cssi/SciSciGPT-SciSciNet huggingface dataset:
Cryosurgery for pruritus ani

Pruritus ani is a male predominant disorder of perianal itching that is associated with an itch-scratch cycle leading to lichenification. It can be caused by infection, medications, irritation, systemic disease, and colorectal/anal disease. Dermatologic diseases associated with pruritus ani include psoriasis, seborrheic keratosis, atopic dermatitis, contact dermatitis, lichen sclerosus, lichen simplex chronicus, Paget’s disease, and Bowen’s disease. The primary treatment for pruritus ani is maintenance of anal hygiene. Steroid creams, capsaicin, tacrolimus, and injectable methylene blue have been used with mixed success. Cryosurgery disrupts nerve endings, causing cessation of the itch-scratch cycle. Only 1 out of 18 patients had recurrence after cryosurgery. Cryosurgery is an effective option for pruritus ani due to its cost-effectiveness and low morbidity.
Restricting Immigration Fairly

Commitment to the liberal democratic ideals of equality and liberty suggests that all should be allowed to live where they choose and that controlled and restricted borders are therefore unjustified. I argue, however, that nation-states can have reasons for restricting immigration that are both justifiable and compatible with treating people as free and equal beings. Liberal commitments do not require open borders. Not all immigration restrictions, however, pass the test of conforming to the demands of equality and liberty. Immigration may be restricted but only if restricted fairly.
Anemia and Ineffective Erythropoiesis Caused by Somatic RAS Mutation.

Ras proteins modulate cell fates by integrating extracellular stimuli and transducing signals that regulate proliferation, survival, and differentiation via downstream effector cascades. Somatic activating mutations in RAS oncogenes are found in approximately one third of cases of myelodysplastic syndrome (MDS), and are common in myeloproliferative disorders (MPDs) such as CMML and JMML that frequently have a dysplastic component. We have modeled these human diseases in the mouse using a conditional allele of oncogenic Kras , which is activated in mice bearing the inducible Mx1-Cre transgene by injection with polyinosinic-polycytidilic acid (pI-pC). Mice treated with pI-pC to induce K-rasG12D expression at 21 days of life develop not only myeloid proliferation, but also progressive anemia which is the likely cause of death with median survival 84 days after injection. Erythroid precursors are abundant in spleens of anemic mice, suggesting ineffective erythropoiesis. These features are highly reminiscent of human MDS, and suggest that anemia in MDS is a direct consequence of hyperactive RAS signaling. Further analysis reveals that although erythroblasts are absent from the bone marrow, earlier erythroid progenitors such as BFU-E and CFU-E are abundant in both bone marrow and spleens of anemic mice. However, despite hyperproliferation of primitive erythroid cells, there is a block in terminal erythroid differentiation. This is also seen in primary E14.5 fetal liver cells acutely induced to express K-rasG12D in vitro , and in wild type recipients of Mx1-Cre, Kras G12D bone marrow, demonstrating this to be a cell-intrinsic property of erythroid progenitors expressing oncogenic Ras. Together, these findings support a model in which RAS mutations in MDS both confer a proliferative advantage to a neoplastic clone as well as directly impede differentiation, resulting in ineffective erythropoiesis and anemia. The improved efficiency of differentiation observed in spleen relative to bone marrow also suggests that microenvironmental influences modify the cell-intrinsic effects of oncogenic Ras.
Is conscious content available only to the skeletal muscle system

I applaud Morsella et al.'s approach to investigate consciousness in terms of behavioral control. After all, the function of the brain is to control behavior, and consciousness contributes to the function of the brain. However, I question whether conscious content is available only to the skeletal muscle system, as the principle of parallel responses into skeletal muscle (PRISM) (Morsella 2005) proposes.
Guano Core Evidence of Palaeoenvironmental Change and Woodland Indian Inhabitance in Fern Cave, Alabama, USA, from the Mid-Holocene to Present

Bat guano cores have been used as a source of palaeoenvironmental information to aid in the reconstruction of past climates and vegetation. We collected a 104-cm-long (43 cm compacted) guano core from Fern Cave, Alabama, USA, that provided a c. 6000-year record of guano accumulation. Pollen, nutrients (C, N, P) and stable isotopes (δ13C, δ15N) were measured on the guano core with the objective of reconstructing the environmental history of the area from the mid-Holocene to present. Our data indicate that bats have utilized Fern Cave for at least 6000 years and that Woodland Indians also utilized the cave for a short period. A 3-cm charcoal layer was dated to 2720±30 cal. a BP and inferred to be Woodland Indian in origin from microscopic inspection and thickness. Pollen and geochemical data showed that bat diets changed in the late Holocene possibly linked to food supply and climate changes. These results demonstrate that guano cores are a useful tool of palaeoenvironmental reconstruction when other forms of palaeorecords do not exist and can add to local archaeological information.
Magnitude of Deformity Correction May Influence Recovery of Quadriceps Strength After Total Knee Arthroplasty

