cssi/SciSciGPT-SciSciNet huggingface dataset:
Secular Trends in Deaths From Cardiovascular Diseases: A 25-Year Community Study

Background— Although age-adjusted cardiovascular disease (CVD) mortality has declined over the past decades, controversies remain about whether this trend was similar across locations of death and disease categories and about the existence of age and sex disparities. Methods and Results— We examined CVD mortality trends in Olmsted County, Minnesota, between 1979 and 2003 using the categories defined by the American Heart Association, including coronary heart disease (CHD), non-CHD diseases of the heart, and noncardiac circulatory diseases. Data on demographics, cause, and location of death of all 6378 residents who died of CVD were analyzed. Although decreases in the age-adjusted rates occurred in all groups, the magnitude of the decline varied widely. Lesser annual declines were noted in out-of-hospital than in-hospital deaths (1.8% versus 4.8%; P<0.001), in older than in younger persons (1.5% at age ≥85 years versus 3.9% for those ≤74 years of age; P<0.001), and in women relative to men (2.5% versus 3.3...
Methodological review: Intelligent decision support systems for mechanical ventilation

Objective: An overview of different methodologies used in various intelligent decision support systems (IDSSs) for mechanical ventilation is provided. The applications of the techniques are compared in view of today's intensive care unit (ICU) requirements. Methods: Information available in the literature is utilized to provide a methodological review of different systems. Results: Comparisons are made of different systems developed for specific ventilation modes as well as those intended for use in wider applications. The inputs and the optimized parameters of different systems are discussed and rule-based systems are compared to model-based techniques. The knowledge-based systems used for closed-loop control of weaning from mechanical ventilation are also described. Finally, in view of increasing trend towards automation of mechanical ventilation, the potential utility of intelligent advisory systems for this purpose is discussed. Conclusions: IDSSs for mechanical ventilation can be quite helpful to clinicians in today's ICU settings. To be useful, such systems should be designed to be effective, safe, and easy to use at patient's bedside. In particular, these systems must be capable of noise removal, artifact detection and effective validation of data. Systems that can also be adapted for closed-loop control/weaning of patients at the discretion of the clinician, may have a higher potential for use in the future.
Field additivity of the middle-wavelength cone pathway under various test and field configurations.

Abstract The field additivity of the M-cone pathway was measured with psychometric functions at 10 times absolute threshold on monochromatic fields and their mixtures. Observers detected a 500 nm test on 530 or 610 nm fields, and a 530 nm test on 481 or 622 nm fields. For both sets of wavelengths, field additivity held with the 1 deg test, 10 deg field condition which defines π-4 and with the 3.6 min arc test on a 8.6 min arc field used to isolate the M fundamental by Stockman [(1983) Ph. D. thesis, Trinity College, Cambridge University, Cambridge. Sub-additivity occurred for a 1 deg test on a 1 deg field, a condition for Foster's “spectral sharpening” which may evince opponency.
A Novel Mechanism for Switching a Neural System from One State to Another

An animal's ability to rapidly adjust to new conditions is essential to its survival. The nervous system, then, must be built with the flexibility to adjust, or shift, its processing capabilities on the fly. To understand how this flexibility comes about, we tracked a well-known behavioral shift, a visual integration shift, down to its underlying circuitry, and found that it is produced by a novel mechanism – a change in gap junction coupling that can turn a cell class on and off. The results showed that the turning on and off of a cell class shifted the circuit's behavior from one state to another, and, likewise, the animal's behavior. The widespread presence of similar gap junction-coupled networks in the brain suggests that this mechanism may underlie other behavioral shifts as well.
Proof-theoretic techniques for term rewriting theory

A bridge is presented between term-rewriting theory in computer science and proof theory in logic. It is shown that proof-theoretic tools are very useful for analyzing two basic attributes of term rewriting systems, the termination property and the Church-Rosser property. A counterexample is given to show that Knuth's critical pair lemma does not hold for conditional rewrite systems. Two restrictions on conditional systems under which the critical pair lemma holds are presented. One is considered a generalization of Bergstra-Klop's former result; the other is concerned with a generalization of Kaplan's and Jouannaud-Waldmann's systems. >
Moving Humans Detection Based on Multi-Modal Sensor Fusion

Moving object detection plays an important role in automated surveillance systems. However, it is challenging to detect moving objects robustly in a cluttered environment. In this paper, we propose an approach for detecting humans using multi-modal measurements. The approach is based on using Time-Delay Neural Network (TDNN) to fuse the audio and video data at the feature level for detecting the walker with multiple persons in the scene. The main contribution of this paper is the introduction of Time-Delay Neural Network in learning the relation between visual motion and step sounds of the walking person. Experimental results are presented.
Optimal parallel construction of prescribed tournaments

A tournament is a digraph in which every pair of vertices is connected by exactly one arc. The score list of a tournament is the sorted list of the out-degrees of its vertices. Given a nondecreasing sequence of nonnegative integers, is it the score list of some tournament? There is a simple test for answering this question. There is also a simple sequential algorithm for constructing a tournament with a given score list. However, this algorithm has a greedy nature, and seems hard to parallelize. We present a simple parallel algorithm for the construction problem. Our algorithm runs in time O(log n) and uses O(n2/log n) processors on a CREW PRAM, where n is the number of vertices. Since the size of the output is Θ(n2), our algorithm achieves optimal speedup. The tournament constructed has the property that it is the closest possible to a transitive tournament in a precise sense.
The Production of Homozygous Deficient Tissues with Mutant Characteristics by Means of the Aberrant Mitotic Behavior of Ring-Shaped Chromosomes.

