cssi/SciSciGPT-SciSciNet huggingface dataset:
Outcomes in the current surgical era following operative repair of acute Type A aortic dissection in the elderly: a single-institutional experience

Objectives We reviewed our single-centre experience with emergent operative repair of Stanford Type A aortic dissections, with particular attention to outcomes in the elderly. Methods Consecutive adult patients undergoing emergent operative repair of acute Type A aortic dissections between February 2004 and December 2011 at a single institution were identified. Patients were stratified into elderly (≥ 70 years) and control cohorts ( Results A total of 117 patients undergoing emergent repair of Type A aortic dissection were identified during the study period, including 31 (26.5%) elderly and 86 (73.5%) control patients. The mean age in the elderly cohort was 78.0 ± 4.7 years, with 41.9% (13 of 31) being 80 years or older. The elderly and control groups were well matched with regard to preoperative comorbidities (each P>0.05) and the presence of malperfusion at presentation (elderly: 19.4 vs controls: 27.9%, P = 0.35). The most common site of tear involved the proximal ascending aorta (elderly: 83.9 vs controls: 84.9%), with fewer cases affecting the aortic arch (12.9 vs 14.0%; P = 0.75). Operative data, including cardiopulmonary bypass and aortic cross-clamp time, concomitant aortic valve procedures and arch replacement were also similar between cohorts. Fewer elderly patients underwent hypothermic circulatory arrest (67.7 vs 90.7%, P = 0.002). Overall survival to discharge was 87.2% (n = 102), with no difference in the elderly (83.9%; n = 26) vs controls (88.4%; n = 76; P = 0.52). The 30-day (elderly: 82.8 vs controls: 86.2%), 90-day (elderly: 79.0 vs controls: 84.8%) and 1-year (elderly: 75.4 vs controls: 84.8%) survivals were also comparable. Conclusions Excellent operative outcomes can be achieved in elderly patients undergoing emergent repair of Type A aortic dissections. Advanced patient age should therefore not serve as an absolute contraindication to operative repair in this high-risk cohort.
Survival trends in primary myelodysplastic syndromes: a comparative analysis of 1000 patients by year of diagnosis and treatment.

Survival trends in primary myelodysplastic syndromes: a comparative analysis of 1000 patients by year of diagnosis and treatment
Liquid State Polydimethylsiloxane (PDMS) Wrinkle Formation Process for Various Applications.

Here we report an epoch-making simple fabrication for wrinkle formation. The present wrinkle formation process is a solution for controlling the area, shape and direction of wrinkle area by forming wrinkles on the liquid state polydimethylsiloxane directly exposed to sputtered metal particles in the low vacuum plasma chamber in various vacuum states and deposition conditions. Also the process allows us to make extremely flexible metal thin film electrode with approved adhesion. These bring us possibilities of actual electrical and biological applications.
Maximizing recovery through the promotion of mindfulness and spirituality

ABSTRACTSpirituality is generally regarded as a protective factor against the initiation of substance use and may be effective in enhancing recovery and promoting abstinence. Preliminary studies on the effects of mindfulness practices on relapse prevention for substance use and behavioral addictions have shown promise. This study sought to determine whether elevated levels of mindfulness were linked to increased spirituality and subsequently decreased the warning signs of relapse among individuals in substance use treatment. Path analysis with bootstrapping methods indicated that there was a direct negative effect between mindfulness and warning signs of relapse, which supported the utility of mindfulness in relapse reduction. Mindfulness also enhanced spirituality, but there was an unexpected positive effect between spirituality and warning signs of relapse. These results provide evidence for the effectiveness of mindfulness to increase spirituality and add to our knowledge of the relationship between mi...
Effect of Ketamine on Triggering Neuronal Apoptosis in the Neonatal Rat Brain

Objective To investigate the effect of ketamine on neuronal apoptosis in the neonatal rat brain.Methods Fifteen 7-day-old Sprague-Dawley rats were randomly divided into 3 groups(n = 5 each),and received intraperitoneal(i.p) injection with saline(control),keamine 20 mg /kg and ketamine 80 mg /kg respectively.Apoptotic neurons were observed by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) and the Caspase-3 expression was detected by immunohistochemical method.Results Compared with the control group,the TUNEL positive cells were increased but no obvious difference(P 0.05),the Karyopyknosis neuron number and the Caspase-3 positive cells were significantly increased in 20 mg /kg ketamine group(P 0.05),the TUNEL positive cells,the Karyopyknosis neuron number and the Caspase-3 positive cells were significantly increased in 80 mg /kg ketamine group(P 0.05).The apoptotic cells,the Karyopyknosis neuron number and the Caspase positive cells in ketamine group were mostly seen in cortical area.Conclusions 80 mg /kg ketamine can induce neuronal apoptosis in the neonatal rat brain,the cortical area is the main target organ,Caspase-3 activation may be one of the mechanisms.The effect of 20 mg /kg Ketamineon triggering neuronal apoptosis in the neonatal rat brain is minor,the clinical equivalent dose of 20 mg /kg ketamine is 3 mg /kg.The amount of ketamine anesthesia in children should not be too many for avoiding causing brain cells apoptosis.
Data-driven Optimal Operational Control of Complex Grinding Processes

