cssi/SciSciGPT-SciSciNet huggingface dataset:
A kinetic analysis of activation of smooth muscle adenylate cyclase by forskolin

Abstract Forskolin action was studied using uterine smooth muscle adenylate cyclase, an enzyme form that is slowly and irreversibly activated by treatment with nonhydrolyzable GTP analogs. Activation of the particulate smooth muscle enzyme by prolonged treatment with Gpp[NH]p (guanyl-5′-yl imidodiphosphate) at 24 °C followed simple Michaelis-Menten kinetics with respect to the guanine nucleotide. Under these treatment conditions, forskolin increased both the V max and the K m for Gpp[NH]p, suggesting diterpene action affected the guanine nucleotide-binding coupling factor. Sensitivity of a detergent-solubilized form of the enzyme to stimulation by both Gpp[NH]p and forskolin was much more labile at 4 °C than was the Mn +2 sensitivity of the catalytic subunit. In the particulate form, the catalytic subunit was more resistant to the denaturing effects of N -ethylmaleimide than was its sensitivity to stimulation by Gpp[NH]p or forskolin. Forskolin stimulation of the particulate form of the enzyme followed simple Michaelis-Menten kinetics with respect to the concentration of the diterpene. Denaturation of the enzyme by treatment with N -ethylmaleimide lowered the V max and increased the K m for forskolin, further suggesting that forskolin had an indirect effect on the activity of the catalytic subunit. These results could be accounted for if the diterpene, like Gpp[NH]p, was bound by the coupling factor.
A hybrid physics-based subdivision technique using coupled dynamic and subdivision parameters

The last few decades have seen enormous progress in both geometric subdivision, and physics-based simulation techniques. Mesh-based dynamic systems often require both subdivision and physical simulation for realistic and accurate results. However, the simulation parameters have been independent of the subdivision parameters, and vice-versa. This paper attempts to bridge this gap. We propose a hybrid approach that combines the physics-based simulation techniques and geometric subdivision algorithms, and demonstrate a mass-spring based system with physics-based butterfly subdivision. The initial subdivision coefficients are extracted using the physical properties of the base (L 0) mesh. Latter subdivision steps generate both the geometric and physical properties of the subdivided (Lk) mesh. This approach conserves mass, center of gravity, linear momentum and external force, and minimizes the distance between the Lk and Lk+1 meshes, at any time step. Our approach is general, efficient, and serve as a foundation for many applications in many fields
Optimal Wavelength Scheduling in Optical Burst-Switched Networks Using Constant Time Burst Resequencing

Optical burst switching (OBS) is an emerging technology that allows variable size data bursts to be transported directly over DWDM links. In order to make OBS a viable solution, the wavelength scheduling algorithms need to be able to utilize the available wavelengths efficiently, while being able to operate fast enough to keep up with the burst incoming rate. For example, for a system with 32 wavelengths per link, each operating at 10 Gb/s, we need to process one BHC every 25 ns, in order to support an average burst length of 1 KByte. When implemented in hardware, the running time of the well-known horizon scheduler is O(1) for practical numbers of wavelengths. Unfortunately, horizon scheduling cannot utilize the voids created by previously scheduled bursts, resulting in low bandwidth utilization. To date, Min-SV is the fastest scheduling algorithm that can schedule wavelengths efficiently. However, its complexity is O(log m) and it requires 10log m memory accesses to schedule a single burst. This means that it can take up to several microseconds for each burst request, which is still too slow to make it a practical solution for OBS deployment. In this paper, we propose an optimal wavelength scheduler using constant time burst resequencing (CTBR), which runs in O(1) time. The proposed CTBR scheduler is able to produce optimal wavelength schedules while having the same processing speed as the horizon scheduler. The algorithm is well-suited to high performance hardware implementation.
Folic acid and prevention of birth defects

Folate was first isolated in an unknown form in 1941. The pharmaceutical form of folate is folic acid (pteroylglutamic acid). The major source of folate in the USA is food, with primary sources being grain products, especially fortified cereals, citrus fruits, and dried beans and lentils. However, the estimation of dietary intake of folate by food tables may not reflect actual intake because naturally occurring folate in the diet may be rendered inactive by cooking and food processing.
Cost-effectiveness of alternative thresholds of the fasting plasma glucose test to identify the target population for type 2 diabetes prevention in adults aged ≥45 years

