cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract W P53: Extracranial Traumatic Aneurysms Due to Blunt Cerebrovascular Injury

Background and Purpose: Traumatic aneurysms occur in about 10% of extracranial blunt traumatic cerebrovascular injuries (TCVI). The clinical consequences and optimal management of traumatic aneurysms are poorly understood. Methods: A prospective systematic study of TCVI at a Level I trauma center identified seven patients with 19 extracranial carotid or vertebral artery aneurysms. An additional six patients with seven traumatic aneurysms were followed outside of the prospective study. All patients were treated with aspirin 325 mg daily and underwent clinical follow up and imaging beyond the initial hospitalization. Endovascular treatment was reserved for aneurysms demonstrating significant enlargement on follow-up imaging. Ischemic complications, aneurysm symptoms, and aneurysm appearance on follow-up CT angiography (CTA) were assessed. Results: The seven patients with traumatic aneurysms identified in the prospective cohort comprised 10.3% of all patients with TCVI. Two patients (15.4%) patients had an ischemic stroke. No patient experienced an ischemic stroke or new symptom following the initiation of antiplatelet therapy. Clinical and radiographic follow-up with CTA averaged 22.0 months (range 6.6-55.7 months). Ten of 26 (38.5%) aneurysms were not visualized on last follow up CTA, 10/26 (38.5%) were smaller, 1/26 (3.8%) were unchanged, and 5/26 (19.2%) were larger. Saccular aneurysms were more likely to enlarge than fusiform aneurysms (33.3 vs 11.8%). Two aneurysms (both > 15 mm in size) were treated with stenting. Conclusion: The majority of traumatic aneurysms can be managed with an antiplatelet regimen of aspirin 325 mg daily and serial imaging. Saccular aneurysms have a greater tendency to grow when compared to fusiform aneurysms. ![][1] [1]: /embed/graphic-1.gif
Accelerate, Reverse, or Find the Off Ramp? Future Automobility in the Fragmented American Imagination

AbstractHow is the future of automobility envisioned in US policy discourse? This paper examines the policy documents of the US Energy Department, Transportation Department, and Environmental Protection Agency, as well as the writings of the post-carbon movement. Using discourse analysis, the paper investigates how, in narrating the future of the automobile in the US, these texts perform political work: producing forms of subjecthood and legitimating action. It concludes that the dominance of automobility in the American imagination is being unsettled as discourse about the future of the automobile fragments into three distinct narratives of progress, return, and radical change.
And, or, not: teaching logic in CS0

The use of logical expressions is at the heart of much of what we do as Computer Scientists. This paper addresses the centrality of Boolean expressions as a repeating theme in an introductory Computer Science course that serves both non-majors and Information Technology majors, and is also a gateway to the Computer Science major. Booleans are the key to unlocking how to express specificity to a computer; not only are they a central component to writing computer programs, but they also play a key role in the effective use of many information systems such as databases, spreadsheets, library catalogs, and Google, all of which have high relevance to a diverse audience.
Kinematics of the buccal mass during swallowing based on magnetic resonance imaging in intact, behaving Aplysia californica.

SUMMARY A novel magnetic resonance imaging interface has been developed that makes it possible to image movements in intact, freely moving subjects. We have used this interface to image the internal structures of the feeding apparatus (i.e. the buccal mass) of the marine mollusc Aplysia californica . The temporal and spatial resolution of the resulting images is sufficient to describe the kinematics of specific muscles of the buccal mass and the internal movements of the main structures responsible for grasping food, the radula and the odontophore. These observations suggest that a previously undescribed feature on the anterior margin of the odontophore, a fluid-filled structure that we term the prow, may aid in opening the jaw lumen early in protraction. Radular closing during swallowing occurs near the peak of protraction as the radular stalk is pushed rapidly out of the odontophore. Retraction of the odontophore is enhanced by the closure of the lumen of the jaws on the elongated odontophore, causing the odontophore to rotate rapidly towards the esophagus. Radular opening occurs after the peak of retraction and without the active contraction of the protractor muscle 12 and is due, in part, to the movement of the radular stalk into the odontophore. The large variability between responses also suggests that the great flexibility of swallowing responses may be due to variability in neural control and in the biomechanics of the ingested food and to the inherent flexibility of the buccal mass.
Elastic reverse-time migration with OBS multiples

Receiver-side water-column multiples acquired with ocean-bottom seismic sensors can be used for elastic imaging of the subsurface, which can provide additional information relative to more conventional acoustic imaging. In this paper, we generalize the procedures for elastic migration using water-column multiples. We first separate receiver-side water-column multiples from primaries in recorded OBS data, and then use mirror imaging to migrate the multiples. However, additional procedures are required in the elastic case, including correcting the polarity change in PS and SP images and attenuating artifacts caused by non-physical wave-mode conversions. With these additional procedures, we are able to obtain PP, PS, SP, and SS images.
The performance of commercial broilers when fed various levels of rendered whole-hen meal.

