cssi/SciSciGPT-SciSciNet huggingface dataset:
The future of pain pharmacy: driven by need.

Background Opioid prescribing has increased by ~400% over the past 20 years in the US and has been correlated with dramatic increases in accidental overdose-related deaths. Emerging evidence of serious dose-dependent side effects of opioid analgesics has led to recommendations from multinational pain societies and governments to decrease opioid doses and increase referrals to pain specialists. Demand for pain specialists of all types has increased; however, training programs for health care professionals struggle to satisfy this need. Objective The purpose of this article is to highlight the role of clinical pharmacy specialists in pain management and to discuss available residency training programs and subspecialties within each program. Methods We surveyed all eleven accredited pharmacy postgraduate year two (PGY-2) Pain and Palliative Care Residency programs in the US. Program information was derived from interviews with residency directors, current residents, program brochures, and residency Web sites. Data collected included core, elective, and longitudinal rotations, with the time frame dedicated to each experience. Primary practice areas, as well as inpatient vs outpatient focus, were also documented. Additionally, a review of the available literature was completed to determine the areas in greatest need for future pain specialists. Results Pharmacy pain specialists have been referenced as highly effective additions to interdisciplinary pain management teams. Pharmacists provide expertise in complex pain medication management, which remains the primary focus of most chronic pain encounters. The PGY-2 programs surveyed differ considerably, with the majority providing significant emphasis to either acute pain management or palliative care with brief or limited exposure to chronic pain management. Four of the eleven programs require 2 months of chronic pain management; however, only two of the eleven programs identify chronic pain management as a primary practice setting. Discussion Pain specialists in all fields are in high demand; however, the need for health care professionals specialized in chronic pain management probably exceeds that for professionals specialized in acute pain management and palliative care combined. This disparity between disease prevalence and specialty training programs is not reflected in the current residency training structure, nor have additional training programs arisen to fill this critical need. Conclusion Health care systems will continue to struggle to meet the demands of patients with chronic pain until significant emphasis is placed on the education and training of health care professionals in this area. Clinical pharmacy should aim to meet this demand through the expansion of PGY-2 training programs and improved didactic education in pharmacy school that reflects the increased need for chronic pain specialists.
The Aesthetic Emotion of Wei Inspiration on the Plight of Contemporary Life

"Nature",namely,"Bohemianism"in manner inconsistent with Confucian Rites,advocated by scholars of Wei-Jin Dynasty.The origin of their ideas rested on that they got unfettered from the rigescent and old Confucian rites and obtained support from the spirit of nature of"Taoism".Then"Self-Consciousness of Human Being"appeared.There has some degree of similarity between the background of the appearance of humans consciousness of Wei-Jin period and the living extremity of contemporary people.But the contemporary people lack of the Wei-Jin period kind of Aesthetic emotion which is the original reason that the contemporary people cannot get rid of the spiritual torture.With an aesthetic view on life and with an aesthetic approach to business life is one good way to change the plight of the contemporaries.
Crisis Management Advertising Effectiveness: The Impact of Psychological Ownership and Message Abstractness

When businesses cope with the risk of bad press, they seek to limit the impact of negative publicity by engaging in crisis management (Lamb et al., 2010). Inspired by BP ads in the wake of the Gulf spill, we aim to decipher which crisis management message factors result in different attitudes across individuals. In particular, we expect psychological ownership to impact attitudes towards the ad and BP and that these attitudes will mediate the impact of the ad on purchase intentions.
Monochromatic CCD Images of Three Planetary Nebulae

We present monochromatic false-color images of three planetary nebulae obtained by means of a CCD camera at the f/13.5 focus of the 0.91m reflector of the Cerro Telolo Interamerican Observatory in August, 1985. The resultant image scale is 0.363 arcsec square per pixel. The objects, IC 1297, NGC 7009, and M2–9 were imaged through narrow band filters in the V band, [O III] λ5007, and Hα λ6563, respectively. The V band filter corresponds to the standeard Johnson V magnitude. The λ5007 filter has a FWHM of 14 A. The Hα filter has a FWHM of 73 A, thus including contributions from the [N II] λλ6548, 6584 lines. IC 1297 shows a double shell structure with a pronounced bright rim at the extreme edge of the faint outer envelope, suggesting that it is density bounded. NGC 7009 (the ”Saturn” nebula), in addition to the well-known double shell and extended W-W ansae, also shows a faint large, circular outer halo which strongly suggests that NGC 7009 is a member of the rare class of triple-shell nebulae. The bipolar object M2–9 (the ”Butterfly” nebula) shows a bright, non-stellar central core from which the wings extend in a nearly N-S direction. Condensations in the wings are seen particularly well for the [O III] λ5007 images. The CCD images were obtained by B. Schaefer at CTIO and were processed at the Goddard Image Processing Facility.
Two-dimensional melting of colloids with long-range attractive interactions

