cssi/SciSciGPT-SciSciNet huggingface dataset:
Behavior of harassed caterpillars and consequences for host plants

To determine how non-lethal interactions between insect predators and their herbivorous prey influence prey behavior and the consequences of that for the herbivores' hostplants, I conducted a field experiment. There were three factors: plant diversity (monoculture of plantain (Plantago lanceolata) versus diculture of plantain and dandelion (Taraxacum officinale)), harassment level (none versus simulation of attack by predatory wasps) and herbivore species (sessile, specialist Junonia coenia versus free-ranging, generalist Pyrrharctia isabella caterpillars). Harassment caused the free-ranging, generalist Pyrrharctia to take cover more during daylight and feed more on dandelion, with the result that the caterpillars gained less weight than unharassed caterpillars. Increased plant diversity on the plots reduced the apparency of the generalist Pyrrharctia. The sessile, specialist Junonia was more apparent than the Pyrrharctia caterpillars. There was an interaction of plant diversity, harassment level and caterpillar species on amount of leaf material eaten, such that the Junonia caterpillars ate more than the Pyrrharctia caterpillars on the monoculture plots when harassed. Neither harassment level nor caterpillar species affected the proportion of leaf material eaten, but the Junonia caterpillars ate a greater proportion of new leaves than the Pyrrharctia caterpillars (42% vs 16%). Despite the effects of harassment on the free-ranging, generalist Pyrrharctia and the behavioral differences between these caterpillar species, neither harassment level nor caterpillar species affected leaf biomass. Although biomass of flowering stalks was greater on plots with the Junonia caterpillars than on plots with the Pyrrharctia caterpillars, harassment level had no effect on biomass of flowering stalks. In sum, the free-ranging, generalist Pyrrarctia caterpillars clearly altered their behavior in response to harassment, but neither those behavioral changes nor the harassment of the sessile, specialist Junonia caterpillars resulted in effects on the growth of the plants over the test period.
Vibrational analysis of dioptase Cu 6 Si 6 O 18 · 6(H 2 O) and its puckered six-membered ring

The normal modes of vibration and their frequencies are calculated for dioptase, a mineral whose crystal structure (space group R $$\bar 3$$ or C 3 ) consists of puckered six-membered silicate rings (Si6O18) linked by Cu2+ ions and H2O groups. The calculation employs a valence force potential consisting of central interactions between nearest neighbors and bond-bending interactions centered at the Si4+ and Cu2+ ions. The force constants are determined by fitting the calculated frequencies to values obtained by measuring the single-crystal Raman spectra. The calculated frequencies are in reasonable agreement with experiment, permitting assignment of normal modes to the observed spectral frequencies. Considerable mixing of Cu and H2O motions with those of the ring is found for the Raman-active modes below 430 cm-1. The normal modes and frequencies of the hypothetical isolated ring with C 3i symmetry are determined by neglecting all interactions between the rings and the surrounding Cu and H2O. The identification of normal modes characteristic of the puckered six-membered silicate rings and the effect of the environment on these modes may prove useful in the interpretation of the Raman spectra of amorphous silicates.
Oxidation Resistant Dilute Copper (Boron) Alloy Films Prepared by DC-Magnetron Cosputtering

To enhance the corrosion resistance and reliability of the proposed copper interconnections in silicon integrated circuits, alloying with small amounts thermodynamically favorable elements has been pursued. In the present investigation dilute copper (boron) alloy thin films (in boron concentration range of 0–4 at % in copper) were deposited by DC magnetron co-sputtering using a high purity copper and Cu-4 at: % Β targets. Films were then annealed in Ar-3% H2, pure Ar, vacuum, and air ambients in the temperature range of 200-500°C. Sheet resistance, Rutherford backscattering, x-ray diffraction measurements were made to characterize the films. The residual resistivity of the as-deposited alloy films was found to be 5.3 μΩ-cm/at %. To obtain sufficiently low working resistivity, an alloy content below 0.5 at % is suggested for application as a potential metallization material. The addition of boron, which is the common dopant in Si, to the copper films offers considerable oxidation protection. The resulting oxidation rates are considerably lower than that for pure copper films. All this will be presented and discussed.
Completing the Circuit: Routine, Reflection, and Ethical Consumption

Efforts to explain why some people incorporate ethical concerns into everyday shopping for food and household goods, while many do not, have so far left significant variation in “ethical consumption” unexplained. Seeking to move beyond explanations that rely mainly on differences in consumers' social class, gender, and political engagement, I draw on concepts associated with “practice theory” to argue that ethical consumption is closely tied to people's willingness and ability to spend time, while shopping, on distinct activities associated with breaking old routines and establishing new ones. The central insight of practice theory is that most consumption is the product of unconscious routine. And it is precisely because consciously departing from routine is, according to my study, a fundamentally time-consuming process, that lack of time emerges as a crucial obstacle to translating abstract ethical concerns into concrete action as a consumer.
Arctic Offshore Oil: Great Risks in an Evolving Ocean