This lengthy article stemmed from McClintock's discovery of ring chromosomes in 1932 and research she conducted on the gene bm1, or brown midrib, after returning to the University of Missouri in 1938. McClintock concluded that the extent of variegation in a mature plant was proportional to the size of the ring that was sometimes lost at cell division.
Pilot embedding for channel estimation and tracking in OFDM systems

We consider the problem of channel estimation and tracking in OFDM systems and explore the idea of adding pilot symbols to the data symbols as a means of conserving bandwidth. The term pilot embedding (PE) is used to refer to this scheme. Compared to the pilot insertion (PI) scheme, i.e., the conventional pilot symbol assisted modulation (PSAM), PE is more bandwidth efficient since no separate subcarriers/timeslots are allocated to pilots. We formalize this by evaluating the capacity of the two schemes and showing that PE indeed has the potential to transmit at a higher rate. The problem of channel tracking using a decision directed approach is reviewed and found to be unreliable, in the sense that the channel estimator fails to track the channel variations after some iterations because of unavoidable decision errors. We propose an ad hoc channel estimation algorithm that uses the embedded pilots along with the past decisions of data for reliable tracking of the channel.
Discrete spatial solitons in a diffraction-managed nonlinear waveguide array: a unified approach

Abstract Localized, stable nonlinear waves, often referred to as solitons, are of broad interest in mathematics and physics. They are found in both continuous and discrete media. In this paper, a unified method is presented which is used to describe the propagation of linearly polarized light as well as two polarization modes in a diffraction-managed nonlinear waveguide array. In the regime of normal diffraction, both stationary and moving discrete solitons are analyzed using the Fourier transform method. The numerical results based on a modified Neumann iteration scheme as well as renormalization techniques, indicate that traveling wave solutions are unlikely to exist. An asymptotic equation is derived from first principles which governs the propagation of electromagnetic waves in a waveguide array in the presence of both normal and anomalous diffraction. This is termed diffraction management. The theory is then extended to the vector case of coupled polarization modes.
Are cleft palate fistulae a cause of dental decay

Aim: To investigate a possible correlation between fistula and dental decay in children at 5 years of age from a single-surgeon series of cleft palate repairs. Methods: Retrospective review of data over a 9-year period between 2003 and 2011 of cleft palate repairs performed by the senior author at Birmingham Children's Hospital, U.K. Data collected on age, sex, age at repair, presence of fistula, and number of decayed, missing, or filled primary teeth (i.e., decayed, missing, and filled teeth score) at age 5 years. Results: The overall fistula rate for this patient population was 24.1%. Fistulae were more common in the more severe forms of cleft type, as was frequency of dental decay. Comparison of fistula versus nonfistula groups showed a higher rate of dental decay (40%) in the fistula group, compared with only 20% in the nonfistula group (P = .036). Conclusion: A positive association was established between dental decay and the presence of a fistula. Although not proven as causative, possible reasons f...
Focus Issue: Decisions, Great and Small

This Focus Issue of Science ’s STKE concerns cellular "decision-making" in the nervous system, with Perspectives on how diet affects the "decision" of a neuron to fire and on the "decision" of progenitor cells to become neurons or glia.
Thermal characterization of a tape carrier package

The unenhanced thermal performance of 20 mm Tape Carrier Packages (TCP) packages on 8 layer boards with internal planes is 19/spl deg/C/W. Package thermal resistance /spl Theta//sub jc/ has been measured at 2/spl deg/C/W. Simple PCB enhancements such as the addition of thermal vias, alone or with the use of low profile heat sinks, brings the thermal performance in line with requirements for mobile computing platforms which do not have forced convection cooling options available. With forced convection cooling, devices with power dissipation requirement of 5/spl deg/C/W and higher can be packaged in TCP format. >
Gait deficits in liver disease: Hepatic encephalopathy and hepatic myelopathy

Summary In this issue, the unusual clinical presentation of a horse diagnosed is described with severe liver cirrhosis and hepatic encephalopathy. The horse initially presented for thoracic and pelvic limb ataxia and weakness, and signs of forebrain disease were not apparent until later in the disease process. The typical pathology of central nervous system disease associated with liver disease is related to encephalopathy and forebrain disease; however, the spinal cord is occasionally also involved. Hepatic myelopathy is a rare syndrome usually associated with surgical or acquired portosystemic shunts, liver cirrhosis and/or portal hypertension in man. Where a gliopathy is the most prominent pathological feature seen in hepatic encephalopathy, in hepatic myelopathy the most remarkable feature is demyelination of the corticospinal tracts of the distal cervical and thoracic spinal cord with occasional axon loss. The clinical signs of hepatic myelopathy are spastic paresis/paralysis with normal sensory findings and preserved sphincter function. The prognosis for hepatic myelopathy is generally poor. In summary, in severe liver disease, motor deficits can occur secondary to the encephalopathy, but motor deficits can also occur as a result of spinal cord pathology such as seen in hepatic myelopathy. In examination of horses with myelopathies, liver disease as a cause of myelopathy should be included in our list of differentials.
Friendship-based location privacy in Mobile Social Networks

