cssi/SciSciGPT-SciSciNet huggingface dataset:
Is Hyperarousal Essential to Obsessive-compulsive Disorder?: Diminished Physiologic Flexibility, but Not Hyperarousal, Characterizes Patients With Obsessive-compulsive Disorder

Objective: To examine the hypothesis that the pathologic features of obsessive-compulsive disorder (OCD) are facilitated by abnormal levels of arousal, we compared patients with OCD with controls on self-reports and psychophysiologic measures. Methods: Twenty-three patients with OCD were compared with 21 controls on rating scales and on psychophysiologic measures (ie, heart interbeat interval, skin conductance, respiration, blood pressure, and electromyographic activity) during rest and during two psychologically stressful tasks. Results: Patients rated themselves higher on psychic and somatic anxiety scales. Mean physiologic activities were not elevated at rest. During tasks, changes in electrodermal, cardiovascular (except blood pressure), and muscle activities were smaller in patients with OCD, indicating decreased physiologic flexibility. Conclusions: Hyperarousal, measured peripherally, is not an essential pathologic feature of OCD. Decreased physiologic flexibility indicates an anxiety-related, but not OCD-specific, impairment of psychophysiologic reactivity to one's environment.
Inaccurate communications in telephone calls to an antimicrobial stewardship program.

background. Antimicrobial stewardship programs (ASPs) decrease unnecessary antimicrobial use, decrease antimicrobial resistance, and improve patient outcomes. The effectiveness of a prior approval system—that is, the requirement that approval be obtained from ASP practitioners before certain antimicrobials can be used—depends on the accuracy of the patient data communicated from the primary service. objectives. To determine the incidence of inaccurate communication of patient data during ASP interactions, describe examples of inaccurate communications, and identify risk factors for inaccurate communication. design. We used a retrospective cohort design. We evaluated the communicated patient data for clinically important inaccuracies, using the patients’ medical records as the gold standard. setting. A tertiary care medical center that has a prior approval system for restricted antimicrobials. patients. Inpatients discussed in telephone ASP interactions. intervention. Observational study. results. Of telephone calls requesting prior approval from ASP practitioners, 39% (95% confidence interval [CI], 31%-48%) contained an inaccuracy in at least 1 type of patient data (eg, current antimicrobial therapy); the incidence varied widely between data types. Examples of inaccuracies are given to demonstrate their clinical relevance. In multivariable analysis, inaccurate communications were more common for telephone calls from surgical services (versus calls from nonsurgical services: odds ratio, 2.1 [95% CI, 1.1-3.9]) and for calls received by Infectious Diseases fellows (versus pharmacists: odds ratio, 2.0 [95% CI, 1.1-3.8]). conclusions. A high proportion of ASP calls requesting prior approval included patient data inaccuracies, which have the potential to affect the prescribing of antimicrobials. Although risk factors were identified, these communication errors were common across the different types of ASP interactions. Inaccurate communications may compromise the utility of ASPs that use a prior approval system for optimizing antimicrobial use.
Paradise Revisited (2 Cor 12:1–12): The Jewish Mystical Background of Paul's Apostolate: Part 2: Paul's Heavenly Ascent and its Significance

Part one of this article examined the Jewish sources that record the story of four individuals who “entered pardes,” three of whom came to grief while R. Aqiba, alone, survived unscathed. The story is preserved within a talmudic compilation of materials concerning maʿaśeh merkabah (an esoteric, visionary-mystical tradition associated with Ezekiel I), in Song of Songs Rabbah, and in two “merkabah-mystical” hekhalot compilations: Hekhalot Zuṭarti and Merkabah Rabbah. Several scholars have adopted the suggestion, first offered by Wilhelm Bousset, that this story indicates the background in Jewish mystical tradition of Paul's account of his ascent to paradise (2 Cor 12:1–12).
Genetic Variation and Species Boundaries in Calopogon (Orchidaceae)

Morphological and habitat similarities among the five species of the terrestrial orchid genus Calopogon have led to nomenclatural and taxonomic confusion. The taxa are marked by subtle character differences and little apparent reproductive isolation. Here we investigate allozyme diversity at the species level and the partitioning of genetic variation within and among species and their populations. Genetic identities are used to define species boundaries and suggest phylogenetic relationships. All five species of Calopogon maintain high levels of allozyme variation within their populations (P 5 50.0%294.4%, AP 5 2.67-3.32, H e 5 0.11-0.43). Calopogon oklahomensis, an autotetraploid that appears to have under- gone gene silencing at 13 of its 19 polymorphic loci, consistently had the highest genetic diversity values. Calopogon multiflorus, which has the most restricted range and rarest occurrence, had the lowest mean genetic diversity values. In C. oklahomensis, C. pallidus and C. tuberosus most of the genetic variation exists within rather than among populations (G ST 5 0.037-0.085). The UPGMA phenogram generated using genetic identity data has three phenetic groups and supports designation of the taxa as separate species. The data suggest that C. oklahomensis most closely resembles the basal extant taxon within Calopogon.
Bringing Our Whole Person to Whole Person Care: Fostering Reflective Capacity with Interactive Reflective Writing in Health Professions Education