Abstract Background Malalignment of the lower extremity is commonly seen in patients with severe osteoarthritis undergoing total knee arthroplasty (TKA) and is believed to play a role in quadriceps strength loss. Deformity correction is typically achieved through surgical techniques to provide appropriate ligamentous balancing. Therefore, this study examined the influence of change in lower extremity alignment on quadriceps strength outcomes following TKA. Methods Seventy-three participants (36 male; mean age 62 years; mean BMI 29.7) undergoing primary unilateral TKA were used in this investigation. Prior to surgery and at 1 and 6 months following surgery measures of isometric knee extensor strength, quadriceps activation, and long standing plain films were collected. Using the films, measures of Mechanical Axis (MA), Distal Femoral Angle (DFA), Proximal Tibial Angle (PTA), and Patellar Femoral Angle (PFA) were performed. Hierarchical linear regression was used to evaluate how change in alignment from baseline to 1 and 6 months influenced the change in quadriceps strength. Results DFA was found to significantly contribute to changes in quadriceps strength at 1 and 6 months following TKA, above that contributed by associated covariates. None of the other measures of lower extremity alignment were found to contribute to quadriceps strength in this sample. Conclusion Reductions in quadriceps strength experienced following TKA are likely to be influenced by changes in lower extremity alignment. Specifically, measures of DFA angle were found to significantly contribute to these changes. Future work is needed to prospectively examine measures of lower extremity alignment change and recovery following TKA.
Categorical representations of decision-variables in orbitofrontal cortex

The brain creates internal representations of the external world in the form of neural activity, which is structured to support adaptive behavior. In many cortical regions, individual neurons respond to specific features that are matched to the function of each region and statistics of the world. In frontal cortex, however, neurons display baffling complexity, responding to a mixture of sensory, motor and other variables. Here we use an integrated new approach to understanding the architecture of higher-order cortical representations, and use this approach to show that discrete groups of orbitofrontal cortex (OFC) neurons encode distinct decision variables. Using rats engaged in a complex task combining perceptual and value-guided decisions, we found that OFC neurons can be grouped into distinct, categorical response types. These categorical representations map directly onto decision-variables of a choice model explaining our behavioral data, such as reward size, decision confidence and integrated value. We propose that, like sensory neurons, frontal neurons form a sparse and over-complete population representation aligned to the natural statistics of the world - in this case spanning the space of decision-variables required for optimal behavior.
Developing policies for green buildings: what can the United States learn from the Netherlands?

Political jurisdictions in the United States have begun to develop plans that address green buildings, a topic on which the Netherlands has extensive experience. This article analyzes the literatur...
A new approach of quantitatively analyzing water states by neutron scattering in hardened cement paste

Abstract The three-component model is typically used to analyze the quasi-elastic neutron scattering data and study the water dynamics of hydrating cementitious system. Its application to the hardened cement paste is hindered due to the inaccuracy in evaluating free water at normal ambient temperature. This paper presents a novel approach to quantifying the amount of free water through conducting neutron scattering under freeze-thaw cycling. Disk-like cement paste samples were prepared and applied with four freeze-thaw cycles by varying temperatures in the range of 240 K to 300 K. Quasi-elastic neutron scattering data collected before and after the freeze-thaw cycles and elastic neutron scattering data was collected during each cycle. The signal intensity associated with the free water was obtained by combining QENS and ENS data analysis and a mathematical deduction. We introduced the index of the total immobile water to quantitatively demonstrate water content. The fractional change of the immobile water after freeze-thaw cycle was also studied. The significance of this method is that it is not limited to be applied to cement paste system but also compatible with other systems where the amount of free water cannot be accurately quantified by the standard QENS analysis.
When Suicide Kills: An Empirical Analysis of the Lethality of Suicide Terrorism

Why are some suicide terrorist attacks deadlier than others? Suicide bombers, unlike stationary bombs, are self-guided human weapons; they can deliver and detonate explosives at a specific time and place with precision. Coding and analyzing new data on over four hundred suicide terrorist incidents from all around the world between 1998 and 2015, this paper argues that the number of fatalities resulting from suicide attacks is a function of strategic choices made by the perpetrators, such as where to attack and whom to target. Results of this analysis show that suicide attacks that seize targets of opportunity are the most lethal. Specifically, suicide attacks that target civilians in enclosed and easily accessible places, and that are undertaken by multiple perpetrators result in the highest numbers of fatalities. Understanding these strategic tactical attributes of suicide terrorism is fundamental to devising effective counterterrorism strategies that aim at hardening soft targets and minimizing the lethal impact of these attacks.
Clinical Characteristics and Associated Systemic Diseases in Patients With Esophageal "Absent Contractility"-A Clinical Algorithm.

Goals:This study was carried out to assess the clinical characteristics and associated systemic diseases seen in patients diagnosed with absent contractility as per the Chicago Classification version 3.0, allowing us to propose a diagnostic algorithm for their etiologic testing.Background:The Chicag
Policy symmetry and cross-racial linked fate in the early years of the Obama presidency

The United States is undergoing a significant demographic shift that will have critical implications for education, economics, and politics. Combined, Latinos and African Americans will become the ...
Ethnicity and smoking: differences in white, black, Hispanic, and Asian medical patients who smoke.