Location privacy in Mobile Social Networks (MSNs) has generated significant interest in recent years, with many proposed methods to address the problem. Commercial solutions to this problem have suggested designing better ways for users to determine when to report their locations, while academic researchers have proposed solutions that involve deploying trusted third party servers to protect user privacy. In this paper, we showed that simply omitting location updates does not provide adequate privacy protections, especially in situations where the friendship relationships between users are known. We proposed a fake location update algorithm that allows a user to protect his privacy. A key feature of our approach is that it can be adopted without the use of any third party services, making them more practical. We evaluate our approach using extensive simulation experiments.
Distributed Acoustic and Seismic Sensing

An overview of fiber optic distributed acoustic and seismic sensor system architectures is presented.
Application of the pseudo-spectral time domain method to compute particle single-scattering properties for size parameters up to 200

Abstract The applicability, efficiency, and accuracy of the pseudo-spectral time domain (PSTD) method are investigated with specific emphasis on the computation of the single-scattering properties of homogeneous dielectric particles. By truncating the high spectral terms, the Gibbs phenomenon is eliminated, and, consequently, the applicability of the PSTD is enhanced. The PSTD simulations for ice spheres, with moderate refractive indices and size parameters up to 200, are compared with the exact Lorenz–Mie solutions at three wavelengths. In addition, the comparison is extended to a case with an extremely large refractive index (7.150+i2.914) and size parameters up to 40. Furthermore, the single-scattering properties of randomly oriented spheroids and circular cylinders for size parameters up to 150 and 75, respectively, are calculated with the PSTD in comparison with those computed from the T-matrix method. The aspect ratio of the spheroid and the diameter-to-length ratio of the circular cylinder are 0.5 and 1, respectively. The relative errors, given by the PSTD for these randomly oriented non-spherical particles, are smaller than 2% for the extinction efficiencies and asymmetry factors and less than 30% for the phase function. The PSTD is also employed to compute the phase matrices of randomly oriented hexagonal columns with size parameters of 50 and 100. The simulations show the PSTD to be a robust method for simulating the single-scattering properties of particles with small-to-medium size parameters and for a wide range of refractive indices.
Diagnostic accuracy in child sexual abuse medical evaluation: Role of experience, training, and expert case review

OBJECTIVES: (1) The purpose of this study was to assess the ability of clinicians who examine children for suspected sexual abuse to recognize and interpret normal and abnormal ano-genital findings in magnified photographs using an online survey format. (2) Determine which factors in education, clinical practice, and case review correlate with correct responses to the survey questions. METHODS: Between July and December 2007, medical professionals participated in a web-based survey. Participants answered questions regarding their professional background, education, clinical experience, and participation in case review. After viewing photographs and clinical information from 20 cases, participants answered 41 questions regarding diagnosis and medical knowledge. Answers chosen by an expert panel were used as the correct answers for the survey. RESULTS: The mean number of correct answers among the 141 first-time survey respondents was 31.6 (SD 5.9, range 15-41). Child Abuse Pediatricians (CAP) had mean total scores which were significantly higher than Pediatricians (Ped) (34.8 vs. 30.1, p Language: en
Twelve‐ and 16‐month‐old infants recognize properties of mentioned absent things

Absent reference comprehension is a critical achievement of early development, yet little is known about its emergence. In the current study, 12- and 16-month-old infants' recognition of properties of mentioned absent things was used as an index of absent reference comprehension. Infants were presented with displays matching the color and prior spatial location of a mentioned absent object and displays matching the color and prior spatial location of a non-mentioned absent object. Infants could reveal their comprehension of absent reference by directing more looking and gesturing at the display matching the mentioned absent object than at the display matching the non-mentioned absent object. Infants at both ages revealed some tendency to do so, but infants at 16 months revealed more advanced understanding--infants at 16 months, but not at 12 months, coordinated their attention to the display matching properties of the mentioned absent thing with looks to the speaker. Implications for the infants' understanding of communicative intentions are discussed.
When endothelial cells go rogue

Endothelial‐to‐mesenchymal transition (EndMT) is a poorly understood phenomenon that leads to endothelial cells acquiring a variety of different mesenchymal fates. This results in a number of pathological consequences of considerable clinical significance in diseases ranging from cavernous malformations in the brain to tissue fibrosis, atherosclerosis, and cancer. Importantly, while there appears to be a number of different triggers activating EndMT, the final common pathway driving the transition appears to be the same.
The V81M variant of tyrosine hydroxylase is associated with more severe freezing of gait in Parkinson's disease

