cssi/SciSciGPT-SciSciNet huggingface dataset:
AB1013 Pulse of Methylprednisolone May Reduce the Risk of Renal Involvement in Children with Henoch-Schonlein Purpura

Background Henoch-Schonlein purpura (HSP) is a disease with small blood vessels inflammation. Although HSP can affect people at any age, most cases occur in children between the ages of 2 and 11. The disease involves skin, intestines, kidneys, and joints. The main symptom is a rash with numerous small bruises, which have a raised appearance, over the legs or buttocks. Almost 30-40% of children with HSP may have renal involvement. In most patients, the kidney impairment is mild and goes away without any long-term damage. However, about 5% of patients may develop progressive kidney disease and 1% may go on to end stage renal disease (ESRD). Objectives To date, treatment of HSP remains primarily supportive in most cases. Hematuria at disease onset and persistence of renal manifestations during the occurrence of HSP can be significant predictors of possible development of renal sequelae. These manifestations, along with other features may predict the development of renal sequelae in most patients. Various drugs have been used to prevent renal disease from progressing. The results have been inconsistent. The aim of our study was to evaluate the efficacy of pulsed Methylprednisolone in children with HSP and renal manifestation. Methods 69 children with HSP who had HSP and were admitted to Mofid Children9s Hospital were evaluated; Children who had the indication of treatment were received 30mg/kg of Methylprednisolone for three consecutive days instead of traditionally oral prednisolone therapy. All of children were followed for ten years and evaluated for renal involvement. Results Of 69 patients with HSP, 55 children full filed the indication of therapy and were received pulsed methylprednisolone. Only 6 patients had the renal manifestation but no ESRD. Only one patient had persistent renal disease that was treated by Cyclophosphamide. Conclusions The previous results showed that 30-40% of children with HSP may have renal involvement and about 5% of patients may develop progressive kidney disease. Our 10 years follow up showed that only 10% of children who were admitted to Hospital and were received pulse of Methylprednisolone, had renal involvement. None of 69 patients suffered ESRD. We suggest limiting the indications of steroid therapy for children with HSP. However, if the patients need to receive steroid therapy, pulse of Methylprednisolone may reduce the latent renal complications. Disclosure of Interest None declared
Outcomes research: high hopes, low yield?

The bulk of the nation's health services research has been redirected toward patient outcomes research conducted by the U.S. Agency for Health Care Policy and Research. But those expecting dramatic changes from the agency's work are likely be disappointed. One reason is the tendency to seize upon clever new theories as solutions to intricate problems, such as the inflated expectation that managed care will reap huge cost-savings.
The Broughamian Philosophy of Enlightenment and its Critics

Henry Lord Brougham (1778-1868) belongs with Thomas Jefferson and Horace Mann in the United States and Egerton Ryerson in Canada as one of the great promoters and founders of public education in the English-speaking world. His most famous phrase is The schoolmaster is abroad and this quote symbolizes his belief that the fate of the modern, liberal society depends on free access to education for the population at large. It is not that Brougham any more than Jefferson failed to draw a distinction between the education that was fitted for the gifted few and that suited to the general public whose lives would lack the leisure for intellectual pursuits of the highest difficulty and training. Rather it is that Brougham adheres to a philosophy of enlightenment which sees the interests of science and society as ultimately indistinguishable and which insists that the spread of knowledge about both the natural and social worlds carries with it no price in terms of individual or social morality. This paper gives an overview of Brougham's philosophy of public enlightenment including his views on the example of Benjamin Franklin. It then reviews the attacks on this philosophy from the Anglican point of view in the form of the Reverend E.W. Grinfield's A Reply to Mr. Brougham's Practical Observations upon the Education of the People and from the Roman Catholic point of view in Cardinal Newman's famous Tamworth Reading Room and Discourse on University Education.
Labeling the semantic roles of commas

Commas and the surrounding sentence structure often express relations that are essential to understanding the meaning of the sentence. This paper proposes a set of relations commas participate in, expanding on previous work in this area, and develops a new dataset annotated with this set of labels. We identify features that are important to achieve a good performance on comma labeling and then develop a machine learning method that achieves high accuracy on identifying comma relations, improving over previous work. Finally, we discuss a variety of possible uses, both as syntactic and discourse-oriented features and constraints for downstream tasks.
An Introduction to Global Family Therapy: Examining the Empirical Evidence of Terror Management Theory Within the Family and Social System

ABSTRACTTerror Management Theory (TMT) endorses that individuals manage fears of mortality by establishing a coherent cultural worldview and earning self-esteem by meeting cultural worldview standards. Global Family Therapy (GFT) examines these constructs within family and social systems. Aims of GFT include the development of a culturally-fluid worldview that earns self-esteem across various resources. Barriers to this process include GFT's concepts of systemic cultural worldview discrepancies, systemic disproportions of resources for self-esteem, and symbolic immortality's multigenerational process. By emphasizing the role of cultural worldviews, GFT expands the concept of culture from being a component of family therapy to being the emphasis of family therapy.
A Practical Guide, With Theoretical Underpinnings, for Creating Effective Virtual Reality Learning Environments

