cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract TMP77: Development of a Collaborative Transition Coaching Program for Reduction of Post-stroke Hospitalizations

Issue: All-cause 30 day hospital readmission rate following discharge for ischemic stroke has been instituted by CMS as a quality measure. Successful readmission reduction planning is a hospital imperative. Purpose: We set out to establish a stroke-specific transitions coaching program with the intention of decreasing readmissions in our ischemic stroke population. Methods: Fiscal year 2013 stroke readmissions to our hospital were individually reviewed for factors leading to readmission. After determining 62.5% of avoidable readmissions were attributed to outpatient factors, a regional home care agency was contacted for collaboration. The agency has proven readmission reductions utilizing the Coleman Care Transitions Model. This model incorporates visits prior to discharge, by telephone, and at home by a trained transitions coach to ensure understanding of medications, follow up visits, and recognition of concerning symptoms. Cost estimates for expanding the program to stroke patients were made using the prior year’s volume based on primary payer, county, and discharge destination. A business plan was established and training and informational sessions planned. Results: Of the outpatient factors contributing to readmission the most common were medication issues, seeking emergency care prematurely, and need for education or support. Based on the data and prior successes of the home care agency a pilot program was developed. The estimated cost for patients not covered by their primary insurance is $52,000 annually. The estimated cost for one hospital readmission is $11,200. Preventing 5 readmissions per year would save $56,000. A successful collaborative was formed resulting in the ability to enroll a larger number of ischemic stroke patients in the transitions coaching program. Conclusions: Solving the problem of readmissions after ischemic stroke is complex and requires extensive planning and collaboration. Identifying our issues and establishing a pilot program took nearly a year. Key stakeholders and a committed team are essential components of establishing a collaborative process of this magnitude. The pilot program will be evaluated by comparting readmission rates in the ischemic stroke population pre and post initiation.
Advances in cryopreservation: we are not frozen in time

Life is like riding a bicycle, to keep your balance you must keep moving. -Albert Einstein.
Drivers and Risk Factors of Unplanned 30‐Day Readmission Following Spinal Cord Stimulator Implantation

Objectives Unplanned 30-day readmission rates contribute significantly to growing national healthcare expenditures. Drivers of unplanned 30-day readmission after spinal cord stimulator (SCS) implantation are relatively unknown. The aim of this study was to determine drivers of 30-day unplanned readmission following SCS implantation. Methods The National Readmission Database was queried to identify all patients who underwent SCS implantation for the 2013 calendar year. Patients were grouped by readmission status, “No Readmission” and “Unplanned 30-day Readmission.” Patient demographics and comorbidities were collected for each patient. The primary outcome of interest was the rate of unplanned 30-day readmissions and associated driving factors. A multivariate analysis was used to determine independent predictors of unplanned 30-day readmission after SCS implantation. Results We identified 1521 patients who underwent SCS implantation, with 113 (7.4%) experiencing an unplanned readmission within 30 days. Baseline patient demographics, comorbidities, and hospital characteristics were similar between both cohorts. The three main drivers for 30-day readmission after SCS implantation include: 1) infection (not related to SCS device), 2) infection due to device (limited to only hardware infection), and 3) mechanical complication of SCS device. Furthermore, obesity was found to be an independent predictor of 30-day readmission (OR: 1.86, p = 0.008). Conclusion Our study suggests that infectious and mechanical complications are the primary drivers of unplanned 30-day readmission after SCS implantation, with obesity as an independent predictor of unplanned readmission. Given the technological advancements in SCS, repeated studies are necessary to identify factors associated with unplanned 30-day readmission rates after SCS implantation to improve patient outcomes and reduce associated costs.
Shakespeare / Not Shakespeare: Afterword

This afterword identifies Shakespearean fidelity as a central, largely untheorized issue in current Shakespeare adaptation studies. While stressing that fidelity is only one part of an adaptation’s relationship to its source(s), Lanier offers the theory of “selective essentialization” as a way to conceptualize how adaptations lay claim to some principle of resemblance between themselves and their sources. He then turns to the tricky case of “unmarked Shakespeare adaptations,” adaptations which do not announce their relationship to Shakespeare, to consider questions of attribution, critical legitimation, and the specter of disciplinary imperialism in recent studies.
Effective active learning tools for an embedded systems course

This paper presents tools the author uses to enhance student motivation in a microcontroller-based embedded systems course. The course is offered as part of a requirement in a computer engineering degree program. In the traditional lecture-based teaching and learning process, information typically flows in one direction with very little active involvement by the students. There are a number of techniques available in the literature that present the use of active learning techniques in the classroom. To take this active learning approach to the next level, this paper presents three important tools that are utilized in a systematic way to further enhance the students' role in their learning. The first tool uses laboratory assignments for practical hands-on activities that help reinforce the theoretical concepts covered in the classroom. The second tool uses “peer-teaching” technique in which students take active role in learning a topic and present it to the class, followed by questions, discussions, and quiz. The third tool is “self-proposed” final course project in which students are expected to apply their creativity in coming up with a proposal for a project of their own choice (with the instructor approval), implement the project and present it to the class.
Nurses’ Caring Behaviors: The Perception of Patients With Cancer at the Time of Discharge After Surgery