Abstract Introduction Many of the symptoms and signs of Parkinson's disease (PD) arise from the death of midbrain dopamine neurons that utilize tyrosine hydroxylase (TH) as the rate-limiting enzyme in catecholamine biosynthesis. Methods We investigated whether the presence of a common TH polymorphism affects the clinical outcomes in 101 PD subjects. We further examined the effect of this polymorphism on the purified recombinant enzyme. Results PD subjects homozygous for the common V81M polymorphism, have higher overall freezing of gait scores after controlling for disease duration, although this polymorphism does not associate with the occurrence of PD or FOG. In vitro functional assays on pure recombinant wild type TH and V81M TH revealed that the Km of the mutant enzyme for tyrosine was twice that of the wild-type. This polymorphism, however, did not change the stability of the enzyme, nor did it affect the Vmax or Km for the co-substrate BH4. Conclusion The data suggest that presence of a homozygous V81M polymorphism is associated with more severe FOG, possibly due to lower catecholamine synthetic capacity. Further studies are warranted to investigate the role of subtle changes in catecholamine availability in the development of FOG.
Cross-Linked Disulfonated Poly(arylene ether sulfone) Telechelic Oligomers. 2. Elevated Transport Performance with Increasing Hydrophilicity

Disulfonated poly(arylene ether sulfone) copolymer membranes are of interest for water purification by desalination. These negatively charged copolymers exhibit lower fouling and greatly improved resistance to oxidants such as chlorinated disinfectants compared to state-of-the-art highly cross-linked aromatic polyamide, porous polysulfone supported thin film composite (TFC) systems. A systematic series of controlled molecular weight 4,4′-biphenol and bisphenol A based partially disulfonated poly(arylene ether sulfone)s were synthesized with terminal amine functionalities via end-capping with m-aminophenol. The stoichiometric balance of the end-capping reagent, bisphenols, and two activated dihalides controlled Mn and degree of disulfonation. Oligomers with controlled molecular weights and ionic content were thermally cross-linked with a multifunctional epoxy resin (TGBAM) derived from methylene dianiline. The residual masses from boiling solvent extraction confirmed high gel fractions. The networks had im...
HIV/AIDS Related Knowledge,Behaviors and the Infection Status of HIV and Syphilis Among Pregnant Women in Taian City

Objective To understand relevant knowledge,behaviors and the infection status of STD and AIDS among pregnant women(PRG) in Taishan district of Taian city,and provide scientific basis for prevention and control measures.Methods From April to July of 2011,400 PRGs from the obstetrics and gynecology clinics were investigated on aspects of HIV/AIDS related knowledge and behaviors,and blood samples were collected for HIV and syphilis test.Results The overall awareness rate of the AIDS related knowledge was 82.37%,4 cases of sexual promiscuity,1 case of IDU.The syphilis prevalence was 0.25%,no cases were detected as HIV antibody positive.Conclusion There were certain antenatal syphilis cases among PRGs in Taishan district of Taian city,the awareness of HIV/AIDS related knowledge of them was comparatively poor;thus,health education,early detection,early diagnosis and early intervention should be implemented urgently.
Handling malicious switches in software defined networks

Traffic flowing through a software defined network is vulnerable to disruptions caused by malicious switches. The malicious behaviors are diverse such as dropping traffic, adding traffic or modifying it. A switch could be malicious or otherwise dysfunctional or misconfigured. A lot of work in SDN has addressed the problem by securing the control plane and having it validate network wide properties and policy compliance, e.g., loop-freedom, reachability and resolution of conflicting rules. In this paper, we argue that it is imperative as well to ensure the correctness of traffic forwarding itself. Therefore we define a threat model for the security and correctness of forwarding in an SDN switch. We describe several malicious behaviors that could be encountered at an SDN switch and propose possible solutions to each fault type. The capabilities of the SDN paradigm to detect and deter such attacks are analyzed.
Long-Term Anesthetic-Dependent Hypoactivity after Repetitive Mild Traumatic Brain Injuries in Adolescent Mice

Recent evidence supports the hypothesis that repetitive mild traumatic brain injuries (rmTBIs) culminate in neurological impairments and chronic neurodegeneration, which have wide-ranging implications for patient management and return-to-play decisions for athletes. Adolescents show a high prevalence of sports-related head injuries and may be particularly vulnerable to rmTBIs due to ongoing brain maturation. However, it remains unclear whether rmTBIs, below the threshold for acute neuronal injury or symptomology, influence long-term outcomes. To address this issue, we first defined a very mild injury in adolescent mice (postnatal day 35) as evidenced by an increase in Iba-1- labeled microglia in white matter in the acutely injured brain, in the absence of indices of cell death, axonal injury, and vasogenic edema. Using this level of injury severity and Avertin (2,2,2-tribromoethanol) as the anesthetic, we compared mice subjected to either a single mTBI or 2 rmTBIs, each separated by 48 h. Neurobehavioral assessments were conducted at 1 week and at 1 and 3 months postimpact. Mice subjected to rmTBIs showed transient anxiety and persistent and pronounced hypoactivity compared to sham control mice, alongside normal sensorimotor, cognitive, social, and emotional function. As isoflurane is more commonly used than Avertin in animal models of TBI, we next examined long-term outcomes after rmTBIs in mice that were anesthetized with this agent. However, there was no evidence of abnormal behaviors even with the addition of a third rmTBI. To determine whether isoflurane may be neuroprotective, we compared the acute pathology after a single mTBI in mice anesthetized with either Avertin or isoflurane. Pathological findings were more pronounced in the group exposed to Avertin compared to the isoflurane group. These collective findings reveal distinct behavioral phenotypes (transient anxiety and prolonged hypoactivity) that emerge in response to rmTBIs. Our findings further suggest that selected anesthetics may confer early neuroprotection after rmTBIs, and as such mask long-term abnormal phenotypes that may otherwise emerge as a consequence of acute pathogenesis.
Properties of the Low Mass $\omega p$ Enhancement Observed in $p$ Polarized $p \to p \omega p$ at 11.75-{GeV}/$c$