With the advent of open source virtual environments, the associated cost reductions, and the more flexible options, avatar-based virtual reality environments are within reach of educators. By using...
Developing Rural Water Systems: An Evaluation of Haiti’s First Chlorinated Municipal Water System in the Central Plateau

Haiti has the worst drinking-water indicators in the Western Hemisphere and access to improved water sources has not dramatically improved for over two decades. This limited success despite hefty investments can be attributed to a variety of reasons including lack of community involvement and lack of long-term support of operation and maintenance for rural water systems. This paper presents a case study of Haiti’s first municipal chlorinated water system in the rural Central Plateau and critically examines its effectiveness. While the technology behind the Cange water system is highly innovative and effective, its lack of community involvement and feasible operation/maintenance jeopardizes its long-term viability. Methods to sustain the system without major external intervention are currently being developed and attempted through a partnership with Haiti’s public water sector. NGOs and organizations should ensure that an appropriate community development framework is established prior to system installation so that these problems can be avoided.
Every PACE Counts: Learning About Blood Cells and Blood Flow in Peripheral Artery Disease.

Article, see p 1417 In our care of patients with peripheral artery disease (PAD), the fundamental goal is to “walk more, suffer less.” More than 200 million people worldwide have PAD.1 Patients with PAD experience limb ischemia leading to claudication, disability, and risk of amputation. Available therapies to enhance limb function remain inadequate. Even with optimal medical therapy, including cilostazol and supervised exercise intervention, many patients with PAD experience declining walking ability.2 Revascularization with surgical or endovascular approaches may restore function but carries procedural risks and may have limited durability. Thus, considerable need exists for novel approaches to treat limb symptoms in PAD. Obstructive atherosclerotic lesions precipitate limb ischemia in PAD. However, available evidence indicates that the generation of claudication symptoms is more complex.3 Hemodynamic compromise measured by the ankle-brachial index correlates poorly with symptom severity and is not changed along with improvements in walking ability induced by exercise intervention. Animal models of PAD suggest that insufficient microvascular flow contributes to limb ischemia. The concept of a therapy to promote vascular growth remains an appealing therapeutic strategy to help patients with …
Abstract 83: Modulation of Macrophage Function via Metabolism by Trypanosoma cruzi

Chagas heart disease is an inflammatory cardiomyopathy which presents with mononuclear infiltrates in the interstitium and myocardial fibrosis in the chronic phase. Incomplete clearance by macrophages of the etiologic agent, Trypanosoma cruzi , is a significant cause of chronic disease development in approximately 30% of those serologically positive for the blood-borne parasite. The differential metabolic status, anaerobic glycolysis and mitochondria-dependent oxidative phosphorylation, are respectively associated with pro-inflammatory (M1) and anti-inflammatory (M2) functional activation of macrophages. Reactive oxygen species (ROS) have been shown to be an intracellular signal for glycolysis while peroxisome proliferator-activated receptors (PPARs) that enhance fatty acid oxidation provide transcription control of macrophage functional state. In our studies using diverse T. cruzi isolates, we showed that SylvioX10 (virulent), but not TCC (non-virulent), isolates are able to differentially control extracellular and intracellular ROS levels in macrophages. We found in macrophages infected with SylvioX10, the nuclear expression of PPAR-α was increased by 18 hours post-infection, and mitochondrial metabolic activity was similar to that of not-infected and M2 controls; which indicates anti-inflammatory function of macrophages, and therefore prohibiting T. cruzi clearance. In our ongoing studies, we are examining the impact of PPAR-α inhibitors in modulating the metabolic gene expression profile, functional phenotype and parasite survival in macrophages. Our data will provide the first indication that host macrophages have deficient pro-inflammatory capacity due to sub-optimal glucose oxidation, and enhancing the metabolism that supports T. cruzi clearance will provide a valuable basis for a strategy to arrest Chagas disease progression.
Trump’s Paris withdrawal and the reconfiguration of global climate change governance

President Donald Trump’s 1 June 2017 decision to withdraw the United States from the Paris Climate Accord understandably generated significant concern about the future of the planet. To be sure, th...
Of Piketty and Perpetuities