Climate change has created unexpected tipping points in the contemporary history of the Arctic. Diminishing summer sea ice has encouraged energy companies to plan for an expansion of Arctic offshor...
Analysis of influenza virus nucleic acid detection results from 2009 to 2011 in Hanzhong city

Objective:To analyze influenza virus nucleic acid test results from 2009 to 2011 in Hanzhong and provide a scientific basis for the flu prevention and control.Methods:Real-time RT-PCR method was used to detect nasopharyngeal swabs specimens selected from national influenza surveillance sentinel hospitals.Results:Intotal,896 specimens were detected and 236 were positive for the influenza virus nucleic acid.The positive rate was 26.34%.Influenza virus infection was found no sex difference(P0.05) but to have urban-rural differences(P 0.05),the positive rate of each age group had difference(P0.05).Conclusion:In Hanzhong city,influenza was prevalent in winter and spring from 2009 to 2011.A(H1N1) was the dominant strain from September 2009 to January 2010,and January 2011 to February 2011,influenza type B was the dominant strain in 2010 and March 2011 to April 2011,while influenza subtype H3 was the dominant strain from September to next March.
The use of prostaglandin F2 alpha for the prophylaxis of cyclophosphamide induced cystitis in rats.

Abstract It is well-established that cystitis is a significant cause of morbidity after cyclophosphamide administration in clinical populations. We induced hemorrhagic cystitis in rats using cyclophosphamide and compared controls to those pretreated with prostaglandin F2 alpha. Rats were then evalutated for differences in bladder weights, gross edema, gross bleeding, and histologic changes. The weights of the bladders which had been treated with cyclophosphamide were 94% greater than the controls. The weights of the bladders which were pretreated with prostaglandin F2 alpha before cyclophosphamide were only 19% greater than controls. Significant differences were found between cyclophosphamide controls and prostaglandin F2 alpha pretreated groups for gross weight (p
Prothrombinase: recognition and developments.

At the beginning of this century the crux of the blood coagulation problem centered on the question: what activates prothrombin? Answers commonly turned out to be found inside the diciplines of basic sciences. As these and clinical sciences developed, their language accomodated the phenomenon designated prothrombin activation.
Regulations and Operations

There are air ambulance companies that are solely dedicated to air ambulance work. Their aircraft are permanently equipped to carry patients and are modified in ways to improve their ability to meet this function. However, because of cost factors, such aircraft are usually of a type that have limitations of performance with regard to range and speed that make their use for transfers over 1000 miles unsuitable. This is overcome by using, on a charter basis, aircraft that are faster, have greater range, and are more sophisticated. Since very few of these very expensive planes are structured for aeromedical use, they have to be modified as the need arises. There is a remarkable choice of aircraft that might be used to transport patients.
Cell types differ in global coordination of splicing and proportion of highly expressed genes

Balance in the transcriptome is regulated by coordinated synthesis and degradation of RNA molecules. Here we investigated whether mammalian cell types intrinsically differ in global coordination of gene splicing and expression levels. We analyzed RNA-seq transcriptome profiles of 8 different purified mouse cell types. We found that different cell types vary in proportion of highly expressed genes and the number of alternatively spliced transcripts expressed per gene, and that the cell types that express more variants of alternatively spliced transcripts per gene are those that have higher proportion of highly expressed genes. Cell types segregated into two clusters based on high or low proportion of highly expressed genes. Biological functions involved in negative regulation of gene expression were enriched in the group of cell types with low proportion of highly expressed genes, and biological functions involved in regulation of transcription and RNA splicing were enriched in the group of cell types with high proportion of highly expressed genes. Our findings show that cell types differ in proportion of highly expressed genes and the number of alternatively spliced transcripts expressed per gene, which represent distinct properties of the transcriptome and may reflect intrinsic differences in global coordination of synthesis, splicing, and degradation of RNA molecules.
An in Vitro RNA Synthesis Assay for Rabies Virus Defines Ribonucleoprotein Interactions Critical for Polymerase Activity

ABSTRACT We report an in vitro RNA synthesis assay for the RNA-dependent RNA polymerase (RdRP) of rabies virus (RABV). We expressed RABV large polymerase protein (L) in insect cells from a recombinant baculovirus vector and the phosphoprotein cofactor (P) in Escherichia coli and purified the resulting proteins by affinity and size exclusion chromatography. Using chemically synthesized short RNA corresponding to the first 19 nucleotides (nt) of the rabies virus genome, we demonstrate that L alone initiates synthesis on naked RNA and that P serves to enhance the initiation and processivity of the RdRP. The L-P complex lacks full processivity, which we interpret to reflect the lack of the viral nucleocapsid protein (N) on the template. Using this assay, we define the requirements in P for stimulation of RdRP activity as residues 11 to 50 of P and formally demonstrate that ribavirin triphosphate (RTP) inhibits the RdRP. By comparing the properties of RABV RdRP with those of the related rhabdovirus, vesicular stomatitis virus (VSV), we demonstrate that both polymerases can copy the heterologous promoter sequence. The requirements for engagement of the N-RNA template of VSV by its polymerase are provided by the C-terminal domain (CTD) of P. A chimeric RABV P protein in which the oligomerization domain (OD) and the CTD were replaced by those of VSV P stimulated RABV RdRP activity on naked RNA but was insufficient to permit initiation on the VSV N-RNA template. This result implies that interactions between L and the template N are also required for initiation of RNA synthesis, extending our knowledge of ribonucleoprotein interactions that are critical for gene expression. IMPORTANCE The current understanding of the structural and functional significance of the components of the rabies virus replication machinery is incomplete. Although structures are available for the nucleocapsid protein in complex with RNA, and also for portions of P, information on both the structure and function of the L protein is lacking. This study reports the expression and purification of the full-length L protein of RABV and the characterization of its RdRP activity in vitro . The study provides a new assay that has utility for screening inhibitors and understanding their mechanisms of action, as well as defining new interactions that are required for RdRP activity.
Motion Planning Using Medial Axis