Reflective learning and practice foster personal, professional, and interprofessional identity development within health professions education to encourage humanistic, competent patient care. Reflection on experience nurtures mindful presence and adaptive expertise/”practical wisdom,” enabling the health care professional to recognize and address patients’ and families’ emotional, psychosocial, cultural, and spiritual needs for optimizing whole person care (WPC). By heightening awareness of strengths, values, biases, and/or limitations, reflection also helps the provider bring more of his/her “whole person” to WPC, strengthening the provider-patient therapeutic relationship (reciprocity for healing). The use of reflective writing (RW) to augment reflective practice is well documented. RW in the small group setting fosters narrative competence (hearing/responding to a patient’s story, awareness of one’s own stories), self-assessment, moral sensitivity, empathy, emotional processing, and provider well-being. At Alpert Med, we have implemented an “interactive reflective writing” (IRW) paradigm of guided individualized feedback from interdisciplinary faculty to students’ RW in a Doctoring course and Family Medicine clerkship (with small group peer-based narrative sharing and collaborative feedback). Frameworks for enhancing educational value of feedback (BEGAN and REFLECT-reflective level evaluation rubric) were developed, incorporated into student and faculty guides, and applied in faculty development.INTERACTIVE WORKSHOP OBJECTIVES: 1) Participants will be familiarized with constructs of reflective learning/practice and IRW, 2) Participants will apply BEGAN and REFLECT to a student’s reflective essay as exemplar, 3) Participants will engage in interactive dialogue with medical student presenters on positive learning outcomes of IRW for WPC 4) Participants will consider and share merits, limitations, and possible utility of presented curricula/evaluative tools for their settings. FORMAT/ACTIVITIES:1. Didactic - Reflective Learning/Practice for WPC2. Participants provide feedback to student’s RW3. Discussion4. Introduce BEGAN/REFLECT frameworks5. Participants re-craft feedback with frameworks/Discuss6. Student/faculty presenters share experiences of IRW pedagogy for fostering reflection and WPC7. Wrap-up/Q and A.
Online Polylingual Topic Models for Fast Document Translation Detection

Many tasks in NLP and IR require efficient document similarity computations. Beyond their common application to exploratory data analysis, latent variable topic models have been used to represent text in a low-dimensional space, independent of vocabulary, where documents may be compared. This paper focuses on the task of searching a large multilingual collection for pairs of documents that are translations of each other. We present (1) efficient, online inference for representing documents in several languages in a common topic space and (2) fast approximations for finding near neighbors in the probability simplex. Empirical evaluations show that these methods are as accurate as—and significantly faster than— Gibbs sampling and brute-force all-pairs search.
Analysis of Resistance over Staggered Roughness

This note proposes a method of predicting the resistance factor for a given combination of flow and roughness properties. The only pattern considered in this study is the staggered pattern because of its common usage. Based on study results, the writers determined that more data on the development of the friction factor for flexible roughness are needed for further analysis.
Across the Apocalypse on Horseback: Biodiversity Loss and the Law

The most significant drivers of biodiversity loss can be described by HIPPO, the Greek word for horse. Habitat destruction, Invasive species, Population, Pollution, and Overkill - in that order - are exterminating species at a rate worthy of one of geological history's mass extinctions. Unfortunately, existing legal tools for stemming biodiversity loss are aimed precisely where human agency matters least. The Endangered Species Act, for instance, more clearly punishes overkill than either habitat destruction or the introduction of alien invasive species. This article describes the predicament and prescribes a modest agenda for improving the law of biodiversity conservation.
Analysis of the Traveling Salesman Problem with Flexible Colors

This paper analizes a new variant of the Traveling Salesman Problem (TSP) in which nodes belong to various color classes and each color class must be visited as an entity. We show that the problem is APX-hard and provide exact solutions for special cases and a two-phase heuristic for the general case. Lastly, we analyze the worst case and asymptotic performanc of the heuristic.
PREDICTING THE LIKELIHOOD FOR CORONARY ARTERY BYPASS GRAFTING IN NON ST ELEVATION MYOCARDIAL INFARCTION PATIENTS

Current ACC/AHA guidelines recommend dual antiplatelet therapy (DAPT) on presentation in patients with non ST elevation myocardial infarction (NSTEMI). This practice, however, can complicate coronary artery bypass (CABG) procedures, required in 8% to 25% of NSTEMI patients, and lead to delays in
Optical and Physical Characterization of Cu2-xSe Thin Films for Real Time Spectroscopic Ellipsometry on Cu(In,Ga)Se2-based Photovoltaic Devices

