% and 53%, with the combined diagnostic yield of 64.8%. Treatment response was achieved in 51 (94%) patients, based on which EBUS was estimated to have sensitivity and specificity of 89% and 99% respectively, with no reported complications. Conclusion Mediastinal TB can have diverse manifestations among cancer patients and can often be clinically occult, with overlapping radiological impressions. EBUS-TBNA can serve as a safe and reliable diagnostic tool in this regard.
No additional effects of ursolic acid supplementation associated with combined exercise program on metabolic syndrome of postmenopausal women: A double-blind, randomized, placebo-controlled trial.

Summary Background & aims Ursolic acid (UA) supplementation may have therapeutic effects on metabolic syndrome (MetS). Therefore, this study aimed to investigate the effects of UA supplementation associated with a combined exercise program on MetS components in postmenopausal women. Methods Twenty-six women (61 ± 7 years) were randomized into two groups: UA (n = 13) and placebo (PLA, n = 13). Both groups followed a combined exercise program for 8 weeks (twice a week; ~60 min at moderate intensity) associated with either UA (450 mg/day) or placebo supplementation. Before and post-intervention, waist circumference (primary outcome), resting blood pressure, fasting blood analyses, body composition and physical function (secondary outcomes) were evaluated. Results Greater changes in the absolute (mean difference: 1.8 kgf, 95% CI 0.3, 3.2) and relative (0.03 kgf/kg, 95% CI 0.01, 0.05) handgrip strength was observed for the UA group compared with PLA. However, no significant effects between groups were observed for waist circumference and other secondary outcomes. Furthermore, remission of MetS (according to the NCEP ATP III criteria) occurred in 38.5% of the participants in both groups. Conclusions The UA supplementation did not promote additional MetS profile improvement after 8 weeks of free-living intervention. However, our data indicated that UA resulted in a higher response on handgrip strength than did placebo in postmenopausal women, but further long-term studies are needed. Trial registration Brazilian Registry of Clinical Trials (ensaiosclinicos.gov.br): number RBR-276rrt.
The Role of Computer Skills in Personal Health Record Adoption Among Patients With Heart Disease: Multidimensional Evaluation of Users Versus Nonusers

Background: In the era of precision medicine, it is critical for health communication efforts to prioritize personal health record (PHR) adoption. Objective: The objective of this study was to describe the characteristics of patients with heart disease that choose to adopt a PHR. Methods: A total of 79 patients with chronic cardiovascular disease participated in this study: 48 PHR users and 31 nonusers. They completed 5 surveys related to their choice to use or not use the PHR: demographics, patient activation, medication adherence, health literacy, and computer self-efficacy (CSE). Results: There was a significant difference between users and nonusers in the sociodemographic measure education (P=.04). There was no significant difference between users and nonusers in other sociodemographic measures: age (P=.20), sex (P=.35), ethnicity (P=.43), race (P=.42), and employment (P=.63). There was a significant difference between PHR users and PHR nonusers in CSE (P=.006). Conclusions: In this study, we demonstrate that sociodemographic characteristics were not an important factor in patients’ use of their PHR, except for education. This study had a small sample size and may not have been large enough to detect differences between groups. Our results did demonstrate that there is a difference between PHR users and nonusers related to their CSE. This work suggests that incorporating CSE into the design of PHRs is critical. The design of patient-facing tools must take into account patients’ preferences and abilities when developing effective user-friendly health information technologies.
Trust Doesn’t Explain Regional U.S. Economic Development and Five Other Theoretical and Empirical Problems with the Trust Literature

Economists have developed a vast empirical literature on how cultural traits like generalized trust affect economic output. Much of this literature finds a positive causal relationship between measures of generalized trust, as gathered by international surveys, and economic output. However, the trust literature commits five deadly empirical and theoretical sins that undermine its findings. From the quality of the survey questions and responses to the paucity of theoretical models used to explain how trust affects economic outcomes to the radically different results from experimental evidence, the trust literature is riven with poor methods and bad data that undermine its conclusions. Even so, applying the best methods in the trust literature to regional level analysis in the United States reveals no statistically significant correlation between economic output and trust. We see no reason to trust the findings of the trust literature.
Nonspecific activation of murine lymphocytes: VIII. Effects of d-penicillamine☆

