cssi/SciSciGPT-SciSciNet huggingface dataset:
End-tidal carbon dioxide monitoring: a VITAL sign worth watching.

Abstract Capnography is the monitoring of end-tidal carbon dioxide in waveform and numeric display. For this technology to be useful, the critical care nurse must have a clear understanding of the normal capnography waveform and what the alterations in this waveform represent. The critical care nurse can use this information to plan patient care interventions with other critical care team members and to adjust care based on the patient's response. End-tidal carbon dioxide physiology, normal waveforms, abnormal waveforms, and clinical aspects of capnography monitoring are included.
Polymorphism at position 97 in MHC class I molecules affects peptide specificity, cell surface stability, and affinity for β2-Microglobulin

The two mouse MHC class I alleles, L(d) and L(q), share complete amino acid sequence identity except in the alpha2 domain, where they differ at six positions. Despite their similarity, L(q) has a stronger association with beta2-microglobulin (beta2m), is expressed at higher levels on the cell surface, demonstrates an increased cell surface half-life, and has fewer open forms on the cell surface than L(d). To determine the basis for their phenotypic differences, L(d) molecules containing chimeric L(d)-L(q) alpha2 domains were characterized, and these analyses implicated residue 97 (L(d)Trp and L(q)Arg) as the polymorphic site responsible for the disparity in beta2m association between the two alleles. Single substitution analysis at this site (L(d)W97R and L(q)R97W) confirmed this. Furthermore, the L(d)W97R mutant molecule has a longer cell surface half-life than either L(q) or L(d), and fewer open forms of L(d)W97R are observed on the cell surface. In addition, both L(d)W97R and L(q) possess decreased binding affinity for the L(d)-restricted tum(-) P91A(14-22) peptide compared with L(d). Collectively, these results and the known location of Trp(97) in the peptide binding cleft of L(d) strongly suggest that the substitution of Arg for Trp(97) in L(d) alters the peptide binding cleft, increasing its affinity for endogenous peptides, which results in greater cell surface stability and better retention of beta2m. Furthermore, these results imply that Trp(97) plays an important role in the ability of L(d) to efficiently participate in alternative MHC class I Ag presentation pathways.
The effects of Valsalva maneuver on global and segmental left ventricular function in presence and absence of coronary artery disease

To determine the effects of the Valsalva maneuver on global and regional left ventricular function, single-plane left ventriculograms were performed in the 30-degree right anterior oblique projection in 50 patients during normal breath holding and during the late strain phase of the Valsalva maneuver. Thirty-one patients had significant coronary artery disease (greater than 70% luminal narrowing in a major coronary artery). Ventriculograms were analyzed for determination of ejection fraction, end-diastolic, and end-systolic volumes. Regional wall motion was analyzed by a chord method of calculating segmental fractional shortening. Ejection fraction increased significantly in the entire group of patients (62 +/- 16% to 70 +/- 19%, p less than 0.0001), while both end-diastolic (105 +/- 33 cc to 88 +/- 34 cc, p less than 0.0001) and end-systolic volumes (43 +/- 29 cc to 30 +/- 29 cc, p less than 0.0001) showed striking reductions with Valsalva maneuver. Patients without significant coronary disease usually exhibited global augmentation in left ventricular function, while those with coronary disease often exhibited only segmental improvement. This augmentation appeared to be dependent on the patency of the supplying coronary vessel.
Heads Together: A Peer-Mediated Option for Improving the Academic Achievement of Heterogeneous Learning Groups

The present study compared the effects of two teacher questioning strategies, Heads Together and Whole Group, on elementary school students' on-task rates and their performance on daily social studies quizzes. Twenty 3rd graders in a racially and ethnically integrated classroom were exposed to both treatments under an alternating treatment design. Data indicated that students always performed better under Heads Together conditions. These performance differences ranged from 2 to 30 percentage points on daily quizzes and averaged about 16 percentage points over the course of the investigation. Moreover, the percentage of pupils on task was always higher when the cooperative learning intervention was in effect. Consumer satisfaction findings suggest that the students themselves preferred Heads Together over the more traditional teaching method. Implications for instructional practice are discussed.
Spatial variation of fuel loading within varying aged stands of chaparral