The solid–liquid melting transition in a two-dimensional (2-D) attractive colloidal system is visualized using superparamagnetic colloids that interact through a long-range isotropic attractive interaction potential, which is induced using a high-frequency rotating magnetic field. Various experiments, supported by Monte Carlo simulations, are carried out over a range of interaction potentials and densities to determine structure factors, Lindermann parameters, and translational and orientational order parameters. The system shows a first-order solid–liquid melting transition. Simulations and experiments suggest that dislocations and disclinations simultaneously unbind during melting. This is in direct contrast with reports of 2-D melting of paramagnetic particles that interact with a repulsive interaction potential.
Crystallization of a fungal lytic polysaccharide monooxygenase expressed from glycoengineered Pichia pastoris for X‐ray and neutron diffraction

Lytic polysaccharide monooxygenases (LPMOs) are carbohydrate-disrupting enzymes secreted by bacteria and fungi that break glycosidic bonds via an oxidative mechanism. Fungal LPMOs typically act on cellulose and can enhance the efficiency of cellulose-hydrolyzing enzymes that release soluble sugars for bioethanol production or other industrial uses. The enzyme PMO-2 from Neurospora crassa (NcPMO-2) was heterologously expressed in Pichia pastoris to facilitate crystallographic studies of the fungal LPMO mechanism. Diffraction resolution and crystal morphology were improved by expressing NcPMO-2 from a glycoengineered strain of P. pastoris and by the use of crystal seeding methods, respectively. These improvements resulted in high-resolution (1.20 A) X-ray diffraction data collection at 100 K and the production of a large NcPMO-2 crystal suitable for room-temperature neutron diffraction data collection to 2.12 A resolution.
Use of cylindrical coordinates to localize prostate cancers on MRI and prostatectomy pathology.

Abstract Purpose To describe and test a quantitative system for designating prostate tumor location on magnetic resonance imaging (MRI) and prostatectomy. A system for describing tumor location will facilitate research correlating MRI and pathology. Materials and methods The prostate cylindrical coordinate (PCC) system was developed for locating prostate tumors using 3 coordinate values. The 3 coordinate values include the angular location centered on the urethra, the radial distance to the periphery and the long axis from apex to base. To evaluate this system, 26 tumors were identified where the prostate cancer was noted by both the radiologist and the pathologist. PCC values were assigned independently to MRI lesions and corresponding tumors. Intraclass correlation coefficient (ICC) was calculated to assess agreement between PCC assigned using MRI and pathology. The coordinates were used to calculate the average distance between the centers of the same lesion measured by MRI and pathology. Results Each of the cylindrical coordinates assigned by MRI and pathology were compared and there was no significant difference. The agreement was excellent, and the ICC was 0.70 ( P P P 2 , P P Conclusions The PCC system quantitatively characterizes lesions seen on MRI and prostatectomy pathology with good agreement.
Tobacco Use Prevalence and Smoking Cessation Pharmacotherapy Prescription Patterns Among Hospitalized Patients by Medical Specialty.

Introduction Effective smoking cessation medications are readily available but may be underutilized in hospital settings. In our large, tertiary care hospital, we aimed to (1) characterize patient tobacco use prevalence across medical specialties, (2) determine smoking cessation pharmacotherapy prescription variation across specialties, and (3) identify opportunities for improvement in practice. Methods Using electronic health records at Barnes Jewish Hospital, we gathered demographic data, admitting service, admission route, length of stay, self-reported tobacco use, and smoking cessation prescriptions over a 6-year period, from 2010 to 2016. We then compared tobacco use prevalence and smoking cessation prescriptions across medical specialties using a cross-sectional, retrospective design. Results Past 12-month tobacco use was reported by patients in 27.9% of inpatient admissions; prescriptions for smoking cessation pharmacotherapy were provided during 21.5% of these hospitalizations. The proportion of patients reporting tobacco use was highest in psychiatry (55.3%) and lowest in orthopedic surgery (17.1%). Psychiatric patients who reported tobacco use were most likely to receive pharmacotherapy (71.8% of admissions), and plastic surgery patients were least likely (4.7% of admissions). Compared with Caucasian tobacco users, African American patients who used tobacco products were less likely to receive smoking cessation medications (adjusted odds ratio [aOR] = 0.65; 95% confidence interval [CI] = 0.62 to 0.68). Conclusions Among hospitalized tobacco users, safe and cost-effective pharmacotherapies are under-prescribed. We identified substantial variation in prescribing practices across different medical specialties and demographic groups, suggesting the need for an electronic medical record protocol that facilitates consistent tobacco use cessation pharmacotherapy treatment. Implications Tobacco use cessation pharmacotherapy is underutilized during hospitalization, and prescription rates vary greatly across medical specialties and patient characteristics. Hospitals may benefit from implementing policies and practices that standardize and automate the offer of smoking pharmacotherapy for all hospitalized patients who use tobacco.
Binder jetting additive manufacturing with a particle-free metal ink as a binder precursor