Samples of the reaction $p_{\ensuremath{\uparrow}}p\ensuremath{\rightarrow}p\ensuremath{\omega}p$, consisting of 20 000 and 1000 events at 11.75 and 6 GeV/c, respectively, were obtained using the Zero Gradient Synchrotron polarized proton beam and the Effective Mass Spectrometer. A narrow enhancement near threshold is seen in the $\ensuremath{\omega}p$ mass distribution. The $t$ distribution of this enhancement shows a pronounced dip near $t=\ensuremath{-}0.2$ Ge${\mathrm{V}}^{2}$ at both beam momenta, suggesting that $\ensuremath{\omega}$ exchange is the dominant production mechanism. The joint-decay-angular-distribution moments and polarization correlations have been determined as functions of $\ensuremath{\omega}p$ mass. Amplitude analysis of these moments indicates that the low-mass enhancement is due to the high-mass tails of spin-parity ${\frac{3}{2}}^{\ensuremath{-}}$ and ${\frac{3}{2}}^{+}$ states below $\ensuremath{\omega}p$ threshold. Polarization correlations consistent with zero provide evidence for the lack of resonant behavior in the low-mass enhancement itself.
SECONDARY BATTERIES – LEAD– ACID SYSTEMS | Automotive Batteries: New Developments

For the foreseeable future, 12 V lead–acid batteries (LABs) will remain the predominant storage technology for automotive power supply systems. They can meet growing demands in modern cars through technology improvements and better system integration, based on cost-effective battery monitoring systems (BMSs). Absorbent glass mat (AGM) batteries offer a threefold increase in cycle life while meeting all other requirements for 12 V automotive batteries. Owing to their lower cost, flooded LABs may still keep a significant market share even in demanding new applications, like micro-hybrids, if they offer improvements in dynamic charge acceptance (DCA) throughout life and robustness against shallow cycling at partial state of charge (PSoC). Medium and full hybrid vehicles so far employ exclusively advanced battery technologies (nickel–metal hydride (Ni–MH), lithium ion). Several new variants of the AGM technology attempt to compete with these. Although the lead–acid chemistry suffers from inherent disadvantages in terms of energy density and cycle life, a significant advantage in cost may make these advanced lead–acid batteries (LABs) an attractive choice for certain applications.
Cell surface physiology and outer cell envelope impermeability for hydrophobic substances in Burkholderia multivorans

Purpose. The purpose of the present study was to obtain a better understanding of the relationship between cell surface physiology and outer cellular envelope permeability for hydrophobic substances in mucoid and non-mucoid B. multivorans strains, as well as in two capsule-deficient derivatives of a mucoid parental strain. Methodology. Cell surface hydrophobicity properties were determined using the hydrocarbon adherence method, while outer cell envelope accessibility and permeability for non-polar compounds were measured using hydrophobic antimicrobial agent susceptibility and fluorescent probe assays. Extracellular polysaccharide (EPS) production was assessed by cultivating strains of disparate origin on yeast extract agar (YEA) containing different sugars, while the resultant colonial and cellular morphological parameters were assessed macro- and microscopically, respectively. Results/Key findings. The cell surfaces of all the strains were hydrophilic, impermeable to mechanistically disparate hydrophobic antibacterial agents and inaccessible to the hydrophobic probe N-phenyl-1-napthylamine, regardless of EPS phenotype. Supplementation of basal YEA with eight different sugars enhanced macroscopic EPS expression for all but one non-mucoid strain, with mannose potentiating the greatest effect. Despite acquisition of the mucoid phenotype, non-mucoid strains remained non-capsulated and capsulation of a hyper-mucoid strain and its two non-mucoid derivative strains was unaffected, as judged by microscopic observation. Conclusion. These data support the conclusion that EPS expression and the consistent mucoid phenotype are not necessarily associated with the ability of the outer cell surface to associate with non-polar substances or cellular capsulation.
Impact of Interprofessional Falls Risk Assessment Program on Student Perceptions of Other Healthcare Professionals