Questions How do stand-level biomass and percentage of dead material in chaparral vary as a function of stand age? How do the landscape properties of aggregation index and patch size vary in each of the dominant species groups as a function of stand age? Location Stands of 7-, 28- and 68-yr-old chaparral, San Diego County, CA, US. Methods We sampled and estimated above-ground biomass in 8 m × 8 m field plots. Each stand was classified into species groups using high-resolution imagery. After establishing coefficients for the average biomass per area for each species group and stand age using field data, we estimated biomass in 30 random plots in each stand age using the classified map. We also estimated biomass using pooled coefficients (average of the 28- and 68-yr-old biomass per area). We calculated landscape metrics in six 60 m × 60 m study sites for each stand age. Results While we found a statistically significant pattern of higher biomass in the older chaparral stands when using age-specific biomass coefficients, there was no statistical difference between the 28- and 68-yr-old stands using the more conservative pooled coefficients. Both approaches revealed a wide range in biomass in all age classes. We were not able to map dead biomass with sufficient accuracy to measure age-related differences, but no differences in the two older stands were obvious in the field. There were no significant differences in landscape metrics between the two older stands, and the differences observed in the younger stand might have been partially due to aspect differences. Conclusions Our approach of using a combination of field plots and classification of remote sensing imagery is a valuable method for enlarging the effective study area in chaparral, and allowed us to better measure how widely biomass varies across the study area. High spatial resolution measurements of fuel properties could help support more detailed models of fire behaviour.
Human papillomavirus type 16 viral load is decreased following a therapeutic vaccination

In the dose-escalation phase of a Phase I clinical trial in which six subjects each were vaccinated with PepCan at the 50, 100, 250, and 500 μg per peptide dose, the 50 μg dose showed the best histological regression rate. Ten additional subjects were vaccinated at this dose in the final dose phase. As with the dose-escalation phase, no dose-limiting toxicities were observed. Overall, the histological regression rates were 50% at the 50 μg dose (7 of 14) and 100 μg dose (3 of 6), and 45 % overall (14 of 31). Of subjects in whom HPV type 16 (HPV 16) was detected at entry, it became undetectable in three subjects after vaccination, and the viral loads significantly decreased in nine subjects in whom HPV 16 infection was detected at entry and exit (p = 0.008). Immune profiling revealed increased T-helper type 1 cells after vaccinations (p = 0.02 and 0.0004 after 2 and 4 vaccinations, respectively). T-helper type 2 cells initially increased after two vaccinations (p = 0.01), but decreased below the baseline level after four vaccinations although not significantly. Pre-vaccination regulatory T cell levels were significantly lower in histological responders compared to non-responders (p = 0.03). Feasibility of testing plasma for multiplex cytokine/chemokine analysis and of performing proteomic analysis of PBMCs was examined for potentially identifying biomarkers in the future. While these analyses are feasible to perform, attention needs to be given to how soon the blood samples would be processed after phlebotomy. As sufficient safety of PepCan has been demonstrated, enrollment for the Phase II clinical trial has been opened.
Aliens in the promised land? Keynote address for the 1986 National Gathering of the United Church of Christ's Coalition for Lesbian/Gay Concerns.

The following article is a condensed version of the keynote address given at the 1986 National Gathering of the Lesbian/Gay Coalition of the United Church of Christ (UCC). Problems encountered by lesbians and gay men in organized religion, especially within the liberal tradition, are identified by a method of inquiry developed by Christian educator John Westerhoff for assessing egalitarianism within institutions. The story of Queen Vashti from the Book of Esther in Hebrew scripture, and the emerging tradition of coming-out experiences by lesbians and gay men, provide the norm and model for declaring independence from denominations that neglect the concerns of lesbians and gay men and for constructing religious alternatives.
Nodal Points and the Nonlinear Stability of High-Order Methods for Unsteady Flow Problems on Tetrahedral Meshes

High-order methods have the potential to efficiently generate accurate solutions to fluid dynamics problems of practical interest. However, high-order methods are less robust than lower-order methods, as they are less dissipative, making them more susceptible to spurious oscillations and aliasing driven instabilities that arise during simulations of nonlinear phenomena. An effective approach for addressing this issue comes from noting that, for nonlinear problems, the stability of high-order nodal methods is significantly effected by the locations of the nodal points. In fact, in 1D and 2D, it has been shown that placing the nodal points at the locations of quadrature points reduces aliasing errors and improves the robustness of high-order schemes. In this paper, the authors perform an investigation of a particular set of nodal points whose locations coincide with quadrature points. Analysis is performed in order to determine the conditioning of these points and their suitability for interpolation. Thereafter, numerical experiments are performed on several canonical 3D problems in order to show that this set of nodal points is effective in reducing aliasing errors and promoting nonlinear stability.
Description and Theoretical Considerations of Mate Finding and Other Adult Behaviors in a Colorado Population of Claassenia sabulosa (Plecoptera: Perlidae)

