cssi/SciSciGPT-SciSciNet huggingface dataset:
Grandparent Involvement in the Communication Development of Children Who are Deafblind

Abstract The purpose of this study was to investigate the role of grandparents in the communication development of children who are deafblind. The two-tiered study was conducted through State Projects for Deafblind Children in Arkansas, Mississippi, and Tennessee with 143 parents and 80 grandparents. The grandparents identified as “most involved” provided information about factors that influence their levels of involvement. The results suggest that maternal grandparents are the most involved. A needs analysis in areas of communication, nurturing, and school indicated the need for grandparents to be included as participants in developing communication plans.
Calculation of Attributable Risks from Epidemiological Data

Attributable risk is an important epidemiological index, and may be more relevant to many health planning situations than other indices such as the relative risk. This paper outlines the requirements of typical epidemiological data in order to estimate attributable risks, and illustrates the calculations for some common types of research study. The examples chosen have no special significance per se, but represent the main findings of several typical investigations reported in the epidemiological literature. The combination of estimates from several studies and extrapolation to other populations are discussed. Finally the concept of attributable risk as the causal effect of a risk factor is presented.
Cost analyses of adjunct colony stimulating factors for acute leukemia: can they improve clinical decision making.

Colony stimulating factors reduce the duration of neutropenia following intensive chemotherapy in a variety of settings, but the advantages in the management of leukemia are inconclusive. The variations in clinical results and the high costs of granulocyte colony-stimulating factor (G-CSF) and granulocyte macrophage colony-stimulating factor (GM-CSF) have led to confusion over appropriate use for leukemia patients. In this paper, we reviewed published information on costs and cost-effectiveness of growth factors for childhood and adult leukemia patients. Medline and Healthstar databases were searched for original research articles that contain cost or cost-effectiveness analyses of G-CSF (filgrastim) and GM-SCF (sargra-mostim) in oncology cooperative group trials. Published manuscripts and abstracts presented at national or international oncology conferences were included. The cost of adjunct treatment was evaluated in two studies of pediatric ALL, one study of adult AML, and two studies of AML in older a...
Riesz Representation Theorems

In this chapter we discuss a well-known family of theorems, known as Riesz Representation Theorems, that assert that positive linear functionals on classical normed Riesz space C(X) of continuous real functions on X can be represented as integrals with respect to Borel measures. To make sure everything is integrable, we restrict attention either to continuous functions with compact support, C c(X) and measures that are finite on compact sets, or to finite measures and bounded continuous functions, C b(X). We also consider positive functionals on the spaces of bounded measurable real functions B b (X).
Importance of the Emergency Medicine Application Components: The Medical Student Perception

Abstract Background The National Resident Matching Program (NRMP) application has several elements. With limited time and resources, students must prioritize the key application elements on which to focus. It is unclear if medical students applying to emergency medicine (EM) prioritize the same items as program directors. Objective We sought to determine medical student perception of the importance of each factor of the NRMP application to an EM residency. Methods This was a cross-sectional study approved by the Institutional Review Board at an academic tertiary care Level I trauma center. A pilot-tested and validated survey tool was given to all medical students rotating in EM during an 18-month period. The students ranked each application item on a 5-point scale (1 = not important and 5 = very important) with verbal anchors. Results Of 136 medical students, 85.3% responded. Excluded were 31% who were not planning to apply to EM, leaving 80 responses for analysis. Items ranked higher were EM rotation grade, interview, clinical rotation grades, and letters of recommendation. Less emphasis was placed on Alpha Omega Alpha (AOA) honor society status, publication in medical literature, and personal statement. Items most agreed upon and believed to be most important by the students were EM rotation grade, interviews, and clinical rotation grades. Conclusions This is similar to previously reported rankings by program directors. Although medical students agreed on the importance of most aspects of the NRMP application, areas of discordance included emphasis on extracurricular activities and AOA. This can have implications for medical student mentoring and advising.
The Business of Government and Government as a Business

Economists have historically believed that some goods and services can be provided only by the government. The traditional theory, Boettke and Ellig suggest, does not mean that we know for certain which specific goods those are in the real world. They propose allowing the market to decide what private enterprise can or cannot do by allowing private firms to compete with the government in the production of public goods, including the monetary system. As the scope of government activity shrinks, so, of course, will deficits.
Heparin-Induced Thrombocytopenia Associated with a Heparin-Bonded Stent Graft