Abstract Fall prevention programs with exercise interventions and medication reviews improve short-term function for community-dwelling older adults with risk of falls. 1 We describe an Interprofessional Falls Risk Assessment Program for community-dwelling adults to teach students how to assess falls risk associated with poor balance and medications that increase falls risk. The primary objective of this program was to evaluate whether participation in this Interprofessional Falls Risk Assessment Program altered the attitudes toward collaborative team-based healthcare practice in physical therapist and pharmacist students. Second-year physical therapist students and third-year pharmacist students were involved with the program. The Interprofessional Falls Risk Assessment Program consisted of three sessions. Sessions 1 and 2 were held in an academic setting, and Session 3 was held at a local senior living facility. Fall risk assessments were initially practiced by students amongst themselves, then formally provided to elderly volunteers from the community, and finally were provided to residents at a senior living facility. Students' attitudes toward collaborative practice were assessed before and following the program using the Student Perception of Interprofessional Clinical Education (SPICE-R). We found that SPICE-R scores increased following participation in this program. The Interprofessional Falls Risk Assessment Program represents a new IPE resource to increase students' interprofessional attitudes, knowledge, and experience before they enter the healthcare workforce. Our results indicate that IPE using an Interprofessional Falls Risk Assessment Program has a positive influence on students' understanding of both their own and other healthcare professionals role within an interprofessional team.
Sex differences in M2-polarization during allergic lung inflammation

Asthma is a chronic airway inflammatory disease affecting over 300 million people world-wide. Asthma exhibits sex differences by affecting mostly women, suggesting that hormones like estrogen may participate in disease progression. Alveolar macrophages become activated in asthma, promoting pathology but also repairing tissue damage. Estrogen is known to enhance macrophage activation and function in a variety of systems although its role in asthma is poorly understood. We hypothesized that macrophages from female mice are intrinsically hyper-responsive to IL-4 and that estrogen signaling enhances M2-polarization. We assessed IL-4-induced M2-gene expression in bone marrow-derived macrophages (BMMs) from male and female C57BL/6 mice and found enhanced expression of two M2 genes, Ym1 and Arg1, in response to IL-4 in female compared to male BMMs. Histone H3 acetylation and K4-trimethylation was elevated in female BMMs, consistent with enhanced transcriptional activity. Pre-treatment of BMMs with an ERα-specific agonist further enhanced IL-4-induced M2-gene expression. Next, we assessed sex differences in a mouse model of allergic lung inflammation. We found that alveolar macrophages from female compared to male mice exhibited increased Ym1 expression following allergen challenge. Therefore, macrophages exhibit intrinsic sex differences in their ability to polarize to an M2-phenotype and estrogen augments IL-4-induced M2-gene expression. Together these data suggest that intrinsic and hormonal factors contribute to sex differences in macrophages in asthma. Understanding the role of estrogen signaling in M2-polarization is paramount for identifying novel therapeutic targets to better treat women with asthma.
Elevated Liver Enzymes in Pregnancy

A 32-year-old female, G1P0, 32 weeks pregnant, with diet-controlled gestational diabetes and a history of Crohn’s disease was admitted to the hospital with elevated serum transaminases, and for the previous 2 weeks, she had nausea and vomiting. For Crohn’s disease, she had required several bowel resections and placement of an ileostomy, but at the time of presentation, she was not on immunosuppressive therapy. Several days before the hospital admission, she developed a diffuse follicular-appearing pruritic rash that she attributed to a new soap she used in her bath.
Early events in protein import into mitochondria.

Assembly of newly synthesized precursor proteins into mitochondria involves events occurring both in the cytosol and at the surface of the organelle. Co-incident with or shortly following protein translation, recognition events must take place to allow a precursor to be correctly targeted to its final destination (Pfanner and Neupert, 1990; Glick and Schatz 1991). Cellular recognition of specific structural features of mitochondrial proteins takes several forms Structural information must be recognized that specifies the destination of the protein, such as that contained in amino terminal pre-sequences that are sufficient to direct even foreign proteins to mitochondrial locations. In addition to this “positive” targeting information, the cell must recognize “negative” targeting information, i.e., properties of a protein which might impair its ability to be correctly localized. To be more specific, a precursor must be prevented from aggregating or assuming a tightly folded conformation that cannot be translocated linearly through a small diameter membrane channel (Rassow et al., 1990). Recognition of “positive” targeting information is the job of the receptors and translocation apparatus on the surface of the mitochondria (Pfanner et al., 1991). Recognition of “negative ” targeting information, i.e. the maintenance of a “transport-competent” conformation, is the work of cytoplasmic protein chaperones such as hsp70 (Deshaies et al., 1988). In neither case are the molecular details well understood. In this paper we will describe work addressing both systems.
Learning Construction Engineering: Why, What, and How?

AbstractRecent increases in technical requirements for constructed facilities along with new contractual approaches and technologies used to deliver them provide special opportunities for increased...
Evaluating The Impact Of The Orphan Drug Act's Seven-Year Market Exclusivity Period.