Abstract In each of two experiments, approximately 1200 straight-run broiler chicks were fed 0, 4, 8, or 12% rendered whole hen meal (RHM) to determine its effectiveness and acceptability as a nutrient source from hatch to 6 wk of age. Approximately 2,275 kg of commercial laying hen mortality losses were collected, frozen, and stored over a 3-wk period. The birds were rendered at a commercial facility, stabilized, sampled, analyzed, dried, and stored again by freezing. Based on sample analysis and moisture content, diets were computer-formulated to be isocaloric and equivalent in as many nutrients as possible. Fat, fiber, arginine, and tryptophan levels varied slightly within age-related diet groups. The diets were consumed ad libitum from hatch to either 41 (Experiment 1) or 42 (Experiment 2) d. In both experiments, the addition of RHM at any level resulted in equal or greater body weight than that observed with control diets that contained no RHM. The effect of RHM on body weight was not significant in the first experiment; however, it was significant in the second experiment. Feed intake generally increased relative to body weight. Feed intake differences were significant in both studies, but in Experiment 2 did not parallel body weight patterns. Contrasting results were obtained with feed efficiency with control birds being most efficient in one trial and least efficient in the other. Rendered whole-hens were acceptable and highly utilizable as a protein and nutrient substitute in the diets of the commercial broiler. The RHM was found to be pathogen-free upon analysis, with no resulting differences in mortality due to either presence or level of the material.
Exceptionalism as the Rule? U.s. Health Policy Innovation and Cross-National Learning

American health care reformers, who often look to other nations for models of desirable health systems, are often surprised nowadays by cross-national infatuation with health policy innovations minted in the United States. American innovations appeal to policy makers abroad as they struggle with cost pressures, distinguish knowledge about how health systems work, and deal with changing images of what constitutes good public policy. These strategems are adapted, not adopted; however, the premises and practices with which other nations follow American directions differ deeply from those in the United States. Ironically, even cross-national experiments may end up offering instructive policy "rules" to the exceptionalist United States.
James Hillman (1926–2011).

Presents an obituary for James Hillman. James Hillman, the third child of Madeline and Julian Hillman, died of metastatic bone cancer at his home in Thompson, Connecticut, on October 27, 2011. The parent of "archetypal psychology," he was born on April 12, 1926, at the Breakers, a then-opulent hotel founded by his family that overlooked the boardwalk and beach in Atlantic City, New Jersey. With an extensive footing in the classics and classical humanism, Jim established the foundations for his emerging archetypal psychology. With archetypal psychology, he was to move away from a dependence on the concept of a personal ego in favor of larger sources that relied on his notion of variegated identity. He proposed a profusion of mythical images that emerge under the rubric of "soul." Soul stands as an appellation indicating a deepening of psychic events, such as when dreams, chaos, and "pathologizing" (the struggles of imagination) are most experienced. For Hillman, psychology could not be taken as a separate discipline isolated from mythology, literature, art, philosophy, politics, religion, natural science, and the ordinary affairs of individuals. Hillman envisioned archetypes as processes that bear evidence to personal suffering and, in so doing, prompt the expansion of compassion. In 1975, Jim was nominated for a Pulitzer Prize for his book Re-Visioning Psychology (Harper & Row). In addition to many other citations, Jim had the high honor in 2001 of receiving the Medal of the Presidency of the Italian Republic.
A Study of Large UHV Electric Power Grid Development Planning

The study of UHV grid development is introduced in this paper.Several newly research and development aspects are investigated,which include the distribution of energy resources and demand in China,the strategy for development of electric power industry,the advantages of UHV transmission technology,the progressof UHV project,as well as the preliminary planning scheme and security evaluation for UHV grid.Finally,the future developing strategy of electric power grid is presented.
Relationship between amblyopia and the angle of strabismus.

(1976). Relationship between Amblyopia and the Angle of Strabismus. American Orthoptic Journal: Vol. 26, No. 1, pp. 31-33.
Impact of solvent granularity and layering on tracer hydrodynamics in confinement.

Classic hydrodynamic arguments establish that when a spherical tracer particle is suspended between parallel walls, tracer–wall coupling mediated by the solvent will cause the tracer to exhibit position-dependent diffusivity. We investigate how the diffusivity profiles of confined tracers are impacted by the diameter size-ratio of the tracer to solvent: starting from the classic limit of infinite size-ratio (i.e., continuum solvent), we consider size-ratios of four or less to examine how hydrodynamic predictions are disrupted for systems where the tracer and solvent are of similar scale. We use computer simulations and techniques based on the Fokker–Planck formalism to calculate the diffusivity profiles of hard-sphere tracer particles in hard-sphere solvents, focusing on the dynamics perpendicular to the walls. Given wall separations of several tracer diameters, we first consider confinement between hard walls, where anisotropic structuring at the solvent lengthscale generates inhomogeneity in the tracer free-energy landscape and undermines hydrodynamic predictions locally. We then introduce confining planes that we term transparent walls, which restrict tracer and solvent center-accessibilities while completely eliminating static anisotropy, and reveal position-dependent signatures in tracer diffusivity solely attributable to confinement. With or without suppressing static heterogeneity, we find that tracer diffusivity increasingly deviates on a local basis from hydrodynamic predictions at smaller size-ratios. However, hydrodynamic theory still approximately captures spatially-averaged dynamics across the pores even for very small tracer–solvent size-ratios over a wide range of solvent densities and wall separations.
Influence of Preoperative Therapy on Short- and Long-Term Outcomes of Patients with Adenocarcinoma of the Ampulla of Vater.