We describe a case of heparin-induced thrombocytopenia (HIT) in association with heparin-bonded stent grafts. A 61-year-old man with claudication secondary to a left superficial femoral artery (SFA) occlusion was treated with 2 heparin-bonded polytetrafluorethylene (hep-PTFE) grafts. Despite the use of antiplatelet medication, he presented with thrombosed hep-PTFE grafts 1 week after initial treatment. An additional hep-PTFE graft was placed at the SFA origin because of migration of the first graft. He was discharged on anticoagulation; however, he presented again 2 weeks later with recurrent SFA thrombosis and a platelet count of 60,000, raising suspicion for HIT. All exogenous forms of heparin were discontinued, and he was started on an alternative anticoagulant. The patient returned again 5 days after being discharged with recurrent symptoms of acute limb ischemia. He underwent a left femoropopliteal artery bypass with autogenous conduit and removal of the grafts. He has since had an uneventful recovery. We believe HIT should be considered as a potential cause of hep-PTFE graft thrombosis. Diagnosis and management of these patients is complex and may require explantation of the graft.
N–H and N–C Bond Formation with an N2-Derived Dihafnium μ-Nitrido Complex

Exposure of the base-free isocyanato dihafnocene μ-nitrido complex prepared from CO-induced N2 cleavage to a dihydrogen atmosphere resulted in rapid 1,2-addition across the hafnium–nitrogen bond followed by insertion of the terminal isocyanate ligand into the putative hafnium hydride ligand and formed a bridging formamide ligand. Terminal alkynes and sterically hindered allenes underwent preferential addition of a C–H bond across the hafnium nitride fragment and resulted in isolation of the μ-imido acetylide and allenyl dihafnocene complexes, respectively. Reducing the steric profile of the allene enabled N–C rather than N–H bond-forming chemistry arising from cycloaddition of the π system. In the presence of additional allene, the resulting azahafnacyclobutanes underwent exchange, establishing the reversibility of the N–C bond forming reaction. Ketones with enolizable hydrogens, amines, and guanidines underwent rapid deprotonation upon addition to the isocyanato dihafnocene μ-nitrido complex and offer a ...
Molecular testing for targeted therapy – sequencing based assay

Significant advances have been made in molecular and genetic studies, and our knowledge of genomic alterations in various cancers has increased. It is generally accepted that oncogenesis is initiated by genetic alteration of drivers. Detection of mutations of these driver genes can lead to targeted therapy agents, referred as personalized medicine. Examples include HER2 amplification in breast cancer, EGFR mutations in lung cancer and BRAF mutations in melanoma. Single gene assays for selected driver genes were the method of choice until more robust gene panel testing by next generation sequencing came to the horizon. Several different methodologies are available to detect mutations and each assay has its own pros and cons, which will be discussed in this session. Sanger chain termination sequencing has been considered the gold standard for long time, but it is time consuming and has lower sensitivity. Pyrosequencing, sequencing by synthesis, is more sensitive and quick, but is limited to short read lengths. Allele-specific real-time PCR has been utilized for clinical testing for oncogene mutations as FDA-cleared assays are available. It is very sensitive, but is limited to hot spot mutation detection. Real-time PCR melt curve analysis is also sensitive, but cannot identify the exact mutation.
16 – Smart coatings for protective clothing

Smart coatings change their properties in response to an environmental stimulus such as a change of temperature, light, mechanical damage, and contact with chemicals. This chapter reviews the applications of smart coating on textile substrates for use in protective clothing. It covers coating of a sheer thickening fluid on Kevlar, nylon, and ultrahigh-molecular-weight polyethylene for body armor; using layer-by-layer assembly technology to coat multifunctional thin films on textiles for hazardous material suit use; coating titanium dioxide and silver nanoparticles on cotton or polyester fabrics for health care clothing use; and coating phase change materials on fabrics used in firefighter turnout coats. Future trends in smart coating for protective clothing applications are also discussed.
Scissors Lifting Machine Digital Prototype Design and Analysis

This paper studies the scissors lifting machine movement rules,and in the lift table has the safe and smooth work conditions,studies the key components of the movement rule and characteristics.Application Pro/E software model design,the application of ADAMS software in motion simulation and analysis,get the lifting machine lord the main points of the motion law and track.
Engineering the New Boundaries of AI

Recognizing the increasingly critical role that AI plays in all aspects of modern society, the XPRIZE Foundation launched the IBM Watson AI XPRIZE. Interdisciplinary teams will advance current AI technologies as they compete for the grand prize.
Pancreatic cysts: Diagnostic accuracy and risk of inappropriate resections