For the first time since independence, in a nation founded in large part on the rejection of a fixed nobility determined by birth and perpetuated by inheritance, America is paving the way for the creation of dynastic family wealth. Abolition or evisceration of the Rule Against Perpetuities in over half the states along with the likely repeal of the federal estate tax mean that there soon will be no obstacles to creating large pools of wealth that will insure lavish incomes to lucky heirs for generations without end. The timing of these legal changes could hardly be worse. Marshaling innovative economic data extending back centuries, Thomas Picketty convincingly argues that the relatively egalitarian incomes enjoyed in developed economies from the end of World War II until around 1980 were an aberration and that we are in the process of returning to the historical norm of much greater income and wealth inequality. The driving force is the return to a world in which the rate of return to capital (r) exceeds the growth rate of national income (g) — another historical norm temporarily abrogated during the 20th century. The wealthy hold an extremely high fraction of national wealth, and when returns to that wealth exceed the growth rate of national income, their relative economic power (and all that goes with that) increases proportionally. The main contribution of this article is, unhappily, to explore reasons that this revival of unending inherited wealth is of even greater concern than previously thought. First and foremost, the savings rate to a significant degree will be set by the dead hand control of those creating perpetual dynastic trust. In order to insure that trust assets keep up with income and beneficiary class growth, settlors will need to mandate very high savings rates for trust income. In the long term excessive savings (in excess of the “golden rule” savings rate), perhaps surprisingly, can actually retard the growth of consumption. In the shorter term, in a well-known phenomenon called the “paradox of thrift,” high savings rates can cause recessions, make them more severe, and increase their duration. Second, beneficiaries of dynastic trusts lack the power to dissipate the pools of family wealth that provide their high incomes. Prodigal children’s spending of principal is a powerful force for reducing inequality and increasing socioeconomic mobility. When not barred from doing so, descendants’ ability to sell trust assets to fund even more lavish lifestyles means that they will buy copious goods and services from those with lower incomes and less wealth. Thus perpetual dynastic family wealth thus imposes real social costs. This article recommends the conventional solution to such negative externalities: calibrated taxation of the anti-social behaviors. Instead of reinstating the Rule Against Perpetuities, this article instead suggests imposing perpetuities taxes on dynastic trusts with rates set, as closely as possible, to equal the costs imposed in terms of lower growth; more frequent and sharper business cycles; higher inequality; and lower socioeconomic mobility.
Risk prediction for heterogeneous populations with application to hospital admission prediction

This article is motivated by the increasing need to model risk for large hospital and health care systems that provide services to diverse and complex patients. Often, heterogeneity across a population is determined by a set of factors such as chronic conditions. When these stratifying factors result in overlapping subpopulations, it is likely that the covariate effects for the overlapping groups have some similarity. We exploit this similarity by imposing structural constraints on the importance of variables in predicting outcomes such as hospital admission. Our basic assumption is that if a variable is important for a subpopulation with one of the chronic conditions, then it should be important for the subpopulation with both conditions. However, a variable can be important for the subpopulation with two particular chronic conditions but not for the subpopulations of people with just one of those two conditions. This assumption and its generalization to more conditions are reasonable and aid greatly in borrowing strength across the subpopulations. We prove an oracle property for our estimation method and show that even when the structural assumptions are misspecified, our method will still include all of the truly nonzero variables in large samples. We demonstrate impressive performance of our method in extensive numerical studies and on an application in hospital admission prediction and validation for the Medicare population of a large health care provider.
Polaron size and shape effects on oxygen vacancy interactions in lanthanum strontium ferrite

Both aliovalent doping and the charge state of multivalent lattice ions determine the oxygen non-stoichiometry (δ) of mixed ionic and electronic conductors (MIECs). Unfortunately, it has been challenging for both modeling and experiments to determine the multivalent ion charge states in MIECs. Here, the Fe charge state distribution was determined for various compositions and phases of the MIEC La1−xSrxFeO3−δ (LSF) using the spin-polarized density functional theory (DFT)-predicted magnetic moments on Fe. It was found that electron occupancy and crystal-field-splitting-induced differences between the Fe 3d-orbitals of the square pyramidally coordinated, oxygen-vacancy-adjacent Fe atoms and the octahedrally-coordinated, oxygen-vacancy-distant-Fe atoms determined whether the excess electrons produced during oxygen vacancy formation remained localized at the first nearest neighbor Fe atoms (resulting in small oxygen vacancy polarons, as in LaFeO3) or were distributed to the second-nearest-neighbor Fe atoms (resulting in large oxygen vacancy polarons, as in SrFeO3). The progressively larger polaron size and anisotropic shape changes with increasing Sr resulted in increasing oxygen vacancy interactions, as indicated by an increase in the oxygen vacancy formation energy above a critical δ threshold. This was consistent with experimental results showing that Sr-rich LSF and highly oxygen deficient compositions are prone to oxygen-vacancy-ordering-induced phase transformations, while Sr-poor and oxygen-rich LSF compositions are not. Since oxygen vacancy induced phase transformations cause a decrease in the mobile oxygen vacancy site fraction (X), both δ and X were predicted as a function of temperature and oxygen partial pressure, for multiple LSF compositions and phases using a combined thermodynamics and DFT approach.
Review: Continuous compression and 30:2 compression-to-ventilation CPR ratio do not differ for survival