OBJECTIVE The study objective was to evaluate the cost-effectiveness of alternative fasting plasma glucose (FPG) thresholds to identify adults at high risk for type 2 diabetes for diabetes preventive intervention. RESEARCH DESIGN AND METHODS We used a validated simulation model to examine the change in lifetime quality-adjusted life years (QALYs) and medical costs when the FPG threshold was progressively lowered in 5-mg/dL decrements from 120 to 90 mg/dL. The study sample includes nondiabetic adults aged ≥45 years in the United States using 2006–2010 data from the National Health and Nutrition Examination Survey. High-risk individuals were assumed to receive a lifestyle intervention, as that used in the Diabetes Prevention Program. We calculated cost per QALY by dividing the incremental cost by incremental QALY when lowering the threshold to the next consecutive level. Medical costs were assessed from a health care system perspective. We conducted univariate and probabilistic sensitivity analyses to assess the robustness of the results using different simulation scenarios and parameters. RESULTS Progressively lowering the FPG threshold would monotonically increase QALYs, cost, and cost per QALY. Reducing (in 5-mg/dL decrements) the threshold from 120 to 90 mg/dL cost $30,100, $32,900, $42,300, $60,700, $81,800, and $115,800 per QALY gained, respectively. The costs per QALY gained were lower for all thresholds under a lower-cost and less-effective intervention scenario. CONCLUSIONS Lowering the FPG threshold leads to a greater health benefit of diabetes prevention but reduces the cost-effectiveness. Using the conventional benchmark of $50,000 per QALY, a threshold of 105 mg/dL or higher would be cost effective. A lower threshold could be selected if the intervention cost could be lowered.
Factors Associated With Occipital Pressure Ulcers in Hospitalized Infants and Children

Background The occiput is a common location for development of pressure ulcers in hospitalized infants and young children. However, risk factors associated with occurrence of the ulcers have not been fully described. Objective To identify factors associated with development of occipital pressure ulcers in acutely ill infants and children. Methods Charts of all patients with occipital pressure ulcers reported in a computerized safety event reporting system since its implementation in 2005 and of any patients with such ulcers recalled by members of the skin care special interest group were reviewed retrospectively. Results During a 4-year period, 60 cases of occipital pressure ulcers were identified: 40% stage I, 12% stage II, 30% unstageable, and 18% deep tissue Injury. The median age of the sample was 12 months. Among the patients, 86% were in the intensive care unit with cardiovascular or pulmonary problems. A total of 68% had comorbid conditions. Most of the patients were less than 1 year old; were critically ill, requiring high-risk therapies; and had multiple medical devices in place. Patients with the ulcers were commonly treated with mechanical ventilation (83%) and sedation (74%) and were described as agitated (42%). Many of these patients were receiving vasoactive medications (50%) and had vascular access devices in the neck that restricted head movement (45%). When documented, the median Braden Q score was 16. Conclusions Infants and children at risk for occipital pressure ulcers can be prospectively identified, allowing implementation of nursing interventions to prevent these ulcers.
Society's Changing Perception of the Professional and Ethical Conduct of the Civil Engineer: 1776-1976

The years 1776-1976, in this country, have been characterized by the increasing dependence of society on the expertise and judgement of civil engineers. This has been forced on society because of the increasing complexity of technical decisions. Today society recognizes this situation and freely allows the civil engineer to make the narrow technical decisions, for example, what size girders are required on the southeast corner of the new office building. In the recent past, however, society has more and more frequently questioned the professional judgment of the engineer in the broader technical problems facing our country. This paper examines this somewhat paradoxical situation. The major emphasis is placed on the present day. The major driving forces behind these trends are examined.
A Balanced Scorecard Framework for IS Outsourcing Metrics

As the nature of IS outsourcing contracts has changed from simple cost saving projects to strategic initiatives, the focus of the control and measurement processes has also changed. However, cost savings are still the most important metric. We adapt the Balanced Scorecard framework to apply in outsourcing contracts, arguing for a comprehensive mix of 'lead' and 'lag' indicators of contract performance. We propose a survey to map the metrics to be used for different outsourcing projects.
A Different Kind of Criminal? Miranda, Terror Suspects, and the Public Safety Exception