In situ, real time spectroscopic ellipsometry (RTSE) has been used to study the growth processes and optical properties of Cu2-xSe - an important binary compound in the fabrication of high efficiency copper indium gallium diselenide (CIGS) photovoltaic devices. It was found that the high surface roughness of the Cu2-xSe layers necessitated a “graded” optical model in order to extract meaningful dielectric functions at both 550 °C and room temperature. The optical model was verified at room temperature against SEM micrographs and reflectance measurements carried out ex situ. The growth temperature dielectric functions presented in this study are expected to allow for a greater level of control and understanding of the so-called 2- and 3-stage processes for CIGS fabrication in which a Cu2-xSe phase, present at the CIGS grain boundaries, acts as a fluxing agent for the growth of photovoltaic quality CIGS. Real time optical feedback via RTSE combined with the growth temperature dielectric functions presented here could play an important role in improving material fabrication on both the laboratory and industrial scales.
The Reagan compromise on ABM

Major progress made at the Washington summit toward a strategic arms agreement has been concealed from the U.S. public, since the administration does not want to reveal that it made a concession to the Soviets on honoring the ABM Treaty.
A Tensor Decomposition Method for High Dimensional Fokker-Planck Equation Modeling Polymeric Liquids

The multi-bead-spring (MBS) model for polymeric liquids is commonly employed to represent the coarse-grained molecular configuration characterized by the Fokker-Planck Equation (FPE). For chain consisting of several beads, the state space involved in the resulting transient FPE would become rather high dimensional. And solving this high dimensional FPE is a challenging task even on supercomputers due to curse of dimensionality. In this paper, a tensor decomposition approach combined with Chebyshev spectral differentiation is used to tackle this problem, where the transient solution is sought in the CANDECOMP/PARAFAC decomposition form by the alternating least squares algorithm, and the temporal dimension is treated (and hence decoupled) in the same manner as all other spatial dimensions. This tensor method drastically reduces the degrees of freedom required in the solution process. Numerical results for MBS models with 3D and 9D sate spaces are provided by implementing this tensor method on a regular PC.
The Service-Learning Project as a Supportive Context for Charismatic Leadership Emergence in Nascent Leaders

I conducted exploratory research that examined the relationships between psychological and behavioral attributes and charismatic leadership emergence in nascent leaders using a leadership service-l...
Uncertainty and Sensitivity Analysis of Activated Sludge Model No.1 by Monte Carlo Simulation for Single CSTR with Universal Distribution Parameters

Uncertainty in activated sludge design parameters can result in unacceptable levels of uncertainty in plant performance. We conducted Monte Carlo simulations of the Activated Sludge Model No. 1 (ASM1) to quantify the extent to which uncertainty in the model parameters, as determined from a survey of the literature, leads to uncertainty in plant performance. The results demonstrate that the levels of uncertainty may, depending on the effluent permit, be unacceptably high. We use Spearman rank correlation analysis of the Monte Carlo results to identify the model parameters to which the model is most sensitive as an aid in selecting model parameters to be measured as part of the design process. As a result, engineers and regulators can have a high degree of confidence that the plant will perform as required, without resorting to overly conservative assumptions or large safety factors.
Diagnostics for Multiple Imputations

Multiple imputation technique is becoming a popular method for analyzing data with missing values. Several methods have been proposed for creating multiple imputations and most of these methods assume that the data are missing at random (MAR). However, limited diagnostic tools are available to check whether the imputations created by these methods are reasonable. This article develops a set of diagnostic tools based on certain conditional distributions of the observed and imputed values. These conditional distributions should be similar if the assumed model for creating multiple imputations is a good fit. The tools are formulated in terms of numerical summaries and graphical displays and could be easily implemented using the standard complete data software packages. For implementing these methods the exact nature of the model used by the imputer is not needed. The method is illustrated using a data set with large number of variables of different types with varying amount of missing values.
Heparin-Binding Proteins in Hemostasis

This chapter discusses the fact that a large number of proteins which are key players in the hemostatic pathways have been identified as the heparin-binding proteins. Many of these proteins play important roles in normal hemostasis. The primary heparinoid involved in these roles is the endothelial cell heparan sulfate proteoglycan. The binding constants for the interactions of these proteins are quite variable. Although the binding constants are dependent of the ionic strength, the values reported have not always been measured at physiological ionic strengths. A few studies of these protein interactions with heparin have been extended to heparan sulfate. This is of great importance for proteins that require high molecular weight fractions of heparin for binding and activity. This chapter also describes some of the heparin- binding proteins that apparently, have no significant interactions with heparan sulfate in normal hemostasis, but become important players when exogenous heparin is present. The heparin-binding properties of these proteins can no longer be considered random, biologically insignificant properties. Heparin-binding proteins probably do not encounter heparin in vivo , but there is a reasonable likelihood that they interact with heparan sulfate in a physiologically significant way.
Case Study on Ancestry Estimation in an Alaskan Native Family: Identity and Safeguards against Reductionism