Background Duffy's Quality-Caring Model guides nursing practice at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, FL. No published studies using this model in oncology were found. Objectives The purpose of this article is to determine patients' perceptions of nurse caring behaviors at the time of discharge after surgery. Methods A descriptive correlational design was used. Data were collected using Duffy's Caring Assessment Tool (CAT). Simple regression analyses were performed. Findings Spearman's correlation coefficients between the scores and age, length of stay, and number of nurses caring for the patients were not significant. No significant association was found between surgical site and CAT scores, nor between gender, race, and disposition posthospitalization. Appreciation of unique meanings and mutual problem solving showed need for improvement.
Ocean/Atmosphere Cycling of Dimethylsulfide

Sulfur is one of the elements for which man’s activities represent a major perturbation of a global geochemical cycle. Although sulfur is a minor element in terms of its abundance in the earth’s crust and atmosphere it plays an important role in atmospheric chemistry by virtue of the fact that it is the principle source for acidic aerosols. For this reason the sulfur cycle is involved in a number of ecological issues of importance on local, regional, and global scales. These issues include 1) the formation and transport of acid precipitation, 2) the impact of aerosols on human health and 3) the effect of aerosols on atmospheric visibility and radiative properties, and 4) the effect of aerosols on cloud distributions and their radiative properties. The possibility has also been raised that sulfur-containing aerosols may have an impact on stratospheric chemistry and thus potentially play a role in the regulation of the planetary ozone layer.
An introduction to compartmental modeling for the budding infectious disease modeler

Mathematical models are ubiquitous in the study of the transmission dynamics of infectious diseases, In particular, the classic ‘susceptible-infectious-recovered’ (SIR) paradigm provides a modeling...
ARTMIP-early start comparison of atmospheric river detection tools: how many atmospheric rivers hit northern California’s Russian River watershed?

Many atmospheric river detection tools (ARDTs) have now been developed. However, their relative performance is not well documented. This paper compares a diverse set of ARDTs by applying them to a single location where a unique 12-year-long time-series from an atmospheric river observatory at Bodega Bay, California is available. The study quantifies the sensitivity of the diagnosed number, duration, and intensity of ARs at this location to the choice of ARDT, and to the choice of reanalysis data set. The ARDTs compared here represent a range of methods that vary in their use of different variables, fixed vs. percentile-based thresholds, geometric shape requirements, Eulerian vs. Lagrangian approaches, and reanalyses. The ARDTs were evaluated first using the datasets documented in their initial publication, which found an average annual count of 19 ± 7. Applying the ARDTs to the same reanalysis dataset yields an average annual count of 19 ± 4. Applying a single ARDT to three reanalyses of varying grid sizes (0.5°, 1.0°–2.5°) showed little sensitivity to the choice of reanalysis. While the annual average AR event count varied by about a factor of two (10–25 per year) depending on the ARDT, average AR duration and maximum intensity varied by less than ± 10%, i.e., 24 ± 2 h duration; 458 ± 44 kg m− 1 s− 1 maximum IVT. ARDTs that use a much higher threshold for integrated vapor transport were compared separately, and yielded just 1–2 ARs annually on average. Generally, ARDTs that include either more stringent geometric criteria or higher thresholds identified the fewest AR events.
The Demise of the Women’s Pages

The “golden era” of the women’s pages was the 1950s and early 1960s. Yet, the end was on the way. While the women who worked in the sections made the most of their positions, journalism critics continued to describe the sections as “ghettos.” Further, women’s liberation leaders wanted to see the end of the women’s pages. Ultimately, the sections were turned into lifestyle or features sections, and most of the women editors lost their positions.
Cognitive test battery for evaluating elderly Chinese Americans.

ABSTRACTObjectives:This study aimed to determine the diagnostic utility of a Chinese test battery for evaluating cognitive loss in elderly Chinese Americans. Methods Data from a pilot study at the Mount Sinai Alzheimer's Disease Research Center was examined. All participants were g 65 years old, primarily Chinese speaking, with adequate sensorimotor capacity to complete cognitive tests. A research diagnosis of normal mild cognitive impairment (MCI) or Alzheimer's disease (AD) was assigned to each participant in consensus conference. Composite scores were created to summarize test performance on overall cognition, memory, attention executive function, and language. Multivariable logistic regression models were used to assess the sensitivity of each cognitive domain for discriminating three diagnostic categories. Adjustment was made for demographic variables (i. e., age, gender, education, primary language, and years living in the USA). Results The sample included 67 normal, 37 MCI, and 12 AD participants. Performance in overall cognition, memory, and attention executive function was significantly worse in AD than in MCI, and performance in MCI was worse than in normal controls. Language performance followed a similar pattern, but differences did not achieve statistical significance among the three diagnostic groups. Conclusions This study highlights the need for cognitive assessment in elderly Chinese immigrants.
Integrative regulation of physiology by histone deacetylase 3