To describe differences in the attitudes and behaviors of white, black, Hispanic, and Asian medical patients who smoke, we surveyed 2,835 patients of primary care physicians who participated in a controlled trial on smoking cessation. White smokers smoked more cigarettes per day, were more addicted to cigarettes, had more smoking-related symptoms and illnesses, and were more likely to relate smoking to their symptoms and illnesses. Black smokers found less pleasure in smoking, expressed the least concern about the health risks of smoking, but reported the greatest desire to quit and the most confidence that they could quit. Hispanic and Asian smokers more often wanted to quit to keep their children from being exposed to smoking. We conclude that a single approach to helping patients quit smoking is less likely to be effective than one tailored to the ethnic differences among those patients.
Pakistan’s Tax Gap: Estimates By Tax Calculation and Methodology

This report provides estimates of Pakistan’s tax gap by type of tax and describes the methodologies and data used to produce these estimates. A country’s tax gap is the amount of tax that goes uncollected due to non-compliance with the tax law. For estimation purposes, the operational definition of the tax gap is the difference between potential and actual federal tax revenue, where potential revenue is the amount of tax that the government would collect if everyone fully complied with the tax law. It is a simple matter to get actual tax collections by type of tax, so the trick to estimating a country’s tax gap is to obtain a reasonably accurate measure of potential tax revenue. Our basic strategy is to use micro-simulation models to estimate the potential revenues from Pakistan’s federal taxes of which there are only a hand full. Such modeling requires micro-economic data with information about the relevant tax bases and a tax calculator to simulate tax liabilities by type of tax. The advantage of this approach is the detailed information that it provides on the rate of compliance by type of tax which should be helpful in targeting scarce tax enforcement resources and in evaluating tax policy reforms.
Use of bivalirudin as a primary anticoagulant in a child during Berlin Heart EXCOR ventricular assist device support.

We describe our experience of bivalirudin use, a newer direct thrombin inhibitor, in an infant who was supported with Berlin Heart EXCOR VAD (Berlin VAD) as bridge to transplant for 122 days withou...
On understanding the nature and evolution of social cognition: a need for the study of communication

Social cognition involves a wide range of processes, including the ability to recognize group members, to remember past interactions with them and to influence their behaviour strategically. Key arguments and findings in studies of the evolution of social cognition revolve around individuals flexibly and adaptively influencing the behaviour of others. One of the most effective ways of influencing the behaviour of others is through communication. Curiously, however, research focused on the evolution of social cognition rarely addresses communication in the species being studied. Here we describe four major hypotheses to explain the evolution of social cognition and, for each, raise specific predictions regarding communication and how it relates to social cognition. We argue that because communication is foundational to social cognition, studies of communication should be a core feature of future work on the evolution of social cognition.
Textbook Confessions: Government Policies and Market Outcomes

This paper focuses on how government action in the market is presented in Economics Principles textbooks. It looks at whether the government’s role (and failure) is addressed in two topics, price controls and trade barriers, which are presumed by many outside of the economics community that they are strategic uses of government resources and will be efficiency enhancing. These topics are covered in all textbooks in our sample, and are typically explained, in economic fashion, as voluntary policies that subvert the market outcome. However, the motivations provided by textbook authors for adopting these measures are woefully inadequate. In particular, while authors regularly bring up the role of special interests when discussing the implementation of trade barriers, those pressures brought to bear in favor of price controls are rarely acknowledged.
The discovery and prediction of vortex flow aerodynamics

High-speed aircraft often develop separation-induced leading-edge vortices and vortex flow aerodynamics. In this paper, the discovery of separation-induced vortex flows and the development of methods to predict these flows for wing aerodynamics are reviewed. Much of the content for this article was presented at the 2017 Lanchester Lecture and the content was selected with a view towards Lanchester’s approach to research and development.
Rogues and Deviants: a game-theoretic perspective on opportunism in strategic alliances

This research examines how relational factors, such as monitoring, relative alliance identity (RAI), and trust, influence opportunism and, consequently, alliance performance. The authors suggest th...
Guillain-Barre Syndrome After Minimally Invasive Transforaminal Interbody Fusion: A Case Report.

Guillain-Barre syndrome (GBS) is an autoimmune disorder in which an individual’s immune system attacks the peripheral nerve myelin. Although rare, but serious, the syndrome typically starts with numbness, tingling, or weakness in the lower extremities and progresses in an ascending fashion. Severe weakness can transmit into paralysis and respiratory compromise. Although rare, GBS has been reported as a complication of multiple surgeries including orthopedic, cardiovascular, transplant, and general surgeries. To our knowledge, we here present the first case report of GBS after minimally invasive transforaminal interbody fusion. Furthermore, we highlight the importance of understanding the presenting symptoms and identifying proper examination findings, particularly in the setting of confounding factors, for prompt diagnosis, treatment, and reduction of morbidity.
Teaching NeuroImages: Trochlear nerve schwannoma.