Abstract Metal-Organic-Decomposition (MOD) ink is a particle-free metal ink that can precipitate metal nanoparticles upon heating. This ink-jettable metal nanoparticle ink can be used as a binder precursor to replace commonly used polymer adhesives in the Additive Manufacturing of metals components using binder jetting technology. After being deposited into the powder bed interstices and exposed to a heat, the jetted ink decomposes and form metal nanoparticles that are then fused by sintering to provide bonding strength to the printed parts. Regions of the powder bed that do not receive the jetted nanoparticles remain as loose powder, as the heat supplied to sinter nanoparticles is maintained below the initial sintering temperature of larger powder bed particles. The proof of concept is demonstrated in the context of printing copper by jetting copper MOD ink as a precursor to the binder, with the capability of producing satisfactory geometries when using sufficiently high binder saturation ratio. After sintering, the MOD ink printed parts produce a denser core section but more porous shell in the sintered parts, compared to the polymer binder printed counterparts.
Demographic rates of two southeastern populations of Painted Bunting, 2007–2015

ABSTRACT Painted Buntings (Passerina ciris) have been declining in the southeastern United States since the 1970s. A recent demographic assessment highlighted the importance of estimating demographic parameters, which have received little attention to date. The dearth of information is troublesome because attempts to reverse declining trends require a better understanding of the relationship between habitat quality and age- and sex-specific survival and recruitment rates. We used capture–mark–recapture data collected from 2007 to 2015 on Bald Head Island (BHI) and at Hammocks Beach State Park (HBSP) in North Carolina, USA, to estimate local age- and sex-specific annual survival rates and local population size and recruitment rates using programs MARK and LOLASURVIV. Juveniles had lower local survival rates than adults (HBSP: 0.28 ± 0.14 vs. 0.67 ± 0.06; BHI: 0.28 ± 0.04 vs. 0.57 ± 0.02). Local annual survival rates for males on BHI (0.50 ± 0.03) were lower than those for females (0.57 ± 0.02). Age-specifi...
Clinical Outcomes among Diagnostic Subgroups of Infants with Severe Bronchopulmonary Dysplasia through 2 Years of Age.

Objective This article aimed to identify readmission risk factors through 2 years of life for infants with severe bronchopulmonary dysplasia (BPD) who do not require tracheostomy and ventilatory support after neonatal intensive care unit (NICU) discharge. It also aimed to identify if clinical differences exist between the subcategories of severe BPD. Study Design A retrospective chart review was performed on 182 infants with severe BPD born between 2010 and 2015. A total of 130 infants met the inclusion criteria and were stratified into three groups based on their respiratory status at 36 weeks of gestational age: group A—oxygen (O2), group B—assisted ventilation (AV), group C—both O2 and AV. NICU clinical risk factors for readmission were assessed at set time points (6/12/18/24 months). Reasons for readmission were assessed for the entire cohort and severe BPD subgroups. Conclusion An NICU diagnosis of neurologic abnormality, necrotizing enterocolitis, invasive NICU infection, dysphagia, and O2 at NICU discharge differed between the three subgroups of severe BPD. The most common cause of readmission was viral respiratory tract infection. Inhaled steroid use remained stable over time, while oxygen use and diuretic use declined over time. Risk factors for readmission in the entire cohort included g-tube, O2 use, and diuretic use at 12 months. There was no significant difference in readmission rates between the three BPD subgroups.
Les enjeux de la traduction dans les agences de presse

Les enjeux de la traduction dans les agences de presse by Lucile Davier is an important new contribution to a small but growing area of research that concerns the translation of news. The book star...
Adaptive teaching strategies to improve individual student achievement in problem-based learning environments

This study investigates the use of adaptive teaching strategies to promote learning in cooperative learning settings. The Biology Sleuth, a problem-based learning environment, was developed as a testbed to vary the distribution of critical resources and to examine the use of teaching strategies and their effects on group dynamics and individual learning. Students work in small groups, aided by various resources including a knowledge-base, each other, the software, and the teacher. This study examines the effects of applying two different teaching strategies and suggests that these strategies can have a large impact on both group dynamics and individual learning. A 35% improvement (p < .05) was measured in the treatment group. Based on this work we suggest that while many design features are chosen while developing training tools, designers also need to explicitly consider how these environments can be adapted during use to maximize the learning experience.
An Efficient Brightness Preserving Contrast Enhancement Technique Using Discrete Wavelet Transform and Singular Value Decomposition

The primary necessities of vision based application are to have an image with good contrast and brightness of the image. In image enhancement, we process given image; therefore, results are more appropriate than given image for any particular application or set of objectives. A new technique is for enhancement of given image having low contrast based on brightness preserving dynamic histogram equalization, singular value decomposition and discrete wavelet transform are suggested. There are four sub-bands of different frequencies: high-high, high-low, low-high and low-low are obtained by the DWT decomposition of the given image. For improving image’s contrast, BPDHE technique is applied on the specific image and to boost the illumination, this contrast enhanced image’s LL band information and input image’s LL band information are passed through SVD. Through inverse discrete wavelet transform, output image obtained having high contrast. Quantitative metric and qualitative result of presented technique are evaluated and compared with other existing techniques. A result reveals that presented technique is more effective strategy for enhancement of image having low contrast. The technique presented by this study is simulated on Intel I3 64-bit processor using MATLAB R2013b.
Assessing risk of opioid misuse in the treatment of chronic pain: Building a practical actuarial approach.