Ten years after the tragic terror attacks of September 11, 2001, the tension between civil liberties and national security-based law enforcement endures. The due process rights of terror suspects are at the pinnacle of this ongoing debate. Two cases in particular pushed the boundaries of constitutional compliance. On December 25, 2009, Umar Farouk Abdulmutallab attempted to detonate an explosive device while on a flight from Amsterdam to Detroit. The “Christmas Day Bomber” was then taken into custody and questioned by FBI agents before being read his Miranda rights. In May 2010, Faisal Shahzad attempted to detonate a car bomb in Times Square and was later questioned by FBI agents for three hours prior to his rights advisement. In light of these cases, Attorney General Eric Holder announced that he would work with Congress to seek new legislation formalizing Miranda’s public safety exception. When these efforts stalled, the FBI issued a memorandum in October 2010 establishing the current policy; terror suspects will not be read Miranda warnings during the first critical hours of custodial interrogation. This article critically examines the policy to forego providing rights warnings to terror suspects due to public safety concerns. Taking into consideration the tension between the forward looking nature of intelligence gathering, and the post-hoc deterrence and incapacitation goals of criminal punishment, this article concludes that these goals are not irreconcilable. After discussing the merits of both the policy and legal consideration of the current approach to formalizing the public safety exception, this article analyzes proposals aimed at allowing the full use of a terror suspect’s statements to prevent future attacks, and suggest limits to the introduction of those same statements at trial.
OMVPE Growth of GalnAs/InP Quantum Well Structures

InP/GaInAs/InP quantum well structures have been grown using atmospheric pressure organometallic vapor phase epitaxy (AP-OMVPE). The optimum conditions for growth of extremely abrupt interfaces were studied. The optimum orientation was exactly (100). The growth had to be interrupted for 40 seconds at the first interface and 2 minutes at the 2nd interface to obtain the most abrupt interfaces. The narrowest photoluminescence half widths were obtained at the lowest values (31) of V/III ratio in the input vapor phase. These growth conditions allow the growth of wells as thin as <10A with photoluminescence (PL) spectra consisting of doublets or triplets. The extremely narrow peaks correspond to regions of the quantum well differing in thickness by a single monolayer. The energy separations of the neighboring peaks are found to increase with decreasing well width until, at a thickness of approximately 12 A, the separation begins to decrease rapidly with decreasing well width. The exciton binding energies in the quantum wells have also been measured using thermally modulated PL. The binding energy is found to increase with decreasing well width until a maximum value of approximately 17 meV is measured for a nominal well width of approximately 13 A. For thinner wells the exciton binding energy is found to decrease with decreasing well width.
Do postoperative antibiotics prevent abscess formation in complicated appendicitis

Recent studies have shown that postoperative antibiotics in nonperforated appendicitis do not reduce infectious complications; however, there is no consensus on patients with complicated appendicitis. The aim of this study is to determine whether postoperative antibiotic administration in complicated appendicitis prevents intra-abdominal abscess formation. We conducted a retrospective chart review of all patients undergoing appendectomy from 2007 to 2012 at our institution. Patients with complicated appendicitis (perforated, gangrenous, or periappendiceal abscess) were identified and data collected including details of postoperative antibiotic administration and rates of postoperative abscess development. Of 444 charts reviewed, 52 patients were included. Forty-four patients received greater than 24 hours and eight patients received 24 hours or less of postoperative antibiotics. In those receiving greater than 24 hours of antibiotics, nine of 44 (20.5%) developed a postoperative abscess, and in those receiving 24 hours or less of antibiotics, two of eight (25.0%) developed a postoperative abscess (P = 1.0000). There is no significant difference in postoperative abscess development among those with complicated appendicitis who received greater than 24 hours of postoperative antibiotics compared with those who did not. Postoperative antibiotics may not provide an appreciable clinical benefit for preventing intra-abdominal abscesses; however, larger sample sizes and prospective studies are needed to confirm these findings.
Comparison on analgesic effect of diclofenac sodium suppository and propofol combined with dezocine in artificial oocyte retrieval