For thirty-five years the Orphan Drug Act of 1983 has provided incentives for pharmaceutical manufacturers to develop drugs to treat rare diseases—conditions that affect fewer than 200,000 people in the US. One key statutory incentive is an exclusive seven-year marketing right for the rare disease indication, which has been heralded as driving a dramatic increase in the number of rare disease treatments. However, most new drugs are also protected by patents. In this study we assessed all new small-molecule drugs approved in the period 1985–2014 that had at least one indication for an orphan-designated disease as of January 1, 2017. We found that orphan drug exclusivity outlasted the last expiring patent in 33 percent of cases overall, and in a smaller percentage of cases for each successive ten-year drug cohort: from 50 percent for drugs approved in 1985–94 to 35 percent for those approved in 1995–2004 and 18 percent for those approved in 2005–14. The Orphan Drug Act’s market exclusivity incentive has pla...
Survey of Recursion Theory

We have developed recursion theory as much as we need for our later purposes in logic. But in this chapter we want to survey, without proofs, some further topics. Most of these topics are also frequently useful in logical investigations.
Preliminary experience with GORE-TEX grafting for right ventricle-pulmonary artery conduits.

Abstract A consecutive series of 12 patients between the ages of 6½ and 37 years underwent implantation of venous ventricle-pulmonary artery conduits. GORE-TEX material without prosthetic valves was used. Four patients had L-transposition of the great vessels with ventricular septal defect (VSD) and pulmonary stenosis; four had tetralogy of Fallot with pulmonary atresia; and one had double outlet right ventricle, pulmonary stenosis, and a complete form of A-V canal. Two patients had D-transposition of the great arteries, VSD, and pulmonary stenosis; and one patient had L-transposition of the great arteries and isolated pulmonary stenosis. All patients had low pulmonary resistance and pressures. The technique for implanting this noncrimped type of prosthesis is described in detail. Follow-up ranged from 2 months to 5½ years. GORE-TEX offers a good choice of material for the construction of this type of conduit to prevent pseudointima formation and obstruction, which is often observed in woven Dacron grafts.
Integrated systems analysis of sow replacement rates in a hierarchical swine breeding structure

Sow replacement rates in a three-tiered breeding structure were investigated for a 10-yr planning horizon using a stochastic life-cycle swine production model. Market hogs were produced in a three-breed static crossing program and marketed on a liveweight basis. Growth and reproductive traits of individual pigs were simulated using genetic, environmental, and economic parameters. Sows were culled after a maximum of 1, 5, or 10 parities. Systems were defined by maximum sow age at culling and included combinations of 1- and 5-parity nucleus and 1-, 5-, and 10-parity multiplier and commercial tiers. Economic response to index selection was considerable for all culling alternatives with yearly increases in system profits ranging from $1.06 to 1.44 for each commercial hog marketed. When sows were culled after one parity in nucleus, multiplier, and commercial tiers, respectively (1,1,1), annual changes in net returns and all cost measures were 40 to 50% larger than responses in systems with lower sow replacement rates. Based on 10-yr averages for net returns, systems with low multiplier- and commercial-level replacement rates were more profitable than systems with higher replacement rates. The most profitable system (5,10,10) differed from the least profitable system (1,1,1) by more than $10 per pig, but when the (1,1,1) system was excluded, the range was only $3 per pig. The system with lowest replacement rates supported 3,388 more multiplier and 34,151 more commercial sows from a 750-sow nucleus level than the (1,1,1) system. Output from the two extremes differed by > 664,000 commercial market hogs sold.(ABSTRACT TRUNCATED AT 250 WORDS)
Formation of 2n gametes in durum wheat haploids: Sexual polyploidization

Allopolyploidy, resulting from interspecific and intergeneric hybridization accompanied by sexual doubling of chromosomes, has played a major role in the evolution of crop plants that sustain humankind. The allopolyploid species, including durum wheat, bread wheat, and oat, have developed a genetic control of chromosome pairing that confers on them meiotic regularity (diploid-like chromosome pairing), and hence reproductive stability, and disomic inheritance. Being natural hybrids, they enjoy the benefits of hybridity as well as polyploidy that make them highly adaptable to diverse environments. Despite the complexities of sexual reproduction, it is widespread among plants and animals. Sexual polyploids are highly successful in nature. Sexual polyploidization is far more efficient than somatic chromosome doubling. Sexual polyploidization effected by functioning of unreduced (2n) gametes in the parental species or in their hybrids has been instrumental in producing our grain, fiber, and oilseed crops. Evidence is presented for the occurrence of sexual polyploidization in durum haploids. ThePh1-induced failure of homoeologous pairing is an important factor in the formation of first division restitution(FDR) nuclei and 2n gametes. The evolutionary and breeding significance of sexual polyploidization is discussed. It is emphasized that three factors, viz.,sexual reproduction, allopolyploidy, and genetic control of chromosome pairing,jointly constitute a perfect recipe for cataclysmic evolution in nature.
Racial Reconciliation or Spiritual Smokescreens?: Blackwashing the Crisis Pregnancy Center Movement

Beginning in the early 2000s, evangelical crisis pregnancy centers (CPCs) sought to establish themselves in areas where they perceive Black women, who have disproportionately higher rates of abortion relative to other racial-ethnic groups, will be drawn to their services. These efforts are tied to larger racial reconciliation efforts by white evangelicals. To this end, in this article we explore how the evangelical CPC movement understands Black women’s higher abortion rates, the solutions they seek to offer Black women to persuade them not to abort, the expansion of the movement into minority areas and how the CPC movement justified this encroachment, and the role of Black leaders and symbolic inclusion through “blackwashing” in this expansion. Drawing upon an ethnographic content analysis, we argue that CPC activism in urban areas is not substantially different from its approaches in white and/or suburban areas and inclusion of Black perspectives and activists is limited to a surface-level veneer we refer to as blackwashing. Throughout the paper, we also provide a counter-narrative examining CPC activists’ claims about Black women and abortion and find many of them to be lacking in veracity.
To transfuse or not to transfuse? Jehovah's Witnesses and postoperative hemorrhage in pediatric otolaryngology.