Understanding the complexities of ancestry-related identity is a necessary component of ethically sound research related to the genetic ancestry of modern-day communities. This is especially true when working with indigenous populations, given the legal and social implications that genetic ancestry interpretations may have in these communities. This study employs a multicomponent approach to explore the intricacies of ancestry-related identity within one extended family with members who identify as Alaskan Native. The seven participants were interviewed about their own self-identity, perceptions regarding genetic ancestry estimation, and their knowledge of oral family history. Additionally, each participant consented to having his or her genetic ancestry estimated. The researchers also surveyed ancestry-related documents, such as census records, birth certificates, and Certificates of Indian Blood. These three different perspectives-oral family history and self-identity, genetic ancestry estimation, historical and legal documentation-illustrate the complex nature of ancestry-related identity within the context of indigenous and colonial interactions in North America. While estimates of genetic ancestry broadly reflected each individual's self-reported biogeographic ancestry and supported all described and historically reported biological relationships, the estimates did not always match federally recorded blood quantum values, nor did they provide any information on relationships at the tribe or clan level. Employing a multicomponent approach and engaging study participants may help to safeguard against genetic essentialism and provide a more nuanced understanding of ancestry-related identity within a larger political, legal, and historical context.
Pressure- and Additive-Mediated Sintering of B 4 C at Relatively Low Temperatures

A significant improvement in sinterability of B4C was achieved at a relatively low temperature by applying high pressure (2 GPa) and adding a small amount (5 wt pct) of Ni. The sintered B4C and Ni powder mixture showed improved hardness in the range of 21 to 32 GPa and improved modulus as compared to the sintered B4C powder without additive. This is mostly attributed to the formation of Ni4B3, as characterized by Reitveld refinement method and transmission electron microscopy (TEM), which enhances the bonding between B4C particles. These results provide a new avenue toward the development of sintering of B4C at relatively low temperatures (<0.5T m of B4C).
Cyclosporine plus methotrexate was superior to methotrexate alone for rheumatoid arthritis

Source Citation Tugwell P, Pincus T, Yocum D, et al. for the Methotrexate- Cyclosporine Combination Study Group. Combination therapy with cyclosporine and methotrexate in severe rheumatoid arthriti...
Environmental and Genetic Determinants of Biofilm Formation in Paracoccus denitrificans

ABSTRACT The genome of the denitrifying bacterium Paracoccus denitrificans predicts the expression of a small heme-containing nitric oxide (NO) binding protein, H-NOX. The genome organization and prior work in other bacteria suggest that H-NOX interacts with a diguanylate cyclase that cyclizes GTP to make cyclic di-GMP (cdGMP). Since cdGMP frequently regulates attached growth as a biofilm, we first established conditions for biofilm development by P. denitrificans . We found that adhesion to a polystyrene surface is strongly stimulated by the addition of 10 mM Ca 2+ to rich media. The genome encodes at least 11 repeats-in-toxin family proteins that are predicted to be secreted by the type I secretion system (TISS). We deleted the genes encoding the TISS and found that the mutant is almost completely deficient for attached growth. Adjacent to the TISS genes there is a potential open reading frame encoding a 2,211-residue protein with 891 Asp-Ala repeats. This protein is also predicted to bind calcium and to be a TISS substrate, and a mutant specifically lacking this protein is deficient in biofilm formation. By analysis of mutants and promoter reporter fusions, we show that biofilm formation is stimulated by NO generated endogenously by the respiratory reduction of nitrite. A mutant lacking both predicted diguanylate cyclases encoded in the genome overproduces biofilm, implying that cdGMP is a negative regulator of attached growth. Our data are consistent with a model in which there are H-NOX-dependent and -independent pathways by which NO stimulates biofilm formation. IMPORTANCE The bacterium Paracoccus denitrificans is a model for the process of denitrification, by which nitrate is reduced to dinitrogen during anaerobic growth. Denitrification is important for soil fertility and greenhouse gas emission and in waste and water treatment processes. The ability of bacteria to grow as a biofilm attached to a solid surface is important in many different contexts. In this paper, we report that attached growth of P. denitrificans is stimulated by nitric oxide, an intermediate in the denitrification pathway. We also show that calcium ions stimulate attached growth, and we identify a large calcium binding protein that is required for growth on a polystyrene surface. We identify components of a signaling pathway through which nitric oxide may regulate biofilm formation. Our results point to an intimate link between metabolic processes and the ability of P. denitrificans to grow attached to a surface.
Distributed and asynchronous unit commitment and economic dispatch

The drastic increase of uncertainties associated with intermittent renewables create major challenges in power system operations. Current centralized unit commitment and economic dispatch (UCED) used by Independent System Operators (ISOs) may not efficiently handle uncertainties in the future as penetration levels of renewables increase. In this paper, to overcome this difficulty, a distributed and asynchronous framework is presented whereby the process of solving unit subproblems is delegated to unit solvers. To investigate the crucial coordination aspect, simplified deterministic UCED is formulated and price-based coordination is performed by asynchronously updating prices. The difficulty of the approach is that multipliers are updated using subproblem solutions obtained using multipliers of different vantages and divergence may occur. To overcome this difficulty, a novel algorithm is developed under an assumption that each subproblem is solved at least once within a finite number of coordinator iterations. This assumption together with diminishing stepsizes ensures that multipliers get closer and closer to the optimum with a certain periodicity and the overall coordination approach converges to the optimum. To test the coordination aspect, the deterministic UCED problem with 1000 units without transmission capacity constraints is considered, and results indicate that the method is robust and fast. To further explore the scalability of asynchronous coordination, a simplified UCED problem with 10,000 units each with generation capacity constraints only indicates that the method converges, is robust and more efficient as compared to the alternate direction method of multipliers (ADMM).
Reliability Prediction and Accelerated Testing