Abstract This paper addresses the problem of planning the motion of a polygonal object through a set of planar obstacles. We propose a two-disk motion planning strategy to navigate the object within the free space between the obstacles from an initial location to a final location. This method makes use of the Medial Axis Transform (MAT) of the free space which can be generated efficiently using the method developed in [11]. We determine two minima] overlapping disks that fully enclose the moving object, and then constrain the centers of the two disks to move continuously aJong a path on the medial axis. In this paper we direct our efforts to the problem of finding the two enclosing disks for a moving object which is considered as a polygon. The problem has been considered as being optimally cutting a polygon into two smaller polygons such that each of smaller polygons can be covered by a minimal disk. We have proved that if the cut is optimal. the resultant minimal disks for two smaller polygons have equal diameters. Based on the geometry of a convex polygon, we formulated the problem as an optimization problem to determine a local optimum for a given edge pair. For a concave polygon, we propose a method to create a hypothetical convex polygon for approximating a given concave polygon, and then perform optimization using the method described above. We have proved that the maximal radii of the disks covering the hypothetical convex polygon generated from a concave polygon is 1.25 times of the radii of the disks that covers the original concave polygon. This shows that the approximation of a concave polygon using a minimal convex polygon does not yield too conservative solution. Simulations are presented for a variety of polygons. The method is being used for disassembly motion planning of a subassembly within its parent subassembly.
The effect of prior probabilities on quantification and propagation of imprecise probabilities resulting from small datasets

Abstract This paper outlines a methodology for Bayesian multimodel uncertainty quantification (UQ) and propagation and presents an investigation into the effect of prior probabilities on the resulting uncertainties. The UQ methodology is adapted from the information-theoretic method previously presented by the authors (Zhang and Shields, 2018) to a fully Bayesian construction that enables greater flexibility in quantifying uncertainty in probability model form. Being Bayesian in nature and rooted in UQ from small datasets, prior probabilities in both probability model form and model parameters are shown to have a significant impact on quantified uncertainties and, consequently, on the uncertainties propagated through a physics-based model. These effects are specifically investigated for a simplified plate buckling problem with uncertainties in material properties derived from a small number of experiments using noninformative priors and priors derived from past studies of varying appropriateness. It is illustrated that prior probabilities can have a significant impact on multimodel UQ for small datasets and inappropriate (but seemingly reasonable) priors may even have lingering effects that bias probabilities even for large datasets. When applied to uncertainty propagation, this may result in probability bounds on response quantities that do not include the true probabilities.
Admission of elderly blunt thoracic trauma patients directly to the intensive care unit improves outcomes.

Abstract Introduction Blunt thoracic trauma in the elderly has been associated with adverse outcomes. As an internal quality improvement initiative, direct intensive care unit (ICU) admission of nonmechanically ventilated elderly patients with clinically important thoracic trauma (primarily multiple rib fractures) was recommended. Methods A retrospective review of the trauma registry at a level 1 trauma center was performed for patients aged ≥65 y with blunt thoracic trauma, admitted between the 2 y before (2010-2012) and after (2013-2015) the recommendation. Results There were 258 elderly thoracic trauma admissions post-recommendation (POST) and 131 admissions pre-recommendation (PRE). Their median Injury Severity Score (13 versus 12, P = ns) was similar. The POST group had increased ICU utilization (54.3% versus 25.2%, P Conclusions Admission of geriatric trauma patients with clinically important blunt thoracic trauma directly to the ICU was associated with improved outcomes.
Intestinal microbiota alters omental tumor growth (TUM9P.1004)