Adult behaviors of a Colorado Gunnison River population of Claassenia sabulosa (Banks) are reported. Synchronized emergences began in late July 1992 and early August 1993; each emergence lasted ≈2 wk. Eighty-nine percent of nymphs crawled out of shallow water onto emergent stones near the shoreline for transformation, predominantly on dark nights beginning at nightfall. Males emerged significantly earlier in the night than females, their molting times were significantly shorter, and they began immediately searching near the shoreline on isolated stones partially exposed above the water surface. Male mate searching consisted of circling and scrambling over high areas and angular sections of the emergent rock encounter sites. Males encountering a molting female guarded her and began attempting copulation when her genitalia became exposed. Copulations lasted ≈62 s, and males subsequently guarded females to delay or reduce further matings by other males. A few unguarded, individual females were observed mating up to 9 times with as many as 5 males. Most females were mated for the 1st time before hardening. Both sexes were active only during the 2-h period just after dusk. When not engaged in mating, they scurried over the water surface between emergent stones and the shore. At all other times, they remained inactive under stones or debris on the stream bank, typically within 1 m of the shoreline. Females with extruded egg masses scrambled over the water surface between emergent stones, washing eggs directly into shallow water. Females were never observed flying and could not be induced to fly. Drumming, by males, did not appear to be a primary requisite for mate finding. Evolution of mate finding behaviors in relation to drumming and other behaviors is discussed, and a paradigm for evolution from a drumming-assisted mate locating method to a search-intensive, encounter site specific method is proposed for this population.
On homo- and heterothallism in Schizosaccharomyces pombe.

The mating-type system of Schizosaccharomyces pombe has previously been studied by Leupold. In his culture, Leupold found heterothallic (h+, h-) and homothallic (h90) strains; the various strains s...
A Self-Correcting Connected Components Algorithm

We present a new fault-tolerant algorithm for the problem of computing the connected components of a graph. Our algorithm derives from a highly parallel but non-resilient algorithm, which is based on the technique of label propagation (LP). To make the (LP) algorithm resilient to transient soft faults, we apply an algorithmic design principle that we refer to as self-correction. Briefly, a self-correcting algorithm detects if it has reached an invalid state given that it was previously in a known valid state; and if so, restores itself back to a valid state assuming the availability of a selective guaranteed-reliable mode. Our self-correcting algorithm, FT-LP, has relatively small storage and computation overheads: in empirical tests on a variety of input graphs, we observe execution time overheads of 10-35% in FT-LP compared to LP even at high fault rates, with the computation overhead increasing gracefully as fault rates increase.
Noise-Induced Tuning Curve Changes in Mechanoreceptors

Fibers from the tibial nerve of rat were isolated and spike activity recorded using monopolar hook electrodes. The receptive field (RF) of each recorded unit on the glabrous skin of the foot was mechanically stimulated with waveforms comprised of various frequency sine waves in addition to increasing levels of white noise. Single-unit responses were recorded for both rapidly adapting (RA) and slowly adapting (SA) units. Signal-to-noise ratio (SNR) of the output was quantified by the correlation coefficient (C1) between the input sine wave and the nerve responses. The addition of noise enhanced signal transmission in both RA and SA fibers. With increasing noise, the initially inverted "V"-shaped, zero-noise tuning curves for RA fibers broadened and eventually inverted. There was a large expansion of the frequencies that the RA receptor responded to with increasing noise input. On the other hand, the typical shape of the SA fiber tuning curves remained invariant, at all noise levels tested. C1 values continued to increase with larger noise input for higher frequencies, but did not do so at the lowest frequencies. For both RA and SA fibers the responses with added noise tended to be rate modulated at the low-frequency end, and followed nonlinear stochastic resonance (SR) properties at the higher frequencies. The changes in the tuning properties due to noise found here, as well as preliminary psychophysics data, imply that external noise is relevant for sensing small periodic signals in the environment. All current models of sensory perception assume that the tuning properties of receptors determined in the absence of noise are preserved during everyday tasks. Our results indicate that this is not true in a noisy environment.
The roles of family, neighborhood, and school contextual factors on social work minority students’ educational aspirations and integration

ABSTRACTThis study examined the significance of three macro social determinants (i.e., family, neighborhood, and school factors) on the educational aspirations and integration of social work minority undergraduate students using a qualitative study of 40 interviews. Two research questions were raised: (1) how did family, neighborhood, and school contextual factors account for the participants’ postsecondary education in social work, a study that places more emphasis on the attainment of humanitarian goals over future economic outlook? and (2) what roles did family, neighborhood, and school play in shaping these participants’ postsecondary educational aspirations and integration? Overall, educationally resilient participants received strong family support but also encountered social roadblocks, stigmatization, and racial discrimination in the mainstream culture. Ironically, these social challenges also served as the major driving forces that inspired them to pursue their postsecondary education and major i...
Quantum cascade lasers on silicon

Silicon integration of mid-infrared (MIR) photonic devices promises to enable low-cost, compact sensing and detection capabilities that are compatible with existing silicon photonic and silicon electronic technologies. Heterogeneous integration by bonding III-V wafers to silicon waveguides has been employed previously to build integrated diode lasers for wavelengths from 1310 to 2010 nm. Recently, Fabry-Perot Quantum Cascade Lasers integrated on silicon provided a 4800 nm light source for MIR silicon photonic applications. Distributed feedback (DFB) lasers are appealing for many high-sensitivity chemical spectroscopic sensing applications that require a single frequency, narrow-linewidth MIR source. While heterogeneously integrated 1550 nm DFB lasers have been demonstrated by introducing a shallow surface grating on a silicon waveguide within the active region, no mid-infrared DFB laser on silicon had previously been reported. Here we demonstrate quantum cascade DFB lasers heterogeneously integrated with silicon-on-nitride-oninsulator (SONOI) waveguides. These lasers emit over 200 mW of pulsed power at room temperature and operate up to 100 °C. Although the output is not single mode, the DFB grating nonetheless imposes wavelength selectivity with 22 nm of thermal tuning.
IR in EU and Other Global Economies: The Role of Social Partners in Tackling the Crisis and Promoting Sustainable Development - United States Report and Questionnaire