Source Citation Ashoor HM, Lillie E, Zarin W, et al; ILCOR Basic Life Support Task Force. Effectiveness of different compression-to-ventilation methods for cardiopulmonary resuscitation: A systemat...
Grief Reactions: A Neurobiological Approach

This chapter reviews the current state of neuroscience research suggesting that there may be neurobiological correlates of grief. This evidence comes from studies involving functional and structural neuroimaging techniques in bereaved individuals with a typical grief pattern as well as in those whose grief is more severe and prolonged. Understanding the neurological mechanisms contributing to various outcomes in grief may allow us to not only better understand and treat bereaved populations, but also to predict and prevent conditions such as complicated grief.
Imaging of Pediatric Salivary Glands

Salivary gland diseases in children are uncommon, and the relative incidence of pathologies is different than in adults. This article presents a comprehensive review of congenital and acquired disorders that affect the major salivary glands in the pediatric population, highlighting the imaging findings that are important in defining the appropriate diagnosis or narrowing of the differential diagnosis.
Novel Techniques as Applied to Fracture Process Zone Theory

A number of relatively new techniques utilizing in situ high voltage electron microscopy (HVEM),1,2 synchrotron radiation, 3 selected area electron channeling patterns (SACP’s),4,5 acoustic emission (AE) 6,7 and flaw reconstruction8–10 are being applied to improve the fundamental understanding of fracture processes. Only a few of these will be discussed in detail, specifically the AE and SACP techniques, and how these are contributing understanding to the details of sub-critical crack growth.
Our dwindling national blood supply.

Blood is a good thing, but like many good things, it comes with risks. In the USA, all emphasis is upon the safety of the blood supply. During the past 3 decades, no less than 13 new tests on donor blood have been mandated. The donors themselves have to hurdle over some 50 questions before being considered suitable to contribute blood and blood products acceptable for transfusion. Consequently, blood has become much safer but is in increasingly shorter supply and very expensive.
Scanning for discounts: examining the redemption of competing mobile coupons

Coupons research has typically focused on single-coupon redemption, with scant attention devoted to multiple, competing coupons. To bridge this gap, we observe supermarket shoppers who used their smartphones to scan products in-store, receiving both coupons for the scanned product and several others as a result. We model the determinants of redemption in this context, particularly net price range (NPR), coupon value, brand loyalty, and number of coupons. Latent class analysis uncovers two consumer segments: brand-focused shoppers (79.9%), who use internal reference prices, and deal-prone shoppers (20.1%), who use stimulus-based reference prices. Targeting by means of segment membership, NPR, and loyalty is indispensable: the same $0.50 coupon can have a redemption probability as low as 30% and as large as 80%, depending on these characteristics. Overall, the study sheds light on drivers of redemption under competition and provides managers with a blueprint to improve redemption rates by targeting shoppers with customized coupons.
A Microservices-Based Smart IoT Gateway System

With IoT-enabled services becoming ubiquitous, the need for its integration with cloud computing is becoming vital. IoT sensors, being of a non-standardized nature, operate over a plethora of radio frequency communication protocols and transmit data in varied packet formats, which are often incompatible with each other. In this paper, we present a microservices-based design and the details of our implementation of an IoT Gateway System that enables sensor-to-cloud connectivity across varying types of sensors, RF communication protocols, data packet formats, and even cloud service providers. The design also includes support for an application-specific edge-analytics module and a database to house sensor telemetry locally. Our proof-of-concept implementation supports 6LoWPAN for sensor communication and Azure for the cloud platform.
Call for Art Submissions: Disability and Shame Forum

The Review of Disability Studies: An International Journal is issuing a Call for Art Submissions to be included in the special forum on the subject of shame and disability, broadly conceived. It is hoped that through critical discourse addressing the historical and current contexts, contributing factors, effects, and responses to shame, greater understanding of this phenomena will diminish discrimination and violence. May 1, 2019 - Art Online Submissions Due. Please submit to the category “Forum - Disability and Shame” at rdsjournal.org June 1, 2019 - Guest Editors Review & Publication Due June - August, 2019 - Publication Process September 1, 2019 - Anticipated Publication Date
THE JOHNSON BEHAVIORAL SYSTEM MODEL FOR NURSING AND THE PURSUIT OF QUALITY HEALTH CARE

ABSTRACT This presentation has several objectives. The first is to provide a general overview of the Johnson Behavioral System Model. The pertinent elements of the model will be identified as will the form of relationships between and among the elements. A concurrent aim is to examine the ways in which this model's concepts and constructs might serve the cause of quality health care. I shall explore this model's potential for improving nursing care in the following three areas: (1). Its potential to provide greater rectitude than the existing nursing history approach; (2). Its potential to identify more relevant behavioral responses to illness for which nurses must plan an effective intervention; (3). Its ability to generate substantive insights which would otherwise be unavailable, especially those which are a joint product of conceptualization and empiricalization linked together in an action-research process.
Radical sensitive zinc-based nanoparticle EUV photoresists