Reliability is one of the key quality characteristics of components, products and systems. It cannot be directly measured and assessed like other quality characteristics but can only be predicted for given times and conditions. Its value depends on the use conditions of the product as well as the time at which it is to be predicted. Reliability prediction has a major impact on critical decisions such as the optimum release time of the product, the type and length of warranty policy and associated duration and cost, and the determination of the optimum maintenance and replacement schedules. Therefore, it is important to provide accurate reliability predictions over time in order to determine accurately the repair, inspection and replacements strategies of products and systems.
Controlling Concurrency and Expressing Synchronization in Charm++ Programs

Charm++ is a parallel programming system that evolved over the past 20 years to become a well-established system for programming parallel science and engineering applications, in addition to the combinatorial search applications with which it started. At its earliest point, the precursor to Charm++, the Chare Kernel, was a purely reactive specification, similar to most actor languages. This paper describes the evolution of a series of concurrency control mechanisms that have been deployed in Charm++ to tame this unrestricted concurrency in order to improve code clarity and/or to improve performance.
Hemorrhoids, anal fissure, and carcinoma of the colon, rectum, and anus during pregnancy.

The management of benign and malignant conditions of the colon, rectum, and anus during pregnancy requires considerations of both the pregnant woman and the unborn fetus. Hemorrhoids and fissures can nearly always be managed nonoperatively. Colorectal and anal carcinomas are rare, and the timing of definitive treatment depends on the term of pregnancy. Generally, definitive surgical therapy is offered if the diagnosis is made early in the pregnancy and deferred until after parturition if made late in the pregnancy.
Endodermal Patterning and Organogenesis

Publisher Summary A substantial problem posed for the developmental biologist studying vertebrate endodermal differentiation and organogenesis is that all endodermally derived organs are actually an interdependent association of epithelial (endodermal) and mesenchymal (mesodermal) components. This chapter discusses some of the advances in the molecular analysis of vertebrate endodermal patterning and organogenesis in the light of classic studies of endodermal–mesenchymal interactions. It presents the insight into endoderm development offered by the various model organisms, and lists their current limitations. This chapter surveys some informative developmental studies performed in other endodermal organs, and highlights the work done on posterior foregut specification and differentiation in Xenopus and mouse embryos, to emphasize the power of using complementary model systems to address a particular developmental problem. Finally, it summarizes some major challenges to be tackled in the near future in the field of endoderm development.
Spot impact welding of an age-hardening aluminum alloy: Process, structure and properties

Abstract Naturally aged AA6111 was successfully spot-welded to itself using vaporizing foil actuator welding in as-received condition as well as after three different heat treatments. Material weldability, mechanical properties, hardness distribution, and weld interface characteristics were evaluated using lap-shear tests, micro/nanoindentation, optical and scanning electron microscopy and energy dispersive spectroscopy analysis. Lap-shear tests indicated that even after aging and varied heat treatments all samples had repeatable button pullout failure, the failure being governed by the thinning and tearing of the base metal around the weld nugget. The strength of the welds and the energy absorbed corresponding to the peak load varied with the heat treatments. Microhardness measurements displayed significant hardening in the weld regions compared to base metal hardness. Optical and scanning electron microscopy revealed re-solidified molten zones in the weld interface, and the extent and size of these zones varied with the heat treatments. Nanoindentation showed softening in these zones signifying presence of weld defects in the weld interior.
Visuospatial Working Memory Mediates the Relationship Between Executive Functioning and Spatial Ability.

This study seeks to understand the relationships among EF, VSWM, VWM, and spatial ability (mental rotation) through testing a series of mediation models. It is hypothesized that VSWM completely mediates the relationship between EF and mental rotation. It is hypothesized that VWM does not significantly mediate the relationship between EF and mental rotation. Because some EF tests also have a spatial processing demand, one goal of this study was to investigate whether the mediation relationship changes as a result of the type of test used to measure EF. Covariates age and gender were controlled for in theses analyses. The first hypothesis was partially supported by the finding that when the Tower test, an EF test with a strong spatial processing demand, was used to represent EF, VSWM was found to be a significant mediator. However, when the combined switching and inhibition scores from the Color-Interference Test, an EF test with a low spatial processing demand, was used to represent EF, VSWM no longer significantly mediates the relationship between EF and mental rotation, suggesting that the test effect is real and that future studies investigating the relationship between EF and VSWM need to consider differences in the spatial processing demand inherent in different types of EF tests. The second hypothesis was fully supported in that VWM was not found to be significantly mediating the relationship between EF and mental rotation, regardless of whether the Tower test or the Color-Interference Test was used to measure EF. Another goal of the study was to investigate the relative importance of EF, VSWM, and VWM in predicting mental rotation via dominance analysis. It was found that VSWM is more important than VWM in explaining mental rotation; the Tower test is more important than the Color-Interference Test in explaining mental rotation. This latter finding again suggests that the significant relationship between EF and spatial ability reported in some studies may at least be partially accounted for by the spatial processing demand inherent in some EF tests used in those studies.
A beginner's guide to data stewardship and data sharing.