Objective: Opioid misuse risk assessment has been highlighted as an important part of clinical practice, but there is a paucity of research identifying an effective approach to assessment. Currently, practitioners use patient history, interviews, and formal questionnaires, and these data are weighed clinically to assign risk. The authors propose the use of an actuarial method—the Bayesian nomogram—as a simple, standard, evidence-based approach to opioid misuse risk assessment. Interventions: The Bayesian nomogram relies solely on empirically established relationships between risk factors and risk and has been found in other fields to be both more efficient and more consistent than clinical judgment. The authors performed a comprehensive search of the literature to identify empirically established risk factors for opioid misuse in the treatment of noncancer chronic pain. Results: As the Bayesian nomogram requires both base rates of the predicted event (opioid misuse) and odds ratios for risk factors, the authors reported the most current evidence available in the literature. The authors also included the nomogram itself for easy clinical application of base rates and risk factors in the predictive model. Finally, the authors provided examples to help illustrate practical application. Conclusions: The authors call for research comparing this methodology to “assessment as usual” to better predict risk of opioid misuse and to aid decision making for medical providers treating chronic-pain patients.
Ovarian Sex Cord-Stromal Tumors: Reflections on a 40-Year Experience With a Fascinating Group of Tumors, Including Comments on the Seminal Observations of Robert E. Scully, MD.

Context.— This year being the 60th anniversary of the publication of the excellent book Endocrine Pathology of the Ovary by John McLean Morris, MD, and Robert E. Scully, MD, the writer reflects on ...
T lymphocytes and cytotoxic astrocyte blebs correlate across autism brains

Objective Autism spectrum disorder (ASD) affects 1 in 59 children, yet except for rare genetic causes, the etiology in most ASD remains unknown. In the ASD brain, inflammatory cytokine and transcript profiling shows increased expression of genes encoding mediators of the innate immune response. We evaluated postmortem brain tissue for adaptive immune cells and immune cell-mediated cytotoxic damage that could drive this innate immune response in the ASD brain. Methods Standard neuropathology diagnostic methods including histology and immunohistochemistry were extended with automated image segmentation to quantify identified pathologic features in the postmortem brains. Results We report multifocal perivascular lymphocytic cuffs contain increased numbers of lymphocytes in ~65% of ASD compared to control brains in males and females, across all ages, in most brain regions, and in white and gray matter, and leptomeninges. CD3+ T lymphocytes predominate over CD20+ B lymphocytes and CD8+ over CD4+ T lymphocytes in ASD brains. Importantly, the perivascular cuff lymphocyte numbers correlate to the quantity of astrocyte-derived round membranous blebs. Membranous blebs form as a cytotoxic reaction to lymphocyte attack. Consistent with multifocal immune cell-mediated injury at perivascular cerebrospinal fluid (CSF)-brain barriers, a subset of white matter vessels have increased perivascular space (with jagged contours) and collagen in ASD compared to control brains. CSF-brain barrier pathology is also evident at cerebral cortex pial and ventricular ependymal surfaces in ASD. Interpretation The findings suggest dysregulated cellular immunity damages astrocytes at foci along the CSF-brain barrier in ASD. ANN NEUROL 2019;86:885-898.
Infectious disease diagnosed by fine needle aspiration biopsy

Introduction Fine needle aspiration biopsies (FNABs) have become increasingly important in the assessment of infectious diseases. We assess the ability of cytopathology to predict the presence of a pathogen and review how often neoplasia occurs concurrently with infection. Materials and methods A 3-year retrospective review of FNABs with concurrent culture results was performed at the Zuckerberg San Francisco General Hospital and Trauma Center. Rapid onsite evaluation was performed for all cases by a pathologist. The results of the special and immunohistochemical stains and polymerase chain reaction testing were correlated, when available. Results A total of 231 samples from 11 different tissue sites were submitted for microbial culture, of which 49 (21%) were positive for pathogenic organisms. Only 2 false-negative cases by cytology were found in immunosuppressed patients. A total of 38 patients had a diagnosis of neoplasia, with 2 (5%) having concurrent infection. Overall, the sensitivity and specificity of cytology in predicting the presence of infection was 96% (95% confidence interval, 86%-100%) and 42% (95% confidence interval, 34%-50%), respectively. Molecular testing was performed in 11 cases, 2 of which were positive for Mycobacterium tuberculosis complex and had cytologic findings of necrosis. Polymerase chain reaction and other ancillary tests were unable to further characterize 2 cases with acid-fast bacilli. Conclusions Our study has shown that FNABs have high sensitivity in detecting infection and that negative cytology findings will correlate with a negative infectious workup. Although infection in the setting of neoplasia is uncommon, it should be considered if clinical data are available to suggest infection.
Multi-level delumping strategy for thermal enhanced oil recovery simulations at low pressure