Objective To investigate the analgesic effect of diclofenac sodium suppository and propofol combined with dezocine in artificial oocyte retrieval. Methods A total of 387 patients undergoing B-ultrasound guided oocyte retrieval from Feb. 2013 and Apr. 2013 were randomly divided into group A and group B. Group A(n=226)applied diclofenac sodium suppository for analgesia, and group B(n=161) used propofol combined and dezocine. The analgesic effect and adverse reactions(including postoperative dizziness, nausea, vomiting) were observed and recorded in the two groups. Results The effective rate of analgesia was 100.00% in group B and 99.14% in group A. There was no significant difference for the analgesic effect between the two groups( χ2=0.228,P=0.633). The incidences of postoperative dizziness, nausea, vomiting, injection site pain, respiratory depression in group B were significantly higher than those in group A(P0.01). Conclusion In artificial oocyte retrieval, diclofenac sodium suppository results in significant analgesic effect, with low incidence of adverse reactions and good safety, which is worthy of clinical use.
Dementia Palliative Care

Palliative care is a form of care provided by an interprofessional team to improve the quality of life of the person with dementia and their caregiver. Palliative care principles are an essential part of the provision of care to persons with dementia and their caregiver, beginning at the time of diagnosis, and extending through the post-death bereavement period. Most palliative care is provided in a generalist manner directly by the primary care provider or dementia care team, though in certain situations, it is appropriate for the interprofessional specialist palliative care team to play a consultative role in the person with dementia’s care. This chapter defines palliative care, covers the palliative needs of persons with dementia and their caregiver, and examines the best ways of providing holistic, interprofessional, palliative care to the person with dementia and their caregiver. It discusses the differences between generalist and specialist provided palliative care, and methods for communicating about the disease, including its prognosis, and keys to effective advanced care planning. This chapter also covers issues around pharmacologic changes as person with dementia decline including withdrawal of medications, managing and preventing functional decline and its correlates such as dysphagia, pressure ulcers, contractures, and the identification and management of non-behavioral symptoms. Finally, it discusses methods for avoiding unnecessary hospitalization, supporting caregivers, and providing spiritual support. These topics will assist both the generalist and specialist palliative care provider as they seek to provide effective clinically and psychosocially meaningful palliative care to persons with dementia and their caregiver.
The Future of Technology in Health Care

Technology is likely to become increasingly important in healthcare. Any professionalism concerns must be weighed against the potential benefits of technology to patients. Major areas of technological innovation in healthcare include: sensors, imaging devices, genetics, supercomputing and “big data” synthesis, robotics, and energy harvesting. Healthcare professionals are likely to embrace technology at differing levels. Those who do embrace technology will need to weigh potential risks and benefits carefully. As technological innovations continue, ways of solving some professionalism concerns are likely to be achieved but ongoing research into technology’s role in improving patient care is needed.
Localized LQR control with actuator regularization

In previous work, we posed and solved the localized linear quadratic regulator (LLQR) problem - a LLQR controller is one that limits the propagation of dynamics to user-specified subsets of the global system. The advantages of taking this approach are tangible, as we show that this allows the controller to be synthesized and implemented in a scalable local manner. Implicit in this previous work was the existence of a feasible spatio-temporal constraint on the controller and closed loop response of the system that enforced these locality properties. This paper proposes and analyzes a procedure for designing such a spatio-temporal constraint, which can be interpreted as a measure of the implementation complexity of a controller, and a sparse actuation architecture that ensures that it is feasible. We show that the computational tasks involved can be suitably decomposed and solved using the alternating direction method of multipliers (ADMM), thus providing a scalable approach to designing a LLQR controller with a sparse actuation architecture.
Surgeon Adoption of Minimally Invasive Radical Prostatectomy

