cssi/SciSciGPT-SciSciNet huggingface dataset:
Ultrasound in the Assessment of the Acute Abdomen in Children: Its Advantages and Its Limitations

Some of the advantages of ultrasound when imaging children, such as the lack of ionizing radiation and the relatively short length of the exam obviating sedation, are obvious. This article outlines the diagnostic considerations within the different pediatric age groups, and considers the ways in which ultrasound can facilitate diagnosis, the cases in which ultrasound is limited in its ability to make a diagnosis, and the ways in which ultrasound can monitor the efficacy of treatment. As it would be beyond the scope of this article to consider each entity in detail, there is a focus on several diseases relatively unique to children. Attention is also paid to appendicitis, an entity seen in both children and adults, which continues to pose diagnostic challenges.
Fostering common ground in human-robot interaction

Effective communication between people and interactive robots would benefit if they have a common ground of understanding. I discuss how the common ground principle of least collective effort can be used to predict and design human robot interactions. Social cues lead people to create a mental model of a robot and estimates of its knowledge. People's mental model and knowledge estimate would, in turn, influence the effort they expend to communicate with the robot. People would explain their message in less detail to a knowledgeable robot with which they have more common ground. This process can be leveraged to design interactions that have an appropriate style of robot direction and that accommodate to differences among people.
Soil erosion and labor shortages in the Andes with special reference to Bolivia, 1953ndash;1991: Implications for “conservation-with-development”

Abstract Many claims in support of soil conservation policies have been flawed by excessively deterministic reasoning and unwarranted spatial overaggregation. A case study remedying these flaws demonstrates that soil erosion in the Bolivian Andes worsened during recent decades (1953-91) due to changes in production as peasants shifted labor from conservation techniques to nonfarm employment. These findings reflect in three policy issues concerning sustainable resource management oriented toward development (“conservation-with-development”) are discussed: (a)environmental consequences and economic causes of increased nonfarm employment by part-time peasant farmers; (b) environment-related aspects of technology innovation and technique modifications in labor-scarce peasant production; and (c) the environmental perceptions of peasant farmers in participatory development planning.
The Antinomy of Values Weber, Tolstoy and the Limits of Scientific Rationality

In this article, I revisit Max Weber's lecture 'Science as a Vocation' by considering his position that choices between values are, in the end, irrational. In examining an argument, which he attributes to Tolstoy, on the relationship between modern culture, science and the meaningless of death, I attempt to prove that Weber's position nullifies the premises on which it is based. As a result, his case for the irrationality of values is self-destructive and incoherent.
Pediatric Bipolar Disorder: The Child Psychiatrist Perspective

This study’s objectives were to gain insight into reasons for the considerable rise in pediatric bipolar disorder (PBD) and what impact the new diagnosis of disruptive mood dysregulation disorder (DMDD) may have on child psychiatric treatment. A purposive sample of 10 child psychiatrists was interviewed for this qualitative study. Interviews were transcribed and coded for themes. Participants believe that PBD is often misdiagnosed and overdiagnosed, though their understandings of the reasons behind this vary. The majority attribute it to providers trying to help children who need services but do not fit a diagnostic category, and undertrained professionals diagnosing children. Most see DMDD as positive, though opinions on how it might impact children and treatment vary. All see family as vital in the treatment process. Participants in this exploratory study support a team approach and social workers have a key role as part of this team.
Probabilities and the Persistence of Memory in a Bingo-like Carnival Game

Seemingly simple probabilities in the m-player game bingo have never been calculated. These probabilities include expected game length and the expected number of winners on a given turn. The difficulty in probabilistic analysis lies in the subtle interdependence among the m-many bingo game cards in play. In this paper, the game i got it!, a bingo variant, is considered. This variation provides enough weakening of the inter-player dependence to allow probabilistic analysis not possible for traditional bingo. The probability of winning in exactly k turns is calculated for a one-player game. Given a game of m-many players, the expected game length and tie probability are calculated. With these calculations, the game’s interesting payout scheme is considered. Keywords—Conditional probability, games of chance, nperson games, probability theory.
The Tax Consequences of Human Organ Transactions

Claudia L. Kelley, an associate professor in the Walker College of Business at Appalachian State University, reviews the tax consequences of human organ transactions.
Mlh1 deficiency enhances several phenotypes of Apc Min/+ mice

Defects in APC and DNA mismatch repair genes are associated with a strong predisposition to colon cancer in humans, and numerous mouse strains with mutations in these genes have been generated. In this report we describe the phenotype of Min/+ Mlh1−/− mice. We find that these doubly mutant mice develop more than three times the number of intestinal adenomas compared to Min/+ Mlh1+/+ or +/− mice but that these tumors do not show advanced progression in terms of tumor size or histological appearance. Full length Apc protein was not detected in the tumor cells from Min/+ Mlh1−/− mice. Molecular analyses indicated that in many tumors from Min/+ Mlh1−/− mice, Apc was inactivated by intragenic mutation. Mlh1 deficiency in Min/+ mice also led to an increase in cystic intestinal crypt multiplicity as well as enhancing desmoid tumorigenesis and epidermoid cyst development. Thus, Mlh1 deficiency influences the somatic events involved in the development of most of the phenotypes associated with the Min mutation.
Experimental characterization, comparison and image quality assessment of two ultrasound contrast agents: Optison and Definity