Study design A narrative review of principles, benefits and disadvantages, as well as methods of research data sharing. Objectives To assist prospective Spinal Cord authors and others with understanding and implementing data sharing, so that various benefits of such sharing can accrue to all spinal cord injury research stakeholders. Setting International. Methods The medical research and health care services literature was reviewed nonsystematically for relevant articles, and web sites were explored for information and services offered by various pertinent organizations. Results Grant makers, professional organizations, research journals, publishers, and other entities in the research field increasingly stress the ethics as well as societal and practical benefits of data sharing, and require researchers to do so within a reasonable time after data collection ends. Sharing data, retrospectively, generally requires much time and resources, but when a data management plan is part of a research proposal from the start, costs are limited, and grant makers allow these costs to be part of a budget. There are many organizations that offer information on or even assist with preparing data for sharing and actual deposit in a data repository. Conclusions The requirement of data sharing is not likely to go away, and researchers interested in submitting their reports to Spinal Cord would do well to familiarize themselves with the myriad practical issues involved in preparing data for sharing.
Medical complications associated with substance use disorders in patients with type 2 diabetes and hypertension: electronic health record findings

Background and aims Screening for substance use disorder (SUD) in general medical settings may be particularly important in patients with comorbid health conditions exacerbated by SUD. This study evaluated whether SUD is associated with type 2 diabetes mellitus (T2DM) complications in patients with co-occurring T2DM and hypertension. Design Analysis of a limited data set obtained through IBM Watson Health Explorys, a platform integrating data from electronic health records. Matched controls were defined for each of five SUDs: tobacco use disorder (TUD), opioid use disorder (OUD), cocaine use disorder, cannabis use disorder (CUD) and alcohol use disorder (AUD) using Mahalanobis distance within propensity score calipers. Setting All patients were seen in the MetroHealth System (Cleveland, OH, USA) and had diagnosis codes for T2DM and hypertension. Participants SUD group participants had a diagnosis of abuse/dependence for the substance of interest. Controls for each SUD group had no diagnosis code related to the SUD of interest and were selected to match the SUD patients on demographics, residential zip code median income and body mass index. Total sample sizes for each SUD-control comparison ranged from 1160 for CUD to 22 128 for TUD. Measurements Outcome was diagnosis (yes/no) of four T2DM complications (cerebrovascular accident, diabetic neuropathy, diabetic renal disease, myocardial infarction) and all-cause mortality. Findings Logistic regressions revealed that SUD was significantly associated with greater risk of cerebrovascular accident [TUD odds ratio (OR) = 1.79, OUD-OR = 1.94, cocaine use disorder OR = 2.67], diabetic neuropathy [TUD-adjusted OR (aOR) = 1.47, cocaine use disorder-aOR = 1.35, AUD-aOR = 1.27], diabetic renal disease (TUD-aOR = 1.25, OUD-OR = 1.34), myocardial infarction (TUD-OR = 1.96, OUD-OR = 2.01, cocaine use disorder-OR = 2.68, CUD-OR = 2.48, AUD-OR = 1.42) and mortality (TUD-OR = 1.15, cocaine use disorder-OR = 1.61, CUD-OR = 1.49, AUD-OR = 1.35). Conclusions Among patients in Ohio USA with both type 2 diabetes mellitus (T2DM) and hypertension, those with substance use disorders appear to have greater risk for T2DM complications and all-cause mortality.
Association of History of Injection Drug Use with External Cause-Related Mortality Among Persons Linked to HIV Care in an Urban Clinic, 2001–2015

High mortality rates among persons with HIV with a history of injection drug use (PWID) are thought to be driven in part by higher rates of external cause-related mortality. We followed 4796 persons aged 18–70 engaged in continuity HIV care from 2001 to 2015 until death or administrative censoring. We compared cause-specific (csHR) and subdistribution hazards (sdHR) of death due to external causes among PWID and persons who acquired their HIV infection through other routes (non-IDU). We standardized estimates on age, sex, race, and HIV-related health status. The standardized csHR for external cause-related death was 3.57 (95% CI 2.39, 5.33), and the sdHR was 3.14 (95% CI 2.16, 4.55). The majority of external cause-related deaths were overdose-related and standardized sdHR was 4.02 (95% CI 2.40, 6.72). Absolute rate of suicide was low but the csHR for PWID compared to non-IDU was most elevated for suicide (6.50, 95% CI 1.51, 28.03). HIV-infected PWID are at a disproportionately increased risk of death due to external causes, particularly overdose and suicide.
How should we understand the absence of sex differences in the genetic and environmental origins of antisocial behavior