For hematite grinding processes, it is not only difficult to describe the dynamics between grinding particle size(GPS) and control loop outputs by using mathematical formulas, but also impossible to measure the GPS online. Moreover,the process is sensitively influenced by the frequent fluctuation of ore compositions and properties. The above practical problems make the existing control methods unable to be applied. In this paper, a data-driven optimal operational control approach, which consists of loop pre-setting optimizer, performance index estimator, optimum setpoints critic, and GPS soft-sensor, is proposed by using neural network. In this approach, the GPS is estimated by the GPS soft-sensor first,then the loop pre-setting optimizer generates the optimum loop pre-setting values by making performance index estimate close to its optimal value. Finally, via the optimum setpoints critic the optimal setpoint is obtained. With the help of the control loops, the GPS can be maintained inside its desired range, and close to its target value as much as possible.Experiments using a developed research platform of optimal operational control are carried out with real time data to show the effectiveness of the proposed method.
Intelligent Filter Based on Neural Networks for Integrated Navigation System

According to the characteristic of INS/GPS/CNS Integrated Navigation System, the paper constructed the filter with neural networks theory, and did linear optimal estimation with two local filter’s outputs. Simulation results show that the system can obtain higher accuracy, and has better performance of fault tolerant and stability. In addition that the performance of real time and robust are better than that of the former system.
Gm Allotype Preference in Erythrocyte IgG Antibodies of Patients With Autoimmune Hemolytic Anemia

IgG antibodies were isolated from erythrocytes of five patients with autoimmune hemolytic anemia (AHA) and one case of hemolytic anemia of unknown etiology. All six persons were heterozygous for human IgG1 allotypes, and thus their serum immunoglobulins were Gm (a+f+). Quantitative analysis of the antibody preparations disclosed that three patients contained only the Gm(a) allotype; the remaining samples showed a predominance of Gm(a) in comparison to the Gm(f) allele. It was concluded that erythrocyte antibodies of patients with AHA are often restricted in respect to their Gm genetic characters with a preference for the Gm(a) allotype. In a second group of experiments, serums from three cases of hemolytic anemia were incubated with Rh+ erythrocytes from a healthy donor. Subsequently, the red cell IgG coat was eluted and analyzed. One sample had only Gm(a+) antibody; a second case showed Gm(a) predominance. The last antibody preparation varied from a disproportionately high Gm(a) concentration to equal allotype concentrations, depending on the antibody/antigen ratio used during the sensitization of the erythrocytes. The latter data suggested that allelic expression was influenced by the immunologic characteristics of the antibody subpopulation tested. No association could be demonstrated between the Ig allotypes and either the Rh specificity of the eluate, or the presence of complement coating on erythrocytes. These findings are similar to a previous report from this laboratory that noted a preference for the Gm(a) allotype in many isoantibodies with Rh specificity. The data suggest an association between certain erythrocyte antibodies and Ig allotypes.
Factors Affecting and Prediction of Dystocia in Charolais Heifers

Calving difficulty at first and second parturition, using data recorded on 476 purebred Charolais heifers from a ranch in Southeastern Arizona, were analyzed by analysis of variance, step-wise multiple regression and discriminant analysis. Dystocia score (1 = no assistance through 4 = extreme difficulty) was the dependent variable with dam and calf effects independent variables. In this herd, 31.1 and 15.0% of the heifers experienced calving difficulty at first and second parturition, respectively. Birth weight of calf was the most important factor influencing dystocia, accounting for 71 and 61% of the total variation explained by the analysis of variance model when calf effects as well as dam effects were included at first and second parturition. Mean birth weight was 39.0 kg for primiparous heifers and 44.3 kg for second-half cows. A significant increase in dystocia (at both first and second parturition) occurred among male calves with birth weights of 45.5 kg or greater. At first parturition, no significant increase in dystocia occurred among female calves until birth weight exceeded 50 kg. Birth weight was not a significant factor influencing dystocia for female calves at second parturition. Yearling weight of cow and dystocia score of cow's dam were the only significant dam variables, and only at first parturition. Pelvic height measurements did not significantly affect dystocia scores at either parturition. A reasonably accurate prediction of dystocia based on the variables included in this study would be impossible, even if some means were devised to reliably predict birth weight of the calf.
Thick-Film Yttrium Iron Garnet Coatings via Aerosol Deposition