Cell-type-specific gene expression is physiologically modulated by the binding of transcription factors to genomic enhancer sequences, to which chromatin modifiers such as histone deacetylases (HDACs) are recruited. Drugs that inhibit HDACs are in clinical use but lack specificity. HDAC3 is a stoichiometric component of nuclear receptor co-repressor complexes whose enzymatic activity depends on this interaction. HDAC3 is required for many aspects of mammalian development and physiology, for example, for controlling metabolism and circadian rhythms. In this Review, we discuss the mechanisms by which HDAC3 regulates cell type-specific enhancers, the structure of HDAC3 and its function as part of nuclear receptor co-repressors, its enzymatic activity and its post-translational modifications. We then discuss the plethora of tissue-specific physiological functions of HDAC3.
Stress-Induced Cardiomyopathy

Stress-induced cardiomyopathy is characterized by reversible myocardial injury with distinctive regional wall motion abnormalities of the left ventricle, usually precipitated by an emotional or physical stressor. This condition has a strong predilection for older women and has a trend of increasing incidence. The diagnosis can be made based on symptoms, biomarkers, electrocardiogram, coronary angiogram, and noninvasive imaging. It is frequently complicated by acute heart failure, cardiogenic shock, arrhythmias, left ventricular outflow tract obstruction, and ventricular thrombi. Evidence of the treatment of stress-induced cardiomyopathy is limited. Prognosis is not benign; it carries substantial mortality, similar to that of acute coronary syndrome.
Chapter 2 – Molecular Geometries

This chapter introduces the interesting and important topic of molecular geometry of compounds and its implications on the stability, reactivity, and mechanism of the reaction pathway. The geometries that are commonly known as “shapes” play a vital role in natural life, and they are even responsible for the existence of life. One of the best examples is the geometry of iron in hemoglobin that plays an important role in transporting the oxygen in our body function. Molecular geometry can be debated using the valence shell electron pair repulsion (VSEPR) model. There are numerous levels of sophistication—from empirical model to complete model based on Pauli's principle. In this section, the VSEPR approach is at the empirical level to help freshmen understand the basic principles of molecular geometry. This chapter discusses the VSEPR approach for predicting the molecular geometry by considering both general and specific examples. It also discusses the molecular geometry of nonrigid molecules and their stereochemistry.
Primary Cutaneous Rhabdomyosarcoma

Rhabdomyosarcoma is a malignant mesenchymal neoplasm with skeletal muscle differentiation that typically occurs in the deep soft tissue or viscera. Three subtypes comprise the majority of cases of rhabdomyosarcoma: embryonal, alveolar, and pleomorphic. All three types may very rarely occur as primary tumors arising in the skin or subcutis without deep soft tissue involvement. Other uncommon subtypes, such as epithelioid rhabdomyosarcoma, also exist and may occur in the skin, as well. Less than 50 cases of primary cutaneous rhabdomyosarcoma (PC-RMS) have been reported.
Dual Regulation of miR-34a and Notch Signaling in Triple-Negative Breast Cancer by Antibody/miRNA Nanocarriers.

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that lacks expression of the three most common receptors present on other subtypes, leaving it unsusceptible to current targeted or hormonal therapies. In this study, we introduce an alternative treatment strategy for TNBC that exploits its overexpression of Notch1 receptors and its underexpression of the tumor suppressive microRNA (miRNA) miR-34a. Studies have shown that introducing mimics of miR-34a to TNBC cells effectively inhibits cancer growth, but miR-34a cannot be administered in the clinic without a carrier. To enable delivery of miR-34a to TNBC cells, we encapsulated miR-34a mimics in poly(lactic-co-glycolic acid) nanoparticles (NPs) that were functionalized with Notch1 antibodies to produce N1-34a-NPs. In addition to binding Notch1 receptors overexpressed on the surface of TNBC cells, the antibodies in this formulation enable suppression of Notch signaling through signal cascade interference. Herein, we present the results of in vitro experiments that demonstrate N1-34a-NPs can regulate Notch signaling and downstream miR-34a targets in TNBC cells to induce senescence and reduce cell proliferation and migration. These studies demonstrate that NP-mediated co-delivery of miR-34a and Notch1 antibodies is a promising alternative treatment strategy for TNBC, warranting further optimization and in vivo investigation in future studies.
Similar hemostatic responses to hypovolemia induced by hemorrhage and lower body negative pressure reveal a hyperfibrinolytic subset of non-human primates.