Abstract Background Pancreatic cystic neoplasms (PCN) frequently undergo surgery, given malignant potential. Pancreatic cyst surgery is associated with significant rates of morbidity and mortality. It is crucial to accurately characterize these lesions pre-operatively to avoid unnecessary surgery in patients with benign pancreatic cysts. Aim We aimed to assess the correlation between pre-operative (pre-op) diagnosis based on imaging and clinical presentation, and post-operative (post-op) diagnosis based on histopathology in patients undergone pancreatic cyst surgery. Methods From January 2000 to January 2012, we randomly selected 2000 patients with ICD-9 code 211.6 and 577.2. Amongst these we identified 281 patients undergone pancreas surgery. Patients with no pre-op imaging or non-cyst indication for surgery were excluded (n = 107). Imaging details, demographics, pre-operative physician diagnosis and histopathologic details of pancreatic cysts were recorded in 174 patients. Results There was a discrepancy between the pre- and post-operative pancreatic cyst diagnosis in 54 (31%) patients. There was no difference in the proportion of various imaging studies (CT, EUS or MRI) between patients with a correct and patients with an incorrect pre-op diagnosis. The pre-op diagnosis was confirmed at pathology in 87.5% of the presumed SCNs, in 80% of the presumed pseudocysts, in 73.3% of the presumed BD-IPMNs, in 66.7% of the presumed MD/mixed-IPMNs and in 53.6% of the presumed MCNs. The accuracy of the pre-operative diagnosis of presumed MCN was significantly lower compared to the non-MCN cysts (53.6% vs. 75%; p = 0.037). Fourteen percent of resections were performed for asymptomatic benign cysts, preoperatively suspected to be potentially pre-malignant cysts. Conclusion In nearly 1 out of 3 patients undergone pancreas cyst surgery, there is a discrepancy between pre- and post-op diagnosis. Pre-op diagnosis of presumed MCN is more likely to be incorrect, compared to the other cysts.
In Situ Observation of Rh-CaTiO3 Catalysts during Reduction and Oxidation Treatments by Transmission Electron Microscopy

Scanning transmission electron microscopy of high-surface-area Rh-doped CaTiO3 powder, conducted near atmospheric pressure at elevated temperature (250–700 °C) by means of an electron-transparent gas cell with a sample heater, provides evidence for both cyclical precipitation–dissolution of Rh nanoparticles in response to redox cycling of the ambient gas and sintering of the powder.
Health behavior models for informing digital technology interventions for individuals with mental illness.

Objective Theoretical models offer valuable insights for designing effective and sustainable behavioral health interventions, yet the application of theory for informing digital technology interventions for people with mental illness has received limited attention. We offer a perspective on the importance of applying behavior theories and models to developing digital technology interventions for addressing mental and physical health concerns among people with mental illness. Method In this commentary, we summarize prominent theories of human behavior, highlight key theoretical constructs, and identify opportunities to inform digital health interventions for people with mental illness. We consider limitations with existing theories and models, and examine recent theoretical advances that can specifically guide development of digital technology interventions. Results Established behavioral frameworks including health belief model, theory of planned behavior, transtheoretical model, and social cognitive theory consist of important and overlapping constructs that can inform digital health interventions for people with mental illness. As digital technologies continue to evolve and enable longitudinal data collection, real-time behavior monitoring, and adaptive features tailored to users' changing needs over time, there are new opportunities to broaden our understanding of health behaviors and mechanisms of behavior change. Recent advances include dynamic models of behavior, persuasive system design, the behavioral intervention technology model, and behavioral models for just-in-time adaptive interventions. Conclusion and implications for practice Behavior theories offer advantages for guiding use of digital technologies. Future researchers must explore how theoretical models can effectively advance efforts to develop, evaluate, and disseminate digital health interventions targeting individuals with mental illness. (PsycINFO Database Record
A crustal-scale integrated geophysical and tectonic study of the Snake River Plain region, northwestern U.S.A.

ABSTRACTThe Pacific Northwest region of North America is a site of very complex tectonomagmatic activity. This activity is due to subduction of the Pacific plate, the associated Cascade chain of vo...
Leg length inequality.

Objective The (Pacific) Consortium for Chiropractic Research has taken the initiative to research, investigate and provide information directed toward health care accountability, including evaluation of health care measures and practices. This article is a review of the literature pertaining to leg length inequality (LLI). Leg length measures are utilized by various health care providers as an indicator of biomechanical imbalance and necessity for care. Following the overview of the incidence, classifications and clinical significance, emphasis was placed on methods of evaluation, especially the visual "quick" leg length measurement procedure. Finally, a brief section on conservative care has been provided. Data sources The information and studies reviewed were obtained from Medline, the Index to Chiropractic Literature, Chiropractic Research Archives Collection, Physiotherapy Index, Chiropractic Literature Analysis and Retrieval System, various technique manuals, personal communication with technique research advisors, proceedings and dissertations. REFERENCE SELECTION: In spite of the widespread use of leg length measures, there is still much controversy associated with LLI, its biomechanical significance and the reliability of the various measurement systems employed. Therefore, the 182 references utilized were selected on the basis of applicable information, especially studies that provided a detailed methodological design with statistical analysis regarding evaluation procedures. Conclusion There appears to be a lack of agreement concerning incidence, classification and point of clinical significance. However, the manifestations or consequences of LLI demonstrate greater accordance. Of the three most commonly utilized evaluation methods, radiographic measures such as the scanograms are recognized as the most reliable procedure for the evaluation of anatomical LLI. Much controversy exists with some of the clinical orthopedic methods and the visual "quick" leg check. Because there is such a vast range in estimates of reliability, few if any definitive conclusions can be made regarding these methods. Given this, it is evident that more research is needed before the use of certain orthopedic and visual checks are considered reliable and valid.
All-trans-retinoic acid-mediated cytoprotection in LLC-PK1 renal epithelial cells is coupled to p-ERK activation in a ROS-independent manner.