Microbubble-based contrast agents are commonly used in ultrasound imaging to help differentiate the blood pool from the endocardial wall. It is essential to use an agent which produces high image intensity relative to the surrounding tissue, commonly referred to contrast effect. When exposed to ultrasound waves, microbubbles produce an intense backscatter signal in addition to the contrast produced by the fluctuating size of the microbubbles. However, over time, the microbubble concentration depletes, leading to reduced visual enhancement. The retention time associated with contrast effect varies according to the frequency and power level of the ultrasound wave, as well as the contrast agent used. The primary objective of this study was to investigate and identify the most appropriate image acquisition parameters that render optimal contrast effect for two intravenous contrast agents, Optison™ and Definity™. Several controlled in vitro experiments were conducted using an experimental apparatus that featured a perfused tissue-emulating phantom. A continuous flow of contrast agent was imaged using ultrasound at different frequencies and power levels, while a pulse wave Doppler device was used to monitor the concentration of the contrast agent solution. The contrast effect was determined based on the image intensity inside the flow pipe mimicking the blood-pool relative to the intensity of the surrounding phantom material mimicking cardiac tissue. To identify the combination of parameters that yielded optimal visualization for each contrast agent tested, the contrast effect was assessed at different microbubble concentrations and different ultrasound imaging frequencies and transmission power levels.
Growth of High Quality (In,Ga,Al)N/GaN Heterostructure Materials and Devices by Atmospheric Pressure MOCVD

Using atmospheric pressure MOCVD we have obtained high quality InGaN/GaN and AlGaN/GaN heterostructure materials and devices. For nominally undoped 4 μm thick GaN films, we obtained 300 K mobilities of 780 cm 2 /Vs and an unintentional background impurity level of n300K = 6*10 16 cm −3 . For InGaN/GaN heterostructures we have obtained direct band-edge transitions with FWHM as narrow as 7.9 nm (59 meV) for 50A thick In 0.16 Ga 0.84 N quantum wells at 300K, which is the among the best reported values. The quantum wells display energy shifts towards shorter wavelength with decreasing well thickness, and the shift agrees with predicted quantum effects. These materials have been incorporated into InGaN single quantum well LEDs that emit at 450 nm. In addition AlGaN/GaN heterostructure materials have been incorporated into HFETs and MODFETs. Gate-drain breakdown voltage well exceeding 100 V, and extrinsic transconductance gm of up to 140 mS/mm were realized in the MODFET.
Ultrastructural Observations on Giardiasis in a Mouse Model. II. Endosymbiosis and Organelle Distribution in Giardia muris and Giardia lamblia

Ultrastructural observations of Giardia muris in a mouse model revealed endosymbiotic microbes not previously reported in Giardia. Endosymbionts 240--360 nm wide, 600--1,400 nm long, and with an internal structure similar to that of bacilli were not seen entering Giardia but were found and appeared to divide within Giardia. No evidence was found of digestion of the endosymbionts by the giardia host in either the trophozoite or the cyst form. Endosymbionts were concentrated centrally around the nuclear area and were uncommon in peripheral feeding regions. The same cellular organelles seen in G. muris were found in Giardia lamblia from human jejunal biopsy material, but no endosymbionts were identified in G. lamblia trophozoites from the seven patients examined. Endosymbionts within Giardia may be found to alter trophozoite pathogenicity, metabolism, range of infectivity, antigenic surface characteristics, and host specificity, as they do in other protozoa.
Presentation of the 2015 Roebling Medal of the Mineralogical Society of America to Rodney C. Ewing

Mr. President, Members of the Society, and Guests: I am very pleased to introduce Rodney C. Ewing as the recipient of the 2015 Roebling Medal. I first met Rod when he became my post-doctoral advisor at the University of New Mexico in 1995. I have valued scientific collaborations and friendship with Rod over the years. Today, we are still working together, this time to manage the research portfolio of the Energy Frontier Research Center Materials Science of Actinides. While he was a Ph.D. student at Stanford four decades ago, Rod began his pioneering work on the effects of ionizing radiation on crystalline materials. At that time his studies focused on oxide minerals and the crystalline-to-amorphous phase transition caused by accumulation of radiation-induced damage from the decay of incorporated uranium. Rod developed these early studies into a career-long emphasis that has given science a sophisticated understanding of the response of a broad range of minerals and ceramics to ionizing radiation. Rod determined that there is a critical dose of radiation, after which a material becomes amorphous. He showed …
Effect of heat increment and level of dietary energy and environmental temperature on the performance of growing-finishing swine.