Background To study central hypovolemia in humans, lower body negative pressure (LBNP) is a recognized alternative to blood removal (HEM). While LBNP mimics the cardiovascular responses of HEM in baboons, similarities in hemostatic responses to LBNP and HEM remain unknown in this species. Methods Thirteen anesthetized baboons were exposed to progressive hypovolemia by HEM and, four weeks later, by LBNP. Hemostatic activity was evaluated by plasma markers, thromboelastography (TEG), flow cytometry, and platelet aggregometry at baseline (BL), during and after hypovolemia. Results BL values were indistinguishable for most parameters although platelet count, maximal clot strength (MA), protein C, thrombin anti-thrombin complex (TAT), thrombin activatable fibrinolysis inhibitor (TAFI) activity significantly differed between HEM and LBNP. Central hypovolemia induced by either method activated coagulation; TEG R-time decreased and MA increased during and after hypovolemia compared to BL. Platelets displayed activation by flow cytometry; platelet count and functional aggregometry were unchanged. TAFI activity and protein, Factors V and VIII, vWF, Proteins C and S all demonstrated hemodilution during HEM and hemoconcentration during LBNP, whereas tissue plasminogen activator (tPA), plasmin/anti-plasmin complex, and plasminogen activator inhibitor-1 did not. Fibrinolysis (TEG LY30) was unchanged by either method; however, at BL, fibrinolysis varied greatly. Post-hoc analysis separated baboons into low-lysis (LY30 2%) whose fibrinolytic state matched at both HEM and LBNP BL. In high-lysis, BL tPA and LY30 correlated strongly (r = 0.95; P<0.001), but this was absent in low-lysis. In low-lysis, BL TAFI activity and tPA correlated (r = 0.88; P<0.050), but this was absent in high-lysis. Conclusions Central hypovolemia induced by either LBNP or HEM resulted in activation of coagulation; thus, LBNP is an adjunct to study hemorrhage-induced pro-coagulation in baboons. Furthermore, this study revealed a subset of baboons with baseline hyperfibrinolysis, which was strongly coupled to tPA and uncoupled from TAFI activity.
The Reintegration Academy for parolees

The Reintegration Academy was founded in 2009. It was the first program of its kind in the United States to bring a group of parolees to a college campus for an extended period for academic program...
Production of 2,3-Butanediol from non-detoxified wheat straw hydrolysate: Impact of microbial inhibitors on Paenibacillus polymyxa DSM 365

Abstract Lignocellulosic biomass (LB) is a cost-effective, readily available, and attractive substrate to produce 2,3-butanediol (2,3-BD) commercially. Fermentative conversion of non-detoxified wheat straw hydrolysate (WSH) to 2,3-BD was investigated using Paenibacillus polymyxa. The results show that P. polymyxa co-utilizes representative LB-derived sugars (glucose, xylose and arabinose). Comparatively, 2,3-BD fermentations with P. polymyxa in cultures containing glucose-xylose-arabinose in the ratio of 8:11:1 resulted in 1.03- and 1.18-fold increases in 2,3-BD yield and productivity, respectively, relative to glucose-only cultures (control). Subsequently, batch fermentations were conducted using 60 %, 80 %, and 100 % WSH and glucose-only control. P. polymyxa exhibited considerable tolerance to lignocellulose-derived microbial inhibitory compounds (LDMICs) in the 60 %, 80 % and 100 % WSH, as evidenced by growth, which increased 1.16-, 1.26- and 1.32-fold, respectively, when compared to the glucose-only control. The concentrations of 2,3-BD were 32, 31 and 23 g/L in 60 %, 80 % and 100 % WSH, respectively. These concentrations compare favorably to 32 g/L 2,3-BD produced with the glucose-only control without LDMICs. In addition, evaluation of the ability of P. polymyxa to transform LDMICs showed that P. polymyxa has the capacity to use HMF as a carbon source. These results underscore the potential of P. polymyxa for in situ detoxification and large-scale fermentation of WSH to 2,3-BD.
Systematic review with network meta-analysis: comparative efficacy of pharmacologic therapies for fibrosis improvement and resolution of NASH.

Background Nonalcoholic steatohepatitis (NASH) is a common cause of chronic liver disease. There is a major need to understand the efficacy of different pharmacological agents for the treatment of NASH. Aim To assess the relative rank-order of different pharmacological interventions in fibrosis improvement and NASH resolution. Methods A comprehensive search of several databases was conducted by an experienced librarian. We included randomised controlled-trials (RCTs) comparing pharmacological interventions in patients with biopsy-proven NASH. The primary outcome was ≥1 stage improvement in fibrosis. The secondary outcome was NASH resolution. Results A total of 26 RCTs with 23 interventions met the eligibility criteria. Lanifibranor and obeticholic acid had the highest probability of being ranked the most effective intervention for achieving ≥1 stage of fibrosis improvement (SUCRA 0.78) and (SUCRA 0.77), respectively. For NASH resolution, semaglutide, liraglutide and vitamin E plus pioglitazone had the highest probability of being ranked the most effective intervention for achieving NASH resolution (SUCRA 0.89), (SUCRA 0.84) and (SUCRA 0.83), respectively. Lanifibranor, obeticholic acid, pioglitazone and vitamin E were significantly better than placebo in achieving ≥1 stage of fibrosis improvement. Conversely, semaglutide, liraglutide, vitamine E plus pioglitazone, pioglitazone, lanifibranor and obeticholic acid were significantly better than placebo in achieving NASH resolution. Conclusion These data provide relative rank-order efficacy of various NASH therapies in terms of their improvements in liver fibrosis and NASH resolution. Therapies that have been shown to improve NASH resolution may be combined with therapies that have an antifibrotic effect to further boost treatment response rate in future.
Molecular dynamics simulation of synchronization of a driven particle