Abstract We present a multi-level delumping method suitable for thermal enhanced oil recovery processes. At low pressures, the temperature variable is the most critical factor impacting the displacement process through viscosity reduction and evaporation/condensation effects. Hydrocarbon components are vaporized under high temperatures, move downstream in the gas phase and condense back to the liquid phase. That process is governed by the K-values of the components, evaporating out of the liquid phase sequentially with increasing temperatures. To reduce the computational cost, it is standard practice to reduce the number of (pseudo-) 6 components used in thermal reservoir simulation. Depending on the number and type of hydrocarbon pseudo-components retained in the simulations, we may not be able to capture the correct displacement due to large errors in the lumped phase behavior (flash) computations. We address that problem through a multi-level method: we use data obtained from a short simulation using the most detailed fluid description available, and leverage that information to guide a delumping process. We use temperature as a proxy variable for composition, and select reference temperatures. We extract the corresponding reference compositions from the detailed run and use them to extend the lumped pseudo-components to an approximate detailed composition. We compute the phase mole fractions as well as the gas compressibility factor. We test our method using six heavy oil samples, and under two different recovery processes: hot nitrogen injection and in-situ combustion (air injection and exothermic oxidation reactions). The average error on the liquid mole fraction is reduced by 4–12 times (depending on the oil samples) compared to the flash using pseudo-components, and the maximum error by 6–48 times. We illustrate that the method is amenable to manually adding more information about the physics of some oil samples. We also discuss how to efficiently pick the reference temperatures. For uniformly sampled temperatures (between a minimum and maximum temperature), we conduct a sensitivity study which led us to use six temperatures. We ran both local (Pattern Search, PS) and global (Particle Swarm Optimization, PSO) gradient-free optimization methods. PS is able to find the closest local minimum to the uniform set, giving a limited improvement of 6.5%. The known increased cost for PSO is worth the investment in at least one of the cases we considered, leading to a 67% improvement.
Stable and transient bubble formation in acoustically-responsive scaffolds by acoustic droplet vaporization: theory and application in sequential release.

Abstract Acoustically-responsive scaffolds (ARSs), which are fibrin hydrogels containing monodispersed perfluorocarbon (PFC) emulsions, respond to ultrasound in an on-demand, spatiotemporally-controlled manner via a mechanism termed acoustic droplet vaporization (ADV). Previously, ADV has been used to control the release of bioactive payloads from ARSs to stimulate regenerative processes. In this study, we used classical nucleation theory (CNT) to predict the nucleation pressure in emulsions of different PFC cores as well as the corresponding condensation pressure of the ADV-generated bubbles. According to CNT, the threshold bubble radii above which ADV-generated bubbles remain stable against condensation were 0.4 µm and 5.2 µm for perfluoropentane (PFP) and perfluorohexane (PFH) bubbles, respectively, while ADV-generated bubbles of any size in perfluorooctane (PFO) condense back to liquid at ambient condition. Additionally, consistent with the CNT findings, stable bubble formation from PFH emulsion was experimentally observed using confocal imaging while PFO emulsion likely underwent repeated vaporization and recondensation during ultrasound pulses. In further experimental studies, we utilized this unique feature of ADV in generating stable or transient bubbles, through tailoring the PFC core and ultrasound parameters (excitation frequency and pulse duration), for sequential delivery of two payloads from PFC emulsions in ARSs. ADV-generated stable bubbles from PFH correlated with complete release of the payload while transient ADV resulted in partial release, where the amount of payload release increased with the number of ultrasound exposure. Overall, these results can be used in developing drug delivery strategies using ARSs.
History of Sociometry, Psychodrama, Group Psychotherapy, and Jacob L. Moreno

This chapter presents the histories of sociometry, psychodrama, and group psychotherapy while also outlining the history of Jacob L. Moreno, their founder. Major events from Moreno’s life are covered as they relate to the development of his philosophy and the practice of his triadic system, sociometry, psychodrama, and group psychotherapy. The popularity and decline of Moreno’s methods throughout their history are highlighted while offering insights into these historical trends in the USA and globally. Connections are drawn between Moreno’s history and the history of social work while also framing him as a social worker due to the nature of his philosophy, theory, and practice. A comprehensive timeline is offered which depicts the parallel timelines of psychodrama, social work, group therapy, psychology, and society.
18722 Association between neighborhood overcrowdedness, multigenerational households, and COVID-19 in New York City