Although preoperative therapy is increasingly administered to patients with pancreatic adenocarcinoma, the role of preoperative therapy for patients with adenocarcinoma of the ampulla of Vater is undefined. All patients with ampullary cancer who were evaluated between 1999 and 2014 were retrospectively reviewed. Differences in clinicopathologic characteristics, perioperative complications, and overall survival were compared between patients who underwent surgery de novo and those who received preoperative therapy before pancreatoduodenectomy. A total of 142 patients underwent pancreatoduodenectomy: 43 (30.3%) who received preoperative therapy and 99 (69.7%) who did not. Preoperative therapy consisted of chemoradiation (65%), chemotherapy (7%), or both (28%). Patients who underwent surgery first had a lower comorbidity index (p < 0.05) and were more likely to receive postoperative chemotherapy (p < 0.01) and chemoradiation (p < 0.0001). Tumors resected de novo were larger (p < 0.01) and had a different histopathologic subtype distribution (p < 0.01) on final pathology than those resected following preoperative therapy. Six (14.0%) patients demonstrated a complete pathologic response. There were no differences in rates of postoperative complications, mortality, readmission, LR (9.1 vs. 7.0%), median survival (107 vs. 146 months), or 5-year overall survival (60.6 vs. 70.4%). On multivariate cox regression analysis, the receipt of preoperative therapy was not associated with improved survival (odds ratio 1.14, 95% confidence interval (CI) 0.56–2.31). Although these data do not support the routine administration of preoperative therapy to all patients with ampullary cancer, the delivery of preoperative therapy represents an alternative strategy that is associated with excellent short- and long-term outcomes and appears appropriate for a subset of patients.
Cultivar-specific gene modulation in Vitis vinifera: analysis of the promoters regulating the expression of WOX transcription factors.

The family of Wuschel-related Homeobox (WOX) genes is a class of transcription factors involved in the early stages of embryogenesis and organ development in plants. Some of these genes have shown different transcription levels in embryogenic tissues and mature organs in two different cultivars of Vitis vinifera: ‘Chardonnay’ (CH) and ‘Cabernet Sauvignon’ (CS). Therefore, we investigated the genetic basis responsible for these differences by cloning and sequencing in both the cultivars the promoter regions (~2000 bp) proximal to the transcription start site of five VvWOX genes. We then introduced these promoters into Arabidopsis thaliana for expression pattern characterisation using the GUS reporter gene. In the transgenic Arabidopsis, two promoters isolated from CS (pVvWOX13C_CS and pVvWOX6_CS) induced increased expression compared to the sequence isolated in CH, confirming the data obtained in grapevine tissues. These results were corroborated by transient expression assays using the agroinfiltration approach in grapevine somatic embryos. Truncated versions of pVvWOX13C demonstrated that few nucleotide differences between the sequences isolated from CH and CS are pivotal for the transcriptional regulation of VvWOX13C. Analysis of promoters using heterologous and homologous systems appear to be effective for exploring gene modulation linked with intervarietal sequence variation in grapevine.
Introduction to the special issue on the intersection of professional selling and service

As organizational operations continue to evolve in response to increasing customer demands, frontline research has begun to consider how traditionally separate organizational functions may be complementary to firm performance. Specifically, as sales and service activities become increasingly intertwined within the frontline role, this special issue explores how the sales and service functions interact within an organization. The articles contained in this special issue consider the interaction of sales and service with respect to customer, employee, and firm outcomes. After introducing evolving thought in the area, we provide an overview of five articles that make up this special issue. We conclude by offering additional areas of research.
Ultrasound-Guided Placement of Subclavian Central Venous Catheter

Ultrasound guidance may be used to facilitate the safe placement of a central venous catheter into the subclavian vein. This chapter lists the indications, essential steps, common technical variations, and complication of the procedure. A detailed operative dictation note template is included.
Imag(in)ing the severed head: ISIS beheadings and the absent spectacle

This paper examines how fear of ISIS beheadings comes to be taken for granted. It uses the framing of the Bilderverbot, the secularised image ban of biblical origin, to examine how beheadings are r...
Universal biomarker analysis using GC×GC with dual FID and ToF-MS (EI/FI) detection

Abstract Quantitative and qualitative biomarker analysis using GC-MS or GC-MS/MS is limited by chromatographic separation and variable detector response. Here, we present a GC×GC method that provides absolute quantification and non-targeted pseudo MS-MS for all resolved saturated hydrocarbon components in petroleum. Two innovations make this possible: Agilent capillary flow technology (CFT) and the JEOL JMS-T100GCV 4G ToF-MS capable of electron impact (EI) and field ionization (FI) of the GC×GC effluent. Two sequential chromatograms run using EI- and FI-MS are combined, yielding pseudo parent-daughter spectra. The effluent is split at a constant ratio allowing for easy quantitation by FID and eliminating the need for determining MS-response factors. We demonstrate the technique as offering a means for universal biomarker analysis of saturated hydrocarbon fractions.
Acid-Catalyzed Skeletal Rearrangements in Arenes: Aryl versus Alkyl Ring Pirouettes in Anthracene and Phenanthrene.