Synchronization plays an important role in many physical processes. We discuss synchronization in a molecular dynamics simulation of a single particle moving through a viscous liquid while being driven across a washboard potential energy landscape. Our results show many dynamical patterns as the landscape and driving force are altered. For certain conditions, the particle's velocity and location are synchronized or phase-locked and form closed orbits in phase space. Quasi-periodic motion is common, for which the dynamical center of motion shifts the phase space orbit. By isolating synchronized motion in simulations and table-top experiments, we can study complex natural behaviors important to many physical processes.
Postoperative Dysphagia Following Esophagogastric Fundoplication: Does the Timing to First Dilation Matter?

Postoperative dysphagia after anti-reflux surgery typically resolves in a few weeks. However, even after the initial swelling has resolved at 6 weeks, dysphagia can persist in 30% of patients necessitating esophageal dilation. The purpose of this study was to investigate the effect of esophageal dilation on postoperative dysphagia, the recurrence of reflux symptoms, and the efficacy of pneumatic dilations on postoperative dysphagia. A prospectively collected database was reviewed for patients who underwent partial/complete fundoplication with/without paraesophageal hernia repair between 2006 and 2014. Patient age, sex, BMI, DeMeester score, procedure type, procedure duration, length of stay, postoperative dysphagia, time to first pneumatic dilation, number of dilations, and the need for reoperations were collected. The study included 902 consecutive patients, 71.3% females, with a mean age of 57.8 ± 14.7 years. Postoperative dysphagia was noted in 26.3% of patients, of whom 89% had complete fundoplication (p < 0.01). Endoscopic dilation was performed in 93 patients (10.3%) with 59 (63.4%) demonstrating persistent dysphagia. Recurrent reflux symptoms occurred in 35 (37.6%) patients who underwent endoscopic dilation. Patients who underwent a dilation for symptoms of dysphagia were less likely to require a revisional surgery later than patients who had dysphagia but did not undergo a dilation before revisional surgery (17.2% vs 41.7%, respectively, p < 0.001) in the 4-year follow-up period. The duration of initial dilation from surgery was inversely related to the need for revisional surgery (p = 0.047), while more than one dilation was not associated with additive benefit. One attempt at endoscopic dilation of the esophagogastric fundoplication may provide relief in patients with postoperative dysphagia and can be used as a predictive factor for the need of revision. However, there is an increased risk for recurrent reflux symptoms and revisional surgery may ultimately be indicated for control of symptoms.
Zoning: A Guide for 21st-Century Planning: Elliott Sclar, Bernadette Baird-Zars, Lauren Ames Fischer, and Valerie Stahl (Eds.)(2020). Routledge, 308 pages, $42.95 (paperback)

Zoning is the dominant regulatory tool of planning practice. Students in any accredited graduate planning program will learn its basic contours in land use law courses. Practitioners will find that...
"I wish it had a place to go": a nominal group study of barriers to the effectiveness of non-surgical treatments for knee osteoarthritis inclusive of minority populations.

OBJECTIVE To examine patient experience, views, and opinions regarding the ineffectiveness of the current knee osteoarthritis (OA) treatments. METHODS Nominal groups were conducted with consecutive clinic patients with knee OA, oversampling African Americans. Patients discussed and rank-ordered their concerns. RESULTS Fourteen nominal groups with 48 knee OA patients were conducted with a mean age of 60.6 years (standard deviation, 9.8) and a knee OA duration of 7.8 years (sd, 5.4); 25% were men, and 54% were African American. The most frequently cited highly ranked concerns for the ineffectiveness of current knee OA treatments were as follows: (1) medication-related-(A) side effects (3 groups; 4% vote), (B) limited efficacy (5 groups; 11% vote), (C) medication not targeting underlying disease (7 groups; 16% vote), (D) lack of personalized medication use (3 groups; 4% vote), (E) temporary benefit (3 groups; 6% vote), and (F) fear of addiction/natural treatment preference (2 groups; 3% vote); (2) exercise/physical therapy-related-(G) exacerbation of joint pain (1 group; 3% vote), (H) difficulty in doing exercises (2 groups; 2% vote), (I) lack of motivation (8 groups; 12% vote), (J) technical challenges/lack of personalized exercise regimens (1 group; 1% vote), and (K) cost (2 groups; 3% vote); and (3) weight loss-related-(L) difficulty in achieving weight loss (4 groups; 6% vote) and (M) motivation (1 group; 1% vote). CONCLUSIONS A representative sample of participants with knee OA identified several barriers to the effectiveness of current knee OA treatments. This new knowledge provides insights for making the current treatment options potentially more usable and/or more effective.
Build-and-Insert: Anatomical Structure Generation for Surgical Simulators

Development of surgical simulators remains a complex task, especially when the virtual environment (VE) needs modification. In this paper, we describe a build-and-insert mechanism that allows for creation of new anatomical models and their insertion into an existing simulator while preserving the existing tasks (e.g., vessel clipping and cutting) and evaluation metrics. Tools used to generate virtual structures from the Visible Human and patient-specific (CT, MRI, ultrasound, etc.) datasets and insert them into a simulator are presented.
Are we lemmings going off a cliff? The case against the "interventional" pain medicine label.