Zirconium- and hafnium-based nanoparticles demonstrated good patterning behavior in deep-ultra-violet (DUV), electron-beam (E-beam) and extreme ultra-violet (EUV) lithography. Among these Zr- and Hf-based hybrid nanoparticles, the methacrylic acid (MAA) modified zirconium oxide nanoparticles1 (ZrO2-MAA-NP) give out the best over-all-performance: 26 nm lines are obtained at 4.2 mJ/cm2. However, both Zr and Hf are relatively low EUV absorbing metals2, and integration of high EUV absorption elements, such as Zn, is considered to be a more promising route to further improve lithographic performance under EUV radiation. Zinc-based nanoparticle photoresists, possessing ultra-small size, have exhibited promising sensitivities and better resolution. Here, we combined methacrylate ligand and high EUV absorption element Zn, to demonstrate a novel zinc oxide-based nanoparticle photoresist using a photo-radical generator (PRG). Compared with conventional photo-acid initiated nanoparticle-based photoresists, a better resolution and sensitivity has been found with the addition of photo-radical generator (PRG). This unique behavior is promising to provide new possibilities for rapid three-dimensional (3D) -printing.
KESULITAN SISWA DALAM MENYELESAIKAN SOAL OPERASI BENTUK ALJABAR

Mathematics is very important in the face of science and technology and in life everyday. Algebra is one part of mathematics that is close to everyday life, therefore understanding algebraic concepts is necessary for students. Difficulties in one part of mathematics can affect the difficulties of the other. This study aims to determine the difficulties experienced by students in solving the problem of algebraic operations. This type of research is qualitative research. Subjects in this study were students of class VIII D SMP Negeri 1 Salam Magelang , Central Java in the odd semester of the academic year 2016/2017. Data collection methods used include algebraic and open-ended operation tests. Data analysis techniques include data reduction, data presentation, and conclusions. The result of the research stated that there are students' difficulties in doing algebraic problems related to concept and principle. Difficulties experienced by students related to the concept of difficulty in determining variables and constants, including not understanding the definitions of variables and constants, and difficulties in applying the concept of division on algebra. While the difficulty experienced in terms of principle is the application of the principle of addition to the algebraic form, the reduction in algebraic form, multiplication on the algebraic form, simplifying algebraic fractions, factoring, and solving algebra-related stories.
Chapter 1 – Setting the Stage

Publisher Summary This chapter discusses the scientific, clinical, and societal events which led to the recognition of the importance of Alzheimer disease (AD) in the period between 1960 and 1980, presented through the medium of oral history. By 1980, the importance of AD was recognized in the scientific community and an active Alzheimer's Association had been formed where the National Institutes of Health (NIH) began to fund AD research seriously. From the time of the publication of the first case in 1907 throughout the early years, almost all of the publications about AD usually came from people who had first-generation connections with the Alzheimer laboratory in Munich. This chapter also highlights the fact that during the first third of the 20th century, the important discriminating factor in diagnosis seemed to have been the age of the patient. Generally, the greater severity of the clinical presentation of the presenile disease and the focality of the triad of agnosia, apraxia, and aphasia were interpreted as yet another support for the distinction between presenile and senile dementias.
Position-Based Social Choice Methods for Intransitive Incomplete Pairwise Vote Sets (Student Abstract)

Combining the decisions of multiple agents into a final decision requires the use of social choice mechanisms. Pairwise decisions are often incomplete and intransitive, preventing the use of Borda count and other position-based social choice mechanisms. We propose and compare multiple methods for converting incomplete intransitive pairwise vote sets to complete rankings, enabling position-based social choice methods. The algorithms are evaluated on their output's Kendall's τ similarity when implementing pairwise social choice mechanisms. We show that there is only a small difference between the outputs of social choice methods on the original pairwise vote set and the generated ranking set on a real-world pairwise voting dataset. Source code for the analysis is available.1
Transitioning to Long-Term Care: Family Caregiver Experiences of Dementia, Communities, and Counseling.

Objectives: Previous analyses of interventions targeting relationships between family caregivers of people with Alzheimer’s disease and related dementias and residential long-term care (RLTC) staff...
R2D3: A Reliability Engine for 3D Parallel Systems

This paper proposes a holistic reliability management engine, R2D3, for post-Moore’s technology based parallel 3D systems that have low yield and high failure rate. The proposed engine, comprising of a controller, reconfigurable crossbars and detection circuitry, provides concurrent single-replay detection and diagnosis, fault-mitigating repair and aging-aware lifetime management at runtime. We show that R2D3 achieves 96% coverage of defects, repairs faulty cores, and reduces V th degradation by 53%. This leads to a 78% performance improvement over 8 years and a 2.16× longer mean-time-to-failure over a baseline 8-core 3D processor with no reliability management.
Role of Static Displacements in Stabilizing Body Centered Cubic High Entropy Alloys.