Abstract Objectives Discuss the ethical issues in the management of postoperative hemorrhage in pediatric patients whose parents are Jehovah's Witnesses (JW) and 2) Describe a framework for shared decision making in this population. Methods A recall review of pediatric otolaryngology patients with parents of the JW faith and postoperative hemorrhage was performed over a year long period at a single institution. The literature on transfusions for JW minors was reviewed. Results Two patients were identified. The first patient had a severe post-tonsillectomy hemorrhage requiring multiple emergency operative interventions. The child developed a hemoglobin of 5.2 g/dl and received an emergent transfusion against parents’ wishes. The child subsequently did not require further intervention. The second patient hemorrhaged after a supraglottoplasty and was administered erythropoietin and iron infusion but did not require transfusion (hemoglobin nadir 7.9 g/dl). In both cases hematology was consulted, and extensive discussion with the families and the JW Hospital Liaison Committee occurred. Conclusions The risks of hemorrhage should be discussed with JW parents of patients undergoing even routine otolaryngologic surgery. In these cases, early shared decision making with family, the JW Hospital Liaison committee, and hematology was pursued regarding mutually acceptable interventions. Aggressive non-transfusion based resuscitation was carried out to minimize the likelihood of transfusion. In the first case, danger to the patient's life eventually necessitated transfusion in accordance with the patient's best interest and previous case law. A defined framework involving all stake-holders, including Pastoral Care, in the event of postoperative hemorrhage is critical.
Hypertension Management in the Elderly

Hypertension is the most powerful risk factor for cardiovascular disease and mortality globally, especially in the elderly population. In view of aging populations and the high prevalence of hypertension among the elderly, the benefits of lowering blood pressure in the United States and other societies include decreased fatal and nonfatal cardiovascular events and total mortality. Evidence-based guidelines have supported practitioners in carefully treating this special population. Nevertheless, the guidelines have provided inconsistent recommendations regarding target blood pressure in the elderly. There is a delicate balance between both the benefits (including preserving autonomy and quality of life) and the harms of antihypertensive therapy that should be considered when treating the elderly population. This chapter highlights past and recent trials among elderly hypertensive patients and summarizes major current and emerging guideline considerations in the elderly population. First step agents include diuretics and calcium channel blockers with additional agents as needed (depending upon compelling indications), to lower blood pressure and decrease cardiovascular outcomes.
Magnetic Sphincter Augmentation and Postoperative Dysphagia: Characterization, Clinical Risk Factors, and Management

Magnetic sphincter augmentation (MSA) results in less severe side effects compared with Nissen fundoplication, but dysphagia remains the most common side effect reported by patients after MSA. This study aimed to characterize and review the management of postoperative dysphagia and identify the preoperative factors that predict persistent dysphagia after MSA. This is a retrospective review of prospectively collected data of patients who underwent MSA between 2013 and 2018. Preoperative objective evaluation included upper endoscopy, esophagram, high-resolution impedance manometry (HRIM), and esophageal pH testing. Postoperative persistent dysphagia was defined as a postoperative score of > 3 for the dysphagia-specific item within the GERD-HRQL at a minimum of 3 months following MSA. A timeline of dysphagia and dilation rates was constructed and correlated with the evolution of our patient management practices and modifications in surgical technique. A total of 380 patients underwent MSA, at a mean (SD) follow up of 11.5 (8.7) months, 59 (15.5%) patients were experiencing persistent dysphagia. Thirty-one percent of patients required at least one dilation for dysphagia or chest pain and the overall response rate to this procedure was 67%, 7 (1.8%) patients required device removal specifically for dysphagia. Independent predictors of persistent dysphagia based on logistic regression model included (1) absence of a large hernia (OR 2.86 (95% CI 1.08–7.57, p = 0.035)); (2) the presence of preoperative dysphagia (OR 2.19 (95% CI 1.05–4.58, p = 0.037)); and (3) having less than 80% peristaltic contractions on HRIM (OR 2.50 (95% CI 1.09–5.73, p = 0.031)). Graded cutoffs of distal contractile integral (DCI), mean wave amplitude, DeMeester score, sex, and body mass index were evaluated within the model and did not predict postoperative dysphagia. Frequent eating after surgery, avoidance of early dilation, and increase in the size of the LINX device selected decreased the need for dilation. In a large cohort of patients who underwent MSA, we report 15.5% rate of persistent postoperative dysphagia. The overall response rate to dilation therapy is 67%, and the efficacy of dilation with each subsequent procedure reduces. Patients with normal hiatal anatomy, significant preoperative dysphagia, and less than 80% peristaltic contractions of the smooth muscle portion of the esophagus should be counseled that they have an increased risk for persistent postoperative dysphagia.