There is a disturbing trend in pain medicine: the increasing tendency for pain practices to label themselves “interventional pain medicine.” My perspective is based on having practiced as a psychiatrist, an anesthesiologist, and for the last 15 years as a pain medicine specialist in both private and academic settings. For the last 8 years, I have been the chief of pain medicine at the University of Southern California. I see great cause for concern in the movement toward the “interventional subspecialty.” There is even a new subspecialty society, the American Society of Interventional Pain Physicians. The crux of the issue is that the interventional label implies that there is a distinction between “pain medicine” and “interventional pain medicine.” One possible reason that people have been making this distinction might be to prevent possible confusion with those physicians that only provide medications or other noninterventional treatments. Perhaps this confusion can be best avoided by using a term such as “comprehensive pain medicine.” The comprehensive pain physician will be understood to use expertise in medications, rehabilitation therapies, and interventional procedures. There are other, more concerning reasons for the trend toward using the “interventional pain medicine” label. As usual, money appears to be a key issue. Procedural medicine is more highly reimbursed than non-procedure treatments. There are many pain physicians and pain clinics that will only provide services for the more highly reimbursed treatments. These are not practices that seem to focus on the relief of pain and suffering, but rather seem to only focus on the financial bottom line. This kind of thinking will at best be short-lived as regulators crack down. But worse, as the overall reputation of our field diminishes, the opportunity will be left wide open for referring doctors to turn to radiologists to perform these seemingly “non-pain specialist” …
Fatherhood on My Mind

SUMMARY This essay uses an academic letter format to address the topic of fatherhood through the personal perspective of a single, middle-aged, multi-ethnic, gay man. After providing auto-ethnographic reflections of childhood and family life, a survey of influential popular cultural texts and academic literature on fatherhood and parenting is provided. Finally, the letter ends with an in depth examination of the international film Bear Cub/Cachorro, along with concluding auto-ethnographic reflections and thoughts on the author's readiness and desire to become a father.
The Politics of Applied Black Studies An Historical Synthesis for Understanding Social Science Impact

This article documents the activism and applied contributions of select African American social scientists whose applied methods from the mid-1890s to the present made contributions to understanding the black experiences, the achievement of civil rights, and the development of the contemporary Black Studies academic discipline. The resulting historical analysis indicates that black social scientists had initially been, and to some extent continue to be, the progenitors of applied social science methodology. While scholars have recently recognized the marginalization of black social scientists within their respective disciplines, I argue that black social scientists have been the underrecognized intellectual leaders that helped established what is now known as applied social science.
Comment on the accuracy of Rabitz’ effective potential approximation for rotational excitation by collisions

Cross sections for rotational excitation of HCN by low energy collisions with He have been computed with the effective potential approximation of Rabitz and compared with accurate quantum close‐coupling results. Elastic cross sections are found to agree to about 20%; inelastic cross sections agree in general magnitude but not in detailed values for specific quantum transitions.
TD(λ) Converges with Probability 1

The methods of temporal differences (Samuel, 1959s Sutton, 1984, 1988) allow an agent to learn accurate predictions of stationary stochastic future outcomes. The learning is effectively stochastic approximation based on samples extracted from the process generating the agent's future. Sutton (1988) proved that for a special case of temporal differences, the expected values of the predictions converge to their correct values, as larger samples are taken, and Dayan (1992) extended his proof to the general case. This article proves the stronger result than the predictions of a slightly modified form of temporal difference learning converge with probability one, and shows how to quantify the rate of convergence.
A prospective examination of octreotide-induced gall-bladder changes in acromegaly.