Three experiments were conducted to evaluate levels and sources of dietary energy for growing-finishing pigs during cool and warm seasons. The specific objective was to determine the effect of lower energy diets containing more fiber during cooler temperatures. In Exp. 1, lower energy diets supported daily gains equal to those of pigs fed higher energy diets during low temperature trials, but gains were decreased (P less than .05) during high temperature trials. Feed conversion was improved with each increment of dietary energy and pigs were more efficient converters of feed during warm-season trials. Calorie utilization trends were not the same during cool and warm-season trials. Bermudagrass and alfalfa meal were used in lower energy diets in Exp. 2 and bermudagrass was used in lower energy diets in Exp. 3. Daily gains were not different in these trials, but trends in gain and feed conversion were similar to those in Exp. 1. In general, carcass traits did not differ significantly as a result of dietary treatment in these experiments. there was less (P less than .05) backfat on carcasses from low dietary energy groups during summer trials in Exp. 1 and 3. In all experiments, shoulder percentages were higher during warm-season trials. The data were combined with earlier data to illustrate dietary energy sources and levels and environmental temperature interactions and effects on average daily gain, and carcass traits. The response of gain, dressing, ham, belly and lean cut percentages as a function of metabolizable energy differed (P less than .05) between seasons. The effects of diet formulation and environmental temperature on growing pig performance and carcass traits are discussed.
71 DEVELOPMENT AND VALIDATION OF THE COMPREHENSIVE RESILIENCY QUESTIONNAIRE AND THE ADVERSE CHILDHOOD EVENTS-SHORT FORM.

Background Resilience is a set of coping skills people employ in times of stress. These skills can be acquired or modified through various interventions. Resilience may be a protective factor that mitigates the effects of adverse childhood events (ACE), which are risk factors for adult morbidity and mortality. We developed novel screening tools to elicit resiliency factors, the Comprehensive Resiliency Questionnaire (CRQ) and ACE (ACE Short-Form, ACE-SF). With this study, we will examine differences between and relationships of resiliency factors and ACE in two populations and validate the CRQ and the ACE-SF. Methods We delivered the CRQ and ACE-SF to 167 subjects. The CRQ covers 3 constructs: external support systems during childhood, current external support systems and attitudes and personal strengths. The ACE-SF has questions about the occurrence of environmental stressors and abuse during childhood. We recruited subjects from two populations: (1) students and health care professionals at the University of New Mexico School of Medicine and (2) adults seen at clinics for families with environmental risk factors through the Pediatrics Department of UNM Hospital. We performed qualitative interviews with a subset of 22 of these subjects employing the cognitive technique to check the face validity of the CRQ and ACE-SF. Results Population 1 (n = 103) had significantly greater childhood resilience factors than did the clinic patients (n = 43) (means = 46.3 vs 37.9; p Conclusions The CRQ and the ACE-SF have face validity and can discriminate between groups that theoretically are expected to have differential levels of resilience and ACE. Reported resilience factors are negatively related to reported ACE, consistent with the proposition that resilient individuals may interpret adverse events less adversely than nonresilient people do. Our instruments may be employed to guide interventions to increase resiliency factors and therefore reduce risk factors for morbidity and mortality.
Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review.

Study Design Literature review and case report. Objective Review the existing literature and report the successful nonoperative management of a two-level craniocervical ligamentous distraction injury. Methods A PubMed and Medline review revealed only three limited reports involving the nonoperative management of patients with craniocervical distraction injury. This article reviews the existing literature and reports the case of a 27-year-old man who was involved in a motorcycle accident and sustained multiple systemic injuries and ligamentous distraction injuries to both occipitocervical joints and both C1–C2 joints. The patient's traumatic brain injury and bilateral pulmonary contusions precluded safe operative management of the two-level craniocervical distraction injury. Therefore, the patient was placed in a halo immobilization device. Results The literature remains unclear as to the specific indications for nonoperative management of ligamentous craniocervical injuries. Nonoperative management was associated with poor outcomes in the majority of reported patients. We report a patient who was managed for 6 months in a halo device. Posttreatment computed tomography and flexion–extension radiographs demonstrated stable occipitocervical and C1–C2 joints bilaterally. The patient reported minimal neck pain and had excellent functional outcome with a Neck Disability Index score of 2 points at 41 months postoperatively. He returned to preinjury level of employment without restriction. Conclusions Further study is needed to determine which craniocervical injuries may be managed successfully with nonoperative measures.
Rapid genetic and morphologic divergence between captive and wild populations of the endangered Leon Springs pupfish, Cyprinodon bovinus.

The Leon Springs pupfish (Cyprinodon bovinus) is an endangered species currently restricted to a single desert spring and a separate captive habitat in southwestern North America. Following establishment of the captive population from wild stock in 1976, the wild population has undergone natural population size fluctuations, intentional culling to purge genetic contamination from an invasive congener (C. variegatus), and augmentation / replacement of wild fish from the captive stock. A severe population decline following the most recent introduction of captive fish prompted us to examine whether the captive and wild populations have differentiated during the short time they have been isolated from one another. If so, the development of divergent genetic and/or morphologic traits between populations could contribute to a diminished ability of fish from one location to thrive in the other. Examination of genome-wide single nucleotide polymorphisms and morphologic variation revealed no evidence of residual C. variegatus characteristics in contemporary C. bovinus samples. However, significant genetic and morphologic differentiation was detected between the wild and captive populations, some of which might reflect local adaptation. Our results indicate that genetic and physical characteristics can diverge rapidly between isolated subdivisions of managed populations, potentially compromising the value of captive stock for future supplementation efforts. In the case of C. bovinus, our findings underscore the need to periodically inoculate the captive population with wild genetic material to help mitigate genetic, and potentially morphologic, divergence between them, and also highlight the utility of parallel morphologic and genomic evaluation to inform conservation management planning. This article is protected by copyright. All rights reserved.
From “Junkies” to “Soccer Moms”: Newspaper Representations of Overdose, 1988–2014