The configurational entropy of high entropy alloys (HEAs) plays little role in the stabilization of one particular crystal structure over another. We show that disorder-induced atomic displacements help stabilize body centered cubic (bcc) structure HEAs with average valences $l4.7$. These disorder-induced atomic displacements mimic the temperature-induced vibrations that stabilize the bcc structure of group IV elemental metals at high temperatures. The static displacements are significantly larger than for face centered cubic HEAs, approaching values associated with the Lindemann criterion for melting. Chemical disorder in high entropy alloys have a previously unidentified, nonentropic energy contribution that stabilizes a particular crystalline ground state.
Bed downtime: the novel use of a quality metric allows inpatient providers to improve patient flow from the emergency department.

Background Emergency department (ED) boarding time is associated with increased length of stay (LOS) and inpatient mortality. Despite the documented impact of ED boarding on inpatient outcomes, a disparity continues to exist between the attention paid to the issue by inpatient and ED providers. A perceived lack of high yield strategies to address ED boarding from the perspective of the inpatient provider may discourage involvement in improvement initiatives on the subject. As such, further work is needed to identify inpatient metrics and strategies to address patient flow problems, and which may improve ED boarding time. Methods After initial system analysis, our multidisciplinary quality improvement (QI) group defined the process time metric ‘bed downtime’—the time from which a bed is vacated by a discharged patient to the time an ED patient is assigned to that bed. Using the Lean Sigma QI approach, this metric was targeted for improvement on the internal medicine hospitalist service at a tertiary care academic medical centre. Interventions Interventions included improving inpatient provider awareness of the problem, real-time provider notification of empty beds, a weekly retrospective emailed performance dashboard and the creation of a guideline document for admission procedures. Results This package of interventions was associated with a 125 min reduction in mean bed downtime for incoming ED patients (254 min to 129 min) admitted to the intervention unit. Conclusion Use of the bed downtime metric as a QI target was associated with marked improvements in process time during our project. The use of this metric may enhance the ability of inpatient providers to participate in QI efforts to improve patient flow from the ED. Further study is needed to determine if use of the metric may be effective at reducing boarding time without requiring alterations to LOS or discharge patterns.
Just Responsibility: A Human Rights Theory of Global Justice: by Brooke Ackerly, New York, Oxford University Press, 2018, 314 pp., $33.95 (paperback), ISBN 978-0-19-066294-3

In Just Responsibility, Brooke Ackerly tells the political story of Kalpona Akter and the Bangladesh Center for Worker Solidarity (BCWS) to develop a theory, methodology, and praxis called “just re...
Linking criminal justice-involved individuals to HIV, Hepatitis C, and opioid use disorder prevention and treatment services upon release to the community: Progress, gaps, and future directions

Abstract Improving HIV and Hepatitis C Virus (HCV) management among people involved in the criminal justice (CJ) system who use drugs, in particular those with opioid use disorder (OUD), requires effective approaches to screening, linkage, and adherence to integrated prevention and treatment services across correctional and community agencies and providers. This manuscript reviews the literature to explore gaps in HIV, Hepatitis C, and OUD prevention, treatment, and delivery cascades of care for persons involved in the CJ system. Specifically, we compare two models of linkage to prevention and treatment services: Peer/Patient Navigation (PN) wherein the PN links CJ-involved individuals to community-based infectious disease (ID) and substance use prevention and treatment services, and Mobile Health Units (MHU) wherein individuals are linked to a MHU within their community that provides integrated ID and substance use prevention and treatment services. The most notable finding is a gap in the literature, with few to no comparisons of models linking individuals recently released from the CJ system to integrated HIV, Hepatitis C, and OUD prevention and treatment and other harm reduction services. Further, few published studies address the geographical distinctions that affect service implementation and their effects on these substance use, ID and harm reduction care cascades. This manuscript makes specific recommendations to fill this gap through a detailed evaluation of PN and MHU linkage models to co-located and integrated HIV, Hepatitis C, and OUD prevention and treatment services across different communities within the U.S.
Abstract 743: Altered ER and PR transcription factor activity associated with endocrine therapy resistance in breast cancer