This report presents the United States data and information solicited by the European Foundation for the Improvement of Living and Working Conditions (Eurofound) for their conference Studies on, ‘EU and other Global Economies. The Role of Social Partners in tackling the crisis’, Dublin 30 November – 1 December 2011. As stated by Eurofound in developing this conference, the... objective of this work is to focus on the “social sustainability” aspects in a number of countries, such as EU (selected countries) and Brazil, China, Japan and USA, and understand better how each country addresses the social aspects of sustainable growth. There has been a significant shift in the focus of research in industrial relations in recent years. Research findings show changing patterns in the world of work and in markets globally with significant growth of non-standard forms of employment and the growing dominance of the service sector in the advanced economies. These patterns require labour legislation and social dialogue to adapt to the new conditions. Pursuing sustainable policies at times of crisis is not always an easy exercise. However, practices identified in certain countries can help promote a global debate on responsible, sustainable policies at different levels (national, sectoral, local, company). The purpose of this research is to capture trends in forms of employment (i.e. self employment, part time work, temporary work, full time work) in the participating countries, the role of regulation (how different types of employment are regulated), how labour market policies facilitate the economy’s adaptation to changes in the business environment and how can countries achieve the desired economic results but not at the expense of social costs through the adoption of sustainable and responsible policies at all levels, national, sectoral, company. A core question of this work is the role trade unions and business associations (either jointly or separately) play on achieving social sustainability objectives and mitigating the negative effects of the global economic crisis. Governments can pursue measures to support economic growth, along with - what is the focus of our research - adapting labour market institutions, providing skills to match needs, social insurance, providing a legal framework to protect work in a sustainable way. Equally, companies need to innovate, enhance productivity, develop skills, adopt technologies and compete successfully through sustainable policies. In times of economic crisis the right mix of policies is vital to achieve sustainable growth and respond to aspirations of people for economic and social development.
Clinicopathologic correlation and effect of Oncotype DX Recurrence Score on treatment decisions at a community-based academic cancer center.

e11511 Background: Oncotype DX, a 21 gene recurrence score (RS) is used to predict the likelihood of benefit from systemic chemotherapy in women with node-negative, estrogen receptor (ER) positive ...
Residual dose deviation differential histogram analysis using evolutionary-optimized transform parameters for dose distribution warping in patient-specific quality assurance in external beam radiation therapy

Patient-specific quality assurance in external beam radiation therapy is performed to ensure the safe and effective administration of ionizing radiation to patients. This individualized quality assurance process often involves the measurement of a planar radiation dose distribution obtained during irradiation of a surrogate phantom, in order to sample the actual delivered doses to the patient; this measured dose distribution is then compared with that calculated by the radiation therapy treatment planning software. The current work, a continuation of the authors' previous efforts, uses a covariance matrix adaption-evolutionary strategy approach to optimize transform parameters of an affine transformation which includes normalization, translation, dilation (or erosion), roll, pitch, and yaw, such that the application of the transformation warps the measured dose distribution to the planned dose distribution. The deviations, from unity, of the transformation parameters associated with translations and with scaling, and the deviations, from zero, of those associated with rotations, are a means of assessing possible errors in experimental setup, as well as possible errors in the dose calculation algorithm used in the treatment planning system. The optimization selects a Pareto-optimal set of eight transformation parameters that minimizes the difference, in the sense of the sum of least squares, between the doses at distinct points in the calculated and measured dose distributions. The method was tested using four distinct treatment plans, and the results indicate that it may prove useful in the clinic.
Acknowledgements for volumes 64–66

As I conclude my term as editor, I must express my deepest gratitude to a host of people who not only made publication of the journal possible but also contributed immensely to the quality of the j...
Signet ring adenocarcinoma of a urethral diverticulum

Urethral diverticula are a rare entity. Carcinoma in a urethral diverticulum is a particularly unusual finding with only a little over 200 cases in the reported literature. Adenocarcinoma is the most common carcinoma to occur in a urethral diverticulum. To our knowledge, there are only a handful of cases of signet ring cell adenocarcimona of the urethra and no cases of signet ring adenocarcinoma found in a urethral diverticulum. We present a case report of an incidentally found signet ring cell adenocarcinoma of a female urethral diverticulum.
Aspergillus fumigatus preexposure worsens pathology and improves control of Mycobacterium abscessus pulmonary infection in mice

Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. Mutations in this chloride channel lead to mucus accumulation, subsequent recurrent pulmonary infections, and inflammation, which, in turn, cause chronic lung disease and respiratory failure. Recently, rates of nontuberculous mycobacterial (NTM) infections in CF patients have been increasing. Of particular relevance is infection with Mycobacterium abscessus, which causes a serious, life-threatening disease and constitutes one of the most antibiotic-resistant NTM species. Interestingly, an increased prevalence of NTM infections is associated with worsening lung function in CF patients who are also coinfected with Aspergillus fumigatus We established a new mouse model to investigate the relationship between A. fumigatus and M. abscessus pulmonary infections. In this model, animals exposed to A. fumigatus and coinfected with M. abscessus exhibited increased lung inflammation and decreased mycobacterial burden compared with those of mice infected with M. abscessus alone. This increased control of M. abscessus infection in coinfected mice was mucus independent but dependent on both transcription factors T-box 21 (Tbx21) and retinoic acid receptor (RAR)-related orphan receptor gamma t (RORγ-t), master regulators of type 1 and type 17 immune responses, respectively. These results implicate a role for both type 1 and type 17 responses in M. abscessus control in A. fumigatus-coinfected lungs. Our results demonstrate that A. fumigatus, an organism found commonly in CF patients with NTM infection, can worsen pulmonary inflammation and impact M. abscessus control in a mouse model.
Using the Linehan Risk Assessment and Management Protocol With a Chronically Suicidal Patient: A Case Report

Abstract The Linehan Risk Assessment and Management Protocol (LRAMP) is an empirically supported, comprehensive framework used to assess suicide risk and protective factors, and provide a guide for the therapist to consider reasonable options for intervening on suicidal behavior. This protocol includes a structured checklist for assessing, managing, and documenting suicide risk. It also structures the documentation to clearly describe the presentation, assessment, in-session interventions, decision-making process, and follow-up to other members of the treatment team. This paper describes a case in which the LRAMP was used to guide the assessment, intervention, and documentation of the suicidal behavior of a patient, “Ann,” being treated with outpatient Dialectical Behavioral Therapy in a community mental health clinic. Each section of the LRAMP is discussed as it was used with this complex patient, who had history of high utilization of acute psychiatric services. Application of the LRAMP included the assessment of risk and protective factors, and the use of an individualized crisis plan that engaged the patient, her family, the therapist, and the clinical team, to decrease acute risk, continue outpatient treatment, and avoid inpatient hospitalization. The considerations for documenting clinical decision-making with chronically suicidal patients are discussed.
Murine Typhus in South Texas Children: An 18-year Review.

Background Murine typhus is a zoonotic infection caused by Rickettsia typhi that remains endemic in South Texas. In 2003, only 9 Texas counties reported murine typhus compared with 41 counties in 2013. Methods A retrospective study of children discharged with a confirmed diagnosis of murine typhus from Driscoll Children's Hospital between January 1998 and September 2016. Results Two hundred thirteen children (113 female) 3 months through 19 years of age (mean, 11.2 ± 4.5 years) were identified. Cases occurred throughout the year. Children were admitted after a mean of 7.7 ± 5.3 days of fever. The most common symptoms were fever (100%), poor appetite (71.9%), malaise/fatigue (69.0%) and headache (67.6%). The most common laboratory abnormalities were elevated C-reactive protein, hypoalbuminemia, elevated erythrocyte sedimentation rate, elevated transaminases and elevated band count with normal total white blood cell count. Children defervesced in a mean of 31.87 ± 21.36 hours after initiation of doxycycline. Hospitalization lasted for a mean of 2.7 ± 1.8 days when children were administered doxycycline within 24 hours of admission compared with, 4.1 ± 1.8 days, P ≤ 0.0001 when started later. Eleven patients (5.1%) were admitted to the pediatric intensive care unit and were older, P = 0.0009. No children died. Conclusions Murine typhus is endemic in South Texas. Children who were treated earlier with doxycycline had a shorter hospitalization than were those who began therapy later. Recognition of murine typhus is important to prevent delay in treatment and development of complications.
De novo belatacept in clinical vascularized composite allotransplantation

Most immunosuppressive regimens used in clinical vascularized composite allotransplantation (VCA) have been calcineurin inhibitor (CNI)-based. As such, most recipients have experienced CNI-related side effects. Costimulation blockade, specifically CD28/B7 inhibition with belatacept, has emerged as a clinical replacement for CNI-based immunosuppression in kidney transplantation. We have previously shown that belatacept can be used as a centerpiece immunosuppressant for VCA in nonhuman primates, and subsequently reported successful conversion from a CNI-based regimen to a belatacept-based regimen after clinical hand transplantation. We now report on the case of a hand transplant recipient, whom we have successfully treated with a de novo belatacept-based regimen, transitioned to a CNI-free regimen. This case demonstrates that belatacept can provide sufficient prophylaxis from rejection without chronic CNI-associated side effects, a particularly important goal in nonlifesaving solid organ transplants such as VCA.
The School-to-Prison Pipeline