Although all-trans-retinoic acid (ATRA) provides protection against a variety of conditions in vivo, particularly ischemia, the molecular mechanisms underpinning these effects remain unclear. The p...
Grandparent Caregiving, Race, and Cognitive Functioning in a Population-Based Sample of Older Adults:

Objective: The aim of this study was to evaluate the association between noncustodial grandparent caregiving and cognition using the Health and Retirement Study (HRS), a population-based study of older adults. Method: Participants were White and African American grandparents aged ≥65 years. Only noncustodial grandparents who reported not living with their grandchildren over the three waves were included in our analyses. Grandparent caregiving status and cognition were assessed in 2006, 2008, and 2010. Analyses controlled for demographics, baseline health, depressive symptoms, and baseline cognition. Results: Both the number of waves of grandparent caregiving and the total number of grandparent caregiving hours across the three waves were associated with better cognitive functioning at 4-year follow-up in 2010. Associations were observed among Whites, but not among African Americans. Discussion: This study uses longitudinal data to evaluate the association between grandparent caregiving and cognitive functioning. Findings suggest that providing care may be beneficial for some grandparents.
Distributed Economic MPC with Safety-Based Constraints for Nonlinear Systems

Abstract Promoting process safety of chemical processes while operating them in an economically-optimal manner is a matter of great importance. In Albalawi et al. (2016), a safety-based economic model predictive control methodology (safety-EMPC) was developed to operate nonlinear processes in an economically-optimal manner while maintaining process safety and closed-loop stability. However, the safety-EMPC control strategy was developed with a centralized economic model predictive control (EMPC) structure; thus, computation time limitations within a sampling period may reduce the effectiveness of such a controller design for promoting process safety. Alternatively, we develop in this work sequential and iterative safety-based distributed EMPC schemes (safety-DEMPC) that may overcome the computation time limitations of the centralized safety-EMPC while maintaining similar closed-loop performance. Using a catalytic reactor example, the two proposed safety-DEMPC schemes were demonstrated to achieve similar closed-loop performance to the centralized safety-EMPC while reducing the on-line computation time requirements compared to the centralized safety-EMPC.
Learning and Becoming Writers: Meaning, Identity, and Epistemology in a Newsroom Community of Practice

ABSTRACTThis article analyzes a yearlong ethnography of the Southside Free Press, a non-school-affiliated community-based organization that served diverse adolescent staff writers who prepared articles for a monthly newspaper publication. The study employed a perspective of learning as legitimate peripheral participation with/in a newsroom community of practice. Specifically, using Rogoff’s three planes of analysis—apprenticeship, guided participation, and participatory appropriation—demonstrates that the process of becoming staff writers affected their learning and development. Thus, their ongoing participation provided opportunities to come to enact and embody the available meanings, identities, and epistemologies around becoming a staff writer and citizenship.
Synthesis, Structures, and Physical Properties of Yttrium-Doped Strontium Manganese Oxide Films

Cubic strontium manganese oxide is an end-member of the colossal magnetoresistive (CMR) family of manganese-based perovskites, Ln 1-x AE x MnO 3 . Because normal synthesis conditions lead to the 4-H hexagonal polymorph, high-pressure conditions are typically used to obtain the cubic perovskite polymorph. In this work, we describe the synthesis and structural/physical characterization of the cubic perovskite form of the high-alkaline-earth containing phases of Y 1-x Sr x MnO 3 (x ≥ 0.7) as epitaxial thin films. Thin films of various stoichiometries were grown on single-crystal perovskite substrates SrTiO 3 , NdGaO 3 , and LaAlO 3 using pulsed laser deposition. After optimizing deposition conditions, the perovskite polymorph is obtained using PLD at 800°C and 10-100 mTorr O2 for x=1, 0.9, 0.8, and 0.7, as demonstrated by x-ray diffraction. Epitaxial growth was determined to be cube-on-cube. Electrical property measurements demonstrated insulating behavior and no metal-insulator transition or magnetoresistive behavior, similar to related stable compounds.
Hyperspectral Imaging and K-Means Classification for Histologic Evaluation of Ductal Carcinoma In Situ.