In 1 M triflic acid/dichloroethane, anthracene is protonated at C9, and the resulting 9-anthracenium ion is easily observed by NMR at ambient temperature. When heated as a dilute solution in triflic acid/dichloroethane, anthracene undergoes conversion to phenanthrene as the major volatile product. Minor dihydro and tetrahydro products are also observed. MALDI analysis supports the simultaneous formation of oligomers, which represent 10–60% of the product. Phenanthrene is nearly inert to the same superacid conditions. DFT and CCSD(T)//DFT computational models were constructed for isomerization and automerization mechanisms. These reactions are believed to occur by cationic ring pirouettes which pass through spirocyclic intermediates. The direct aryl pirouette mechanism for anthracene has a predicted DFT barrier of 33.6 kcal/mol; this is too high to be consistent with experiment. The ensemble of experimental and computational models supports a multistep isomerization process, which proceeds by reduction to ...
A Descriptive Study of Objectively Measured Pokémon GO Playtime in College Students

Since its debut in July 2016, Pokemon GO has been a wildly popular mobile gaming app. In contrast to many previous apps, Pokemon GO requires the user to be physically active. However, the extent to which Pokemon GO contributes to physical activity is unknown. Therefore, the purpose of this study was to investigate the physical activity profile of playing Pokemon GO for 60 minutes in recreationally active college students. College students (n=27, n=19 female) were fitted with an accelerometer, pedometer, and heart rate monitor to assess the activity demands during a 60-min bout of Pokemon GO. Troiano accelerometer cut points were utilized to estimate time spent in sedentary, light, moderate, and vigorous-intensity physical activity. Of the 60-min allotted playtime, accelerometry indicated 82% was achieved via moderate-to vigorous-intensity physical activity. Pedometer counts indicated approximately 6000-steps/100-steps/min, indicative of moderate-intensity physical activity. Heart rates were approximately 50% of age-predicted maximum, also indicative of moderate-intensity physical activity. The results of this study provide evidence that playing one hour of Pokemon GO can be an effective means of accumulating recommended levels of daily/weekly physical activity.
Abstract 16942: Alternatively Spliced Tissue Factor promotes plaque progression, inflammation and angiogenesis in experimental atherosclerosis

Introduction: Alternatively Spliced Tissue Factor (asTF) is novel isoform of tissue factor with angiogenic activity mediated via HIF-1α signaling (Giannarelli, AHA 13). asTF is highly expressed in ...
CHROMOSOME ERRORS AS A CAUSE OF SPONTANEOUS ABORTION: THE RELATIVE IMPORTANCE OF MATERNAL AGE AND OBSTETRIC HISTORY

Objective To evaluate the likelihood of obtaining a chromosome diagnosis in cases of spontaneous abortion (SAB) and of the relative importance of maternal age versus obstetric history in predicting the fetal karyotype. Design Obstetric history was obtained from all 100 cases of miscarriage in 1year when products of conception were sent for chromosome studies. Multiple logistic regression analysis was used to calculate odds ratio and statistical significance for correlations between historical factors and the probability of any chromosomal abnormality or trisomy. Results A chromosome diagnosis was made in 84% of cases. Maternal age was a more important predictor of chromosome abnormality, specifically trisomy, than history of previous livebirths or miscarriages. Conclusion Results from chromosome studies using chorionic villi from SABs are diagnostically useful, even when the patient has a history of repeated miscarriages.
Characterizing the C-Wave of the Electroretinogram

The c-wave of the electroretinogram is a slow cornea-positive response which must be recorded by d.с. -amplification. It is generated in part by the pigment epithelium but also by the Muller cells and inner retina. The amplitude and waveform of the c-wave are quite variable which complicates its definition for clinical use. Both c-wave amplitude and time-to-peak increase with stimulus energy, and the c-wave can integrate stimulus energy over several seconds. For every light intensity there is a critical duration beyond which integration no longer takes place. If the c-wave is to be used as a clinical measure of pigment epithelial function, the techniques for human recording must be improved, and recording protocols must be devised which selectively emphasize the pigment epithelial components of the response.
The Top 50 Most-Cited Articles on Thoracolumbar Fractures.