In the United States, opioid-related mortality has tripled since 2000, leading the Centers for Disease Control to declare a national overdose epidemic in 2016. With overdose an increasing area of mainstream political and popular concern, some commentators have suggested that sympathetic attention has followed changes in the profile of opioid users, as rates of heroin initiation have doubled among white Americans and women. Yet no studies have examined how media framings of overdose have shifted alongside the epidemic’s demographic contours. Focusing upon southwestern Pennsylvania, this study uses qualitative analysis of news items surrounding three surges in heroin overdose deaths in 1988, 2006, and 2014. 178 items reporting on such overdose outbreaks were selected for thematic coding, with attention directed toward opioid user representations, “drug problem” characterizations, and suggested solutions. Results reveal a transformation in the depiction of overdose sufferers over time, with stories increasingly centered around “unexpected” opioid users, whose habits are made legible through biomedical discourses of addiction; such portraits are used to argue the impropriety of punitive responses to drug misuse. At the same time, the role of criminal justice institutions in addressing overdose is not dismissed, but relocated in recent coverage, with the intensified prosecution of drug dealers offered by many.
Nursing home Facebook reviews: who has them, and how do they relate to other measures of quality and experience?

Background The growing use of social media creates opportunities for patients and families to provide feedback and rate individual healthcare providers. Whereas previous studies have examined this emerging trend in hospital and physician settings, little is known about user ratings of nursing homes (NHs) and how these ratings relate to other measures of quality. Objective To examine the relationship between Facebook user-generated NH ratings and other measures of NH satisfaction/experience and quality. Methods This study compared Facebook user ratings of NHs in Maryland (n=225) and Minnesota (n=335) to resident/family satisfaction/experience survey ratings and the Centers for Medicare and Medicaid (CMS) 5-star NH report card ratings. Results Overall, 55 NHs in Maryland had an official Facebook page, of which 35 provided the opportunity for users to rate care in the facility. In Minnesota, 126 NHs had a Facebook page, of which 78 allowed for user ratings. NHs with higher aid staffing levels, not affiliated with a chain and located in higher income counties were more likely to have a Facebook page. Facebook ratings were not significantly correlated with the CMS 5-star rating or survey-based resident/family satisfaction ratings. Conclusions Given the disconnect between Facebook ratings and other, more scientifically grounded measures of quality, concerns about the validity and use of social media ratings are warranted. However, it is likely consumers will increasingly turn to social media ratings of NHs, given the lack of consumer perspective on most state and federal report card sites. Thus, social media ratings may present a unique opportunity for healthcare report cards to capture real-time consumer voice.
Silica-Supported, Single-Site Sc and Y Alkyls for Catalytic Hydrogenation of Propylene

Single-site Sc and Y on silica catalysts have been prepared by aqueous and organometallic grafting methods. The former yields Y(III) ions with five bonds at an average bond distance of 2.31 A by X-ray absorption spectroscopy. Although the aqueous synthesis gave single-site Y with low coordination number, these were not catalytic for alkane dehydrogenation or olefin hydrogenation. Single-site Sc(III) and Y(III) species were also prepared by grafting Sc(CH2Si(CH3)3)3(THF)2 and Y(CH2Si(CH3)3)3(THF)2, respectively, and these are catalysts for olefin hydrogenation at temperatures from about 60 to 100 °C; however, they were thermally unstable at higher temperatures necessary for alkane dehydrogenation. The structure of the grafted Y complex was determined by X-ray absorption spectroscopy, IR, and NMR. Grafting led to protonolysis of two of the three CH2Si(CH3)3 ligands. Additionally, there was loss of one THF ligand. The EXAFS indicated that there were four Y–ligand bonds in the surface species, two at 2.16 A a...
Efficient Hemorrhage Control Skills Training for Healthcare Employees