Abstract Introduction Minimally invasive radical prostatectomy has become the most common surgical treatment for prostate cancer. In this study we describe patterns of minimally invasive radical prostatectomy adoption among surgeons who performed open radical prostatectomy before their first minimally invasive radical prostatectomy and those who did not. Methods We performed a retrospective cohort study using the population based SEER (Surveillance, Epidemiology, and End Results)-Medicare data set. We identified all surgeons who performed minimally invasive radical prostatectomy in 2003 to 2010 in men with prostate cancer 66 years old or older. Surgeons were classified as “converters” if they performed open radical prostatectomy before their first minimally invasive radical prostatectomy or “de novos” if they had not. We estimated annual minimally invasive radical prostatectomy volume and the proportion of prostatectomies performed minimally invasively. We used logistic regression to identify predictors of minimally invasive radical prostatectomy discontinuation. Results A total of 11,511 minimally invasive radical prostatectomies were performed by 738 minimally invasive radical prostatectomy surgeons (converters 337 and de novos 401). Converters performed 55% of all minimally invasive radical prostatectomies and had higher median annual minimally invasive radical prostatectomy volume than de novos (4 vs 2). About 34% of converters and 54% of de novos discontinued minimally invasive radical prostatectomy after their first year. Second year discontinuation of minimally invasive radical prostatectomy was more likely among de novo surgeons (OR 1.9, 95% CI 1.3–2.7) and less likely among surgeons with higher minimally invasive radical prostatectomy volume in their first year (OR 0.5, 95% CI 0.5–0.6). Conclusions During the years of the greatest growth in minimally invasive radical prostatectomy, surgeon adoption of this technique varied by surgeon type and volume. Many surgeons discontinued, and possibly abandoned, minimally invasive radical prostatectomy. Based on these observations, experienced and higher volume surgeons will be most successful adopting new surgical technology.
Improved Temporomandibular Joint Position After 3-Dimensional Planned Mandibular Reconstruction.

Purpose Virtual surgical planning (VSP) using computer-aided design and manufacturing (CAD-CAM) has been reported to aid in craniofacial reconstruction. The reported improvements have been related mainly to operative performance, with limited evaluations of the position and function of the temporomandibular joint (TMJ). This study analyzed the radiographic detail of postoperative outcomes related to the TMJ. Materials and Methods Patients who underwent mandibular reconstruction with and without VSP were analyzed. All patients underwent preoperative computed tomography (CT) of their mandible. In the VSP group, CAD-CAM planning was performed preoperatively using CT Digital Imaging and Communications in Medicine (DICOM) data. Postoperative CT images from the 2 groups were quantitatively compared to evaluate the TMJ. CT images were digitized for 2- and 3-dimensional analysis using surgical planning software (Materialise, Leuven, Belgium). Anatomic landmarks and cephalometric relations were analyzed. Results Sixteen patients who underwent traditional planning or VSP for mandibular reconstruction were compared. Two groups (n = 8 each) were compared for positioning of the mandibular condyle in the glenoid fossa. Measurements of superior, anterior, and lateral movements were comparable in the pre- and postoperative groups for the traditional and VSP groups ( P P P P P Conclusion These data showed comparable pre- and postoperative positions of the TMJ for traditional and VSP mandibular reconstructions. Evaluation of condyle movements showed differences in the ipsilateral position in the pre- and postoperative groups. VSP resulted in decreased superior and lateral shifts of the ipsilateral condyle and decreased changes in the condylar and condylar neck angles. This work shows that VSP can lead to increased precision in reconstruction leading to preserved normative anatomic relations.
A strong arbiter PUF using resistive RAM

Physically Unclonable Functions (PUF) are the cost effective and reliable security primitives widely used in authentication and in-place secret key generation applications. With growing research in the area of non-CMOS technologies for memories and circuits, it's important to understand their implications on the design of security primitives. Resistive Random Accessible Memory (RRAM) offers easy integration with CMOS due to minimal changes in the process technology. RRAM also demonstrates resistance variability characteristics due to inherent defects in the conducting filament formed inside the metal oxide layer. RRAM based PUF designs exploit either the probabilistic switching of RRAM or the resistance variability during forming, set and reset processes. Memory PUFs using RRAM are weak PUFs with fewer number of Challenge Response Pairs (CRPs). We propose strong arbiter PUF based on 1T-1R bitcell which is obtained from conventional RRAM memory array with minimally invasive changes. Conventional voltage sense amplifier is employed to generate the response. The PUF is simulated using 65nm predictive technology models for CMOS and verilog-A model for a hafnium oxide based RRAM. The proposed PUF architecture is evaluated for uniqueness, uniformity and reliability and by running NIST benchmarks. The proposed PUF demonstrates mean intra-die Hamming Distance (HD) of mean 0.13% and inter-die HD of mean 51.3%.
Dataspaces: co-existence with heterogeneity