A 54-year-old woman presented for evaluation of binocular vertical diplopia worse in downgaze. She had limited infraduction of the right eye in adduction and a right hypertropia worse in left gaze and right head tilt, consistent with a right trochlear nerve palsy. MRI brain revealed enlargement and enhancement of the right trochlear nerve in the subarachnoid space (figure). Laboratory testing and CSF analysis were normal. The imaging findings were stable over several years, suggesting the diagnosis of a trochlear nerve schwannoma.
Comparing the Effects of Protagonist Race on Preschoolers’ Engagement in Book Reading

In the current study, single case research methodology was used to examine whether preschool children’s engagement in book reading activities was greater when the protagonist in the book was of the same or different race as the child participant. Initiations, accurate responses to questions, passive engagement, teacher redirections, and child preference were measured. There was no functional relation demonstrating children’s engagement was greater when read books with protagonists of a corresponding race to the child. However, the non-experimental measure of preference demonstrated that children, when given an opportunity, more often chose books with a protagonist of the same race. Findings are discussed relative to the common recommendation in early childhood education to use diverse children’s books.
Reactive molecular dynamics simulations and machine learning

Machine learning (ML) is revolutionizing scientific and engineering disciplines owing to its ability to capture hidden patterns in large amounts of data. The recent success of ML can be attributed to increasing amount of data, simulation resources, and improving understanding of statistical inference. For these reasons computational materials science is undergoing a paradigm shift. The main reason is that trial-and-error approach to materials design is inefficient: laboratory trials require a lot of time, and the results of previous trials are not utilized in a systematic fashion. A data-driven approach, which draws upon all relevant data from experiments, and reactive and quantum molecular dynamics simulations, can address these issues. The MAGICS (Materials Genome Innovation for Computational Software) Center develops to aid the synthesis of stacked layered materials by chemical vapor deposition, exfoliation, and intercalation. The identification of different phases is a classification problem and can be solved using ML techniques. We have used feed-forward neural network with three hidden layers to identify the different phases present during computational synthesis of MoSe2. Our goal is to carry out exascale MD simulations using forces for multimillion-atom quantum dynamics simulations from neural networks and deep learning using small QMD simulations.
Overhead Mounted Optical Coherence Tomography in Childhood Glaucoma Evaluation.

PReCIS:: Overhead mounted spectral-domain optical coherence tomography (OCT) enables high-quality imaging of the optic nerve and macula in childhood glaucoma, and is particularly useful when standard tabletop OCT has failed or is not possible. Purpose Tabletop OCT, integral to adult glaucoma management, can be limited in childhood glaucoma patients because of young age, poor cooperation, and/or technical challenges. To address these imaging difficulties, we determined the feasibility and quality of an overhead mounted unit in childhood glaucoma. Secondary aims included evaluation of peripapillary retinal nerve fiber layer (pRNFL), parafoveal total retinal thickness, and parafoveal ganglion cell complex (GCC) thickness. Materials and methods Children and adults with a diagnosis of childhood glaucoma were imaged with an overhead mounted spectral-domain OCT as part of a prospective cross-sectional study. Participants had poor quality or unobtainable tabletop OCT and were scheduled for an examination under anesthesia and/or surgery as part of standard care. Results A total of 88 affected eyes in 60 of 65 (92.3%) enrolled patients (mean age, 5.9±5.9 y; range, 0.2 to 24.5) were successfully imaged. The mean image quality for analyzed scans was 22.9±6.0 dB (n=236 images). Mean values for pRNFL (80.5±31.0 µm; n=86), parafoveal total retinal thickness (301.10±39.9 µm; n=79), and parafoveal GCC thickness (96.0±21.6 µm; n=74) were calculated. Conclusions Overhead mounted OCT allowed high-quality image acquisition and analysis in childhood glaucoma patients unable to be imaged with the tabletop counterpart, presenting an opportunity for improved clinical management and study of childhood glaucoma-related pathophysiology. pRNFL, parafoveal total retinal thickness, and parafoveal GCC thickness were decreased for affected eyes of children under 6 years of age compared with age-matched controls from a companion normative study.
Titanium Alloy Cutting Guides in Craniomaxillofacial Surgery-A Minimally Invasive Alternative to Synthetic Polymer Guides.