Half of estrogen receptor (ERα)-positive breast cancer patients treated with endocrine therapies display intrinsic or acquired therapy resistance. One-third of patients with acquired resistance present with metastatic tumors containing ERα-Y537S mutations. This mutation results in constitutive activity of ERα and altered ERα-associated gene expression. Previous research suggests that ERα and the progesterone receptor (PR) engage in complex interactions involving reciprocal regulation of ERα and PR transcription factor activity known as ERα/PR crosstalk. My central hypothesis is that ERα-Y537S alters the transcription factor activity of ERα and PR, causing dysregulation of gene expression in SERM-resistant breast cancer. While previous research has assessed the impact of the ERα-Y537S mutation on ERα-associated chromatin binding and gene expression, here I assess the effect of the resistance-associated ERα-Y537S mutation on ERα and PR activity and crosstalk. Simultaneous analysis of transcription factor binding activity (ChIP-seq), gene expression (RNA-seq), and proximity-based interaction (NanoBRET) indicates that active PR binding across the genome is increased in the context of ERα-Y537S, suggesting that ERα/PR crosstalk is significantly altered. Importantly, PR chromatin binding in the context of ERα-Y537S appears to be elevated regardless of the stimulation of PR activity with the agonist R5020. These findings, along with identification of candidate genes of potential therapeutic value, will be applied using patient-derived tumor organoids to determine the efficacy of simultaneously targeting ERα and PR to overcome endocrine therapy resistance in breast cancer. Citation Format: Rosemary J. Huggins. Altered ER and PR transcription factor activity associated with endocrine therapy resistance in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 743.
Operations for Colonic Diverticulitis (Including Lower Gastrointestinal Bleeding)

This operation is applicable to elective surgery for diverticular disease and may be used during emergency surgery for lower gastrointestinal bleeding. In the latter case, it is crucial to localize the bleeding source before surgery.
Comprehensive Report of Fan Performance from Duct Rake Instrumentation on 1.294 Pressure Ratio, 806 FT/SEC Tip Speed Turbofan Simulator Models

A large scale model representative of an advanced ducted propulsor-type, low-noise, very high bypass ratio turbofan engine was tested for acoustics, aerodynamic performance, and off-design operability in the NASA Glenn 9- by 15-Foot Low-Speed Wind Tunnel. The test was part of NASA s Advanced Subsonic Technology Noise Reduction Program. The low tip speed fan, nacelle, and un-powered core passage were simulated. As might be expected, the effect of stall management casing treatment was a performance penalty. Reducing the recirculating flow at the fan tip reduced the penalty while still providing sufficient stall margin. Two fans were tested with the same aerodynamic design; one with graphite composite material, and the other with solid titanium. There were surprising performance differences between the two fans, though both blades showed some indication of transitional flow near the tips. Though the pressure and temperature ratios were low for this fan design, the techniques used to improve thermocouple measurement accuracy gave repeatable data with adiabatic efficiencies agreeing within 1 percent. The measured fan adiabatic efficiency at simulated takeoff conditions was 93.7 percent and matched the design intent.
Recovery of Blocky Images in Electrical Impedance Tomography

The techniques of electrical impedance tomography (EIT) have been widely studied over the past several years, for applications in both medical imaging and nondestructive evaluation. The goal is to find the electrical conductivity of a spatially inhomogeneous medium inside a given domain, using electrostatic measurements collected at the boundary.
The inventive step and cooperative harmonization

This chapter considers that worldwide patent harmonization on the inventive step requirement (non obviousness) is a distant (and not altogether desirable) probability. Nonetheless, the current harmonization efforts that are occurring on the administrative level may do more to bring harmonization to fruition as a practical matter than the more formal treaty-based mechanisms.
Resolution and algorithmic influences on the baroclinic pressure gradient in finite element-based hydrodynamic models

In 3D shallow water models, the baroclinic pressure gradient (BPG) an become unstable or physically unrealistic in areas of rapidly changing topography and/or density fields. By using a 2D finite element x-z model, whose formulatio uses the generalized wave continuity equation, we assess the impact on accuracy of three methods used to compute the BPG: the sigma coordinate method, the z -coordinate (level coordinate) method and a hybrid method that switches from sigma coordinates to z -coordinates at a prescribed depth. Resolution studies then, look at horizontal and vertical resolution independently, and the interplay of the horizontal and vertical resolutions for these three methods of computing the BPG. Numerical experiments are carried out on several domains, from constant to rapidly changing bathymetry, with two different density fields, which vary only in the horizontal or vertical directions. Results thus far indicate that the z -coordinate method provides the least amount of error in the solution.
Capillaria hepatica: granuloma formation to eggs. III. Anti-immunoglobulin augmentation and reagin acitivity in mice.