• Users want be able to search the entire collection without having knowledge of individual sources. In some cases, they merely want to know where the information exists as a starting point to further exploration. • An organization may want to enforce certain rules, integrity constraints, or conventions (e.g., on naming entities) across the entire collection, or track flow and lineage between systems. Furthermore, the organization needs to create a coherent external view of the data. • The administrators may want to impose a single “support system” in terms of recovery, availability, and redundancy, as well as uniform security and access controls. • Users and administrators need to manage the evolution of the data, both in terms of content and schemas, in particular as new data sources get added (e.g., as a result of mergers or new partnerships). • The organization would like to globally capture human interactions with the sources (e.g., querying, excerpting, annotating, co-use) to provide value-added information about semantics, linkages and quality.
The function of value engineering

Value Engineering (VE) techniques based on function have been the means to improved products and processes for several decades. It is a social design methodology that is usually episodic in application and often confused with narrow interests, such as cost cutting. This paper addresses the role, or function, of VE in a larger model of design practice to give insight into its use, non-use and misuse. The model identifies three levels of design practice, with a dual functional activity at its center. The process of innovative design shows tension between these functions. We conclude that VE is neither a different nor a sufficient way to design compared with more conventional analytical and synthesis techniques. It is rather a parallel and necessary process with different inputs and outputs. Stuiges: Function of Value Engineering 1/23/92 1
Social Reproduction and Learned Helplessness in a Dying Community

This paper reports some of the findings of a broad-based community study of a small Oregon town that depends for its existence on one timber mill--a single plant in a declining industry. The community has been in decline for at least the last decade and prospects for reversal are not good. Specifically, this paper explores the forces that shape the response of high school students and young adults who have grown up in the community to the decline, using survey, ethnographic, and archival data. Despite a clear understanding of the economic plight of the community, young people are not prepared for the changes they face. The research indicates that this is because of (1) a community culture that is fatalistic and highly individualistic and (2) a school system that has as its primary function the preparation of workers for the wood products industry. In this paper the community and its economy are described. Next, research findings on the culture of the community and on its school system are presented, along with their implications for the socialization of young people. Finally, the findings and implications are discussed in relation to the literature on dying communities. By all accounts the structure of the U.S. economy will change dramatically before the turn of the century. Nowhere will the impact of these changes be more dramatic than in the wood products industry of the Pacific Northwest. It is an industry that virtually supports the region: forty-six percent of manufacturing jobs and ten percent of all jobs in the Northwest are in the wood products industry (Howard and Hiserote, 1978). The region faces the same issues as other old-line manufacturing areas: technological change and competition from other regions both in the U.S. and abroad are producing structural unemployment. However, the Northwest is different from most other old industrial regions in one important respect. The Northwest wood products industry has been characterized by numerous small operations, usually located in small, isolated communities. In many cases a town depends on a single mill for its existence. For example, there are in Oregon today seventy-nine towns with populations of less than three thousand that rely on the wood products industry for their economic support. In sixty-two of these communities, more than eighty percent of the total manufacturing workforce is employed in the wood products industry (Weeks, 1982). These towns are extremely vulnerable to the structural changes that their industry is facing. Important segments of the industry are moving to the Southeastern United States and to Southeast Asia, where labor costs are lower and timber is more accessible. Those firms that are staying are engaged in a course of modernization and centralization that is resulting in fewer, larger, more highly capitalized mills located in or near the region's important cities. As a result, an important restructuring of the region's spatial economy is occurring. Since 1976, more than ten percent of all the mills in the Northwest have closed permanently, and many of
Word Confusability - Measuring Hidden Markov Model Similarity

We address the problem of word confusability in speech recognition by measuring the similarity between Hidden Markov Models (HMMs) using a number of recently developed techniques. The focus is on defining a word confusability that is accurate, in the sense of predicting artificial speech recognition errors, and computationally efficient when applied to speech recognition applications. It is shown by using the edit distance framework for HMMs that we can use statistical information measures of distances between probability distribution functions to define similarity or distance measures between HMMs. We use correlation between errors in a real speech recognizer and the HMM similarities to measure how well each technique works. We demonstrate significant improvements relative to traditional phone confusion weighted edit distance measures by use of a Bhattacharyya divergence-based edit distance. Index Terms: Bayes Error, Bhattacharyya divergence, variational methods, gaussian mixture models, unscented transformation, Kullback‐Leibler distance rate.
Treatment of Substance Abuse in Older Adults