Hyperspectral Imaging (HSI) is a non-invasive optical imaging modality that shows the potential to aid pathologists in breast cancer diagnoses cases. In this study, breast cancer tissues from different patients were imaged by a hyperspectral system to detect spectral differences between normal and breast cancer tissues, as well as early and late stages of breast cancer . Tissue samples mounted on slides were identified from ten different patients. Samples from each patient included both normal and ductal carcinoma tissue, both stained with hematoxylin and eosin stain and unstained. Slides were imaged using a snapshot HSI system, and the spectral reflectance differences were evaluated. Analysis of the spectral reflectance values indicated that wavelengths near 550nm showed the best differentiation between tissue types. This information was used to train image processing algorithms using supervised and unsupervised data. The K-means method was applied to the hyperspectral data cubes, and successfully detected spectral tissue differences with sensitivity of 85.45%, and specificity of 94.64% with true negative rate (TNR) of 95.8%, and false positive rate (FPR) of 4.2%. These results were verified by ground truth marking of the tissue samples by a pathologist. In the hyperspectral image analysis, the image processing algorithm, K-means, shows the greatest potential for building a semi-automated system that could identify and sort between normal and ductal carcinoma in situ tissues.
The Present and Future of Diversity Climate Research: Where Are We Now and Where Do We Have to Go?

Ever increasing societal and organizational diversity has necessitated that organizations sharpen their focus on understanding how best to manage the social justice and performance issues associate...
YBC Texte der Yale Babylonian Collection

Das wesentlichste Merkmal der in diesem Kapitel zusammengefasten Texte ist es, das es sich um serienmasig geordnete (d. h. um numerierte) Tafeln handelt1). Die Bearbeitung mus sich daher selbstverstandlich so weit als moglich dieser von den Texten selbst geforderten Anordnung anschliesen, so das in diesem Kapitel das sonst befolgte Prinzip der Anordnung nach den Museumssignaturen aufgegeben ist. Zur Auffindung einer bestimmten Signatur diene die folgende Konkordanz:
Public Health Aspects of Out-of-Hospital Sudden Cardiac Arrest Among Elderly African-Americans.

In the U.S., the ethnic minority populations of elderly Americans are growing faster than the elderly population as a whole. It has been estimated that by the year 2030, minority elders will make up one-fourth of all elderly Americans. Among minority populations, African-Americans are at the highest risk for CHD and SCA. Approximately two-thirds of all out-of-hospital SCA cases are 65 years of age and older. The rate of a bystander initiated CPR as well as the rate of survival after out-of-hospital SCA is significantly lower among blacks than among whites. Studies have shown that racial differences in outcomes of out-of-hospital SCA cannot be fully explained by features of collapse or relevant service factors and that the underlying socioeconomic and health status of the minority population are factors likely to affect outcome of SCA. Most minority populations in the U. S. have a poorer socioeconomic and health status and access to the health care system than their white counterparts. SCA, as a leading cause of mortality, has been found to be associated with socioeconomic status and has been identified as a key area in which to study minority populations. This brief review summarizes public health aspects of SCA among elderly African-Americans with suggestions for new research and preventive interventions needs.
Software Complexity Assessment and Human-Machine Interface Evaluation

Man-machine interfaces may be complex in two ways: 1) they may be complex in their construction, and 2) they may be complex for a user to manipulate. A human-machine interface model is presented which focuses on these two forms of complexity which we term intrinsic and extrinsic complexity, respectively. In terms of their construction we may wish to evaluate their complexity based on metrics defined for computer programs in software science, control structure complexity, or logical complexity. In terms of their manipulation, each interface may be viewed as a language composed of abstractions representing objects and/or actions that the interface embodies. We relate various software metrics to the different aspects of the model and attempt to identify aspects for which measures don’t currently exist. Finally, we discuss implications this model may have on interface design decisions.
Self-explanatory simulations: an integration of qualitative and quantitative knowledge

A central goal of qualitative physics is to provide a framework for organizing and using quantitative knowledge. One important use of quantitative knowledge is numerical simulation. While current numerical simulators are powerful, they are often hard to construct, do not reveal the assumptions underlying their construction, and do not produce explanations of the behaviors they predict. This paper shows how to combine qualitative and quantitative models to produce a new class of self-explanatory simulations which combine the advantages of both kinds of reasoning. Self-explanatory simulations provide the accuracy of numerical models and the interpretive power of qualitative reasoning. We define what self-explanatory simulations are and show how to construct them automatically. We illustrate their power with some examples generated with an implemented system, SIMGEN. We analyze the limitations of our techniques, and discuss plans for future work.
Experimental Investigation of the Grain Noise in Interferometric Detection of Ultrasonic Waves