The omentum is an adipose tissue that contains milky spots (MS). The MS are similar to secondary lymphoid organs and can generate B and T cell immune responses to peritoneal antigens. Additionally, omentum CD4 + CD25 + FoxP3 + T regulatory cells (Tregs) display an activated phenotype CD44 hi CD62L low . Moreover, the omentum also collects metastasizing tumor cells in the peritoneal cavity and tumors growing in the omentum are associated with poor clinical prognosis. Here we show that intestinal microbiota affects Tregs activation profile and impairs tumor growth in omentum. Our transplantable tumor model in wild type (WT) mice shows that peritoneal tumors grow progressively in the omentum and peritoneal cavity in WT mice, whereas in germ free (GF) mice tumors do not grow. Omental tumor growth in WT mice is associated with an increase in PD-1 + Tregs, while tumor-specific CD8 + T are reduced. However, in GF mice numbers of PD1 + Tregs remain unaltered but tumor specific CD8 + T cells are still present. After co-housed GF mice with WT mice, ex-GF mice showed tumor growth and restore the increase in PD-1 + Tregs with low number of specific CD8 + T cells. The induction of tolerance requires PD-1 + Tregs. These data suggest that intestinal microbiota has a role in omental Tr activation and in the tolerance to peritoneal tumors.
An Examination of College Students’ Knowledge, Perceptions, and Behaviors Regarding Organic Foods

ABSTRACTBackground: Although organic foods have been available for decades, they are an emerging trend with increasing prevalence of organic food choices in mainstream markets. College-aged students’ consumer behaviors are understudied in this industry. Purpose: This study examined college students’ knowledge, perceptions, and current behaviors regarding organic food and factors that affect their knowledge, perceptions, and behaviors. Methods: Students were randomly selected from an active student database and sent an e-mail link to an online survey. A total of 238 participants responded to the 58-item survey. Results: Higher knowledge levels correlated with higher positive perceptions. College students do consider buying and are buying organic food. However, age, college, and declared major had no effect on knowledge of organic food. Discussion: Other studies have found no differences in gender with regards to purchasing organic food. This study found that females indicated intent to purchase organic foo...
Notas micológicas XII: Stenocephalopsis subalutacea un discutido hongo hifomicetoso desde el aire de un museo de historia natural (Valparaíso, Chile)

En esta nota micologica, se comentan los aspectos taxonomicos, ecologicos y fisiologicos de la especie fungica Stenocephalopsis subalutacea, la cual fue aislada desde el aire del museo de historia natural de Valparaiso, Chile. Se confirma su identificacion mediante la observacion de las caracteristicas morfologicas.
Resonantly enhanced inner-orbital ionization in molecular iodine

We present a wavelength study of the strong-field single-electron ionization of molecular iodine near its one-photon $B$-state resonance at 530 nm. We have previously identified two ionization channels [Phys. Rev. A 95, 013410 (2017)]: ionization of the high-lying molecular orbitals and ionization of the deep orbitals in ${\text{I}}_{2}$. We find a resonant enhancement of both channels, although the peak enhancement occurs at different wavelengths for the different channels. Moreover, the branching ratio of the ionization of the deep orbitals shows a dispersion-like function, with the branching ratio of the deep orbitals reaching over 98% at 519 nm. Finally, the branching ratio of double ionization into an excited state of ${\text{I}}_{2}^{2+}$ as a function of wavelength closely matches the branching ratio of the single ionization of deep orbitals, implying that excitation of molecular ions generally comes about through inner orbital ionization. These findings are inconsistent with current molecular ionization theory.
Introduction to Current and Emerging mHealth Technologies: Adoption, Implementation, and Use

The proliferation of smart mobile devices and increase in Internet access enabled many of the populations to reach many services with minimum efforts. The reports presented that the economic impact of the mobile market is estimated to reach to 14-digit numbers and over 100% annual growth rate. Mobile devices provide accessibility, reachability, and availability regarding exchanging information. In this context, mobile health (mHealth) is an important factor as a major component of electronic health services.
Ethnic enclaves and birth outcomes of immigrants from India in a diverse U.S. state.

Abstract Sociological theory suggests that ethnic enclaves promote immigrant health. Existing studies of ethnic enclaves and immigrant birth outcomes have generally focused on blacks and Hispanics, while few have focused on immigrants from India — the second largest immigrant group in the U.S., after Mexicans. Paradoxically, this group generally exhibits worse birth outcomes than non-Hispanic whites, despite their high levels of education. This study investigates associations between residence in South Central Asian ethnic enclaves and both birth outcomes and prenatal behaviors of immigrant mothers from India, using population-level birth record data from the state of New Jersey in the U.S. (1999–2012; n = 64,375). Results indicate that residence in a South Central Asian enclave is associated with less prenatal smoking and earlier prenatal care, but not with birthweight- or gestational-age related outcomes, among immigrant mothers from India. These findings are consistent with theory suggesting that social support, social capital, and social norms transmitted through the social networks present in ethnic enclaves foster health-promoting behaviors. Notably, the prenatal behaviors of non-Hispanic white mothers were not associated to a large degree with living in South Central Asian enclaves, which is also consistent with theory and bolsters our confidence that the observed associations for immigrant mothers from India are not spurious.
Aspiration of bone marrow in laboratory animals.