ABSTRACT IMPACT: Patients living in overcrowded zip codes were at increased risk of contracting severe COVID-19 after controlling for confounding disease and socioeconomic factors OBJECTIVES/GOALS: This study sought to examine whether residences in over-crowded zip codes with higher reported over-crowding represented an independent risk factor for severe COVID-19 infection, defined by presentation to an emergency department. METHODS/STUDY POPULATION: In this zip code tabulated area (ZCTA)-level analysis, we used NYC Department of Health disease surveillance data in March 2020 merged with data from the CDC and ACS to model suspected COVID-19 case rates by zip code over-crowdedness (households with greater than 1 occupant per room, in quartiles). We defined suspected COVID-19 cases as emergency department reported cases of pneumonia and influenza-like illness. Our final model employed a multivariate Poisson regression models with controls for known COVID-19 clinical (prevalence of obesity, coronary artery disease, and smoking) and related socioeconomic risk factors (percentage below federal poverty line, median income by zip-code, percentage White, and proportion of multigenerational households) after accounting for multicollinearity. RESULTS/ANTICIPATED RESULTS: Our analysis examined 39,923 suspected COVID-19 cases across 173 ZCTAs in NYC between March 1 and March 30 2020. We found that, after adjusted analysis, for every quartile increase in defined over-crowdedness, case rates increased by 32.8% (95% CI: 22.7%% to 34.0%, P < 0.001). DISCUSSION/SIGNIFICANCE OF FINDINGS: Over-crowdedness by zip code may be an independent risk factor for severe COVID-19. Social distancing measures such as school closures that increase house-bound populations may inadvertently worsen the risk of COVID-19 contraction in this setting.
Need for speed: bacterial effector XopJ2 is associated with increased dispersal velocity of Xanthomonas perforans

Bacterial spot caused by Xanthomonas perforans (Xp) is an economically important disease in tomato. Previous studies have shown that the recently isolated Xp strains have acquired and retained the effector gene, xopJ2, which has been reported to increase fitness of the pathogen in the field. To elucidate the fitness benefit of xopJ2, we quantified the effect of xopJ2 on the dispersal and evolution of Xp populations on tomato. We compared movement of two wild-type Xp strains expressing xopJ2 to their respective xopJ2 mutants when co-inoculated in the field. We developed a binary logistic model to predict the presence of Xp over spatial and temporal dimensions with or without xopJ2. Based on the model, wild-type bacteria were dispersed approximately three times faster than the xopJ2 mutants. In a simulation experiment, the selective advantage due to increased dispersal velocity led to an increase in the frequency of xopJ2 gene in the Xp population and its apparent fixation within 10 to 12 cropping seasons of the tomato crop. Our results show that the presence of a single gene can affect the dispersal of a bacterial pathogen and significantly alter its population dynamics.
Fisher Manufacturing Company (A)

Dorothy Hoffman, plant manager for the Clarksburg, Virginia, location of Fisher Manufacturing Company (Fisher), had a problem: her plant was repeatedly failing to improve its dismal performance when it came to meeting shipping dates. Only 60% of its June shipments had met the well-established four-week service standard of the coated-abrasives industry. She knew that an investment of $8 million in new equipment would provide a significant reduction in setup times for a major portion of Fisher's production process, but she also knew that the board of directors would need more than just her faith that the investment was worthwhile. She needed hard numbers to justify a recommendation.The case can be used to show the benefits of production flexibility through an increase in capacity by setup-reduction efforts. By reducing setup time, smaller batches may be produced, allowing Fisher to be more responsive to the market while lowering its inventory investment. Excerpt UVA-OM-1598 Jul. 5, 2018 Fisher Manufacturing Company (A) Dorothy Hoffman, plant manager for the Clarksburg, Virginia, location of Fisher Manufacturing Company (Fisher), angrily tossed the monthly shipping report back onto her desk and swore under her breath. The Clarksburg plant had again failed to improve its dismal performance when it came to meeting shipping dates. Only 60% of its June shipments had met the well-established four-week service standard of the coated-abrasives industry. Hoffman knew that prompt customer service was necessary to maintain Fisher's competitive position in the industry, but so far, she had seen little improvement in this aspect of the plant's performance. Hoffman was considering the possibility of replacing some of the plant's equipment in hopes of meeting the customer-service targets. An investment of $ 8 million would provide a significant reduction in setup times for a major portion of Fisher's production process. Hoffman knew the board of directors would need more than just her faith that the investment was worthwhile. She needed hard numbers to justify a recommendation. Company Background Fisher was a leading producer of abrasives, including such products as sandpaper and grinding wheels. Industrial firms were the company's primary market. Fisher had four manufacturing plants in the midsouthern and southeastern United States. Fisher's Clarksburg plant produced all of the company's coated-abrasive products—a line consisting of approximately 5,000 finished items in numerous grades, shapes, and sizes. The Clarksburg plant had $ 126.5 million in annual sales, giving it an 18% share of the US coated-abrasives market and making Fisher the third largest of the four major domestic producers. . . .
Neuro-Oncology Practice Clinical Debate: FDG PET to differentiate glioblastoma recurrence from treatment-related changes