Objective To identify the top 50 most-cited articles in the literature focusing on thoracolumbar spine fractures. Methods Using the ISI Web of Science version 5.11 database and the search phrase "thoracolumbar fracture," we queried for the 50 most-cited articles on thoracolumbar fractures. The study was performed in September 2017. We searched for articles published between 1900 and 2017. Articles were sorted and ranked based on the total number of citations. We evaluated the following information pertaining to each article: first author, year of publication, journal, and title. Results A total of 2718 studies matched our search criteria, of which the top 50 most-cited ranged between 267 and 81 citations. Twelve articles were cited more than 200 times. The article by McLain et al. was the most-cited article, with 267 citations, followed by Vaccaro et al. with 237 and Mumford et al. with 236. The majority of the studies originated from the United States (n = 26) and were published in the 1990s. Spine was the most frequent destination journal (n = 26), followed by the Journal of Bone and Joint Surgery (n = 7). Most of the articles focused on the clinical management of thoracolumbar fracture (82%). Vaccaro and McAfee were the most cited first authors, with 3 articles each. Conclusions Thoracolumbar fractures are the most common injuries of the spine, and the incidence is increasing globally. To understand current treatment guidelines and how treatment of these fractures has evolved, it is important to know the most-cited articles pertaining to these fractures.
Arduino and access: value tensions in the maker movement

This paper applies the construct of value tensions to an empirical investigation. Specifically, this work surfaces values tensions in data collected from a prominent online discussion forum about the Arduino electronics prototyping platform. Findings show how two value tensions—easy access versus technical opportunity, and amateur versus expert practices—inform different sentiments toward creative technologies.
Scaling Laws in the Axisymmetric Wake of a Sphere

An axisymmetric turbulent wake is often assumed to be self-similar when the streamwise location x is sufficiently far from the wake generator. Thus, profiles of the single-point statistics have the local wake width, \(\delta (x)\), and the centerline streamwise mean defect velocity, \(U_0 (x)\), as the characteristic length and velocity scales. Under self-similarity, the evolution of the scaling parameters, \(U_0\) and \(\delta \), is described by power laws: \(U_0/U_\infty \sim x^m\) and \(\delta /D \sim x^n\) where D is a characteristic length scale of the body.
Chapter 37. Pediatric Gynecologic Cancer

Summary This chapter contains sections titled: Introduction Ovarian tumors Rhabdomyosarcoma Clear cell cervical/vaginal cancer References
Does Cytomegalovirus Truly Increase Cardiac Allograft Vasculopathy via First-Year Intravascular Ultrasound after Heart Transplant in the Tacrolimus Era?

Purpose Cytomegalovirus (CMV) has been documented as a risk factor for the development of cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). It has not been firmly established whether CMV would cause an increase in first-year intimal thickening via intravascular ultrasound (IVUS) in the current tacrolimus era. First-year maximal intimal thickening (MIT) ≥0.5mm has been found to be predictive of poor outcome (worse survival, CAV) at 5-years post-transplant. In addition, there has not been a differentiation between CMV infection, CMV syndrome, and CMV disease as it applies to IVUS intimal thickening. CMV infection is noted by positive IgG CMV serology only; CMV syndrome refers to patients with documented CMV virus along with a clinical presentation; CMV disease is defined as organ-specific CMV infection i.e. CMV pneumonitis, CMV colitis etc. Therefore, we sought to use first-year IVUS to determine whether CMV infection, syndrome, or disease would lead to more first-year MIT ≥0.5mm. Methods Between 2010 and 2017, 294 heart transplant patients underwent baseline and 1-year IVUS. These patients were then divided into 4 groups: (Group A - no CMV infection (n=108); Group B - CMV infection (n=173); Group C - CMV syndrome (n=9); and Group D - CMV disease (n=3)). Diagnosis of CAV was based on a ≥ 0.5 mm increase in maximal intimal thickness (MIT) from baseline. Results Baseline MIT was similar among all study groups. The percent of patients with first-year MIT ≥0.5mm was also similar among all patient groups. Conclusion The development of CMV infection, syndrome and disease, does not appear to increase CAV risk by first-year MIT obtained by IVUS in the current tacrolimus era. Larger number of patients with longer follow-up studies are warranted to confirm these findings.
Optimal Prescriptive Trees

Motivated by personalized decision making, given observational data {(xi,yi,zi)}i=1n involving features xi∈Rd, assigned treatments or prescriptions zi∈{1,…,m}, and outcomes yi∈R, we propose a tree-...
Diligent TLBs: a mechanism for exploiting heterogeneity in TLB miss behavior

Modern workloads such as graph analytics, sparse matrix multiplication, and in-memory key-value stores use very large datasets and typically have non-uniform memory access patterns which defy traditional concepts of locality. Moreover, many of these algorithms simultaneously use multiple data structures that have very distinct access patterns to the corresponding pages, leading to heterogeneity in TLB behavior. Our intuition suggests that these two factors make it important to architect a heterogeneity-aware TLB hierarchy. Our results confirm the existence of heterogeneity in TLB behavior, where a few pages have high reuse but poor temporal locality. These pages are responsible for a significant percentage of the TLB misses (e.g. over 15% of the TLB misses result from only 17 pages, which is 0.04% of the total number of pages, for Canneal kernel). In this paper, we propose Diligent TLBs (Di-TLBs), a novel hardware-software co-design for TLBs that identifies such delinquent page mappings by tracking their reuse behavior and pinning them in the TLBs to reduce misses. We show that Di-TLBs reduce TLB misses by up to 24.93% on average while improving performance by up to 9.13% on average for a collection of memory-intensive workloads.
Eyelid and Eyelash Malpositions