Background Several national initiatives are aimed at training citizens to assist bleeding victims. The purpose of this study was to evaluate an effort to quickly and efficiently teach basic bleeding control techniques to a clinical and nonclinical workforce. Study Design The research study was conducted at 4 hospitals in a mid-sized metropolitan area. In spring 2017, the trauma department at a Level I trauma center set an ambitious goal to provide hands-on training to 1,000 employees during the course of 6 weeks. Trainings occurred in small groups and lasted approximately 6 to 10 minutes, during which time participants were taught and practiced 2 skills: packing a wound and holding direct pressure, and applying a stretch-wrap-and-tuck tourniquet. Participants completed pre- and post-surveys indicating their likelihood to use these skills. Results More than 1,000 individuals were trained, and there were survey data for 870 participants. More than 40% of participants worked in nonclinical roles and 29% had no first aid or medical training. After completing skills training, 98% of participants indicated that they would be likely to take action to assist a bleeding victim and that they could correctly apply direct pressure or a tourniquet to control severe bleeding. Conclusions Results demonstrate that basic hemorrhage control skills can be taught to clinical and nonclinical people in brief, hands-on training. Efforts like this can be deployed across large workplace environments to prepare the maximum number of employees to take action to assist bleeding victims.
Successful Thrombolysis After Protamine Reversal Of Heparin (P3.287)

Objective: To report a case of acute Ischemic Stroke treated with IV tPA after reversal of Heparin in an anticoagulated patient. Background: One of the main exclusion criteria for IV tPA has been prior administration of anticoagulants and PT > 15 seconds, INR > 1.7, or IV Heparin within 48 hours preceding the onset of stroke and an elevated aPTT . There is currently no evidence regarding safety and efficacy of acute thrombolysis with IV tPA after rapid Heparin reversal with Protamine in patients undergoing thrombolysis. Design/Methods: A 52 year old woman undergoing a diagnostic cardiac angiogram, was administered Heparin 5000 IU IV during the procedure who became unresponsive with right sided hemiparesis. Her last known well was 13 minutes prior to stroke alert. Her initial NIHSS score was 16 and CT Brain w/o contrast was negative for ICH. The initial aPTT was determined to be 51.4 seconds. Given the severity of the stroke and availability of time, decision was made to reverse the Heparin with IV Protamine. 25 mg and repeat aPTT obtained after 30 minutes was down to 25.0. IV tPA at 1 hour and 34 minutes from her LKW. Soon after tPA was given, symptoms started to improve and patient’s NIHSS dropped down to 4 by the end of infusion, which dropped further to 1 by the time of discharge. Brain MRI showed restricted diffusion in left thalamus with no hemorrhagic changes. Results: NA Conclusions: Anticoagulation with Heparin use within last 48 hours with abnormal aPTT before stroke is an absolute contraindication for IV tPA but there is no clear evidence regarding whether reversal of heparin will affect the long term outcome. To our knowledge, this is the first case of acute stroke with Heparin reversal followed by IV tPA. Disclosure: Dr. Almarhoon has nothing to disclose. Dr. Danoun has nothing to disclose. Dr. Rajamani has nothing to disclose.
Ecosystems and their Response to Airborne Chemicals: The Current Situation in North America and Europe

Human activities of many sorts are changing the chemical climate of the earth. Some of these changes are known to increase the productivity of terrestrial and aquatic ecosystems; but others induce stresses that change the current condition of specific plants, animals, and microorganisms or alter the health, productivity, genetic structure, and/or the geographic distribution of whole ecosystems. Recent research to determine the effects of airborne nutrient, acidic, toxic, growth-altering, and radiatively active airborne chemicals is leading to an improved understanding of how ecosystems develop and how they respond to stresses imposed by airborne chemicals and other environmental perturbations. This paper provides an overview of current and future changes in the chemical climate and the responses of ecosystems to such changes in North America and Europe.
Effect of Ultra-Early Endovascular Intracranial Aneurysm Treatment on Rebleeding and Outcomes in Patients with Subarachnoid Hemorrhage (P04.092)

OBJECTIVE: To determine the rates of outcomes associated with ultra-early ( BACKGROUND: The American Heart Association (AHA) recommends early aneurysm treatment without specifying specific time intervals in patients with subarachnoid hemorrhage (SAH) [Bederson JB, et al. Stroke. 2009;40:994-1025]. The AHA further requires Comprehensive Stroke Centers to document the proportion of SAH patients treated within 36 hours after admission as a Quality of Care metric. [Leifer D, et al. Stroke. 2011; 42: 849-877] However, the definition of early treatment remains controversial. DESIGN/METHODS: We analyzed the data from 144 consecutive SAH patients from two academic centers who underwent endovascular treatment of ruptured intracranial aneurysms over a period of 4 years. Pre-procedure rebleeding was defined as an acute neurological deterioration associated with new hemorrhage apparent on a computed tomographic (CT) scan or an increase in hemorrhage burden on a repeat CT scan. Favorable outcome was defined as modified Rankin score of ≤2 at discharge. Baseline characteristics and outcomes were compared between ultra-early ( RESULTS: Of the 144 SAH patients (mean age 54±SD: 13). Ninety nine (68%) were women who underwent endovascular intracranial aneurysm treatment, (58%) underwent ultra-early aneurysm treatment. After adjusting for age, Hunt & Hess scores, and Fisher grades, there was no significant difference in rates of favorable outcomes (odd ratio [OR] 0.6, 95% confidence interval [CI] 0.2-1.3) or in-hospital mortality (OR 0.8, 95% CI 0.3-2.3) between the two groups. Pre-procedure rebleeding was less likely to occur in the ultra-early treatment group (OR 0.1; 95% CI 0.02-0.4, p CONCLUSIONS: Ultra-early aneurysm treatment is possible due to the availability of endovascular treatment and appears to significantly reduce pre-procedural rebleeding rates in patients with SAH. Disclosure: Dr. Sit has nothing to disclose. Dr. Adil has nothing to disclose. Dr. Adil has nothing to disclose. Dr. Rizvi has nothing to disclose. Dr. Gilani has nothing to disclose. Dr. ATACH Investigators has nothing to disclose.
Ethnic Heterogeneity and the Welfare State