Substance abuse is one of the most prevalent health care problems in the United States, accounting for a staggering toll on society and the afflicted individual’s physical and emotional well-being (Schilit & Gomberg, 1991). For older adults, in particular, abuse of alcohol and other drugs is a significant and burgeoning problem (Brody, 1982; Parette, Hourcade, & Parette, 1990; Ruben, 1992; Zimberg, 1987). Indeed, epidemiological research conducted over the past several years reveals that alcohol and substance abuse rank third among leading psychiatric problems in Americans 55 years and older, accounting for approximately 10 to 12% of those who receive services from mental health professionals (see Ticehurst, 1990; Zimberg, 1974). Several estimates of problem drinking or alcoholism in older adults have yielded prevalence rates in the general community of between 2 and 10% (cf. Fredriksen, 1992; Gomberg, 1982; Shuckit, 1977), and these most likely are underestimates. Prevalence estimates are even higher in certain settings, such as medical wards and nursing homes (Horton & Fogelman, 1991). Nevertheless, these data suggest that there are between 1 and 3 million older heavy alcohol users in the United States who suffer deleterious medical, emotional, and legal consequences. Further, these sequelae have an untoward impact at the societal level (e.g., high economic losses, increased health care costs, diminished work productivity) as well (Morey & Martin, 1989; Parette et al., 1990). Unfortunately, only 15% of alcoholics in this age group appear to receive some form of mental health treatment (King, Altpeter, & Spada, 1986; National Council on Alcoholism, 1981).
Design and raytrace simulations of a multilayer-coated Wolter x-ray optic for the Z machine at Sandia National Laboratories.

Recent breakthroughs in the fabrication of small-radii Wolter optics for astrophysics allow high energy density facilities to consider such optics as novel x-ray diagnostics at photon energies of 15-50 keV. Recently, the Lawrence Livermore National Laboratory, Sandia National Laboratories (SNL), the Smithsonian Astrophysical Observatory, and the NASA Marshall Space Flight Center jointly developed and fabricated the first custom Wolter microscope for implementation in SNL’s Z machine with optimized sensitivity at 17.5 keV. To achieve spatial resolution of order 100-200 microns over a field of view of 5 × 5 × 5 mm3 with high throughput and narrow energy bandpass, the geometry of the optic and its multilayer required careful design and optimization. While the geometry mainly influences resolution and the field of view of the diagnostic, the mirror coating determines the spectral response and throughput. Here we outline the details of the design and fabrication process for the first multilayer-coated Wolter I optic for SNL’s Z machine (Z Wolter), including its W/Si multilayer, and present results of raytrace simulations completed to predict and verify the performance of the optic.
Approximation by Shift Invariant Univariate Sublinear-Shilkret Operators

A very general positive sublinear Shilkret integral type operator is given through a convolution-like iteration of another general positive sublinear operator with a scaling type function.For it sufficient conditions are given for shift invariance, preservation of global smoothness, convergence to the unit with rates. Additionally, two examples of very general specialized operators are presented fulfilling all the above properties, the higher order of approximation of these operators is also considered.
Abstract MP30: Gaps in Provider Lifestyle Counseling and Its Adherence Among Obese Adults With Diabetes in the United States

Introduction: The 2013 ACC/AHA guidelines on the management of obesity in adults strongly recommend lifestyle counseling on calorie restriction, improved physical activity and referral to a weight ...
Tocilizumab for Antibody-Mediated Rejection in the Setting of Cardiac Allograft Vasculopathy