Purpose Historically, synthetic polymers, such as polyamide, have been the predominate material used for patient-specific cutting guides in 3-dimensionally guided craniomaxillofacial surgery. The physical properties of polyamide result in guides that are bulky and difficult to place within the confines of the facial soft tissue envelope, requiring larger incisions with resultant morbidity. Despite their utility, we found the need for wider exposure simply for guide placement was unacceptable. The purpose of the present study was to evaluate our experience with the newly marketed titanium alloy cutting guides. Materials and Methods We conducted a retrospective cohort study of patients who had undergone either segmental mandibulectomy or maxillectomy using patient-specific titanium alloy cutting guides from May to December 2019. The primary outcome variable was the need for an extended-access cervical incision or a transfacial incision for either maxillectomy or segmental mandibulectomy in patients with benign disorders. The secondary outcome variables included the need for a transfacial incision in patients with malignant pathology requiring either maxillectomy or composite oromandibular resection and the final histopathologic bone margin status. Results Of the 21 included patients, 11 had undergone maxillectomy (1 of 2) or segmental mandibulectomy (9 of 9) for benign disorders, with 91% (10 of 11) having undergone titanium alloy guide placement and resection entirely transorally without the need for an extended cervical or a transfacial incision. For 10 of the 11 patients undergoing immediate reconstruction with vascularized bone flaps, transcervical access was limited to small 1.5- to 2.5-cm incisions for target vessel access and microvascular anastomosis. None of the 10 patients with a malignant disorder requiring either maxillectomy or composite oromandibular resection required a transfacial incision. The bone margins, as determined by histopathologic analysis, were negative for 100% of the patients. Conclusions Patient-specific titanium alloy cutting guides represent a viable alternative to traditional synthetic polymer guides. Their superior properties permit easier intraoral placement, decreasing the need for cutaneous incisions and excessive periosteal stripping.
arXiv : Recent results from the TOTEM collaboration at the LHC

We describe the most recent results from the TOTEM collaboration at the LHC, namely the elastic cross section measurements at a center-of-mass on 2.76, 7, 8 and 13 TeV. No structure or resonance is observed at high $t$ at high center-of-mass energies. A pure exponential form of $d \sigma/dt$ is excluded both at 8 and 13 TeV. Accessing the very low $t$ region allows measuring the $\rho$ parameter at 13 TeV.
Music Perception and Speech-in-Noise Skills of Typical Hearing and Cochlear Implant Listeners.

Purpose Adult cochlear implant (CI) users rate music as one of the most important auditory stimuli, second to speech perception. However, few studies simultaneously examine music perception and spe...
Whey and soy proteins as wall materials for spray drying rosemary: Effects on polyphenol composition, antioxidant activity, bioaccessibility after in vitro gastrointestinal digestion and stability during storage

Abstract A straightforward protocol was developed to produce rosemary particles using whey and soy protein carriers. The post-processing retention of carnosic acid (CA), carnosol (CR) and rosmarinic acid (RA), their bioaccessibility, in vitro antioxidant activity, and storage stability were investigated in protein-rosemary particles compared to rosemary extract (RME). Solids recovery was highest for whey protein or whey-inulin blend complexed with rosemary (R–WPI, R–WIN, ~90%), followed by soy protein or soy-inulin (R–SPI, R–SIN, 60% and 70%); all were higher than rosemary alone (RME, 52%). Protein or protein/inulin carriers significantly enhanced retention of CR (36.8–50.7 mg/g) and CA (17.1–19.6 mg/g) compared to RME (19.8 mg/g and 8.3 mg/g, respectively). In vitro digestibility showed that whey protein isolate increased the bioaccessibility of CA and CR, with no effect on RA, which was highly bioaccessible in all formulations. The rosemary-protein-treatments retained high antioxidant activity measured by ROS and NO assays. CR and CA were particularly stable during 20 weeks of storage in protein-rosemary particles, and stayed at their higher concentration compared to RME. Water activity was below 0.5 and remarkable color stability was observed during storage. Overall, spray dried protein-rosemary particles constitute a creative solution to deliver preserved phytochemicals in a high-protein food format.
Lipid Metabolism Regulates Oxidative Stress and Ferroptosis in RAS-Driven Cancers: A Perspective on Cancer Progression and Therapy.

HRAS, NRAS and KRAS, collectively referred to as oncogenic RAS, are the most frequently mutated driver proto-oncogenes in cancer. Oncogenic RAS aberrantly rewires metabolic pathways promoting the generation of intracellular reactive oxygen species (ROS). In particular, lipids have gained increasing attention serving critical biological roles as building blocks for cellular membranes, moieties for post-translational protein modifications, signaling molecules and substrates for s-oxidation. However, thus far, the understanding of lipid metabolism in cancer has been hampered by the lack of sensitive analytical platforms able to identify and quantify such complex molecules and to assess their metabolic flux in vitro and, even more so, in primary tumors. Similarly, the role of ROS in RAS-driven cancer cells has remained elusive. On the one hand, ROS are beneficial to the development and progression of precancerous lesions, by upregulating survival and growth factor signaling, on the other, they promote accumulation of oxidative by-products that decrease the threshold of cancer cells to undergo ferroptosis. Here, we overview the recent advances in the study of the relation between RAS and lipid metabolism, in the context of different cancer types. In particular, we will focus our attention on how lipids and oxidative stress can either promote or sensitize to ferroptosis RAS driven cancers. Finally, we will explore whether this fine balance could be modulated for therapeutic gain.
Linear refractive index measurement from visible to infrared region using common path interferometry