Countries cumulate very different experiences on welfare state development and change and the process dominant in one context may not be consistent over time. How welfare states develop and change has partly to do with changes in the need and demand for social protections as well as those in political attitudes and preferences that dictate policy actions and decisions. An integral component of how welfare states change can also be ethnic heterogeneity as it can affect both the economic contexts of needs and demands and the political contexts of attitudes and preferences. Yet, while the existing theories of the welfare state underscore these political and economic contexts of social protection, they fail to adequately link welfare state developments and changes with the changes in ethnic heterogeneity. Given the major changes in welfare state policy provisions and practices, coupled by a landscape of growing ethnic heterogeneity in high-income countries, it is important to examine if this form of social heterogeneity can be a significant factor in thinking about the needs and demands as well as the political attitudes and preferences, which help shape and reshape welfare state policies.
Statistical conclusion validity: an empirical analysis of multiplicity in mental retardation research.

The statistical conclusion validity of mental retardation research was evaluated by reviewing 41 recently published articles in the American Journal on Mental Retardation and the Journal of Mental Deficiency Research. The analysis was focused on the incidence of Type I error as reflected by three different measures: the experiment-wise error rate, the error rate per experiment, and the percentage error rate. Values for each of these measures indicated that the probability of committing a Type I error was considerably greater than the traditionally assumed level of p less than .05, or 5%. The percentage error rate computed for the 41 articles (369 statistical tests) suggested that approximately 20% of the statistically significant results may be erroneous. Procedures to evaluate the impact of Type I errors in mental retardation research were presented and briefly discussed.
Mathematical Model for Tissue Inflammation: Effects of Spatial Distribution, Cell Motility, and Chemotaxis

Clinical evidence has accumulated in the past decade correlating defective host phagocyte function with increased susceptibility to and severity of infection. In particular, deficient leukocyte random motility and Chemotaxis are associated with decreased resistance to infection.
KILLER HEADACHE: SUMATRIPTAN INDUCED CARDIAC ARREST

Triptans are a class of medication that act as serotonin agonists to abort migraines. While efficacious, they can rarely trigger vasospastic angina and ventricular tachyarrhythmias. A 61-year-old female was referred for stress testing after having several episodes of chest pain. She successfully
Sintering of Silicon Carbide

The absence of densification during sintering of pure SiC is the result of its high grain boundary to surface energy ratio. Whenever this ratio exceeds a certain critical value, a solid will fail to densify without external pressure as there is not enough energy available to extend the grain boundaries.
Process Development of Power Delivery Through Wafer Vias for Silicon Interconnect Fabric

At UCLA Center for Heterogeneous Integration and Performance Scaling (CHIPS), we have been developing a fine pitch heterogeneous wafer-scale platform with a single level of hierarchy called the silicon interconnect fabric (Si-IF). The Si-IF is a platform for heterogeneous integration of different bare dies at fine pitch (2 to 10 µm) and close proximity (<100 µm die spacing). The Si-IF platform can accommodate an entire 50 kW data center on a single 300 mm diameter wafer. Power delivery and heat extraction are fundamental challenges. To minimize the overhead of power conversion, current at mission (point-of-load) voltage is planned to be delivered directly to the assembly; this requires a uniform delivery of tens of kilo-amperes. Our approach is to deliver the current from the back of the Si-IF, using cooled Cu fins and through wafer vias (TWVs), to the front side of the wafer, where the dies are assembled facedown. TWVs are a key component of this power delivery system and are required to penetrate through the entire thickness of the Si-IF (500 - 700 µm). A process for fabrication of large-sized (100 µm diameter) TWVs for the Si-IF is described in this paper. The TWVs are etched in 500 µm Si wafer (aspect ratio of 1:5) and are designed to enable back-side power delivery to the integrated system. Each TWV exhibits a resistance of 1.1 mΩ with an extracted resistivity of 1.73⋅10^-8 Ωm. The scale and performance of these large-sized TWVs supports high current density for power delivery applications.
Abstract 416: Evaluation of Antibody Responses Toward Post-Translationally Modified and Unmodified Peptide Epitopes of Apolipoprotein A-I

Antibody responses targeting ApoA-I have been documented in patients suffering from chronic inflammation associated with obesity, autoimmunity and cardiovascular disease (CVD) and correlate with a ...
Impact of standardized protocols for cytomegalovirus disease prevention in pediatric solid organ transplant recipients.