The ability to accurately differentiate treatment-related changes (ie, pseudoprogression and radiation necrosis) from recurrent glioma remains a critical diagnostic problem in neuro-oncology. Because these entities are treated differently and have vastly different outcomes, accurate diagnosis is necessary to provide optimal patient care. In current practice, this diagnostic quandary commonly requires either serial imaging or histopathologic tissue confirmation. In this article, experts in the field debate the utility of 2-deoxy-2[18F]fluoro-d-glucose positron emission tomography (FDG PET) as an imaging tool to distinguish tumor recurrence from treatment-related changes in a patient with glioblastoma and progressive contrast enhancement on magnetic resonance (MR) following chemoradiotherapy.
Midgut malrotation with volvulus discovered at an emergency caesarean section for placental abruption

Adult midgut malrotation with volvulus (AMMV) is an uncommon presentation which may be found incidentally during abdominal radiologic investigations or at laparotomy. We report a case of AMMV and small bowel gangrene in a 35-year-old Gravida four, Para three at 39 weeks, 4 days gestation who presented with a short history of worsening abdominal pain, repeated vomiting and abdominal wall guarding. Emergency caesarean section performed on account of a suspected placental abruption incidentally revealed a long segment of non-viable small intestine. Subsequent midline laparotomy disclosed a midgut malrotation with volvulus and bowel gangrene. This resulted in a 4.6m resection of non-viable small bowel with Ladd’s procedure. The patient developed moderate symptoms of short bowel syndrome in the post-operative period which was successfully managed non-operatively. This case report represents a rare diagnosis, in the West-African sub-region, of an adult midgut malrotation with volvulus mimicking a third trimester obstetric emergency.
Critical vigilance, counter-discourses, and counter-conduct: White Teachers’ attempt at resistance at one ‘no-excuses’ urban charter school

Educational innovations such as ‘no-excuses’ charter schools have emerged as a discipline-focused approach to schooling as they are predicated on communicating high-expectations and personal respon...
Expanding Clinical Education During a Time of Crisis: Innovative Virtual Simulation

Abstract Background Nurse practitioner students have experienced restrictions on face-to-face clinical rotations to protect the health of students and communities during the COVID-19 pandemic. Methods In response to clinical closures, graduate NP faculty created an innovative intraprofessional virtual simulation to supplement the loss of required clinical hours. Results Competency was successfully measured during the simulation for medical and psychiatric scenarios, which allowed for immediate feedback and debrief. Conclusions The virtual simulation supported program rigor in a safe environment and may be applicable to other nurse practitioner programs looking for methods to expand learning experiences outside of the traditional clinical setting.
Operational carbon footprint of the U.S. water and wastewater sector’s energy consumption

Abstract Responding to global climate change requires better accounting of greenhouse gas emissions (GHG) to develop targeted strategies for reducing carbon footprints. Energy demand is a major contributor to operational GHG emissions in the water sector. However, the United States struggles to track GHG emissions in this sector largely due to the absence of a centralized and routinely updated water database, which includes operational information. Previous research focused on estimating operational GHG emissions generated from energy used on site and GHG emissions generated from off-site electricity production, but consumed by the facility. Largely these studies have been conducted at single utilities or cities and rarely at a regional or country scale. In this study, we assess the carbon footprints of operational energy use for 76 wastewater utilities and 64 drinking water utilities across the United States. Additionally, we investigate water-related GHG emissions at a sub-annual scale through three case cities to understand how GHG emissions vary at the monthly scale. Per unit of water, indirect energy in the form of grid electricity is found to be the largest contributor of operational GHG emissions. We estimate the total drinking water and wastewater emissions associated with electricity, natural gas, and fuel oil consumption across the United States to be 26.5 × 109 and 16.2 × 109 kg CO 2 e , respectively. We find the average carbon footprint per volume of drinking water and wastewater emissions to be 0.46 kg CO 2 e / m 3 and 0.38 kg CO 2 e / m 3 , respectively—equivalent to 2.1% of total emissions from the U.S. electricity sector each year. The research provides insights into operational GHG emissions of the water sector and advances the understanding of temporal variations in the life cycle of energy use. Through the research we suggest the need for further analyses of environmental impacts at the sub-annual scale and support continued accounting of the water sector.
Factor structure of the Modified Mini Mental State (3MS) exam among participants in inpatient neurorehabilitation.

Objective To evaluate the factor structure of the Modified Mini Mental State (3MS) Exam and its suitability as a cognitive screening tool among individuals admitted to an inpatient rehabilitation unit for new-onset neurological injury/illness. Method A retrospective chart review was conducted. Of the 187 individuals meeting the inclusion criteria, 116 had a diffuse pattern of neurological injury/illness; 71 had a focal injury/illness. Confirmatory and exploratory factor analyses (CFA; EFA) were conducted for the whole sample and separately by group. Results The CFA suggested poor fit indices. The EFA of the total sample suggested a three-factor solution (Orientation/Awareness; Learning/Recall and Executive Functioning; Psychomotor Ability). The EFA of the diffuse subsample suggested a three-factor solution (Attention and Learning/Recall; Psychomotor Ability; Expressive Language). The Orientation/Awareness, Learning/Recall, Executive Functioning, Psychomotor Ability, and Expressive Language four-factor solution observed among the focal subsample was considered invalid. Conclusion The 3MS provides information about the pattern of cognitive performance among individuals in neurorehabilitation; clinicians are advised to interpret total scores with caution. Among individuals with focal injuries/illnesses, clinicians might use the 3MS to compare the pattern of cognitive ability to expectations for performance and to support strengths-based approaches to participation in rehabilitation therapies.
Geopolitics of Humour and Development in Nepal and Afghanistan