Aerosol deposition is a thick-film deposition process that can produce layers up to several hundred micrometers thick with densities greater than 95 pct of the theoretical value. The primary advantage of aerosol deposition is that the deposition takes place entirely at room temperature, thereby enabling film growth in material systems with disparate melting temperatures. We show representative characterization results of yttrium iron garnet thick films deposited onto a 〈111〉 gadolinium gallium garnet substrate by aerosol deposition using scanning electron microscopy, X-ray diffraction, profilometry, vibrating sample magnetometry, and ferromagnetic resonance. To further elucidate the effect of density and grain size on the magnetic properties, we perform post-deposition annealing of the films to study the effect on the structural and magnetic properties of the films. Our results indicate that our system can successfully deposit dense, thick yttrium iron garnet films and that with moderate annealing the films can achieve a ferromagnetic resonance linewidth comparable to that reported for polycrystalline films deposited by other higher temperature growth techniques.
Confronting and Resisting an Unlivable Age Culture

“Confronting and Resisting an Unlivable Age Culture” draws on the work of feminist and narrative gerontologists to show that women can find value in the years they have lived as they age into old age. Even in the midst of loss, physical decrepitude, and decline, women can discover new possibilities for meaning and personal growth in later life and thus challenge the dominant decline discourse that has long served to strip old women of their identities. As this chapter focuses on the ability of older women to resist shame and affirm the value and complexity of their storied identities through the life review process and their counternarratives of aging and old age, it covers representative post-1960 fictional and nonfiction works by North American and British women authors, including Margaret Drabble, Penelope Lively, Carol Shields, Doris Grumbach, and May Sarton.
Free Flap Salvage in Lower Extremity Reconstruction via Use of Contralateral Lower Extremity Recipient Vessels

Soft-tissue coverage after complex distal lower extremity trauma is often difficult due to limited local flap options and injury to potential recipient vessels when considering microsurgical reconstruction. Therefore, obtaining recipient vessels outside the zone of injury to optimize successful free tissue transfers remains a basic tenet of microsurgery. We present a case of a crush injury to the lower extremity with open tibia and fibula fractures and a large soft-tissue defect that required reconstruction for limb salvage. Due to recipient vessel thrombosis within the affected extremity even well proximal to the zone of injury, contralateral lower extremity recipient vessels were used as an alternative for cross-leg flap limb salvage. We performed flap pedicle division 6 weeks after inset. Follow-up 9 months after reconstruction showed the patient achieving independent ambulation. In conclusion, cross-leg free flaps may be used as a last resort to successfully salvage flaps in the setting of poor ipsilateral recipient vessels and repeatedly occluding anastomoses.
Mapping Knowledge: GIS as a Tool for Spatial Modeling of Patterns of Warangal Cotton Seed Popularity and Farmer Decision-Making

In the Warangal district of Telangana, India, poor farmer knowledge, rapid seed turnover, and farmer conformist bias have resulted in faddish spikes in GM cotton seed popularity. We analyze space as a variable in 2715 seed choices by 136 farmers in two villages between 2004 and 2014, allowing us to model a decade of changes in farmers’ social learning across the village landscape. GIS analysis in combination with ethnographic research reveals shifting loci of seed certainty, in which different farmers were deemed worthy of emulation in different years. Over the study period, Warangal farmers were far more likely to emulate field neighbors’ cotton choices than they were to replant seeds, regardless of their crop yields. Rapid seed turnover and seed choice conformity was strongest among the comparatively poorer Scheduled Tribe farmers who live on the outskirts of the town proper. When the same farmers plant rice, their choices are more consistent through time and across space, suggesting that farmers learn about these two crops in very different ways.
Clinical Trials: Intracerebral Cell Therapy in Stroke Patients

Successful experimental models of intracerebral cell transplantation to enhance neurological recovery from stroke have prompted the pursuit of early phase clinical trials. Published results of three completed studies report that intracerebral delivery of cell therapy is safe and feasible; one study of fetal porcine transplant was stopped prior to full completion due to adverse events. Though early phase clinical trials are primarily for safety and tolerability, all published studies included some measures of neurologic deficit and attempted to identify functional improvement on follow-up. Many individual patients demonstrated objective functional improvement; however, due to small sample size, any conclusions regarding the beneficial nature of intracerebral cell therapy must be reserved until the completion of later phase trials.
Perioperative complications following colpocleisis with and without concomitant vaginal hysterectomy.

Pelvic organ prolapse is common in the elderly population and may be surgically treated with colpocleisis. We aimed to identify and compare surgical characteristics and 30-day perioperative complications in patients who underwent colpocleisis with and without concomitant vaginal hysterectomy (VH) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Women who underwent vaginal closure procedures from 2006 to 2014 were identified utilizing Current Procedural Terminology (CPT) codes for LeFort colpocleisis (57120) and vaginectomy (57110). Patients undergoing a concomitant VH were identified by CPT codes ranging from 58260 to 58294. Variables including patient demographics, operative time, hospital length of stay, transfusion‚ and reoperation were evaluated. Specific medical complications, surgical site infection‚ and urinary tract infection (UTI) rates were calculated. Variables were analyzed using chi-squared, Fisher’s exact, student’s t tests and logistic regression. We identified 1,027 women in the ACS-NSQIP database who underwent vaginal closure procedures. The majority of patients (893, 87.0%) underwent colpocleisis alone, and the remainder (134, 13.0%) underwent concomitant VH. Operative times were shorter in patients undergoing colpocleisis alone. UTI was the most common postoperative complication affecting 4.3% of the entire cohort. Twelve women (1.2%) had a serious medical complication, seven who underwent colpocleisis alone and five who underwent colpocleisis with concomitant VH. In backward logistic regression‚ serious medical complications were the only variable independently associated with VH at the time of colpocleisis (p < 0.05). Colpocleisis is a safe procedure with rare serious adverse events.
The use of cooperative procedures in teacher education and professional development