The upper and lower eyelid structures are similar and analogous, yet distinct, each with a complex anatomy that allows the lids to retain form and function. Anatomic pathology of any cause can disrupt eyelid position, stability, and movement, thus allowing for a range of symptoms including tearing (epiphora), disruption in vision, conjunctival injection, keratopathy, or in extreme cases, corneal perforation. This chapter will briefly review eyelid anatomy, followed by an anatomically based discussion of the etiology and treatment of five common eyelid malpositions – ectropion, entropion, epiblepharon, ptosis, and retraction – as well as a brief review of trichiatic eyelashes.
Aerial escort task using networked miniature unmanned aerial vehicles

Aerial escort generally exists during the formation flight process of multiple aerial vehicles, especially for a heterogeneous system. The main purpose of escort task refers to follow certain aeria...
Counseling Psychology: From Defining the Field to Promoting World Peace:

Dr. John Whiteley, the founding Editor and original publisher of The Counseling Psychologist, discusses foundational and historical resources for psychologists to commemorate the 50th anniversary o...
Abstract WP397: Multidisciplinary Simulation of Stroke Alerts in Resident Education Leads to a 20% Decrease in Door to Needle Times

Introduction: Neurology residents are primarily responsible for responding to stroke alerts within our institution. It is imperative that first year residents understand the process and role expect...
Integrating a Cadaver Review Session into the Existing Regional Anesthesia Training for Anesthesiology Residents: An Initial Experience.

The Department of Anesthesiology’s Acute Pain Service (APS) places ultrasound-guided peripheral nerve blocks (PNBs) to manage acute peri-operative pain. PNB success is dependent on detailed anatomical knowledge which residents may not have formally reviewed since medical school. This study describes the integration of a cadaver review session (CRS) that reintroduces PNB-related anatomy into the existing APS rotation. During each CRS, an anatomist reviewed the major nerve and surrounding structures, while an APS attending integrated the anatomy with PNB techniques. During the pilot, 1st- and 3rd-year clinical anesthesia (CA) residents (9 CA1s, 7 CA3s) completed pre- and post-session surveys and rated the CRS’s perceived value and impact on self-confidence with anatomical knowledge. Following the pilot, an additional 17 CA1s and 9 CA3s participated in the CRS and completed post-session surveys. Descriptive statistics were used to summarize responses and unpaired t tests were used to compare pre- and post-session responses and responses between cohorts. All participants were overwhelmingly positive about the CRS and its value to the APS rotation, with 98% agreeing they recommend the CRS and found it accessible. Residents believed participation would improve board exam (average = 4.83 ± 0.66) and clinical performance (average = 4.86 ± 0.65), and self-reported increases in confidence with anatomical knowledge. Residents in the pilot group reported significantly greater confidence (p < 0.01) in their perceived anatomical knowledge after the CRS. The CRS positively impacted resident confidence in their anatomical knowledge and perceived ability to identify anatomical structures. Residents reported the CRS was a highly valued addition to regional anesthesia training.
An automated system for checking process friendliness and routability of standard cells

In this paper, we propose methodologies used in a software system for checking process friendliness (including lithography friendliness) and routability (including pin accessibility) of standard cells. In the process of designing physical layouts of standard cells, it is essential to consider their process friendliness since specific cells have very high tendencies to create process weakpoints (which include lithography hotspots) after their instances are placed and routed. On the other hand, at advanced process nodes, the routability of standard cells must also be considered since there are combined trends of increasing pin densities and increasing design rule complexities. Experimental results show that our software system is able to effectively detect problematic standard cells which have critical process friendliness and/or routability issues.
A new kind of gatekeeper: The increasing prevalence of Advanced Practice Nurses as case managers in US hospitals.

Case management is a representation of managed care, cost-containment organizational practices in healthcare, where managed care and its constitutive parts are situated against physician autonomy and decision-making. As a professional field, case management has evolved considerably, with the role recently taken up increasingly by Advanced Practice Nurses in various health care settings. We look at this evolution of a relatively new work task for Advanced Practice Nurses using a countervailing powers perspective, which allows us to move beyond discussions of case management effectiveness and best practices, and draw connections to trends in the social organization of healthcare, especially hospitals. We evaluated organizational (hospital-level) and environmental (county and state-level) characteristics associated with hospitals' use of Advanced Practice Nurses as case managers, using data from U.S. community acute care hospitals for 2016-2018, collected from three data sources: American Hospital Association annual survey (AHA), Centers for Medicare and Medicaid Services (CMS), and Area Resource File. Among organizational characteristics, we found that hospitals that are a part of established Accountable Care Organizations (OR = 2.55, p = 0.009; 95% CI = 1.26-5.14) and those that serve higher acuity patients, as indicated by possessing a higher Case Mix Index (OR = 1.32, p = 0.001; 95% CI = 1.13-1.55), were more likely to use Advanced Practice Nurses as case managers. Among environmental characteristics, having higher local Advanced Practice Nurses concentrations (OR = 1.24, p < 0.001; 95% CI = 1.11-1.39) was associated with hospital Advanced Practice Nurses case management service provision. Beyond the health impacts of Covid-19, its associated recession is placing families, governments and insurers under unprecedented financial stress. Governments and insurers alike are looking to reduce costs anywhere possible. This will inevitably result in increasing amounts of managed care, and decreasing reimbursements to hospitals, likely resulting in higher demand for APRN patient navigators.
Language Gap in Reach of "The Real Cost": Examination of a Federal Mass Media Campaign From 2017 to 2019.