This chapter provides a broad overview of school-based criminalization of youth across the US educational institutions and in the process, explores explanations for the surging of what a growing body of scholarship defines as the ‘school-to-prison pipeline’ (STPP). We show that the STPP metaphor refers to a harmful relationship between school-based criminalization of youth, disproportionately those of colour, and the likelihood that criminalized youth will come into contact with the US juvenile and/or criminal justice system. We present key explanations for, and implications of, this phenomenon, as well as possible directions for research on this issue that very clearly deters educational equity and equality in the United States as well as suggested how STPP may be occurring internationally.
Self-reported physician-diagnosed chronic obstructive pulmonary disease and spirometry patterns in Vietnam Era US Army Chemical Corps veterans: A retrospective cohort study.

BACKGROUND Research on chronic obstructive pulmonary disease (COPD) and herbicide exposure in Vietnam War veterans is limited. METHODS Survey data were collected from 3193 US Army Chemical Corps veterans on herbicide exposure and self-reported physician-diagnosed COPD. Three spirometric patterns were used to define airflow obstruction (AFO): (i) FEV1 /FVC < 70% ("fixed ratio"); (ii) FEV1 /FVC < lower limit of normal ("LLN"); and (iii) (FEV1 /FVC < LLN and FVC ≥ LLN and FEV1 <LLN) or (FEV1 /FVC<LLN and FEV1 ≥ LLN) ("specific obstruction"). Associations between herbicide exposure and self-reported COPD and spirometric-AFO were determined using regression. RESULTS COPD prevalence varied (self-reports: 20.1%; spirometry: 29.8%, 12.9%, 8.4% by fixed ratio, LLN, and specific obstruction definitions, respectively). Spirometric parameters did not differ by exposure. Self-reported COPD and herbicide exposure were significantly associated (adjusted odds ratio [aOR] = 1.82, 95% confidence intervaI: 1.48,2.24). No association was found between spirometric-AFO and herbicide exposure. CONCLUSIONS A significant association was found between herbicide exposure and self-reported physician-diagnosed COPD but not when COPD diagnosis was based on spirometry.
Electromagnetic Interference from Left Ventricular Assist Device (LVAD) Inhibiting the Pacing Function of an Implantable Cardioverter-Defibrillator (ICD) Device

There is an increasing prevalence of patients with concomitant implantable cardioverter-defibrillators (ICDs) and left ventricular devices (LVADs). The potential for negative interactions between these continually evolving technologies is a valid concern. Previously reported interactions include inappropriate ICD therapy and interference with ICD telemetry function. Understanding the nature of such interactions and developing a comprehensive strategy to approach such situations are important. In this report, we describe a case of electromagnetic interference from LVAD inhibiting the pacing function of an ICD that was corrected by reprograming the device. We would encourage investigators to review patients with ICD and LVAD in their institutions in order to help assess the frequency and nature of these and other interactions.
Appendix A: Foundational Concepts

This chapter contains a review of certain fundamental concepts in abstract algebra for use throughout the text. Section A.1 deals with the basic properties of commutative rings with identity, Section A.2 focuses on polynomial rings, and Section A.3 introduces ideals. As we discuss in the introduction to this text, these objects occur in numerous areas of mathematics. We strongly encourage readers to make sure they are familiar with the material on generators of ideals in Section A.3, as this notion is absolutely fundamental for this text.
The relationship between lower extremity swelling, quadriceps strength, and functional performance following total knee arthroplasty.

Abstract Background The relationships between swelling after total knee arthroplasty (TKA) and quadriceps strength and functional performance are poorly understood. Therefore, the aim of this study was to examine the relationships between lower extremity swelling, measured using bioelectrical impedance assessment (SF-BIA), and quadriceps strength and timed up and go (TUG) times following TKA. Methods 53 participants (64 ± 9.5 y/o, 43% male) undergoing primary unilateral TKA were recruited for the longitudinal observational study with repeated measures. Quantities of swelling were examined for contribution to two and six-week outcomes of strength and TUG time using hierarchical regression controlling for age, sex, and the baseline value of the dependent variable. Swelling was assessed using bioelectrical impedance assessment and quantified as the peak level of swelling and cumulative swelling (integral) over the post-TKA time window. Maximum isometric quadriceps strength (MVIC) was measured using a electromechanical dynamometer and participant functional performance measured using the TUG. Results Neither peak swelling nor cumulative swelling significantly contributed to the variance of two-week quadriceps strength. At six weeks, peak swelling significantly improved the variance in maximal quadriceps strength by an additional four percent (p = 0.05), while cumulative swelling did not significantly contribute. Peak swelling significantly contributed to the variance in two-week (16%) and six-week (five percent) TUG times (p Conclusions Peak swelling represents a value of post-TKA swelling that is associated with strength and function. Reducing the peak level of swelling, occurring early after surgery, may improve patient functional recovery. Level of evidence Level II — Prospective observational study.
Process-Structure-Property Modeling for Severe Plastic Deformation Processes Using Orientation Imaging Microscopy and Data-Driven Techniques