We develop a common path interferometer to measure the refractive index in liquids. This technique can measure the refractive index from the visible to infrared. In this work, we present experimental data in four wavelengths for several organic solvents.
Understanding the friction and deformation behavior of micro/nano-hierarchical textures through in-situ SEM observation and mechanics modeling

Abstract Micro/nano-hierarchical textures play essential roles in realizing the functionalities of surfaces. Their friction and deformation behavior at the nanoscale, although important, are relatively unknown. In this study, through targeted friction tests inside a scanning electron microscope of individual micro/nano-hierarchical structures (micropillars covered with nanohairs) fabricated by two-photon lithography, we discovered the coupling between micropillar deformation and nanohair height. We also found that the bending of long nanohairs can provide assistive sliding forces, and lateral force can develop even under just normal load before sliding due to the buckling of the longer nanohairs. These findings, supported by finite element modeling of the tests, will shed light on the design of novel micro/nano-hierarchical textures to realize deformation-resistant functional surfaces with controlled friction.
Development, Validation, and Assessment of Clinical Impact of Real-time Alerts to Detect Inpatient As-Needed Opioid Orders With Duplicate Indications: Prospective Study.

Background: As-needed (PRN) opioid orders with duplicate indications can lead to medication errors and opioid-related adverse drug events. Objective: The objective of our study was to build and validate real-time alerts that detect duplicate PRN opioid orders and assist clinicians in optimizing the safety of opioid orders. Methods: This single-center, prospective study used an iterative, 3-step process to refine alert performance by advancing from small sample evaluations of positive predictive values (PPVs) (step 1) through intensive evaluations of accuracy (step 2) to evaluations of clinical impact (step 3). Validation cohorts were randomly sampled from eligible patients for each step. Results: During step 1, the PPV was 100% (one-sided, 97.5% CI 70%-100%) for moderate and severe pain alerts. During step 2, duplication of 1 or more PRN opioid orders was identified for 17% (34/201; 95% CI, 12%-23%) of patients during chart review. This bundle of alerts showed 94% sensitivity (95% CI 80%-99%) and 96% specificity (95% CI 92%-98%) for identifying patients who had duplicate PRN opioid orders. During step 3, at least 1 intervention was made to the medication profile for 77% (46/60; 95% CI 64%-87%) of patients, and at least 1 inappropriate duplicate PRN opioid order was discontinued for 53% (32/60; 95% CI 40%-66%) of patients. Conclusions: The bundle of alerts developed in this study was validated against chart review by a pharmacist and identified patients who benefited from medication safety interventions to optimize PRN opioid orders.
Coagulopathy and FFP Transfusions

Coagulation disorders are commonly encountered in the ICU. Many conditions including sepsis, malignancy, trauma, vasculitic disorders, and obstetrical accidents may give rise to a coagulopathy. In addition, patients may have medical conditions which predispose them to developing a coagulopathy, e.g., patients with liver disease, renal failure, lupus, leukemia, etc. Sepsis, however, is the single most common factor leading to a coagulopathy and DIC. DIC has been reported in about 10–20% of patients with gram-negative bacteremia and 70% of patients with septic shock. In patients with sepsis, DIC appears to be an important independent predictor of ARDS, multiple organ dysfunction syndrome, and death (see Chapter 10).
The Global Structure of Traveling Waves in Spatially Discrete Dynamical Systems

We obtain existence of traveling wave solutions for a class of spatially discrete systems, namely, lattice differential equations. Uniqueness of the wave speed c, and uniqueness of the solution with c≠0, are also shown. More generally, the global structure of the set of all traveling wave solutions is shown to be a smooth manifold where c≠0. Convergence results for solutions are obtained at the singular perturbation limit c → 0.
A team oriented approach to department organization in the microelectronics industry

A summary is presented of an experiment to completely organize an engineering department using the team concept. The effectiveness of the team-oriented department organization was measured by an opinion survey. The results of this survey were tabulated at department, project and organization levels. The results for the team-organized department are compared to the results for the entire organization. The team-oriented department is considered a success. It has proven more flexible to changing demands than the classic department structure. The team organization requires superior time budgeting skills of the engineers, but it also allows more engineers to do problem solving and development on a regular basis. >
Suppression of experimental autoimmune encephalomyelitis using peptide mimics of CD28

The B7:CD28/CTLA-4 costimulatory pathway plays a critical role in regulating the immune response and thus provides an ideal target for therapeutic manipulation of autoimmune disease. Previous studies have shown that blockade of CD28 signaling by mAbs can both prevent and exacerbate experimental autoimmune encephalomyelitis (EAE). In this study, we have designed two CD28 peptide mimics that selectively block B7:CD28 interactions. By surface plasmon resonance, both the end group-blocked CD28 peptide (EL-CD28) and its retro-inverso isomer (RI-CD28) compete effectively with the extracellular domain of CD28 for binding to B7-1. Both the CD28 peptide mimics inhibited expansion of encephalitogenic T cells in vitro. A single administration of EL-CD28 or RI-CD28 peptide significantly reduced disease severity in EAE. Importantly, we show that either CD28 peptide mimic administered during acute disease dramatically improved clinical signs of EAE, suppressing ongoing disease. The ratio of CD80:CD86 expression was significantly lower on CD4(+) and F4/80(+) spleen cells in CD28 peptide-treated mice. Peripheral deletion of Ag-specific CD4(+) T cells occurs following in vivo blockade of CD28 with synthetic CD28 peptides.
The use of hydrogenated cottonseed oil and hexadienol as suppository bases.