OBJECTIVE We wished to determine the effects of octreotide acetate, a somatostatin analogue, on gall-bladder function during treatment of acromegaly. DESIGN We used a prospective, open label trial of somatostatin analogue. PATIENTS Seventeen patients with acromegaly took part. MEASUREMENTS Ultrasonographic evaluation of gall-bladder contents were performed pretreatment, after 1 month, and subsequently at intervals of 3-6 months. RESULTS Non-shadowing floating echogenic particles were observed in the gall-bladder in 12 of 17 patients after (mean +/- SEM) 2.5 +/- 0.6 months of treatment. During long-term treatment (mean 20.8 +/- 4.3, median 13, range 1-59 months), ultrasound evidence for cholelithiasis was observed in four patients after 20 +/- 4 months (range 4.2-43) months of octreotide therapy. No symptoms of biliary tract disease have been observed. Duration of acromegaly, average GH, average IGF-I, gender, age at entry, dose of analogue, and concurrent use of non-steroidal anti-inflammatory drugs did not affect the occurrence of sludge or gallstones. CONCLUSIONS Formation of non-shadowing, floating echogenic particles occurs commonly during the first 6 months of treatment with octreotide acetate. Cholelithiasis is a risk of long-term treatment.
Spectral effects of sampling a continuous-scan Fourier transform spectrometer with a capacitive transimpedance amplifier (CTIA)

In a Michelson interferometer, an incident beam of light ~typically at infrared wavelengths! is split into two beams that travel different distances in the device. Because of the difference in path length ( x), there is a phase difference between the two beams. When the beams are recombined, this phase difference leads to interference, and the output power therefore varies as a function of the path difference (x). This varying output is called the interferogram and will be denoted I(x). It can be shown that apart from multiplicative constants, the spectrum of the incident light @B(n)# can be obtained by taking the Fourier transform of
Hygrothermal Influence on the Flexural Properties of Kevlar-Graphite/Epoxy Hybrid Composites:

The hygrothermal influence on the flexural properties of unidirectional Kevlar 49-graphite/epoxy hybrid composite was investigated in the temperature range -50°C to 150°C. Moisture was introduced into the specimen by immersion in distilled water. Two material lay-ups were used in this investigation. In Kev 49/T-300/Kev 49, Kevlar 49 and graphite prepreg are used as outer and center layer, respectively and in T-300/Kev 49/T-300, it was vice-versa. In both cases the tapes were alternated until the total thickness was achieved. Data for the determination of flexural strength and modulus were generated at various temperatures for both dry and saturated specimens. The results show that both flexural strength and modulus change with the ply sequence of hybrid lami nates. The flexural strength and modulus of Kev 49/T-300/Kev 49 are relatively higher than those of T-300/Kev 49/T-300. The apparent flexural strength decrease with the in crease of temperature in the range 23°C to 150°C. The addition of moisture furt...
On mandatory labeling of animal welfare attributes

This paper assesses US resident support for mandatory labeling of animal welfare information on pork and egg products and outlines policy considerations for assessment prior to implementing any mandatory labeling policies regarding animal welfare practices. Results suggest consumers support mandatory labeling indicating use of gestation crates (stalls) and laying hen cages. Estimates suggest consumers would be willing to pay about 20% higher pork and egg prices to obtain this production practice information. Demographic and latent perception drivers of this support are highlighted. Multiple issues that warrant consideration prior to imposing mandatory labeling are discussed revealing lines of corresponding future research.
Change of sodium chloride surfaces in electric discharges

Abstract A convenient and simple laboratory method for introducing surface defects into some powdered solids is described. The method is applied to monodisperse sodium chloride particles, and the extent of the chemical change associated with the defects is found to depend linearly on the specific surface of the halide.
Interactive multiple model ensemble Kalman filter for traffic estimation and incident detection

This paper studies the problem of real-time traffic estimation and incident detection by posing it as a hybrid state estimation problem. An interactive multiple model ensemble Kalman filter is proposed to solve the sequential estimation problem, and to accommodate the switching dynamics and nonlinearity of the traffic incident model. The effectiveness of the proposed algorithm is evaluated through numerical experiments using a perturbed traffic model as the true model. The supporting source code is available for download at https://github.com/Lab-Work /IMM_EnKF_Traffic_Estimation_Incident_Detection.
Resilience Theory in Archaeology

The past can be characterized by periods of changing and stable relationships between human groups and their environment. In this article, I argue that use of “resilience theory” as a conceptual framework will assist archaeologists in interpreting the past in ways that are interesting and potentially relevant to contemporary issues. Many of the authors in this “In Focus” section primarily concentrate on the relationships associated with patterns of human extraction of resources and the impacts of those human activities on the continuing condition of the ecosystem. These processes are, of course, embedded in a complex web of relationships that are based on multiple interactions of underlying patterns and processes of both the ecological and social domains. In this article, I introduce a resilience theory perspective to argue that these transformations were characterized by very different reorganizations of the socioecological landscape and were the product of a variety of factors that operated at different scales of geography, time, and social organization.
Floral and nesting resources, habitat structure, and fire influence bee distribution across an open‐forest gradient