Machining is a severe plastic deformation process, wherein the workpiece material is subjected to high deformation rates and temperatures. During metal machining, the dynamic recrystallization mechanism causes grain refinement into the sub-micron range. In this study, we investigate the microstructure evolution of oxygen-free high conductivity copper (OFHC Cu) subject to a machining process where the cutting speed and rake angle are controlled to manipulate the process strain, strain rate, and temperatures. Microstructures of the deformed chips are quantified using orientation imaging microscopy and novel statistical descriptors that capture the morphology and local lattice misorientations generated during the several mechanistic stages of the dynamic recrystallization process. Mechanical properties of the resulting chips are quantified using spherical nanoindentation protocols. A multiple output Gaussian process regression model is used to simultaneously model the structure-property evolution, which differs from more common approaches that establish such relationships sequentially. This modeling strategy is particularly attractive since it can flexibly provide both structure and property uncertainty estimates. In addition, the statistical modeling framework allows for the inclusion of multi-fidelity data. The statistical metrics utilized serve as efficient microstructure descriptors, which retain the physics of the observed structures without having to introduce ad hoc microstructure feature definitions.
King Richard III: How a Man Becomes a Monster

History is notorious for being written by the victors, often to the detriment of truth. The losers are usually portrayed as small and insignificant to the course of history. However, such erasure can happen to the greatest and most influential people, even kings. King Richard III is perhaps one of the most infamous kings to wear the English crown. He has been depicted as a ruthless, power hungry villain by famous humanists such as Thomas More, and immortalized as a deformed monster by William Shakespeare. For over five hundred years, historians have commonly agreed with More’s and Shakespeare’s verdicts. It was not until recently that supporters of Richard took up the king’s case to truly examine the evidence against him. Some historians now see Richard, not as evil monster, but as man responding to a political crisis. Less clear, however, is the process by which the image of Richard III as England’s ‘Black Legend’ actually came into being. In this paper, I intend to trace the origin of that extremely negative assessment of both the man and his reign. My goal is to show how the image of the Duke of Gloucester as a monster is largely a literary construct.
Lee Model of Geriatric Palliative Care

The model is based in the theory of human caring authored by Dr. Jean Watson. This theory honors autonomy, choice, and meaning through deep human connection. The Caritas field is the “inner world of practice at the heart level”. The model has four domains. The first one is most important. Is the health care that the person is receiving—the treatments, the surgery, the chemotherapy, the medications—aligned with the person’s wishes, preferences, and values.
"My mama told me it would happen": menarche and menstruation experiences across generations.

ABSTRACTThe purpose of this study was to understand women’s menarche and menstruation-related knowledge, attitudes, and behaviors across generations. Women ages 18 years and older (Mean = 49.13 ± 1...
Use of oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressings to help manage skin graft donor site wounds.

Abstract Harvesting donor site explants for split-thickness skin grafting creates an iatrogenic wound that presents additional challenges to clinicians due to morbidities such as persistent bleeding, pain, infection, and delayed epithelialization. Although there have been several randomized controlled trials to compare wound dressing effectiveness, there is still a lack of standardization for donor site wound dressings. A retrospective comparison of 59 patients that underwent split-thickness skin graft reconstructions between January 2017 and September 2018 was performed. Donor sites of Group 1 patients (n = 29) were treated with a transparent film dressing and transitioned to petrolatum gauze dressings if exudate management became problematic; Group 2 patients (n = 30) were treated with oxidized regenerated cellulose/collagen/silver-oxidized regenerated cellulose (ORC/C/Ag-ORC) dressings. Evaluations of time to epithelialization, number of dressings required, signs of inflammation, and objective pain were compared between groups. Group 1 was comprised of 18 female and 11 male patients, whereas Group 2 was comprised of 14 females and 16 males. There were no significant differences between groups when comparing age, sex, comorbidities, or donor site size (area or depth). Patients in Group 2 had a significantly shorter time to complete re-epithelialization (P Although prospective, controlled studies are still needed, data from this study suggest that ORC/C/Ag-ORC dressings could become a more effective alternative for the management of donor site wounds, especially in patients with known risk factors for wound healing.
Explaining Sequence-Level Knowledge Distillation as Data-Augmentation for Neural Machine Translation

Sequence-level knowledge distillation (SLKD) is a model compression technique that leverages large, accurate teacher models to train smaller, under-parameterized student models. Why does pre-processing MT data with SLKD help us train smaller models? We test the common hypothesis that SLKD addresses a capacity deficiency in students by "simplifying" noisy data points and find it unlikely in our case. Models trained on concatenations of original and "simplified" datasets generalize just as well as baseline SLKD. We then propose an alternative hypothesis under the lens of data augmentation and regularization. We try various augmentation strategies and observe that dropout regularization can become unnecessary. Our methods achieve BLEU gains of 0.7-1.2 on TED Talks.
Towards Fine-grained Flow Forecasting: A Graph Attention Approach for Bike Sharing Systems