End-organ disease caused by CMV is a significant cause of morbidity and mortality in pediatric SOT recipients. Pediatric transplant centers have adopted various approaches for CMV disease prevention in this patient population. We observed significant practice variation in CMV testing, prophylaxis, and surveillance across SOT groups in our center. To address this, we implemented evidence-based standardized protocols and measured outcomes pre- and post-implementation of these protocols. We performed retrospective chart review for SOT recipients from 2009 to 2014 at Boston Children's Hospital. Using descriptive statistics, we measured practice improvement in provision of appropriate prophylaxis, occurrence of neutropenia and associated complications, and occurrence of CMV DNAemia and CMV disease pre- and post-intervention. The pre- and post-intervention periods included 141 and 109 patients, respectively. With the exception of kidney transplant recipients, provision of appropriate valganciclovir prophylaxis improved across SOT groups post-intervention (P 1 episode of neutropenia was greater in the preintervention period (30% vs 10%, P < .001). In both periods, neutropenia was associated with few episodes of invasive infections. The occurrence of CMV disease did not differ and was overall low. However, due to routine surveillance a significantly greater number of asymptomatic CMV DNAemia episodes were identified and treated in the post-intervention period. Implementation of standardized prevention protocols helped to improve the provision of appropriate prophylaxis to patients at risk for CMV acquisition, increased the diagnosis and treatment of asymptomatic CMV DNAemia, and decreased episodes of recurrent neutropenia in patients receiving prophylaxis.
Determination of iodine detectability in different types of multiple-energy images for a photon-counting detector computed tomography system.

In addition to low-energy-threshold images (TLIs), photon-counting detector (PCD) computed tomography (CT) can generate virtual monoenergetic images (VMIs) and iodine maps. Our study sought to determine the image type that maximizes iodine detectability. Adult abdominal phantoms with iodine inserts of various concentrations and lesion sizes were scanned on a PCD-CT system. TLIs, VMIs at 50 keV, and iodine maps were generated, and iodine contrast-to-noise ratio (CNR) was measured. A channelized Hotelling observer was used to determine the area under the receiver-operating-characteristic curve (AUC) for iodine detectability. Iodine map CNR ( 0.57±0.42 ) was significantly higher ( P<0.05 ) than for TLIs ( 0.46±0.26 ) and lower ( P<0.001 ) than for VMIs at 50 keV ( 0.74±0.33 ) for 0.5 mgI/cc and a 35-cm phantom. For the same condition and an 8-mm lesion, iodine detectability from iodine maps ( AUC=0.95±0.01 ) was significantly lower ( P<0.001 ) than both TLIs ( AUC=0.99±0.00 ) and VMIs ( AUC=0.99±0.01 ). VMIs at 50 keV had similar detectability to TLIs and both outperformed iodine maps. The lowest detectable iodine concentration was 0.5 mgI/cc for an 8-mm lesion and 1.0 mgI/cc for a 4-mm lesion.
Two-year outcomes and cost for heart failure patients following discharge from the hospital after an acute heart failure admission.

Abstract Background Follow-up costs among heart failure (HF) patients place a heavy burden on healthcare. We sought to quantify follow-up costs after a HF hospitalization, as well as, length of stay (LOS), time to readmission and mortality for patients with preserved (HFpEF) versus reduced (HFrEF) left ventricular ejection fractions. Methods We developed a retrospective cohort of consecutively admitted acutely decompensated HF patients who had at least 1 follow-up visit. We extracted baseline clinical data from electronic medical records, and collected follow-up data on number of readmissions, length of stay, mortality over a 2-year period, and cost data from our hospital's accounting system. Kaplan-Meier curves and log rank tests were used to evaluate survival and time to first readmission in the two HF groups. Results Our study included 444 patients, of whom 224 (51%) had HFrEF. Patients with HFrEF compared to HFpEF had higher median total costs per month alive during the 2-year follow-up period ($1684 vs. $1496, p = 0.02), and median inpatient costs per month alive ($1368 vs. $991, p = 0.03). HFrEF patients had higher total mean LOS per month alive post index hospitalization discharge (1.6 vs 1 days, p = 0.003). Similarly, HF related mean LOS per month alive was higher for HFrEF patients than for HFpEF patients (1.3 vs 0.3 days, p = 0.003). Patients with HFrEF had a trend for shorter time to first readmission and survival compared to those with HFpEF. Conclusions At 2 years following their index HF admission, patients with HFrEF have higher costs and longer LOS compared to HFpEF patients.
Weight gain velocity in infants with achondroplasia