Besides their other obvious advantages over conventional ultrasonic sensors, laser interferometers offer optical diffraction limited apertures that are far smaller than the acoustic wavelength in the specimen under inspection. This unique feature can be exploited for the purposes of super-resolution near-field acoustic microscopy, which detects the rapidly decaying evanescent vibrations produced by surface and near-surface scatterers such as small fatigue cracks, pores, anomalous grains, etc. However, higher resolution also means higher sensitivity to inherent microscopic material inhomoge-neities. In this paper, experimental results are presented for the incoherent material noise in 2024 aluminum and Ti-6Al-4V titanium alloys at two different nominal frequencies of 5 and 10 MHz. It is shown that the incoherent grain noise significantly increases as the illuminated spot size decreases. Above the acoustic wavelength, the observed phenomenon is mainly due to the increasing sensitivity of the receiver to propagating scattered waves generated in the interior of the specimen. Below the acoustic wavelength, the further increasing material noise is mainly due to evanescent vibrations caused by nearby scatterers.
A Limit on the Speed of Quantum Computation for Insertion into an Ordered List

We consider the problem of inserting a new item into an ordered list of N-1 items. The length of an algorithm is measured by the number of comparisons it makes between the new item and items already on the list. Classically, determining the insertion point requires log N comparisons. We show that, for N large, no quantum algorithm can reduce the number of comparisons below log N/(2 loglog N).
Development and Validation of an Assay for Quantifying Budesonide in Dried Blood Spots Collected from Extremely Low Gestational Age Neonates

Abstract Budesonide is a potential therapeutic option for the prevention of bronchopulmonary dysplasia in mechanically ventilated premature neonates. The dose and concentrations of budesonide that drive effective prophylaxis are unknown, due in part to the difficulty in obtaining serial blood samples from this fragile population. Of primary concern is the limited total blood volume available for collection for the purposes of a pharmacokinetic study. Dried blood spots (DBS), which require the collection of
Efficacy and Safety of Short-Term Universal Prophylaxis for Invasive Aspergillosis after Heart Transplantation

Purpose Invasive aspergillosis (IA) infection is an infrequent complication after heart transplant but is associated with high morbidity and mortality. Universal prophylaxis for invasive aspergillosis in HTx patients in the United States has not been explored. From 2012-2014, 6 patients who underwent heart transplantation in our program developed invasive aspergillosis infection. A retrospective analysis of IA cases was performed to identify risk factors but due to small numbers, no definitive conclusion was made. In response, we implemented universal aspergillosis prophylaxis beginning in January 2015 using micafungin starting on post-op day 1 and continued for the duration of the index transplant admission. We report on the efficacy and safety of our policy change. Methods Clinical and transplant related characteristics of patients who underwent heart transplantation in our center from 2012-2014 (Period 1) and from 2015-2016 (Period 2) were retrospectively reviewed and cases of IA were identified. All dual-organ transplant recipients were excluded. Adverse events potentially related to micafungin use during period 2 were recorded. Results During period 1, 16% (6/37) of patients developed IA with a mean onset of 60 days post-transplant (range 9 to 174 days). Two patients died (28%) and all but one IA infection (86%) occurred within 90 days of transplantation. During Period 2, 22 patients underwent heart transplantation and all received micafungin prophylaxis for a mean of 12.8 days. One patient (4%) had micafungin stopped on post-op day 10 for presumed drug-related transaminitis. At one-year follow-up, no IA cases were identified. Conclusion Short-term universal aspergillosis prophylaxis with micafungin post- operatively for the duration of the index transplant admission is effective in preventing post-transplant aspergillosis infection. The medication is safe and well tolerated with a low discontinuation rate.
The impact of frailty on perioperative outcomes and resource utilization in sinonasal cancer surgery

OBJECTIVES/HYPOTHESIS Frailty is a measure of decreased physiologic reserve that has been associated with adverse outcomes in older surgical patients. We aimed to measure the association of preoperative frailty with outcomes in patients undergoing sinonasal cancer surgery. STUDY DESIGN Retrospective cohort study. METHODS We identified 5,346 patients in the Nationwide Readmissions Database undergoing sinonasal cancer surgery from 2010 to 2014. Frailty was defined using the Johns Hopkins Adjusted Clinical Groups frailty-defining diagnoses indicator. Multivariate regression was used to analyze the association of frailty with postoperative outcomes. RESULTS Frailty was present in 7.4% of patients. Frailty was a significant independent predictor of intensive care unit-level complications (odds ratio [OR]: 4.83; 95% confidence interval [CI]: 2.95-7.93; P < .001) and nonhome discharge (OR: 3.07; 95% CI: 1.68-5.60; P < .001). Compared to nonfrail patients, frail patients had threefold longer median length of stay (12 days vs. 4 days; P < .001) and more than twofold higher median hospital costs ($44,408 vs. $18,660; P < .001). Frailty outperformed advanced comorbidity (defined as Charlson-Deyo score ≥3), age ≥80 years, and markers of surgical complexity (e.g., skull base/orbit involvement, flap reconstruction, neck dissection) in predicting serious complications, nonhome discharge, length of stay, and hospital costs. CONCLUSIONS Frailty appears to have a stronger and more consistent association with adverse outcomes and increased resource utilization after sinonasal cancer surgery than age or comorbidity index. This information may be used in surgical risk stratification and can guide strategies to prevent or mitigate adverse events in this high-risk group. LEVEL OF EVIDENCE NA Laryngoscope, 130:290-296, 2020.
Methylmercury sorption onto engineered materials.