As a healthy, efficient and green alternative to motorized urban travel, bike sharing has been increasingly popular, leading to wide deployment and use of bikes instead of cars. Accurate bike-flow prediction at the individual station level is essential for bike sharing service. Due to the spatial and temporal complexities of traffic networks and the lack of data-driven design for bike stations, existing methods cannot predict the fine-grained bike flows to/from each station. To remedy this problem, we propose a novel data-driven spatio-temporal Graph attention convolutional neural network for Bikestation-level flow prediction (GBikes). We develop data-driven and spatio-temporal designs, and model bike stations (nodes) and inter-station bike rides (edges) as a graph. In particular, we design a novel graph attention convolutional neural network (GACNN) with attention mechanisms capturing and differentiating station-to-station correlations. Multi-level temporal closeness, spatial distances and other external factors (e.g., weather and points of interest) are jointly considered for comprehensive learning and accurate prediction of bike flows at each station. Extensive experiments upon a total of over 11 million trips collected from three large-scale bike-sharing systems in New York City, Chicago, and Los Angeles have corroborated GBikes’s significant improvement of accuracy, robustness and effectiveness over prior work.
Rethinking Concepts and Categories for Understanding the Neurodevelopmental Effects of Childhood Adversity

Discovering the processes through which early adverse experiences affect children's nervous-system development, health, and behavior is critically important for developing effective interventions. However, advances in our understanding of these processes have been constrained by conceptualizations that rely on categories of adversity that are overlapping, have vague boundaries, and lack consistent biological evidence. Here, we discuss central problems in understanding the link between early-life adversity and children's brain development. We conclude by suggesting alternative formulations that hold promise for advancing knowledge about the neurobiological mechanisms through which adversity affects human development.
Combined Oral Contraceptive Use Increases the Risk of Venous Thromboembolism After Knee Arthroscopy and Anterior Cruciate Ligament Reconstruction: An Analysis of 64,165 Patients in the Truven Database.

Purpose To use the Truven MarketScan database to (1) report the incidence of venous thromboembolism (VTE), including deep vein thromboses (DVTs) and pulmonary embolism (PE), in patients undergoing simple knee arthroscopy and anterior cruciate ligament (ACL) reconstruction, and (2) evaluate combined oral contraceptive (COCP) use as a potential risk factor for VTE in patients undergoing knee arthroscopy. Methods All female patients between the ages of 16 and 40 years undergoing knee arthroscopy and ACL reconstruction between 2010 and 2015 were identified in the MarketScan database. Patients were stratified by whether they had a documented pharmaceutical claim for COCP therapy, and the primary outcome was the risk of DVT and or PE within 90 postoperative days. Results In total, 64,165 patients were identified for inclusion. While the overall incidence of VTE was low, patients taking COCPs had an increased risk of a DVT or PE compared with those not on COCPs (odds ratio [OR] 2.1, P Conclusions This study demonstrates that COCP use is associated with an increased risk for a symptomatic DVT or PE (1.70% and 0.27%, respectively) after knee arthroscopy and an increased risk for DVT, but not PE (1.80% and 0.23%, respectively), after ACL reconstruction. In addition, patients with multiple risk factors present such as tobacco use, obesity, and COCP use had odds ratios greater than the sum of the individual risk factors alone. Level of Evidence level III prognostic cohort study
Case Article—GreatDeal and NewChicken Merger: Designing an Omni-Channel Supply Chain

In this case study, we consider the design and redesign of an omni-channel supply chain, following a merger of two existing companies. Prior to the merger, each company has their existing supply ch...
A Collection Profile Analysis and Possible Methodology Based on Current and Projected Needs

Thanks to the ease of access and functionality facilitated by the internet, WorldCat and its contents have acquired more expansive meaning and are now being viewed in more global terms. More specif...
Thoughts on a Federal Government Stimulus Package for Buildings

Residential buildings account for 22% of U.S. carbon emissions and there is widespread consensus that these carbon emissions can only be reduced if buildings become both more efficient and switch all of their fuel sources to electricity. We have developed an outline for an economic recovery package that would support energy retrofits for the 84 million detached single-family homes in the U.S. The goal of the program is to raise the nationwide retrofitting rate to 4% by 2030 so that all single-family homes will be retrofitted by 2050. It is assumed that market forces will self-sustain this 4% retrofitting rate after the program phases out. These retrofits, coupled with a decarbonizing power grid, would cut carbon emissions from U.S. residential homes up to 85% by 2050, leading to up to 11.5 billion tons of CO2 reductions and creating up to 265,000 long term clean tech jobs distributed across the nation. Estimated program costs would be up to $240 billion over ten years.