Abstract Sera from mice with primary and secondary Capillaria hepatica egg granulomas were examined for 48-hr homologous PCA activity and for the presence of IgM, IgG 1 , and IgG 2 using a microtiter anti-globulin augmentation assay following indirect hemagglutination testing. All three antibody types assayed were present. Secondary granuloma formation produced an antibody response characterized by the initial production of IgM followed by IgG 1 and IgG 2 during the latter phase of the test period, however primary granulomatous sera demonstrated a more varied antibody response with the presence of all three during the entire test period. Forty-eight-hour PCA tests demonstrated the presence of reagin activity in sera from granulomatous and infected mice. Reagin activity occurred more frequently in primary than secondary granulomatous mice. These studies thus confirm the presence of antibody during granuloma formation to C. hepatica eggs and conclusively demonstrate the presence of at least two classes of antibody.
Imaging of Thoracic Malignancies

Radiologic imaging of malignancy has evolved over the past 20 years. It not only provides better detection with superior anatomic resolution through computed tomography (CT) and magnetic resonance (MR) imaging, but it also provides physiologic information through positron emission tomography (PET). Today’s technology incorporates the use of image modality fusion for even better disease localization and characterization. By fusing data from PET and CT studies, radiologic imaging brings together the superior resolution of CT with the low resolution of PET, thereby providing important information on tumor metabolism and replication. Tumor imaging is at the forefront of this technology explosion and is the focus of most cutting-edge research, as well as clinical applications. This chapter reviews current imaging of primary and metastatic malignancies of the thorax.
Naming on a directed graph

We address how the structure of a social communication system affects language coordination. The naming game is an abstraction of lexical acquisition dynamics, in which N agents try to find an agreement on the names to give to objects. Most results on naming games are specific to certain communication network topologies. We present two important results that are general to any graph topology: the first proves that under certain topologies the system always converges to a name-object agreement; the second proves that if these conditions are not met the system may end up in a state in which sub-networks with different competing object-name associations coexist.
Large-signal physical modeling of active microwave devices using an adaptive real-coded genetic algorithm

A novel large-signal physical modeling approach for active microwave devices using an adaptive genetic algorithm (GA) is presented. The proposed technique solves Poisson's equation in a two-dimensional quasi-static full hydrodynamic large-signal physical model using a real-coded GA. The proposed technique is validated by simulating a submicrometer MESFET. The physical insight of the problem and being able to develop an accurate mathematical model were the keys to conceiving the new algorithm. The proposed algorithm is compared to different algorithms showing excellent accuracy as well as a reasonable speed of convergence. In addition, the effect of various GA parameters on the algorithm behavior is studied. This is a first step toward applying genetic algorithms to Maxwell's equations in conjunction with the full hydrodynamic model for global modeling of active microwave devices with the aim of developing a robust and fast simulation approach.
Boundary Value Problems: Analytic Methods of Solution

The relations and methods introduced in Chaps. 3 and 4 dealt primarily with point and distributed charges and the electric fields they produce. If the charges were known, the electric field and potential could be determined. However, many practical situations exist in which the charges are either unknown or are distributed in a complex fashion. The use of the simple formulas for the calculation of fields in these geometries is not always possible. In still other geometries, we have no knowledge of charges but only of fields and potentials. For example, in an overhead transmission line, we may know the potential but not the charge on the line. How can we then calculate the electric field intensity everywhere in space? Similarly, when designing an electric instrument, such as an electrostatic filter, the engineer is not going to calculate “how much charge must be present on the electrode.” This information, while important in itself, is not normally a design parameter simply because we do not usually use “charge supply sources” and we are ill equipped to measure charge or charge density. The more common problem in design would be to calculate the required potential on the electrodes of the device to produce the needed effect. This information is important because with it, the power supply required can be designed. Although the principles in Chaps. 3 and 4 and the formulas developed for calculation of fields, potentials, and energy are applicable to these types of problems as well, the difficulty is in applying them.
Evaluation of bipolar design for rechargeable lithium battery

The performances of monopolar and bipolar Li-TiS/sub 2/ batteries are compared using two empirical computer design programs for high power applications. Predicted performance outputs for various designs at various discharge rates, capacities, and voltages are reported. Laboratory-type bipolar Li-TiS/sub 2/ batteries were also fabricated to demonstrate the concept of the rechargeable bipolar lithium batteries. The performance of the batteries under various test conditions is presented. >
Prospective vs Retrospective Data for Evaluating Emergency Care: A Research Methodology

Emergency department records and patient charts do not provide enough or sufficiently detailed data for audit of quality of care in a high volume emergency department. As a solution, at the Department of Emergency Medicine, University of Southern California School of Medicine, three emergency medical technicians — hospital-based paramedics — were trained as observers of patient process and treatment. In addition to basic identification information, the form completed by observers listed 21 procedural steps and process data such as sequence, time for completion, type of personnel performing, necessary equipment and supplies, and space for comments. Direct observation of patient process was carried out in 442 patients, a total of 3,882 procedures was observed and recorded. This direct observation is perhaps the most accurate method of data collection for auditing purposes because it reflects actual events. This data was used by the Research Peer Review Committee to help rate the quality of patient treatment process.