Abstract Four commercially available sorbents (BioChar (BC), ThiolSAMMS® (TS), SediMite (SM), and Organoclay™ PM-199 (OC-199)) were tested for their ability to sorb methylmercury (MeHg) and MeHg complexed with dissolved organic matter (DOM). Testing sorption behavior with DOM is more representative of the environmental conditions and mercury speciation expected during in-situ remediation efforts. Isotherms were fit using a robust, iterative re-weighting scheme. This fitting approach improves upon the traditionally used indirect sorption method by removing the dependence between aqueous and solid phase concentrations in isotherm fitting. Developed isotherms show that without DOM, BC, TS, and SM adsorbed similar amounts of MeHg while OC-199 sorbed substantially less MeHg. Below an equilibrium concentration of 5.6 ng L−1 BC was the best performing sorbent, between 5.6 and 20.9 ng L−1 SM sorbed the most MeHg, and above an equilibrium concentration of 20.9 ng L−1 TS outperformed the other sorbents. BC and OC-199 showed indication of MeHg sorption saturation over the tested concentration range of 3.5–680 ng L−1. With DOM, SM outperformed the other sorbents at equilibrium concentrations less than 0.98 ng L−1 and TS was the superior MeHg:DOM sorbent at higher concentrations. MeHg:DOM sorption was controlled by DOM-sorbent interactions. DOM decreased MeHg sorption onto BC and SM whereas TS exhibited similar sorption with and without DOM. OC-199 had slightly higher MeHg uptake with DOM. East Fork Poplar Creek (EFPC), an industrially Hg contaminated site, was used as a case study example to build a relationship between aqueous and fish MeHg concentrations and subsequently compare the cost of sorbent materials required to meet regulatory objectives. For this case study, SM provided the most cost-effective sorbent option for in-situ remediation efforts to reduce aqueous MeHg concentrations.
Did you really need to ask? Cultural variation in emotional responses to providing solicited social support.

Most prior research on culture and the dynamics of social support has focused on the emotional outcomes for social support recipients. Though an existing body of research has identified cross-cultural differences in the emotional correlates of receiving different types of social support, researchers have seldom examined possible cultural differences in the experience of social support providers. This study used the Day Reconstruction Method to examine cultural differences in the emotional correlates of the provision of solicited and unsolicited and emotional and informational social support in the daily lives of Singaporean (n = 79) and American (n = 88) participants. Singaporean participants reported providing more social support overall. Regardless of culture, participants reported more positive emotion (affection, happiness) and less negative emotion (anger, anxiety) when they provided emotional social support. Also, multilevel modeling analyses revealed a 3-way interaction between culture, social support provision, and social support solicitation, indicating cultural differences in negative emotional responses to providing solicited social support. Specifically, results suggest that attempts to provide more solicited social support were associated with more negative emotions in the U.S. In contrast, provider negative emotions were highest in Singapore when the provider did not meet the recipient’s request for support. Patterns of cultural differences in social support provision are dissimilar to—rather than simply mirroring—those found in published research on social support receipt, highlighting the importance of studying social support provision as a distinct phenomenon.
Structural and functional insight into the Mycobacterium tuberculosis protein PrpR reveals a novel type of transcription factor

The pathogenicity of Mycobacterium tuberculosis depends upon its ability to catabolize host cholesterol. Upregulation of the methylcitrate cycle (MCC) is required to assimilate and detoxify propionyl-CoA, a cholesterol degradation product. The transcription of key genes prpC and prpD in MCC is activated by MtPrpR, a member of a family of prokaryotic transcription factors whose structures and modes of action have not been clearly defined. We show that MtPrpR has a novel overall structure and directly binds to CoA or short-chain acyl-CoA derivatives to form a homotetramer that covers the binding cavity and locks CoA tightly inside the protein. The regulation of this process involves a [4Fe4S] cluster located close to the CoA-binding cavity on a neighboring chain. Mutations in the [4Fe4S] cluster binding residues rendered MtPrpR incapable of regulating MCC gene transcription. The structure of MtPrpR without the [4Fe4S] cluster-binding region shows a conformational change that prohibits CoA binding. The stability of this cluster means it is unlikely a redox sensor but may function by sensing ambient iron levels. These results provide mechanistic insights into this family of critical transcription factors who share similar structures and regulate gene transcription using a combination of acyl-CoAs and [4Fe4S] cluster.
7.13 – Geochemistry of Saline Lakes