two adjacent holes in the cortex of one of the long bones and removing the bony plate between the holes, he could remove a small portion of the marrow with a platinum loop. Basile2 trephined the femur of the dog and made smears from the fluid obtained. Morris and Falconer6 trephined the long bones of rabbits, and, from the core of marrow in the casing of their trephine, were able to make both smears and sections. Although they did not apply their method to a study of the marrow of fowl, they suggested that it might be valuable in research on fowl leukemia. Erf’ punctured the tibia, femur, and humerus of rabbits with a Steinman pin. Then, by replacing the pin with a lumbar tap needle and applying suction as the needle was pushed forward into the medullary cavity, a plug of marrow was sucked into the needle. Imprints and sections were made from this plug. Erf claimed his method would be useful for obtaining marrow from dogs and rats as well as from rabbits. Starkoff,9 by using a small saw, removed a small portion of the posterior surface of the femur of rabbits. After closing the wound and allowing it to heal, he was able to employ this defect in the bone as a site for aspiration of marrow. Kolouch5 obtained consecutive bone marrow biopsies by resecting small portions of the ribs of rabbits. Actual puncture and aspiration technics have also been described. Aspiration of sternal marrow is possible in only some animals. Marrow can be obtained from the manubrium of the dog,’ from the midsternum of Macacus rhesus monkeys,” and
The clinical relevance of psychophysiology: support for the psychobiology of empathy and psychodynamic process.

Psychophysiologic measures, such as skin conductance and heart rate, have been used in both psychotherapy process research and clinical practice. We present a case report of a patient and therapist...
Preparation of Drugs and Medicaments

One of the ways in which drugs are classified is according to their source: (1) plants, (2) minerals, (3) micro-organisms, (4) insects, (5) animals, (6) air, (7) synthetic. The first drugs were obtained from plants but modern chemistry has made it possible to reproduce many of them synthetically in the laboratory. In addition, many new drugs, never before known nor found anywhere in nature, have come from the synthetic chemist’s laboratory.
Attainable Regions in Crystallization Processes: Their Construction and the Influence of Parameter Uncertainty

Abstract Process alternatives for continuous crystallization, i.e., cascades of mixed suspension, mixed product removal crystallizers (MSMPRCs) and plug flow crystallizers (PFCs), as well as batch crystallizers are discussed and modelled using population balance equations. The attainable region approach that has previously been used in the design of chemical reactor networks and separation systems is applied to the above-mentioned alternatives for crystallization processes in order to identify attainable regions in a diagram of mean product particle size vs. total process residence time. It is demonstrated that the boundaries of these attainable regions can be found numerically by solving appropriate optimization problems and that the region enclosed by these boundaries is fully accessible. Knowing the attainable region of particle sizes, it is possible to generate feasible process alternatives that allow specific particle sizes to be obtained in a given process configuration. The influence of uncertainty in the kinetic parameters required for the determination of such attainable regions is also investigated as well. These concepts are illustrated using a case study on the cooling crystallization of paracetamol grown from ethanol.
What is the Utility of a 24 Hour Repeat Head Computed Tomography (CT) in Acute Ischemic Stroke Patients Treated with Intravenous (IV) Tissue Plasminogen Activator (tPA)? (P4.235)

Objective: We questioned whether worsening National Institute of Health Stroke Scale (NIHSS) scores or a post-tPA MRI could be substituted for repeat head CT in identifying hemorrhagic transformation following tPA. Background: Guidelines recommend all ischemic stroke patients given IV tPA receive a 24-hour repeat head CT to evaluate for HT, despite lacking supporting evidence for this in patients without clinical deterioration. We hypothesized patients with unchanged neurological exams 24 hours post-tPA or patients receiving a post-tPA MRI do not require repeat CT. Design/Methods: We conducted a retrospective analysis of acute ischemic stroke patients at University of Missouri Hospital over 51 months. Initial and repeat CT scans were assessed for extent of ischemia using Alberta Stroke Program Early CT Scores (ASPECTs) and HT. CT findings were then compared to NIHSS scores and MRI findings. Results: 88 patients were identified: 22 (mean age 73 years) with HT at 24 hours and 66 (mean age 70 years) without. There were no significant differences in baseline demographics except non-HT patients had higher mean BMI (31.2 vs 27.2; p=0.047). No significant differences existed between HT and non-HT baseline mean NIHSS (12.2 vs 10.5) or ASPECTs (8.6 vs 8.9). At 24 hours, the HT group had significantly worse mean NIHSS (14.8 vs 9.5, p=0.017) and ASPECTs (6.2 vs 7.4, p=0.035). Of the 11 HT patients without NIHSS worsening, 9 (91%) had baseline NIHSS score ≥11. All patients with a parenchymal hematoma had either NIHSS worsening or baseline NIHSS ≥11. 31% of patients with HT on 24-hour CT had a negative MRI. These MRIs were performed Conclusions: Worsening NIHSS and ASPECT scores were associated with HT. When combined with a baseline NIHSS score ≥11, all patients with parenchymal hematoma were identified. Obtaining MRI to identify HT post-tPA was unreliable when obtained Disclosure: Dr. Milligan has nothing to disclose. Dr. Kaur has nothing to disclose. Dr. Newey has nothing to disclose.
Hemostatic properties of cold-stored whole blood leukoreduced using a platelet-sparing versus a non–platelet-sparing filter