AbstractTwo aspects of teacher education for cooperative learning are the content taught and the processes used to teach the content. Of the two, the processes used may have the most powerful influences on the desired outcomes. One important theory related to the processes of learning is social interdependence theory. It posits that there are three ways to structure the learning processes in educational situations: cooperatively, competitively and individualistically. To structure cooperation among participants, five basic elements are needed: positive interdependence, individual accountability, promotive interaction, social skills and group processing. The large body of research on social interdependence indicates that cooperative, compared to competitive and individualistic learning, tends to promote (a) higher levels of achievement, retention and transfer of what is taught; (b) long-term implementation; (c) the internalisation of the required attitudes values and behaviour patterns; (d) the integration...
Displaying the Guitar: The Rock and Roll Hall of Fame and the Museum of Pop Culture

In this essay, I look closely at two museum sites, the Rock and Roll Hall of Fame and Museum (Rock Hall) in Cleveland, Ohio, and the Museum of Pop Culture (MoPOP) in Seattle, Washington, in the con...
Achieving Latina students: Aspirational counterstories and critical reflections on parental community cultural wealth

In this study, six Latina students shared perceptions of their parental influence on their educational aspirations. CRT, LatCrit, and community cultural wealth provide the tripartite framework for analyzing issues of race, class, gender, language, culture, and immigration by examining their roles in society through counterstories. Learning in an after-school program about educational advancement, these participants navigated against deficit ideology. Messages of aspirational hope, navigational inspiration, Spanish language guidance, familial kinship, social networking, and resistant intelligence enabled these students to build a foundation of personal emancipation to disrupt the systemic sociopolitical and sociocultural nature of oppression.
Signal processing on PMD SIMO channels

A single-input multiple-output polarization mode dispersion channel model is proposed based on the principal state model. Linear equalizer and decision feedback equalizer are developed based on the model, which can mitigate all orders of PMD effectively.
External Beam Radiotherapy for Localized Prostatic Cancer at Stanford: Update at the 38th Year

It has been 85 years since Pasteau (1911) in France, and Paschkis and Tittinger (1910) in Austria introduced gamma irradiation through intraurethral radium sources for the treatment of prostatic cancer. Since then, a wide variety of radiation sources have been used in the treatment of this neoplasm (Table 17.1) (Bagshaw 1993). Currently, external beam x-irradiation derived from mid- to high-energy linear accelerators (6–25 MV) is the most widely employed modality, although ultrasound-guided interstitial irradiation is also used. External beam irradiation at 4, 6, and 15 MV has been utilized at Stanford since 1956 in the treatment of 1318 patients with prostatic cancer treated through December 1994. These cases provide the major database for this report.
Heart of Violence: Global Racism, War, and Genocide

In the 21st century, our problem is seeing war and genocide as natural and inevitable, and even worse: not even seeing, not even noticing, but ignoring war, mass killings and genocide. Such act and thought, fueled by global racism, reveal that racial inequality has advanced from the establishment of racial hierarchy and institutionalization of segregation, to the confinement, exclusion, and elimination of those considered inferior through genocide. This article, by examining global racism since 2000, the new century, explores the new terms of exclusion and the path to permanent war and genocide as pivotal to defining global antiracist confrontation as a way to struggle against racism, the struggle of the 21st century.
Anxious Depressions Clinical, Family History, and Naturalistic Outcome -- Comparisons with Panic and Major Depressive Disorders

Patients with anxiety and depressive states were divided into 4 groups: those with panic attacks only, those with panic disorder and secondary depression, those with depression and secondary panic attacks, and those with depression only. Clinical and familial differences between the groups are described. Patients with both depression and panic attacks had the poorest outcome, and were most likely to be chronically depressed.
Unilateral Labial Edema in a Female Adolescent: A Gynecologic Presentation of Rhabdomyolysis.