There are virtually no data regarding appropriate oral intake in infants with dwarfing disorders such as achondroplasia, nor is there clear information regarding appropriate weight gain velocity in this population. Yet, these individuals are at increased risk for both early failure to thrive and, later in life, for obesity. Having appropriate expectations regarding weight gain and reasonable goals in management is imperative. We sought to clarify the rate of weight gain in infants with achondroplasia during the first year of life through analysis of data from 60 infants with achondroplasia seen at least twice during the first year of life in the Midwest Regional Bone Dysplasia Clinic, University of Wisconsin-Madison between 1998 and 2018. The mean weight gain velocity during the first 3 months was 23 g/day which contrasts with 30 g/day in average statured infants. Mean weight gain from 0 to 12 months of age was 13 g/day. The 3% of weight gain velocity during the first year of life was 8 g/day, and this rate did not differ between 0-3 months and 0-12 months of age. Infants with achondroplasia slightly more than doubled their birth weights by 1 year of age in contrast to averaged statured infants who typically triple birth weights by 1 year. Infants with achondroplasia can be thriving but erroneously assessed as failing to thrive if the incorrect reference values are used. This article describes infant weight gain velocity reference data for this population.
Self-Reported Parenting Stress and Cortisol Awakening Response Following Mindfulness-Based Stress Reduction Intervention for Parents of Children With Developmental Delays: A Pilot Study:

Background:Many parents of children with developmental delays (DDs) experience high levels of parental stress, and young children with DDs are likely to exhibit clinical levels of behavioral proble...
Optimization of rs-fMRI Pre-processing for Enhanced Signal-Noise Separation, Test-Retest Reliability, and Group Discrimination

Resting-state functional magnetic resonance imaging (rs-fMRI) has become an increasingly important tool in mapping the functional networks of the brain. This tool has been used to examine network changes induced by cognitive and emotional states, neurological traits, and neuropsychiatric disorders. However, noise that remains in the rs-fMRI data after preprocessing has limited the reliability of individual-subject results, wherein scanner artifacts, subject movements, and other noise sources induce non-neural temporal correlations in the blood oxygen level-dependent (BOLD) timeseries. Numerous preprocessing methods have been proposed to isolate and remove these confounds; however, the field has not coalesced around a standard preprocessing pipeline. In comparisons, these preprocessing methods are often assessed with only a single metric of rs-fMRI data quality, such as reliability, without considering other aspects in tandem, such as signal-to-noise ratio and group discriminability. The present study seeks to identify the data preprocessing pipeline that optimizes rs-fMRI data across multiple outcome measures. Specifically, we aim to minimize the noise in the data and maximize result reliability, while retaining the unique features that characterize distinct groups. We examine how these metrics are influenced by bandpass filter selection and noise regression in four datasets, totaling 181 rs-fMRI scans and 38 subject-driven memory scans. Additionally, we perform two different rs-fMRI analysis methods - dual regression and region-of-interest based functional connectivity - and highlight the preprocessing parameters that optimize both approaches. Our results expand upon previous reports of individual-scan reliability, and demonstrate that preprocessing parameter selection can significantly change the noisiness, reliability, and heterogeneity of rs-fMRI data. The application of our findings to rs-fMRI data analysis should improve the validity and reliability of rs-fMRI results, both at the individual-subject level and the group level.
Emerging and Young Adults: An Introduction

Emerging and young adults may be the first generation that do not subscribe to the illusion the world they will grow old in will look anything like the world they live in now. A complex and unpredictable world awaits them and they are savvy enough to acknowledge that the shifting economic, social, and emotional terrain is ridden with anxiety. This opening chapter explores the changing landscape for emerging and young adults and their experiences related to the prevailing uncertainty and ambiguity they are encountering. Their rich and textured voices, as well as the voices of the primary stakeholders—parents and employers of emerging and young adults—serve as a cornerstone to understanding this developmental period. Five emerging and young adult narratives and their diverse perspectives are represented in this introductory chapter.
Toward greater cultural sensitivity in developmental psychology

With the increased attention given to culture in recent years in developmental psychology, there remains a need to overcome limitations of certain existing approaches. Such limitations include tend...
Prosthetic Valve Disease

Native valvular disease is not “cured” when replaced by a prosthetic valve. The prosthetic valve requires vigilant monitoring and is associated with many complications that often require a multidisciplinary approach to evaluation and management. In this chapter, we will give an overview of the basic properties of mechanical versus bioprosthetic heart valves. This chapter will also highlight the primary complications associated with prosthetic valves, including bleeding, valve thrombosis, thromboembolism, valvular regurgitation, and infective endocarditis. From the perspective of the hospitalist, it is imperative to recognize prosthetic valve disease and to know the fundamental steps in the diagnosis and management of its related complications.
Methods for Measuring the Just Noticeable Difference for Variable Stimuli: Implications for Perception of Metabolic Rate with Exoskeleton Assistance

reduction of metabolic rate has become a pillar for quantifying the success of exoskeletons for performance augmentation, but how well can humans perceive these metabolic benefits? Measuring human perceptual ability in this context presents a unique challenge, since the stimulus of metabolic rate is not directly controllable. In this paper we introduce and compare two methods for addressing indirect stimuli: conventional method of constant stimuli (MOCS) with binning, and single presentation (SP). Both methods are based on a maximum likelihood estimation for a sigmoidal psychometric curve, under the assumption of a constant Weber fraction. Using Monte Carlo simulations, we conclude that while conventional MOCS with binning performs better for low actuation noise levels, single presentation strategies are better otherwise. We additionally present a pilot result for one subject using the single presentation strategy, which quantified the Just Noticeable Difference (JND) of changes to metabolic rate of 25.2 ±23.2%.