BACKGROUND Whole blood (WB) is an appealing alternative to component-based transfusion in patients with significant bleeding. Historically, WB was transfused less than 48 hours after collection and was not leukoreduced (LR). However, LR components are now standard in many hospitals and LR WB is desirable. We investigated the effect of the type of LR filter used, as well as storage duration, on coagulation laboratory testing of WB. STUDY DESIGN AND METHODS Ten units of LR WB-5 units manufactured with a Food and Drug Administration (FDA)-approved platelet (PLT)-sparing filter (WB-PS) and 5 units manufactured with an FDA-approved non-PLT-sparing filter (WB-NPS)-underwent complete blood count, PLT function analyzer (PFA [PFA-100]), thromboelastography (TEG), prothrombin time (PT), partial thromboplastin time (PTT), Factor (F)V activity, chromogenic FVIII, thrombin generation, and microparticle quantification on Storage Days 3, 5, 7, 10, and 14. RESULTS WB-PS contains more PLTs than WB-NPS (mean, 71 × 109 /L vs. 1 × 109 /L, p < 0.001). WB-PS yielded essentially normal TEG tracings, while TEG tracings of WB-NPS were grossly abnormal (mean reaction time, 7.0 min for WB-PS vs. 9.7 min for WB-NPS, p < 0.001; mean alpha-angle 54.9° vs. 38.1°, p < 0.001; mean maximum amplitude, 54.9 mm vs. 13.9 mm, p < 0.001). PFA-100 closure was more common among units of WB-PS compared to units of WB-NPS (72% vs. 4%, p < 0.001). PT, PTT, and factor activities were not dramatically affected by the LR filter. CONCLUSION The choice LR filter has a major impact on the hemostatic properties of WB. Although storage of WB is associated with a rapid decline in PLT count, hemostasis as assessed by TEG and PFA-100 is not diminished over a 2-week storage period.
Improvements to the Escalation with Overdose Control design and a comparison with the restricted Continual Reassessment Method.

The Escalation with Overdose Control (EWOC) design for cancer dose finding clinical trials is a variation of the Continual Reassessment Method (CRM) that was proposed to overcome the limitation of the original CRM of exposing patients to high toxic doses. The properties of EWOC have been studied to some extent, but some aspects of the design are not well studied, and its performance is not fully understood. Comparisons of the EWOC design to the most commonly used modified CRM designs have not yet been performed, and the advantages of EWOC over the modified CRM designs are unclear. In this paper, we assess the properties of the EWOC design and of the restricted CRM and some variations of these designs. We show that EWOC has several weaknesses that CRM does not have that make it impractical to use in its original formulation. We propose modified EWOC designs that address some of the weaknesses and that have some desirable statistical properties compared with the original EWOC design, the restricted CRM design, and the 3 + 3 design. However, their statistical properties are sensitive to correct specification of the prior distribution of their parameters and hence nevertheless will need to be used with some caution. The restricted CRM design is shown to have more stable performance across a wider family of dose-toxicity curves than EWOC and therefore may be a preferable general choice in cancer clinical research.
Adverse outcome pathways in ecotoxicology

Abstract The adverse outcome pathway (AOP) framework is a method that organizes data through biological hierarchies that are critical components of ecotoxicology. AOPs include molecular initiating events linked through key event (KE) relationships to apical endpoints useful to risk assessment and population and/or community estimates. Significant advances have been made by various regulatory agencies in the United States (primarily the United States Environmental Protection Agency) and the European Office of Economic Cooperation and Development to provide databases, computing tools, and models that can qualitatively identify hazards to individual organisms and potentially populations of wildlife. Additional development has also occurred allowing quantitative assessments between key toxicological events, improving predictive capacities of AOPs for individual compounds as well as ecologically relevant mixtures. Examples that show how AOPs can be utilized in chemical mixtures to identify KEs for risk assessment as well as specific chemical classes that may require monitoring within ecosystems are provided. Additionally nonchemical environmental stressors derived from climate change may also be integrated into AOPs to evaluate the potential to enhance or diminish biological impacts of chemical stressors that cooccur during those conditions.
Geographies of Gender: Social Politics of the Partner Dance Venue

The typical partner dance venue will have a standardised layout conducive to the space's function as a marketplace in which attendees can display their own bodies as commodities. Dancers in the ven...
Prognostic Value of Hypochloremia in Critically Ill Patients With Decompensated Cirrhosis