Suppository bases were formulated from mixtures of hydrogenated cottonseed oil and hexadienol with various other ingredients. Suppositories were prepared from these bases that were satisfactory with respect to appearance and consistency. The potential of the bases to release a medicament was determined by a colorimetric method. The effect of Veegum® and other agents on the release of medicament from the base is reported. Suppositories made from these bases were stored for one year and the results of storage are reported. A more detailed study of these bases using other emulsifying agents is recommended.
Idea to implementation: A different perspective on system design

Today’s electronic devices are multi-faceted, software-intensive systems that interact with the real world. These interactions create a new kind of complexity that increases pressure on engineering teams to deliver the right product under shrinking schedules. These multi-disciplinary teams are inhibited by gaps between the different tools and workflows they must use for system concept development, hardware design, and software development. Unless we connect these tools, we’ll continue to see missed deadlines and spiraling verification costs.
Decompressive colonoscopy with intracolonic vancomycin administration for the treatment of severe pseudomembranous colitis.

In reviewing the contribution from Shetler et al. [4], several issues emerged that beg clarification. I agree that there are increasing numbers of this infectious colitis that may be life threatening, especially in debilitated, hospitalized patients with significant comorbid illness [1]. Of the eight men (ages 63–79) reported by Shetler et al., only three (38%) were discharged from the hospital and five died (mortality rate, 62%), although two of the five patients who died actually responded to treatment and did not die of septic colitis. The authors emphasize decompression in the title of their article, but in my experience the threat of overwhelming sepsis leading to multiple system organ failure overshadows the risk of perforation from megacolon as may be seen in other disorders, such as colonic pseudoobstruction or Ogilvie’s syndrome. Of the three deaths due to fulminant pseudomembranous colitis, none were caused by perforation but rather overwhelming sepsis as evidenced by the reported acidosis, fever, refractory hypotension, and progressive organ failure (renal, respiratory, and cardiac) culminating in cardiovascular collapse. This study describes an ingenious method of deliv
Uncertain pharmacokinetic/pharmacodynamic systems: Design, estimation and control

Abstract In the study of many biological systems, measurement of some process variables occurs only infrequently and at irregular intervals relative to system time constants, while others are completely unobservable. The quantitative study of such sparse data systems (common in the fields of biochemistry, endocrinology, immunology, metabolism, pharmacology, pharmaceutical sciences, toxicology, and other areas), requires modeling methodologies developed expressly to handle the challenges of modeling and data analysis under the constraints of limited data. This presentation reviews current methods for design, estimation and control of sparse data systems, focusing on methods that formally incorporate important sources of uncertainty (both biological and experimental) into the modeling and analysis processes. The methods are illustrated using examples from pharmacokinetics and pharmacodynamics .
A mathematical description of the Harkins and Brown correction curve for the determination of surface and interfacial tensions

Abstract It has previously been shown that the experimental data of Harkins and Brown for the drop-weight-volume technique, for surface and interfacial tension measurements, can be fitted to a polynomial equation. However, values for the coefficient of variation between points were in excess of the accepted experimental limit of the technique (0.1%). In order to eliminate the systematic error that exists between predicted points and the experimental data, and to obtain a better fit, regression analysis on a limited section of the experimental data was attempted. The restriction of the experimental data considered in no way limited the range of surface and interfacial tensions that could be measured.
Digital mammography: an evaluation of the shape of microcalcifications

Microcalcifications can be identified on mammograms in approximately 50 - 55% of breast cancer cases. Three factors affect the ability to use the presence of microcalcifications as a sign of cancer. They must be seen (conspicuity), their shape must be assessed (to differentiate benign and malignancy associated shapes) and they should be countable since the greater the number of clustered calcifications, the more likely they are malignancy associated. Concern has been expressed that digital systems with their inherently worse resolution would not allow adequate shape information to be captured. Using a 100 micron pixel size storage phosphor system we randomly selected 20 cases, 10 benign and 10 showing malignancy on biopsy and asked four radiologists to assess the calcifications present comparing the original screen film and the digital images and using the screen film biopsy specimen radiograph as ground truth. The preferences were mixed with some radiologists preferring screen film and others the digital images. Whatever their preferences, the radiologists were unable to use the shape criteria to distinguish benign and malignant cases in this case sample.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Where Are We on the Diffusion Curve? Trends and Drivers of Primary Care Physicians' Use of Health Information Technology