Available twin-family data on sex differences in antisocial behavior (ASB) simultaneously suggest that ASB is far more prevalent in males than in females, and that its etiology (i.e. the effects of genes, environments, hormones, culture) does not differ across sex. This duality presents a conundrum: How do we make sense of mean sex differences in ASB if not via differences in genes, environments, hormones, and/or cultures? The current selective review and critique explores possible contributions to these seemingly incompatible sets of findings. We asked whether the presence of sex differences in behavior could be smaller than is typically assumed, or confined to a specific set of behaviors. We also asked whether there might be undetected differences in etiology across sex in twin-family studies. We found little evidence that bias or measurement invariance across sex account for phenotypic sex differences in ASB, but we did identify some key limitations to current twin-family approaches. These included the questionable ability of qualitative sex difference analyses to detect gender norms and prenatal exposure to testosterone, and concerns regarding specific analytic components of quantitative sex difference analyses. We conclude that the male preponderance in ASB is likely to reflect a true sex difference in observed behavior. It was less clear, however, that the genetic and environmental contributions to ASB are indeed identical across sex, as argued by prior twin-family studies. It is our hope that this review will inspire the development of new, genetically-informed methods for studying sex differences in etiology.
HD (v = 1, j = 2, m) orientation controls HD-He rotationally inelastic scattering near 1 K.

To investigate how molecular orientations affect low energy scattering, we have studied the rotational relaxation of HD (v = 1, j = 2, m) → (v′ = 1, j′ = 0) by collision with ground-state He, where v, j, and m designate the vibrational, rotational, and magnetic quantum numbers, respectively. We experimentally probed different collision geometries by preparing three specific m sublevels, including an m entangled sublevel, belonging to a single rovibrational (v = 1, j = 2) energy level within the ground electronic state of HD using Stark-induced adiabatic Raman passage. Low collision energies (0–5 K) were achieved by coexpanding a 1:19 HD:He mixture in a highly collimated supersonic beam, which has defined the direction of the collision velocity and restricted the incoming orbital angular momentum states, defined by the quantum number l, to l ≤ 2. Partial wave analysis of experimental data shows that a single l = 2 input orbital dominates the scattered angular distribution, implying the presence of a collisional resonance. The differential scattering angular distribution exhibits a greater than fourfold stereodynamic preference for the m = 0 input state vs m = ±2, when the quantization axis is oriented parallel to the collision velocity.
Prognostic utility of hypsarrhythmia scoring in children with West syndrome after ketogenic diet.

Abstract Objective The aim of this study was to evaluate the clinical efficacy and electroencephalographic (EEG) changes of West syndrome after ketogenic diet (KD) therapy and to explore the correlation of EEG features and clinical efficacy. Patients and methods We retrospectively studied 39 patients with West syndrome who accepted KD therapy from May 2011 to October 2017. Outcomes including clinical efficacy and EEG features with hypsarrhythmia severity scores were analyzed. Results After 3 months of treatment, 20 patients (51.3%) had ≥50% seizure reduction, including 4 patients (10.3%) who became seizure-free. After 6 months of treatment, 4 patients remained seizure free, 12 (30.8%) had 90–99% seizure reduction, 8 (20.5%) had a reduction of 50–89%, and 15 (38.5%) had Conclusion Our findings suggest a potential benefit of KD for patients with drug-resistant West syndrome. Early change of EEG after KD may be a predictor of a patient’s response to the therapy.
Efficacy and Safety of Dichlorphenamide for Primary Periodic Paralysis in Adolescents Compared With Adults

Abstract Background Primary periodic paralyses are rare, hereditary skeletal muscle diseases characterized by episodic muscle weakness. Dichlorphenamide was effective and well tolerated in two studies, including one with adolescents. This analysis describes effects of dichlorphenamide among adolescents and adults. Methods Patients with primary periodic paralyses in a double-blind, controlled, crossover study were randomized to dichlorphenamide or placebo for nine weeks, with a nine-week or longer between-treatment washout period. Attack rate and severity-weighted attack rate during the final eight weeks of each treatment phase were calculated for adolescents and adults separately. Results Seven adolescents (10 to ≤17 years) and 66 adults were enrolled; five of seven adolescents were evaluable for efficacy and six for safety. Dichlorphenamide total daily dosing among adolescents was 50 mg (n = 1) or 100 mg (n = 5), and in adults was 105.7 mg (mean; n = 61). In adolescents, the median decrease from baseline in frequency of weekly attacks was greater with dichlorphenamide (−0.96) than with placebo (−0.57), similar to findings in adults (dichlorphenamide, −0.83; placebo, −0.24). Severity-weighted attack frequency was likewise reduced more with dichlorphenamide than with placebo in adolescents and adults. The most common adverse event with dichlorphenamide in adolescents was skin rash (two of six [33%]). In adults, numbness was the most common adverse event (26 of 54 [48%]); skin rash occurred less frequently (10 of 54 [19%]). Conclusions Dichlorphenamide was comparably effective and tolerated among a small number of adolescents as well as adults, although types of adverse events differed between groups.
The Self-directed Channel Memristor: Operational Dependence on the Metal-Chalcogenide Layer