Abstract Background Rhabdomyolysis can be the result of vigorous physical activity. Typical signs and symptoms at presentation are muscle pain, weakness, or dark colored urine. There is no scientific literature associating rhabdomyolysis with gynecologic signs and symptoms. Case We present a case of a 16-year-old girl who presented to our pediatric emergency department with complaints of progressive left vulvar swelling. The patient underwent magnetic resonance imaging, which showed polymyositis in the rectus abdominus, external and internal obliques, and bilateral vastus lateralis muscles. Laboratory evaluation showed elevated liver transaminases, creatine kinase, and myoglobin serum levels. Summary and Conclusion Exertional rhabdomyolysis is associated with muscular damage after vigorous exercise. This case is an example of a patient with rhabdomyolysis presenting with an unusual external gynecological manifestation, as unilateral labial edema.
P044 The use of HLA-DQ EXON 3 Data in SSO analysis can produce discrepant HLA typing results

Herein we document two cases of discrepant typing results obtained when data from both exon 2 and 3 is used to analyze LabType SSO results for HLA-DQ using the HLA Fusion software. The first case is an ASHI PT sample (HT-184) tested by LabType SSO and analyzed using HLA Fusion 4.1. For this sample, 39% of survey participants reported HLA-DQA1*05:05, 26% HLA-DQA1*05:02 and the remaining labs reported either a new allele, HLA-DQA1*05:01G or P. By sequence based analysis (SBT) the correct typing is HLA-DQA1*05:02,*01:01. When using LabType SSO and analyzing with HLA Fusion 4.1, including both exon 2 and 3, the typing obtained is HLA-DQA1*05:05/09/11 when bead #56 is excluded. The software flags bead #56 as a false positive bead. No typing is obtained without excluding bead 56. HLA-DQA1*05:05 was the most common response on the PT survey indicating several labs may be analyzing data using Fusion and excluding bead #56 from the analysis. The correct typing HLA-DQA1*05:02 can only be obtained when HLA-DQA1 exon 3 is excluded from the analysis despite the fact that the probe attached to bead 56 binds to DQA1*05:02 but not DQA1*05:05. The issue encountered with this sample stems from the fact that HLA-DQA1*05:02 does not have an exon 3 sequence in IMGT. As such, the probe pattern for exon 3 has not been established for this allele. The software automatically rules out alleles with no exon 3 sequences from the possible allele string when the analysis includes both exon 2 and 3 rather than flagging it as a possibility and indicating exon 3 sequence is not available for this allele. The second case is a patient typed by SBT as HLA-DQB1*06:11, *03:03. When the sample is tested using LabType SSO and analyzed using HLA Fusion 4.1 the typing obtained is HLA-DQB1*03:03, *06:112 N. The correct typing, HLA-DQB1*03:03, *06:11 can only be obtained when HLA-DQB1 exon 3 data is excluded from the analysis. Again this is because the sequence for exon 3 is not available in IMGT for HLA-DQB1*06:11:01. The two cases presented are representative of others we have encountered and reinforces the importance of software validation in the laboratory. Regardless of vendors and methodologies most software have limitations and impute some HLA typing data. As such, a variety of typing samples with specific allele combinations should be used in validation studies.
Administrative Boundaries, Transport Accessibility and Functional Relations: a Critical Review of Administrative Regions in the Czech Republic from a Spatial Perspective

The main purpose of the article is a critical evaluation of current administrative regions in the Czech Republic from a spatial point of view. The post-socialist transformation processes took place very quickly in the Czech Republic and they strongly influenced the spatial organization of the society. The study is focused on the present administrative organization of the Czech Republic in form of the ‘districts of municipalities with extended competence’. We evaluate their role in fulfilling the spatial equity principle through the time accessibility of the administrative centers from their administrative regions and through current socio-economic spatial flows (expressed by daily commuting). The study brings important results of current spatial arrangement of public administration in the Czech Republic. The most problematic administrative regions in the Czech Republic in terms of their accessibility and their role in space are also mentioned. The results could be useful both in research and practice.
Structure formation in turbulence as an instability of effective quantum plasma

Abstract Structure formation in turbulence can be understood as an instability of “plasma” formed by fluctuations serving as effective particles. These “particles” are quantumlike in the sense that their wavelengths are non-negligible compared to the sizes of background coherent structures. The corresponding “kinetic equation” describes the Wigner matrix of the turbulent field, and the coherent structures serve as collective fields. This formalism is usually applied to manifestly quantumlike or scalar waves. Here, we show how to systematically extend it to more complex systems using compressible Navier–Stokes turbulence as an example. In this case, the fluctuation Hamiltonian is a five-dimensional matrix operator and diverse modulational modes are present. As an illustration, we calculate these modes for a sinusoidal shear flow and find two modulational instabilities. One of them is specific to supersonic flows, and the other one is a Kelvin–Helmholtz-type instability that is a generalization of the known zonostrophic instability. Our calculations are readily extendable to other types of turbulence, for example, magnetohydrodynamic turbulence in plasma.
Good Quality and Clinical Practices for the Future Development of Herbal Medicines

Abstract Traditional medicines (TMs) continue to serve the healthcare needs of millions, if not billions, of people worldwide. Herbal medicines (HMs) play a central role in TM and can contribute to the goal of ensuring healthcare for all people, when proven to be of sufficient quality, safety, and efficacy. However, continuing problems that deter the progression of HMs include the same issues of quality, safety, and efficacy. Following published Good Manufacturing guidelines or developing new ones where none exist may overcome these issues, as good quality herbal products significantly improve their overall safety and efficacy. Consumers of HMs often believe that HMs are safer than are prescription drugs, and in fact, the adverse event reporting for HMs continues to be low. While there are thousands of in vitro and in vivo studies, good quality clinical data for many commonly used HMs are still lacking and should be a priority for future research.
We Are a Long Ways Past Maus: Responsible and Irresponsible Holocaust Representations in Graphic Comics and Sitcom Cartoons