OBJECTIVES Cirrhosis is frequently complicated by electrolyte disturbances, with prior studies primarily focused on the importance of hyponatremia. Emerging evidence on patients with chronic heart failure and chronic kidney disease has identified hypochloremia as an independent predictor for mortality. This study aimed to investigate the prognostic value of serum chloride and its association with mortality in cirrhotic patients. DESIGN Retrospective cohort study. SETTING The medical ICU at Parkland Memorial Hospital, a tertiary care public health system in Dallas, Texas. PATIENTS Adult patients with confirmed diagnosis of decompensated cirrhosis who were admitted to the ICU between March 2015 and March 2017. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Kaplan-Meier analysis and multivariable Cox proportional hazard ratio models were performed to determine the impact of hypochloremia on 180-day mortality. Of the 389 enrolled patients, 133 (34.2%) died within 180 days of ICU admission. Patients with hypochloremia had higher 180-day mortality than those with normochloremia (45.2% vs 26.7%; p < 0.0001). Cumulative survival via the Kaplan-Meier method was significantly lower in the hypochloremic group. Serum chloride was independently associated with 180-day mortality with multivariable adjustment (hazard ratio, 0.95; 95% CI, 0.93-0.98; p = 0.001) or after adjusting for Model for End-stage Liver Disease or Sequential Organ Failure Assessment. Contrarily, the inverse association between serum sodium and mortality no longer existed in all multivariable models. CONCLUSIONS Serum chloride is independently and inversely associated with short-term mortality in critically ill cirrhotic patients. Hypochloremia, but not hyponatremia, remained associated with mortality with multivariable analyses, suggesting that hypochloremia may account for the mortality risk previously attributed to hyponatremia. These findings signify the prognostic value of serum chloride and potential inclusion of chloride into future cirrhosis prognostic scores.
Reforming American Medical Licensure

The current medical training and licensure system in the United States limits the supply of medical practitioners, exacerbating the shortage of care our country is facing. Fundamental reforms to the process of training and licensing medical practitioners in the United States have the potential to expand the supply of medical providers significantly and thus improve patient access to needed medical care. Under the policy recommendations outlined above, experienced and qualified foreign-trained doctors could practice in the United States without having to repeat the same residency training that they have already completed at home. Furthermore, under a system of provisional licensure, recent medical school graduates who cannot obtain a residency training position would have alternative opportunities to participate in the care of patients, help ameliorate the physician shortage, and receive training in the process. These reforms will help alleviate the current and future shortage of qualified physicians.
Identifying ranges of combined lime and heat treatments to achieve biosolids stabilization fecal coliform targets.

To ensure safe reuse, biosolids are stabilized to reduce pathogens, odor, and volatile solids. Stabilization by lime addition have high material costs, high transportation costs, and loss of ammonia. Decreasing required lime additions would improve the sustainability of biosolids reuse. This study examined combining lime and heat treatment to reduce lime additions needed for required fecal coliform destruction. In contrast to the current best management practice requiring a pH of 12, fecal coliform reduction for final concentrations <1000 MPN/g (where MPN is most probable number) was achieved with pH as low as 10 when combined with a short (1-h) incubation at 60 °C. Analysis of D-values (the time required to destroy 1-log fecal coliform) supported a synergistic treatment response at moderate pH and heat treatments. Samples receiving higher temperature treatments had lower specific oxygen uptake rates, suggesting that readily-available carbon was lost during heat treatment. Samples with lower lime additions had higher final ammonia concentrations, which is a desired characteristic for biosolids reclaimed as a fertilizer. The study demonstrated that optimizing combined lime and heat stabilization can improve beneficial reuse as a means toward enhancing environmental sustainability and improving the circular economy.
A Surgeon Badge or Text Message Sign-in Intervention Improves Operating Room Start Efficiency.

Abstract Background Operating room (OR) efficiency, often measured by first case on-time start (FCOTS) percentage, is an important driver of perioperative team morale and the financial success of a hospital. Materials and Methods In this quasi-experimental study of elective surgical procedures at a single tertiary academic hospital, an intervention requiring attending surgeon attestation of availability via SMS text message or identification badge swipe was implemented. Key measures of OR efficiency were compared before and after the change. Results FCOTS percentage increased from 61.6% to 66.9% after the intervention (P = 0.01). After adjusting for patient and procedural characteristics, postintervention period remained associated with an increased odds of an on-time start (odds ratio 1.29, P = 0.01). Additionally, procedural start times from the pre- to postintervention period were significantly improved (-0.08 min/day, P = 0.009). Conclusions Implementation of an attending surgeon text or badge sign-in process was associated with improved FCOTS percentage and earlier procedure start times.
Egalitarianism and Exclusion: U.S. Guest Worker Programs and a Non-Subordination Approach to the Labor-Based Admission of Nonprofessional Foreign Nationals