The basic self-directed channel memristor is comprised of five layers of Ge2Se3, SnSe, and an oxidizable metal, Ag. Each layer plays a role in the operation of the memristor, influencing both the electrical and thermal properties of the device. Device operation can be altered by manipulation of these layers through material changes, layer ordering, or layer exclusion. In this chapter the function of the SnSe layer is explored through electrical characterization of several device types in which this metal chalcogenide layer has been altered, either by changing the metal, or replacing Se with Te.
Challenges of Implementing Progressive Design-Build in Highway Construction Projects

AbstractProgressive design-build (PDB) has been successfully administered and executed in the private, airport, transit, and water/wastewater sectors. Although these sectors have experienced succes...
Independent Control of Dynamic Material Properties by Exploiting Structural Hierarchy and Intrinsic Structural Gradients

Abstract Achieving high damping and stiffness is challenging in common materials because of their inter-dependent scaling. Controlling extreme mechanical waves requires synergistically enhanced damping and stiffness. We demonstrate superior damping and stiffness in vertically aligned carbon nanotube (VACNT) foams that are also independently controllable by exploiting their synthesis-tailored structural hierarchy and structural gradients. They exhibit frequency- and amplitude-dependent responses with dramatically tunable dynamic stiffness while maintaining constant damping. Developing independent control over critical dynamic properties via engineered hierarchical and gradient materials will enable the creation of non-Hermitian metamaterials and active control of mechanical waves and vibrations.
Obstructive sleep apnea in pediatric obesity and the effects of sleeve gastrectomy

The prevalence of severe pediatric obesity is rising and poses many adverse health risks. Children with obesity are at increased risk of several cardiovascular and metabolic diseases. They are also more likely to have obstructive sleep apnea (OSA), which increases the risk of cardiovascular and metabolic problems. In this review, we examine the relationship between OSA and obesity, improvements in OSA after non-surgical and surgical weight loss, and explore potential directions for future research.
Academic Emergency Medicine Physicians' Anxiety Levels, Stressors, and Potential Stress Mitigation Measures During the Acceleration Phase of the COVID-19 Pandemic.

Author(s): Rodriguez, Robert M; Medak, Anthony J; Baumann, Brigitte M; Lim, Stephen; Chinnock, Brian; Frazier, Remi; Cooper, Richelle J | Abstract: ObjectiveThe objective was to assess anxiety and burnout levels, home life changes, and measures to relieve stress of U.S. academic emergency medicine (EM) physicians during the COVID-19 pandemic acceleration phase.MethodsWe sent a cross-sectional e-mail survey to all EM physicians at seven academic emergency departments. The survey incorporated items from validated stress scales and assessed perceptions and key elements in the following domains: numbers of suspected COVID-19 patients, availability of diagnostic testing, levels of home and workplace anxiety, severity of work burnout, identification of stressors, changes in home behaviors, and measures to decrease provider anxiety.ResultsA total of 426 (56.7%) EM physicians responded. On a scale of 1 to 7 (1 = not at all, 4 = somewhat, and 7 = extremely), the median (interquartile range) reported effect of the pandemic on both work and home stress levels was 5 (4-6). Reported levels of emotional exhaustion/burnout increased from a prepandemic median (IQR) of 3 (2-4) to since the pandemic started a median of 4 (3-6), with a difference in medians of 1.8 (95% confidence interval = 1.7 to 1.9). Most physicians (90.8%) reported changing their behavior toward family and friends, especially by decreasing signs of affection (76.8%). The most commonly cited measures cited to alleviate stress/anxiety were increasing personal protective equipment (PPE) availability, offering rapid COVID-19 testing at physician discretion, providing clearer communication about COVID-19 protocol changes, and assuring that physicians can take leave for care of family and self.ConclusionsDuring the acceleration phase, the COVID-19 pandemic has induced substantial workplace and home anxiety in academic EM physicians, and their exposure during work has had a major impact on their home lives. Measures cited to decrease stress include enhanced availability of PPE, rapid turnaround testing at provider discretion, and clear communication about COVID-19 protocol changes.
Using Photovoice to Understand Perspectives on Safe Infant Sleep Practices among Caregivers Enrolled in Perinatal Home Visiting

Sudden and unexpected infant death (SUID), often associated with unsafe infant sleep practices, remains a leading cause of infant mortality in the United States. Maternal, Infant, and Early Childho...
Chemistry of Metal Silicates and Germanates: The Largest Metal Polygermanate, K11Mn21Ge32O86(OH)9(H2O), with a 76 Å Periodic Lattice.

An examination of manganese silicates and germanates revealed unusual structural motifs and extremely different chemistries, with identical hydrothermal reactions forming K2Mn2Si3O9 versus K11Mn21Ge32O86(OH)9(H2O). The germanate is exceptional in both its c-axis length (exceeding 76 A) and unit cell volume (nearly 18000 A3), the largest known polygermanate structure to our knowledge.