Given bees' central effect on vegetation communities, it is important to understand how and why bee distributions vary across ecological gradients. We examined how plant community composition, plant diversity, nesting suitability, canopy cover, land use, and fire history affected bee distribution across an open-forest gradient in northwest Indiana, USA, a gradient similar to the historic Midwest United States landscape mosaic. When considered with the other predictors, plant community composition was not a significant predictor of bee community composition. Bee abundance was negatively related to canopy cover and positively to recent fire frequency, bee richness was positively related to plant richness and abundance of potential nesting resources, and bee community composition was significantly related to plant richness, soil characteristics potentially related to nesting suitability, and canopy cover. Thus, bee abundance was predicted by a different set of environmental characteristics than was bee species richness, and bee community composition was predicted, in large part, by a combination of the significant predictors of bee abundance and richness. Differences in bee community composition along the woody vegetation gradient were correlated with relative abundance of oligolectic, or diet specialist, bees. Because oligoleges were rarer than diet generalists and were associated with open habitats, their populations may be especially affected by degradation of open habitats. More habitat-specialist bees were documented for open and forest/scrub habitats than for savanna/woodland habitats, consistent with bees responding to habitats of intermediate woody vegetation density, such as savannas, as ecotones rather than as distinct habitat types. Similarity of bee community composition, similarity of bee abundance, and similarity of bee richness between sites were not significantly related to proximity of sites to each other. Nestedness analysis indicated that species composition in species-poor sites was not merely a subset of species composition at richer sites. The lack of significant proximity or nestedness effects suggests that factors at a small spatial scale strongly influence bees' use of sites. The findings indicate that patterns of plant diversity, nesting resource availability, recent fire, and habitat shading, present at the scale of a few hundred meters, are key determinants of bee community patterns in the mosaic open-savanna-forest landscape.
The accuracy of Internet search engines to predict diagnoses from symptoms can be assessed with a validated scoring system

Abstract Purpose To validate a scoring system that evaluates the ability of Internet search engines to correctly predict diagnoses when symptoms are used as search terms. Methods We developed a five point scoring system to evaluate the diagnostic accuracy of Internet search engines. We identified twenty diagnoses common to a primary care setting to validate the scoring system. One investigator entered the symptoms for each diagnosis into three Internet search engines (Google, Bing, and Ask) and saved the first five webpages from each search. Other investigators reviewed the webpages and assigned a diagnostic accuracy score. They rescored a random sample of webpages two weeks later. To validate the five point scoring system, we calculated convergent validity and test–retest reliability using Kendall's W and Spearman's rho, respectively. We used the Kruskal–Wallis test to look for differences in accuracy scores for the three Internet search engines. Results A total of 600 webpages were reviewed. Kendall's W for the raters was 0.71 ( p p p =0.007). Pairwise comparisons revealed higher scores in the first webpages vs. the fourth (corr p =0.009) and fifth (corr p =0.017). However, this significance was lost when creating composite scores. Conclusions The five point scoring system to assess diagnostic accuracy of Internet search engines is a valid and reliable instrument. The scoring system may be used in future Internet research.
A Genome-wide Screen Identifies p97 as an Essential Regulator of DNA Damage-Dependent CDT1 Destruction

Summary Several proteins, including the replication licensing factor CDT1 and the histone methyltransferase SET8, are targeted for proteolysis during DNA replication and repair by the E3 ubiquitin ligase CRL4 CDT2 . CRL4 CDT2 function is coupled to replication and repair because it only ubiquitinates substrates that associate with chromatin-bound PCNA. Here, we report a genome-wide siRNA screen that identifies multiple factors necessary for CDT1 destruction after UV irradiation. Among these, nucleotide excision repair factors promote CDT1 destruction due to a role in recruiting PCNA to damaged DNA. The COP9/Signalosome regulates CDT2 stability through CUL4 deneddylation. Finally, the p97 AAA + -ATPase and its cofactor UFD1 are required for proteasome-dependent removal of ubiquitinated CDT1 and SET8 from chromatin and their subsequent degradation both in vivo and in a Xenopus egg extract system in vitro. This study provides insight into and a resource for the further exploration of pathways that promote timely degradation of chromatin-associated CRL4 CDT2 substrates.
“Nutrition Pathways” - A Distance Learning Course for Introduction to Nutrition

Abstract LEARNING OUTCOME: To describe the components of a college-level introduction to nutrition course designed for distant learners. The process of developing an introductory college-level telecourse for distant learners involved time, commitment, and the talents of many professionals. "Nutrition Pathways" is an introduction to human nutrition course released in the Fall of 19% to colleges and universities throughout the United States and in foreign countries. The course constitutes an extensive learning system having several components which form a multifaceted learning experience for the distant learner. "Nutrition Pathways" consists of 26, half-hour television programs, an introductory text, a student telecourse guide, a diet analysis project, assignments relating to course content, and a faculty guide with testbank. The television programs personalize the course content by profiling real people in real-life situations using a documentary format. Each video lesson also utilizes renowned experts in nutrition and related fields to validate lesson content. In addition to the comprehensive testbank in the faculty guide are lesson summaries, lesson objectives, and supplementary assignments. The faculty guide also provides implementation suggestions for those who offer the telecourse including samples of a syllabus, welcome letter, and newsletter. The creation of "Nutrition Pathways" was a team effort involving a nutrition content specialist, an instructional designer, a television producer/director, and local, national, and professional advisory committees. Because of the extensive formative evaluation and validation procedures involved in its production, "Nutrition Pathways" promises to be an effective distance learning package.