In 1986, cartoonist Art Spiegelman published Maus: A Survivor’s Tale, the first book in his two-volume graphic comic novel about the Holocaust. He established, perhaps unwittingly, a new genre of Holocaust representation, i.e., comic animation that thrives in current times. While his intervention was “responsible” in the sense that it spurred, rather than spurned reverent remembrance, contemporary Holocaust-themed animation on sitcoms like Family Guy and South Park sometimes poke “irresponsible” fun. American cultural producers have a long tradition of ridiculing Adolf Hitler and Nazism. Joking about the Holocaust and its survivors, however, is something new. This chapter does not consider the question of whether or not this sort of humor is amusing, or appropriate. Rather, this study examines the messaging, delivery, and visible impact of such pop cultural icons on the ways people remember and forget the Holocaust.
Interaction effects in the association between methadone maintenance therapy and experiences of racial discrimination in U.S. healthcare settings.

Background Disparities in methadone maintenance therapy (MMT) outcomes have received limited attention, but there are important negative outcomes associated with MMT that warrant investigation. Racial discrimination is common in healthcare settings and affects opioid use disorder (OUD) treatment and comorbidities. However, race/ethnicity alone may not fully explain experiences of discrimination. MMT remains highly stigmatized and may compound the effect of race/ethnicity on discrimination in healthcare settings. We sought to quantify differential associations between MMT and experiences of racial discrimination between racial/ethnic groups in a U.S. national sample. Methods We used the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012–2013) to identify a subset of individuals with a lifetime OUD who had ever used MMT (survey n = 766; weighted population n = 5,276,507). We used multivariable logistic regression to model past-year experience of racial discrimination in a healthcare setting. We included an interaction term between race/ethnicity and MMT status to identify the odds of discrimination (MMT vs. no MMT [referent]) within racial/ethnic groups. We used survey procedures with weights to account for the parent study’s complex survey design. Findings Twenty-two percent of our sample experienced racial discrimination in a healthcare setting in the past year. Discrimination was more common among those who had ever used MMT (x2 = 10.00, p = 0.001) and racial/ethnic minorities (x2 = 23.15, p<0.001). The interaction effect was much stronger than the main effects of race/ethnicity and MMT status. MMT status (versus no MMT) was positively associated with discrimination among Blacks (aOR = 3.93, 95% CI = 3.87–3.98, p<0.001), Whites (aOR = 2.25, 95% CI = 2.23–2.27, p<0.001), and Latino/Latinas (aOR = 1.59, 95% CI = 1.55–1.62, p<0.001). Among American Indian/Alaska Natives (AI/AN), those who had used MMT had over thirty times the odds of racial discrimination, compared to their non-MMT counterparts (aOR = 32.78, 95% CI = 31.16–34.48, p<0.001). Conclusion Race/ethnicity alone did not sufficiently account for racial discrimination in healthcare settings among those with a lifetime OUD. MMT status was strongly associated with racial discrimination among AI/AN. Our strong interaction effect is indicative of an additional barrier to health services utilization among AI/AN, which has important implications for OUD treatment outcomes and comorbidities. Health promotion programs aimed at increased adoption of MMT are promising, but should be considered in the context of racial/ethnic disparities, drug use and MMT stigma, and implicit biases in clinical settings.
Antiretroviral drug class and anaemia risk in the current treatment era among people living with HIV in the USA: a clinical cohort study.

Objective Anaemia is common among people living with HIV (PLWH) and has been associated with certain, often older, antiretroviral medications. Information on current antiretroviral therapy (ART) and anaemia is limited. The objective was to compare the associations between anaemia incidence or haemoglobin change with core ART classes in the current ART era. Design Retrospective cohort study. Setting USA-based prospective clinical cohort of PLWH aged 18 and above receiving care at eight sites between January 2010 and March 2018. Participants 16 505 PLWH were included in this study. Main outcome measures Anaemia risk and haemoglobin change were estimated among PLWH for person-time on a protease inhibitor (PI) or an integrase strand transfer inhibitor (INSTI)-based regimen, relative to a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based reference. We also examined PLWH on regimens containing multiple core classes. Cox proportional hazards regression analyses were conducted to measure the associations between time-updated ART classes and incident anaemia or severe anaemia. Linear mixed effects models were used to examine the relationships between ART classes and haemoglobin change. Results During a median of 4.9 years of follow-up, 1040 developed anaemia and 488 developed severe anaemia. Compared with NNRTI use, INSTI-based regimens were associated with an increased risk of anaemia (adjusted HR (aHR) 1.26, 95% CI 1.00 to 1.58) and severe anaemia (aHR 1.51, 95% CI 1.07 to 2.11) and a decrease in haemoglobin level. Time on multiple core classes was also associated with increased anaemia risk (aHR 1.39, 95% CI 1.13 to 1.70), while no associations were found for PI use. Conclusion These findings suggest INSTI use may increase the risk of anaemia. If confirmed, screening for anaemia development in users of INSTIs may be beneficial. Further research into the underlying mechanisms is warranted.
Technology Integration at the University Level: An Analysis of an Elementary Social Studies Methods Course