Abstract The effects of d -penicillamine on proliferation and polyclonal activation of lymphocytes were studied in cultures of spleen cells from a variety of murine strains. Inclusion in serum-free or serum-containing medium of optimal concentrations of d -penicillamine resulted in the uptake of tritiated thymidine in a dose-dependent fashion, with both lower and higher doses causing less marked effects. The kinetic peak of these responses was found to occur at Day 2 of culture. Experiments examining the responsiveness of B-cell-enriched and T-cell-enriched populations demonstrated that d -penicillamine, like 2-mercaptoethanol, stimulates both types of cell. The magnitude of the response remained unchanged in populations depleted of adherent cells. In correlation with previous results seen for 2-ME, d -penicillamine was mitogenically active both in reduced and oxidized forms. The oxidized form failed to enhance the response to LPS, in contrast to the marked effect of the reduced form. Additionally, d -penicillamine failed to evoke a mitogenic response from B cells of CBA/N mice, a strain characterized by a deficit in the function of a particular set of mature B cells. Young mice from autoimmune strains responded to d -penicillamine as well as normal mice did. No relationship could be observed between responsiveness to d -penicillamine and the H-2 phenotype of the cell donor, and in A/J mice hyporesponsiveness was shown to be a function of their background rather than H-2. d -Penicillamine was found to function as a polyclonal B-cell activator, and to significantly enhance the primary humoral immune response to sheep erythrocytes in vitro . These immunomodulatory effects of d -penicillamine are discussed in relation to possible pathogenetic mechanisms of its spectrum of autoimmune side effects.
Studies on leukokinins. 3. Pharmacological activities of leukokinins M and PMN.

Abstract Studies on the pharmacology of two leukokinins, which do not contain bradykinin as part of their molecules, have shown them to be very active as hypotensive agents and as agents which increase vascular permeability. The leukokinins relax the rat duodenum, indicating that this assay can no longer be considered specific for bradykinin. The importance of these agents in inflammation and other pathological processes is discussed.
B-vitamin intake, metabolic genes, and colorectal cancer risk (United States).

Objective: This population-based case–control study was designed to investigate the interrelationships between polymorphisms in the methylenetetrahydrofolate (MTHFR C677T and A1298C) gene and other genes (MTR A2756G; MTRR A66G and CBS 844ins68), intake of B-vitamins and colorectal cancer risk (CRC). Methods: We interviewed 727 CRC cases of Japanese, Caucasian, or Native Hawaiian origin and 727 controls matched on sex, age, and ethnicity. Results: Compared to the homozygous wild-type genotype, the odds ratios for subjects with one or two MTHFR 677T variant alleles were 0.8 (0.6–1.1) and 0.7 (0.5–1.1), respectively (p for gene–dosage effect: 0.04). The TT genotype was associated with a 50–60% decrease in CRC risk among subjects with high intake of folate or vitamin B6, compared to those with the CC genotype and low levels of intake. The MTHFR 1298C and CBS8 44ins68 variant alleles were also found to be weakly protective against CRC and to act jointly with the 677T allele. Conclusions: This study provides additional evidence for a decreased CRC risk for subjects with the MTHFR 677T allele, particularly at high levels of folate and vitamin B6 intake. Our data also suggest that the relationships between CRC and the MTHFR A1298C and CBS 844ins68 polymorphisms warrant further study.
Experimental Evidence of Multiple Diffusion Mechanisms in Thin-Film Cu(In,Ga)Se 2

Lattice and grain boundary diffusions of cadmium in copper indium gallium diselenide (Cu(In,Ga)Se2 or CIGS) thin films were investigated by annealing cadmium into samples of 700-nm CIGS thickness at temperatures between 250 and 300 °C. Diffusion profiles of cadmium were analyzed by dual-beam time-of-flight secondary ion mass spectroscopy (TOF-SIMS). In addition to fast cadmium grain boundary diffusion, experiments revealed cadmium diffusion profiles with two distinct lattice diffusion stages, which could be indicative of simultaneous vacancy and dissociative diffusion mechanisms.
Test Results of an Active Magnetic Regenerative Refrigerator

The principle of the Active Magnetic Regenerator (AMR) is tested with an experimental refrigerator designed to operate within the temperature range of about 4 to 80 K. Applications, including helium and hydrogen liquefaction and hydrogen slush generation, are envisioned. The device uses a single moveable superconducting solenoidal magnet in persistent mode to alternately charge and discharge two in-line beds of magnetic material. Between magnet motions, a double-acting piston displacer moves heat transfer fluid in the form of helium gas through the beds, absorbing heat at the cold heat exchanger and rejecting heat at the hot heat exchanger.