Comprehensive immigration reform has been a top legislative priority for the last several years, and recent bills have contemplated the expansion of guest worker programs to adjust the status of undocumented immigrants and to control the future migrant flow. While there is a broad consensus that the current immigration system is broken, there is sharp disagreement about whether it is wise public policy to expand labor-based admissions in order to provide nonprofessional foreign nationals with an authorized means to migrate. This Article contributes to this debate by examining current guest worker programs, and recommends their reform through a “non-subordination” approach that balances the interests of nonprofessional foreign nationals and U.S. workers. Analyzing the current work visa programs, this Article determines that there exist worker disincentives to complain about or to leave exploitative workplaces, illusory visa-based rights and exemptions from and under-enforcement of key workplace protections, and caps and other limitations on guest worker programs that do not approach the migration demand,resulting in increased unauthorized migration and the expansion of the underground economy. These conditions create formal and informal systems of inequality that subordinate guest workers in the workplace, and fail to provide a meaningful avenue to engage in authorized migration. Small and restricted guest worker programs also harm nonprofessional U.S. workers, who cannot compete with a captive guest workforce or undocumented workers in the underground economy. This Article proposes a “non-subordination” approach to labor-based admissions that would reduce the centrality of individual employers in guest workers’ recruitment and authorized presence in the U.S., equalize the workplace rights of nonprofessional foreign nationals with U.S. workers, expand authorized admissions, and permit the circular migration and the eventual permanent settlement of visa holders. This approach would balance the nonprofessional foreign national interests in authorized migration and in equality in the workplace, and the nonprofessional U.S. worker interests in controlling the migrant flow and in preserving workplace standards. Finally, this approach would not be objectionable to employers, who could employ foreign nationals with reduced government restriction and delay. This Article concludes that while this approach would better control the migrant flow and preserve workplace standards, it would not fully address unauthorized migration, which would require a shift in foreign policy to address global inequality.
Juvenile myelomonocytic leukemia in the molecular era: a clinician's guide to diagnosis, risk stratification, and treatment.

Summary Juvenile myelomonocytic leukemia is an overlapping myeloproliferative and myelodysplastic disorder of early childhood. It is associated with a spectrum of diverse outcomes ranging from spontaneous resolution in rare patients to transformation to acute myeloid leukemia in others that is generally fatal. This unpredictable clinical course, along with initially descriptive diagnostic criteria, led to decades of productive international research. Next generation sequencing now permits more accurate molecular diagnoses in nearly all patients. However, curative treatment is still reliant on allogeneic hematopoietic cell transplantation for most patients, and additional advances will be required to improve risk stratification algorithms that distinguish those that can be observed expectantly from others who require swift hematopoietic cell transplantation.
Case 79: A Military Conflict

You are stationed in a South African army field hospital in Namibia. The hospital has a blood bank, X-ray facilities, etc. The 1975 Angolan war is ongoing. A firefight between Cuban and South African soldiers has just been concluded with casualties on both sides. The casualties are brought by helicopter to your field hospital.
Postmastectomy Radiation Therapy Following Pathologic Complete Nodal Response to Neoadjuvant Chemotherapy

PURPOSE/OBJECTIVE(S) Postmastectomy radiation therapy (PMRT) is recommended for patients with breast cancer who have positive nodal disease. Whether there is a benefit to PMRT in patients who have cN+ disease at diagnosis, but a pathologic complete response following neoadjuvant chemotherapy (NAC) in the lymph nodes (pCRn) is unknown. The purpose of the present study is to determine if there is a benefit to PMRT in patients who have a pCRn following neoadjuvant chemotherapy, and which subsets of patients may derive the benefit from PMRT following a pCRn. MATERIALS/METHODS This study was conducted using patients from the National Cancer Data Base (NCDB). Patients included in this study were women diagnosed with breast cancer with cT1-4N1-3 disease who had invasive ductal carcinoma histology and received treatment with NAC and then mastectomy. Overall survival (OS) was compared between all patients using the Kaplan- Meier analysis. To further determine if subsets of patients may derive a greater benefit from PMRT, OS was compared after stratifying patients for clinical T stage, clinical N stage, pathologic T stage, and molecular subtype. Multivariable logistic regression ascertained factors associated with PMRT use. Cox proportional hazards modeling determined variables associated with OS. RESULTS A total of 14,960 patients met the selection criteria, of whom 10,092 (67.5%) received PMRT, and 4598 (30.7%) did not. Amongst all patients, there was no difference in OS with the use of PMRT (10-year OS 76.3% vs 78.6%, P = 0.4147). Improvement with the use of PMRT was observed amongst patients with cN3 (10-year OS 73.1% vs 51.7%, P < 0.001), cT3 (10-year OS 77.0% vs 72.2%, P = 0.0154) or cT4 (10-year OS 69.6% vs 59.1%, P = 0.0001) disease, ypT2 (10-year OS 72.9% vs 65.0%, P = 0.0053) or ypT3 disease (10-year OS 62.3% vs 45.3%, P = 0.0466), as well as patients with ER+HER2+ disease (10-year OS 85.4% vs 56.5%, P = 0.0225). Factors predictive of PMRT use include younger age, Private health insurance, higher socioeconomic status, cT2/3/4 stage, and cN2/3 stage. On multivariate analysis, factors predictive of worse OS include increasing age, Charlson Deyo Comorbidity score ≥ 2, cT3 or cT4 disease, cN2 or cN3 disease, ypT1-4 disease, progression of the primary tumor after neoadjuvant chemotherapy, or ER-HER2- disease. CONCLUSION The extent of nodal disease and primary tumor size both at diagnosis and following NAC may be able to select for patients with pCRn most likely to benefit from PMRT. Further research is required to confirm these findings and to select the patients most likely to benefit from PMRT following NAC and mastectomy.