National trends in physicians’ use of health information technology (HIT) are clear: in 2001, 18 percent of office-based physicians had implemented either a partial or full electronic medical record (EMR), 48 percent had done so in 2009, and 72 percent in 2012 (Hsiao and Hing 2012). Less is known about the nature of the progress in areas such as computerized physician ordering or clinical decision support. Furthermore, little is known about how external factors such as shared technical assistance programs and delivery system and payment reforms are impacting adoption. Studies have described significant variation in EMR adoption by physician practice size, setting, and physician age (Decker, Jamoom, and Sisk 2012). Documented barriers include costs, the lack of expertise, and technical support infrastructure (Audet et al. 2004; DesRoches et al. 2008; Boonstra and Broekhuis 2010; Patel et al. 2013). The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 injected unprecedented resources to build the national HIT infrastructure. Those resources support several programs, including the “Meaningful Use” incentives, technical assistance through regional extension centers, and the creation of health information exchange communities. In addition, the Patient Protection and Affordable Care Act (ACA) of 2010 fostered payment and delivery system reforms, such as an increased focus on the patient-centered medical home model and accountable care organizations (ACOs). These initiatives aim to create and support an environment and infrastructure where all primary care practices can provide advanced primary care, regardless of their size or setting. In this study, we use results from two international surveys of primary care physicians—the first conducted in 2009, before the ACA and in the very early stages of deployment of HITECH funds, and the second in 2012—to describe trends in adoption of HIT functionalities. While HIT adoption in a cross-national context has been reported elsewhere (Schoen et al. 2009, 2012), this study further explores the factors that may facilitate or hinder HIT adoption and functionality in the United States.
Simulating uniform roof snow loads

Abstract Snow tends to slide from unobstructed slippery sloped roofs of sufficient steepness. This behavior can reduce the required design load and deposit additional loading on lower adjacent structures. Computer-based data acquisition systems have made it possible to obtain the necessary data to understand sliding snow. Microcomputers can collect data, transmit the information while unattended, and control laboratory equipment. Data from field sites, combined with data generated using artificial snow, comprised the database; thus, the conditional probability of sliding was expressed using temperature as the random variable. The probability of sliding on any given day was expressed using the equation of joint probability; with these probabilities and actual meteorological data, roof loads for each winter day over a period of 25 years were simulated. A log Pearson type III extreme value distribution yielded 50-year mean recurrence interval roof loads that correlated with measured values.
Stretched axisymmetric vortices in a compressible fluid

Stretched axisymmetric vortices in a compressible fluid are considered. The flow associated with the vortex is perpendicular to the plane of the uniform straining flow, a situation that is well suited to modeling an axisymmetric mixing-layer flow. Compressibility effects are considered to be weak to facilitate an analytic solution. Applications to compressible turbulence are discussed.
Neodymium ion dopant effects on the phase transformation in sol-gel derived titania nanostructures

Abstract Doped and undoped nanostructured titanium dioxide was synthesized via a sol–gel method under varying conditions to determine the effects of neodymium ion doping on the titania lattice. Specifically, the effects of doping on the anatase to rutile phase transformation were studied. Samples were analyzed by a variety of techniques, including X-ray diffraction, Rutherford back-scattering spectroscopy, scanning electron microscopy, and energy dispersive X-ray spectrometry to investigate the thermodynamic and structural effects of dopant addition. Analysis of the anatase to rutile phase transformation in TiO 2 showed a maximum increase in activation energy for 0.1 mol% Nd 3+ doped TiO 2 with no further response at higher dopant concentrations. This was supported by structural analyses, which showed distortion only along the c -axis of anatase TiO 2 with a maximal distortion at 0.1 mol% Nd 3+ and no further response at higher concentration. This is due to a combination of interstitial and substitutional accommodation of the dopant ions.
Intertidal distribution and feeding habits of the mud crab,Eurytium limosum

Average summer densities of the xanthid crab,Eurytium limosum, in an intertidal salt marsh on Sapelo Island, Georgia were in the range of 7.5 to 80.0 individuals m−2. Crab densities were lowest in wet, lowlying marsh and highest in well-drained creekbank and mussel mound habitats. An analysis of crab stomach contents indicated that feeding occurred mostly around high tide, especially at night. Although the diet included some plant material,Eurytium limosum is primarily predatory and consumed crabs, polychaetes, ostracods, bivalves, and snails. In the laboratory, under simulated low-tide field conditions, both small (11–15 mm carapace width) and large (20–37 mm CW)Eurytium could capture and consume young killifish (Fundulus heteroclitus). Large crabs consumed the entire size range (7–19 mm total length) of larval/juvenile fish offered, but small crabs did not prey upon fish >11.5 mm TL. The potential importance ofE. limosum as a predator on young killifish may not be realized in the field because alternative prey are available and the crabs feed primarily at high tide, when young killifish are dispersed in the water column and are less vulnerable to benthic predators.
Is the "presidential image" reserved for males? Sex-role stereotypes and the 1984 presidential election.

With the selection of Geraldine Ferraro as a vice presidential candidate and the emergence of the “gender gap” issue in the campaign, the 1984 U.S. presidential election provided a unique opportuni...