INTRODUCTION Approximately 25% of youth in the United States speak a language other than English at home. These youth may have less exposure to English-speaking media, including public smoking prevention initiatives such as the FDA's "The Real Cost" campaign. Research is needed to explore potential gaps in the reach of "The Real Cost" campaign among bilingual youth. AIMS AND METHODS Data were pooled from the 2017-2019 National Youth Tobacco Surveys. Participants were n = 12 803 middle and high school students who were either: (1) susceptible never smokers; or (2) ever smokers that had smoked less than 100 cigarettes; these criteria reflect the FDA's definition of "target population" for "The Real Cost" campaign. Multiple, logistic regression analyses examined the relationship between speaking a language other than English at home (ie, bilingual) and self-reported exposure to "The Real Cost" campaign among both samples. Analyses controlled for sex, race/ethnicity, grade level, tobacco marketing exposure, and current tobacco use. RESULTS The majority (61.7%) of youth who met "target population" criteria self-reported exposure to "The Real Cost" from 2017 to 2019. Regression analyses found that youth who reported speaking a language other than English at home were significantly less likely to self-report exposure to "The Real Cost" campaign (adjusted odds ratio: 0.85; p < .001), adjusting for covariates. CONCLUSIONS Bilingual youth were significantly less likely to report exposure to "The Real Cost" campaign. Findings suggest the need to develop methods of increasing reach among bilingual youth, given the high smoking prevalence among these youth. IMPLICATIONS This study highlights a social and cultural gap in the reach of the FDA's "The Real Cost" campaign. Agencies such as FDA should consider enhancing existing mass media campaigns to reach diverse communities, including the nearly 25% of youth who speak a language other than English.
Empiric aztreonam is associated with increased mortality compared to beta-lactams in septic shock.

Abstract Purpose To determine if aztreonam as initial empiric treatment of adult septic shock is associated with increased mortality compared to the use of anti-pseudomonal beta-lactam agents. Methods This was a multicenter, retrospective cohort study of 582 adult emergency department patients admitted to 12 acute care facilities within a single health system from January 2014 to December 2017 with septic shock receiving either aztreonam or an anti-pseudomonal beta-lactam for empiric treatment and discharged with an infection-related ICD-9 or ICD-10 code. The primary endpoint was in-hospital mortality. Results Initial exposure to aztreonam was associated with increased hospital mortality compared to treatment with an anti-pseudomonal beta-lactam agent (22.7% vs. 12.9%, OR = 1.98, 95% CI: 1.27–3.11). When adjusted for APACHE II score, the treatment group effect on mortality remained statistically significant (OR = 1.74, 95% CI: 1.08–2.80). Aztreonam use was also associated with increased utilization of aminoglycosides (28.9% vs. 12.4%, p Conclusions Compared to anti-pseudomonal beta-lactams, empiric treatment with aztreonam is associated with increased mortality and greater antibiotic exposure among patients with acute septic shock. These findings suggest that treatment with anti-pseudomonal beta-lactams should be prioritized over allergy avoidance whenever feasible.
Submandibular Injection of Indoleamine 2,3-Dioxygenase Galectin-3 Fusion Protein Inhibits and Prevents Periodontal Disease Progression Over 12 Weeks

A major challenge in the treatment of chronic inflammatory diseases including periodontal diseases is the development of therapeutics to safely and specifically direct resolution of inflammation in a localized manner. Here we demonstrate the efficacy of a novel approach that addresses this unmet clinical need. Using an enzyme fusion protein of indoleamine 2,3-dioxygenase 1 (IDO) and galectin-3 (Gal3) with tissue-anchored and thus localized immunomodulatory properties, we prevented and halted progression of induced polymicrobial periodontal disease. Efficacy was achieved with repeated treatment with IDO-Gal3 and was measured by effects on mandibular bone loss, soft tissue inflammation and local T cell plasticity. Specifically, both prophylactic and therapeutic administration of IDO-Gal3 were effective in reducing vertical mandibular bone loss and loss of mandibular bone volume and bone thickness induced by chronic polymicrobial infection. The efficacy observed is at least in part due to localized regulation of innate immune mediators such as IL-1β, IL-6 and IL-8 as well as chemoattractants including IP-10, MCP-1 and MIP-1α, while enhancing the expression of immunoregulatory cytokines such as IL-10. In addition, IDO-Gal3 treatment suppressed the induction of pathogenic CD4+Th1, CD8+Tc1, CD4+Th1/Th17, and CD8+Tc1/Tc17, while promoting the induction of homeostatic CD4+Th17, CD8+Tc17 and CD4+Tregs. Importantly, the efficacy of prophylactically and therapeutically administered IDO-Gal-3 is not dependent on bacterial burden as there were no appreciable effects on bacterial burden following either method of administration. Lastly, therapeutic rather than prophylactic administration of IDO-Gal3 is most effective in preventing mandibular bone loss through more robust innate and adaptive immune modulation. Together these and our previously published data indicate that therapeutic administration of IDO-Gal3 addresses the clinical needs for adjunctive therapeutics to treat active and/or established periodontal diseases.
Tailored catalyst microenvironments for CO2 electroreduction to multicarbon products on copper using bilayer ionomer coatings