Advocates of integrating technology education in teacher education face a significant obstacle that may not be experienced by other curriculum reformers – they probably do not know much about curriculum r eform. By examining models of curricular change, technology integration advocates may be more successful in implementing their ideas. Tanner and Tanner (1995) presented a model of “Curricular Sources and Influences” to explain the development of the K -12 school curriculum. The model shows the school curriculum in the center of a circle. Around the circumference of the circle are political influences, social influences, economic influences, and technological influences. These four types of influences affect each other as they help determine the curricular decisions made by school boards, administrators, teachers, parents, and students. Specific examples of the four influences are governmental agencies, publishers and testing companies, professional educationa l organizations, and colleges and universities. “Curriculum development is a process of synthesizing the forces that influence the experiences that learners have under the guidance of teachers” (p. 594). The Tanner and Tanner model appears to describe curr iculum development effectively at the K-12 level, but may also be useful in understanding curricular changes at the university level. This article focuses on a series of curricular changes in a single course, Elementary Social Studies Methods, over a 10 -year period. Although there were many adaptations and adjustments in the course, this analysis will examine only attempts to integrate technology education into the course. The Tanner and Tanner model will guide the discussion.
Partition Coefficients of Rare-Earth Elements and Barium between Igneous Matrix Material and Rock-Forming-Mineral Phenocrysts—I.

Partition coefficients between natural melts, as represented by igneous matrix material, and amphibole, augite, olivine and plagioclase phenocrysts have been determined for eight rare-earth elements and barium by a mass-spectrometric stable-isotope-dilution technique. Peridotite nodules, crystallization of plagioclase and relationships between basalts are briefly discussed in terms of the partition coefficient data.
Tomographic incoherent digital holography using a lattice light-sheet microscope

We present tomographic fluorescence imaging using an incoherent detection technique on a lattice light-sheet microscope (LLSM) without moving sample stage or the detection objective. The system provides an adaptable low excitation and high-resolution 3D image.
Hyperspectral multiphoton microscopy for in vivo visualization of multiple, spectrally overlapped fluorescent labels.

The insensitivity of multiphoton microscopy to optical scattering enables high-resolution, high-contrast imaging deep into tissue, including in live animals. Scattering does, however, severely limit the use of spectral dispersion techniques to improve spectral resolution. In practice, this limited spectral resolution together with the need for multiple excitation wavelengths to excite different fluorophores limits multiphoton microscopy to imaging a few, spectrally distinct fluorescent labels at a time, restricting the complexity of biological processes that can be studied. Here, we demonstrate a hyperspectral multiphoton microscope that utilizes three different wavelength excitation sources together with multiplexed fluorescence emission detection using angle-tuned bandpass filters. This microscope maintains scattering insensitivity, while providing high enough spectral resolution on the emitted fluorescence and capitalizing on the wavelength-dependent nonlinear excitation of fluorescent dyes to enable clean separation of multiple, spectrally overlapping labels, in vivo. We demonstrated the utility of this instrument for spectral separation of closely overlapped fluorophores in samples containing 10 different colors of fluorescent beads, live cells expressing up to seven different fluorescent protein fusion constructs, and in multiple in vivo preparations in mouse cortex and inflamed skin, with up to eight different cell types or tissue structures distinguished.
Using situation awareness measures to characterize mental models in an inductive reasoning task

The objective of this study was to develop and validate an empirical method of situation awareness (SA) assessment for characterizing mental models in an inductive reasoning task. We conducted an e...
Shrinkage stress and cuspal deflection in MOD restorations: analytical solutions and design guidelines.