The authors of this chapter draw upon their respective research experiences in Nepal and Afghanistan to discuss the use of humour during times of political uncertainty, conflict, and displacement from a geopolitical perspective. The authors argue that humour is a method for creating shared spaces of connection and community during adversity. Vulnerable populations often experience humour through the temporally limited spaces of connection and community it creates. Humour is also used as a method for countering oppression, structural and physical violence, and identity-based marginalization. When uncertainty is met through humour and humorous actions, it creates moments of solidarity among the actors. This chapter provides an overview of the literature in geography on the geopolitics of humour followed by each author’s discussion of political and everyday uses of humour in Nepal and Afghanistan. The Nepal case study examines uses of humour among Tibetan refugees and indigenous Himalayan communities when faced with state surveillance and political marginalization. The Afghanistan case study examines humour through the media and everyday interactions among individuals in the face of profound political precarity, violence, and continued uncertainty.
Energy Security, Climate and Your Car: US Energy Policy and Beyond

This chapter provides information on some of the major supply risks currently facing international oil markets. It considers the carbon emission implications of the kinds of energy supplies that countries like the United States may turn to in an effort to diversify away from the rising dependence on Middle East oil and to create a more secure energy future.
Residual Stresses and Microcracking Induced by Thermal Contraction Inhomogeneity

Brittle materials are subject to microcrack formation at grain boundaries and at second phase particles. These cracks are induced by residual stress that results from incompatibilities in thermal contraction. The development of residual stress and its partial relaxation by diffusion (at elevated temperatures) are described. The evolution of microcracks within the residual stress fields are then examined. Particular attention is devoted to considerations of the critical microstructural dimension at the onset of microcracking.
Neural Representations of Objects

This article is a revision of the previous edition article by M.J. Tarr, volume 15, pp. 10563–10567, © 2001, Elsevier Ltd.
Wolves, Canis lupus , Carry and Cache the Collars of Radio-collared White-tailed Deer , Odocoileus virginianus , they Killed

Wolves ( Canis lupus ) in northeastern Minnesota cached six radio-collars (four in winter, two in spring-summer) of 202 radio-collared White-tailed Deer ( Odocoileus virginianus ) they killed or consumed from 1975 to 2010. A Wolf bedded on top of one collar cached in snow. We found one collar each at a Wolf den and Wolf rendezvous site, 2.5 km and 0.5 km respectively, from each deer's previous locations.
Up in Smoke: Neighborhood Contexts of Marijuana Use from Adolescence Through Young Adulthood.

The current understanding of the neighborhood contexts wherein adolescent substance use emerges remains limited by conflicting findings regarding geographic variation in, and neighborhood effects on, both the prevalence of and risk factors for such use. Using four waves of longitudinal data from the National Longitudinal Study of Adolescent to Adult Health [n = 18,697 (51 % female, 54 % White, 24 % Black, 16 % Hispanic, 7 % Asian, 2 % American Indian/Other)], latent class analysis, and growth curve modeling, this study identified distinct neighborhood types—patterned by race/ethnicity, socioeconomic class, and geography—and explored how trajectories of adolescent and young adult marijuana use differed across neighborhood types. The results demonstrated complexity in neighborhood contexts, illustrating variation in trajectories of marijuana use across neighborhood types heretofore unobserved in neighborhoods research, and largely unexplained by key individual, family, and peer risk and protective factors. This approach highlights how social structural forces intersect and anchor trajectories of youth substance-using risk behavior.
Design and operation of immobilized enzyme reactors

This review encompasses recent advances in the design and operation of immobilized enzyme reactors for industrial applications. Basic immobilized enzyme reactor engineering concepts are described as a reference point for recent innovations. Although practical examples are cited, the subject is approached from the viewpoint of reactor design and operation and the potential general applicability of new concepts or developments. Areas reviewed include reactor types, reactor performance, operating strategy, and general design and economic considererations. Most of the progress reported in this field is in the form of refinements, rather than basic innovations.
Social dimensions of expertise in World of Warcraft players

Expertise development in the massively multiplayer online game World of Warcraft (Blizzard Entertainment, 2004) depends greatly on a player's use of social skills to gain access to expert player groups and accrue social and cultural capital. Drawn from ethnographic research, this paper maps out various forms of expert practice and highlights the social aspects of game play that often eclipse the importance of game-mechanics knowledge. At the time of this research, playing World of Warcraft and developing expertise in the game happened roughly within a two-stage process: (1) leveling up, or advancing one's character or avatar while learning the mechanics of the game, and (2) drawing on social capital gained during the first stage to join a group of up to 40 players to partake in high-end or endgame content.