Electrochemical carbon dioxide reduction (CO2R) provides a promising pathway for sustainable generation of fuels and chemicals. Copper (Cu) electrocatalysts catalyse CO2R to valuable multicarbon (C2+) products, but their selectivity depends on the local microenvironment near the catalyst surface. Here we systematically explore and optimize this microenvironment using bilayer cation- and anion-conducting ionomer coatings to control the local pH (via Donnan exclusion) and CO2/H2O ratio (via ionomer properties), respectively. When this tailored microenvironment is coupled with pulsed electrolysis, further enhancements in the local ratio of CO2/H2O and pH are achieved, leading to selective C2+ production, which increases by 250% (with 90% Faradaic efficiency and only 4% H2) compared with static electrolysis over bare Cu. These results underscore the importance of tailoring the catalyst microenvironment as a means of improving overall performance in electrochemical syntheses. Copper catalyses electrochemical reduction of CO2 to valuable multicarbon products, but its selectivity depends on the local microenvironment near the catalyst surface. Here, the authors explore and optimize this environment to improve performance using bilayer ionomer coatings to control the local pH and CO2/H2O ratio.
Detection, not mortality, constrains the evolution of virulence

Why would a pathogen evolve to kill its hosts when killing a host ends a pathogen9s own opportunity for transmission? A vast body of scientific literature has attempted to answer this question using "trade-off theory," which posits that host mortality persists due to its cost being balanced by benefits of other traits that correlate with host mortality. The most commonly invoked trade-off is the mortality-transmission trade-off, where increasingly harmful pathogens are assumed to transmit at higher rates from hosts while the hosts are alive, but the pathogens truncate their infectious period by killing their hosts. Here I show that costs of mortality are too small to plausibly constrain the evolution of disease severity except in systems where survival is rare. I alternatively propose that disease severity can be much more readily constrained by a cost of behavioral change due to the detection of infection, whereby increasingly harmful pathogens have increasing likelihood of detection and behavioral change following detection, thereby limiting opportunities for transmission. Using a mathematical model, I show the conditions under which detection can limit disease severity. Ultimately, this argument may explain why empirical support for trade-off theory has been limited and mixed.
The Problem of Time Scales in Computer Visualization

A new approach to temporal aspects of visualization is proposed. Empirical and theoretical studies of visualization processes are presented in a more general context of human-computer interaction (HCI). It makes possible to develop a new model of HCI as a base for visualization. This model implements a methodology of autonomous intelligent agents. Temporal aspects of the model are rooted in the system theory of time. This theoretical background provides for obtaining properties of time coordination. In particular, it is proved that some theoretically advanced models for computation and visualization cannot be realized by physical devices. Applications of the model, its implications for visualization and problems of realization are considered. The new approach does not refute or eliminate previous research in this area, but puts it in a more general and adequate context, systematizing it and providing efficient facilities for the development of computer visualization.
Fragment Maps of φX-174 Replicative DNA Produced by Restriction Enzymes from Haemophilus aphirophilus and Haemophilus influenzae H-I

Abstract X-174 replicative form (RF) DNA was cleaved by restriction enzymes from Haemophilus aphirophilus (Hap) and H. influenzae (H-I strain Osaka) (HinH). Five fragments were produced by Hap and eight by HinH. The positions of all of the Hap fragments and six of the HinH fragments were mapped on the genome by heteroduplex transfection and DNA-DNA hybridization methods. In addition, fragment sizes of X-174 RF DNA and S13 RF DNA by Hap and HinH were compared. Considerable differences of the size of the fragments produced from these closely related phage genomes were observed.
General Recipe and Properties of a Four Inch Hydroceramic Waste Form

Sodium bearing waste (SBW) having a high loading of sodium salts (typical of the SBW stored at Hanford) must be pretreated before it can be incorporated in a hydroceramic waste form. One such method, using thermal decomposition of the nitrate/nitrite compounds in the SBW is described. Calcination of the SBW with sucrose and various aluminosilicate sources produced a granular solid that was solidified by mixing it with additional metakaolinite and a minimal amount of NaOH solution. The caustic and metakaolinite combine and form tectosilicates and in doing so bind the sample together forming a strong and highly stable solid we are calling a hydroceramic. A summary of the systematic study that allowed us to optimize both recipe and associated processing is reported. Scoping experiments use gram sized samples. A 4 inch cube was also produced using the optimized recipe and procedure in order to test for the homogeneity of a larger sample. The scale-up sample was evenly divided into 27 sub-samples. The properties of all the sub-samples indicate that the larger sample is homogeneous and thus it might very well be feasible to produce a massive hydroceramic nuclear waste form for the large-scale solidification/stabilization of SBW stored at Hanford.