Saline lakes are important environmental features in continental basins worldwide. They are critical for water and mineral resources, economic activity, and paleoenvironmental studies. Water and solute sources for saline lake brines are direct precipitation, surface flow, local or regional meteoric groundwaters, interstitial water of sediments, or deep basinal fluids. Solute concentrations are controlled by the weathering of source rocks, evaporation, and solute losses to minerals and biota. Aquifer residence times, rock dissolution rates, leakage ratios, and dissolution–precipitation fractionation are also important factors. With evaporation, inflow waters generally reach supersaturation first with respect to alkaline-earth carbonates, the first of several major ‘chemical divides.’ Subsequent chemical divides occur for gypsum, magnesite, and sulfates of magnesium and sodium, as shown in the revised brine evolution flowchart. Brine evolution along different flow paths is therefore controlled by the molar ratio of solutes, eventually producing diagnostic mineral assemblages. Idealized brine evolution paths and the associated evaporite mineral assemblages are complicated by local variation in hydrology, biotic activity, mineral kinetics, and diagenesis. The ‘Spencer Triangle’ is a valuable tool for assessing solute behavior in the system Ca–SO4–HCO3. Such plots show that the initial solution chemistry is a good predictor of the resulting mineral assemblage. A similar triangle in which the calcium vertex is replaced with magnesium shows that the initial Ca/Mg ratio and the timing of calcium depletion relative to magnesium are critical factors in determining whether the subsequent brine will be dominated by sulfate or carbonate. These two triangles together demonstrate the principal major ion behaviors responsible for solution chemistries in saline lakes worldwide. In addition, normative calculations on the major ion concentrations of representative saline lake waters can provide specific measures of their hydrochemical evolution.
Past and Current Dynamics of U.S. Agricultural Land Use and Policy

Over the past century, agricultural land use in the United States has seen drastic shifts to support increasing demand for food and commodities; in many regions, this has resulted in highly simplified agricultural landscapes. Surmounting evidence exhibits the negative impacts of this simplification on the long-term provisioning of necessary ecosystem services to and from agriculture. However, transitions toward alternative systems often occur at a small scale, rather than at a systemic level. Within the National Research Council’s (NRC) sustainable agricultural systems framework, we utilize national open-source datasets spanning several decades to broadly assess past and current agricultural landscapes across the U.S. We integrate and analyze agricultural land use and land cover data with policy data to address two main objectives: 1) Document and visualize changes over recent decades in cropland conversion, agricultural productivity, and crop composition across the U.S.; and 2) identify broad policy changes of the U.S. Farm Bills from 1933 to 2018 associated with these land use trends. We show that U.S. agriculture has gradually trended toward an intensely regulated and specialized system. Crop production is heavily concentrated in certain areas, larger farms are getting larger, while the number of smaller operations is decreasing, and crop diversity is declining. Meanwhile, federal agricultural policy is increasing in scope and influence. Through these data-driven insights, we argue that incremental and transformative pathways of change are needed to support alternative production practices, incentivize diversified landscapes, and promote innovation toward more sustainable agricultural systems across multiple scales.
Circular Inter-Digitated Design for Self-Phased Reflective Pixel/Cell for Metasurfaces and Reflectarrays

A reflective metasurface cell allows electromagnetic waves to be reflected with a desired phase. The reflection phase can also be tuned by incorporating active circuit elements into the metasurface cells/pixels. In this paper, we present a design concept of circular inter-digitated (CID) self-phased reflective (SPR) metasurface pixel/cell that offers a reconfigurable reflection phase. Unlike using active circuit elements in conventional approach, we use a constituent material in dielectric layer supporting the metasurface. As the constituent material permittivity changes, the resonance wavelength of the metasurface also changes, which results in a phase change. The presented pixel/cell design consists of a dual-circular ring, incorporating a meandered slot line, or an interdigitated line, in between. All are integrated on a dielectric layer with metal backing that is used as a constituent material. The design can achieve polarization-independent phase control with 220 degrees of tunable phase and loss of less than 2 dB. The design can be applied in coding metasurfaces to control the scattering pattern, where reflection phase tuning is needed. The design can also be used in reflectarrays.
Human Brain Surrogates: Models or Distortions?

Although neurological disease and mental illness can cause terrible human suffering, strategies for researching their causes and cures are not obvious. Invasive brain research on actual human being...
Segment-Based Assessment of Consequences of Failure on Water Distribution Systems

AbstractThis paper presents an assessment methodology that considers the impact of actual valve locations in a water distribution system in creating discrete isolated groups of pipes or segments wh...