Abstract Objective This paper aimed to derive analytical solutions for the shrinkage stress and cuspal deflection in model Class-II mesial-occlusal-distal (MOD) resin-composite restorations to better understand their dependence on geometrical and material parameters. Based on the stress solutions, it was shown how design curves could be obtained to guide the selection of dimensions and materials for the preparation and restoration of this class of cavities. Methods The cavity wall was considered as a cantilevered beam while the resin composite was modeled as Winkler’s elastic foundation with closely-spaced linear springs. Further, a mathematical model that took into account the combined effect of material properties, sample geometry and compliance of the surrounding constraint was employed to relate the shrinkage stress at the “tooth-composite” interface to the local compliance of the cavity wall. Exact analytical solutions were obtained for cuspal deflection and shrinkage stress along the cavity wall by solving the resulting differential equation, which had the same form as that for a beam on elastic foundation with a distributed load. To quantify the shrinkage stress at the cavity floor, the resin composite was assumed to be a beam, fixed at both ends and loaded with a uniformly distributed load that approximated the shrinkage stress. The analytical solutions thus obtained were compared with results from finite element analysis (FEA). Results The analytical solution for cuspal deflection contains a dimensionless parameter, γ, which represents the stiffness of the cavity wall relative to that of the cured resin composite. For the same shrinkage strain, cuspal deflection increases with reducing γ, i.e. reducing stiffness of the cavity wall or increasing stiffness of the composite. For the same γ, cuspal deflection increases proportionally with shrinkage strain. Shrinkage stress along the cavity wall is maximum at the cavity corner and reduces towards the occlusal surface; the maximum value depends only on Young’s modulus and the shrinkage strain of the resin composite. For low values of γ, the interfacial stress at the occlusal surface can become compressive. The interfacial stress at the cavity floor can be much higher than that along the cavity wall, increasing exponentially with the resin composite’s thickness. The analytical solutions agree well with FEA predictions. Significance When validated, the analytical solutions and design curves presented in this study can provide useful guidelines for choosing appropriate dimensions of cavity preparations and resin composite materials with suitable mechanical properties for Class-II MOD restorations to help avoid tooth fracture and interfacial debonding caused by polymerization shrinkage.
Myopericarditis in a Young Adult Secondary to COVID-19 Vaccination

We present the case of a healthy 29-year-old male with no significant medical history who presented with electrocardiogram findings consistent with pericarditis and elevated troponin levels, commonly seen in myocarditis, after receiving his second Pfizer-BioNTec vaccination for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The patient had significant clinical improvement shortly after receiving aspirin and colchicine and was discharged home with these medications. His laboratory findings returned to baseline less than 2 weeks after his illness. While this case highlights the importance of diagnosis, intervention selection, and treatment of myopericarditis amid ongoing global vaccination campaigns, it should be emphasized that the benefits of vaccination considerably outweigh the risks.
Patient specific IMRT quality assurance with film, ionization chamber and detector arrays: Our institutional experience

Abstract Purpose This study was conducted to review patient specific IMRT QA delivered at our institution using Varian LINACs and TomoTherapy Hi-Art system and categorized according to the anatomical site, type of treatment machine, and treatment planning systems (TPS). Material and methods Three thousand and three hundred seven patient data were evaluated for a time ranging from 2006 to 2011; these data were gauged using several methods used in the QA process. Ion chambers and film were used in 1738 patient plan QA in the earlier years followed by ion chamber arrays in 1569 patient plan QA in the latter years. Patients were grouped according to several parameters including TPS, site of treatment, and type of treatment machine in comparing the measured versus computed dose differences. From 2006 through early 2009, 736 TomoTherapy plans, 651 Pinnacle3 plans, and 351 Corvus plans were evaluated using ion chambers and films. The pass criterion at the institution at the time of these measurements was 3% dose difference and 3 mm distance to agreement. For the years ranging from 2009 to 2011, 1569 patient IMRT QAs were performed and evaluated on the institution's pass criteria of 90% γ value on Varian linacs with Millennium 80, 120 and High-Definition 120 multileaf collimators. Results Average point dose difference between measured and calculated plans for Pinnacle3, Hi-ART TomoTherapy, and Corvus TPS were 0.1205%, −0.0042%, and −0.0178%. Among the QA plans measured using a 2D array, average gamma values for brain, head and neck, thorax, abdomen, and pelvis were 97.2%, 95.7%, 96.2%, 97.0%, and 96.2%, respectively. Average gamma values based on 80, 120, HD 120 and TomoTherapy MLC configurations were 96.5%, 96.2%, 96.3%, and 97%, respectively. A 2-tailed paired Student's T-test did not reveal the presence of statistically significant differences based on either TPS, anatomical sites, number of beams or arcs, number of control points, or the MLC configuration (p-value>0.05). Conclusions Among the TPSs, Tomoplan and Corvus had the best agreement with the point dose measurement. Based on anatomical location of treatment site, head and neck cancers had the lowest gamma value for the patients treated and brain sites had the highest gamma value. However, the values are not significantly different. TomoTherapy machines continue to have the best overall gamma values as compared to CLINAC machines.
When is surgery indicated in retrodisplacement of the uterus

Abstract The material for this paper has been accumulated from a review of the histories of 145 women with retrodisplacement on whom Dr. Arthur H. Curtis or I have operated during the past five years. These cases have been gleaned from a large number of women with retrodisplacement and represent the group in whom surgical intervention appeared necessary. However, I have not determined the percentage of retrodisplacements which require surgical correction. In this paper, “retrodisplacement” means marked retrodisplacement, usually of a heavy uterus.
Urologic Emergencies: Overview

Compared to other surgical fields there are relatively few emergencies in urology. For this reason we may become unaccustomed to caring for the acutely ill patient. Therefore, it is important to keep certain guiding principles in mind when confronted with a patient with an emergent urologic condition.