Introduction IL-6 is a pro-inflammatory cytokine that potentiates the effect of plasma cells, immunoglobulins, T-cells, and macrophages. IL-6 levels are associated with atherosclerotic plaque progression and graft fibrosis; IL-6 blockade may have a role in therapy for cardiac allograft vasculopathy (CAV). Preclinical data has also implicated IL-6 signaling in graft rejection. Tocilizumab, an IL-6 receptor antagonist, has successfully decreased donor-specific antibodies (DSAs) in renal transplant patients with antibody-mediated rejection (AMR). Herein, we report on the use of tocilizumab in a heart transplant recipient with treatment-refractory AMR and established CAV. Case Report A 65 year old male who underwent heart transplantation 13 years ago presented with dyspnea. His history was significant for AMR 5 years post-transplant and CAV 10 years post-transplant. On admission, studies revealed reduced LV ejection fraction (LVEF, 70% to 50%) and cardiac index (CI, 1.27 L/min/m2), severe 3-vessel CAV, and elevated pulmonary capillary wedge pressure (PCWP, 28 mmHg). He had new DSAs against HLA-A, -B, -DQ, and -DR antigens (MFI 5,792-24,748); biopsy grade was 1R/1A. He was treated with steroids, plasmapheresis, IVIg, and rituximab; maintenance immunosuppression was revised to tacrolimus, everolimus, mycophenolate, and prednisone. He was readmitted twice within the next month with acute decompensation requiring inotropes. He had a further decline in LVEF to 45%, CAV progression, and largely unchanged DSAs. He was again treated with steroids, plasmapheresis, and IVIg. Given progressive decline despite traditional AMR and CAV therapy, we initiated tocilizumab 800 mg monthly. He has received tocilizumab for one year without significant complications or hospitalizations; he reports NYHA class II symptoms. HLA screen showed resolution of HLA-A, -B, and -DR DSAs and MFI reduction of HLA-DQ DSA (24,748 to 14,994). Right heart catheterization was significantly improved (CI 2.06 L/min/m2 and PCWP 18 mmHg); LVEF remains unchanged and coronary angiography shows CAV progression. Summary To our knowledge, this represents the first report of using tocilizumab for refractory cardiac AMR and CAV. Additional studies are warranted to evaluate the safety and efficacy of tocilizumab in heart transplant recipients and to elucidate the mechanism of DSA clearance by tocilizumab.
Unicellular Cyanobacteria Exhibit Light-Driven, Oxygen-Tolerant, Constitutive Nitrogenase Activity Under Continuous Illumination

Abstract Cyanobacteria have played a profound role in shaping the biosphere, most notably through the Great Oxygenation Event (GOE) with the advent of photosynthesis1. Cyanobacteria also contribute to global primary production through biological nitrogen fixation (BNF) using nitrogenase2,3, an oxygen-labile enzyme complex that evolutionarily predates the GOE4. Current literature reports nitrogenase activity in unicellular cyanobacteria is protected from oxygen through diurnal separation of photosynthesis and BNF5. However, historic conditions of continuous-light and warm temperature at polar latitudes during the Triassic and Cretaceous may have created a selective advantage amongst unicellular cyanobacteria for non-temporal mechanisms of maintaining nitrogenase activity in the presence of oxygen. Here we report constitutive nitrogenase activity concurrent with a net-gain of oxygen through photosynthesis in a continuous-light adapted culture of the unicellular cyanobacteria, Cyanothece sp. ATCC 51142. Nitrogenase activity in the adapted culture exhibited dependence on light and an increased resilience to artificially raised oxygen-tension compared to traditional culture. We predict cyanobacteria closely related to Cyanothece sp. ATCC 51142 also possess this physiology and found an accessory predicted proteome with functional relevance. This work provides a model of light-driven, oxygen-tolerant, constitutive nitrogenase activity and suggests this physiology may be conserved in closely related unicellular diazotrophic cyanobacteria with implications for primary production in polar ecosystems and potential biotechnological application in sustainable agriculture production.
Effects of Glomus fasciculatum or Glomus mosseae on Growth of Liriodendron tulipifera under High Fertility

Liriodendron tulipifera L. seedlings were grown under greenhouse conditions and inoculated with the endomycorrhizal fungi Glomus fasciculatum (Thaxter) Gerdemann & Trappe or G. mosseae (Thaxter) Ge...
Outcomes of Atrial Fibrillation Ablation in Morbidly Obese Patients Following Bariatric Surgery Compared With a Nonobese Cohort.

Background: Morbid obesity is associated with unacceptable high recurrence rates following atrial fibrillation ablation. The role of risk-factor modification including weight loss and improved glyc...
Marsh Rams-Horn, Marsh Ramshorn Helisoma (Planorbella) trivolvis (Say) (Gastropoda: Planorbidae)

The marsh rams-horn, Helisoma (Planorbella) trivolvis (Say), is a species of air-breathing freshwater aquatic snail that is native to Florida. It belongs to the family Planorbidae, commonly known as the ramshorn snail, which comes from the shape of its shell.https://edis.ifas.ufl.edu/in1234 Also published on Featured Creatures: http://entnemdept.ufl.edu/creatures/MISC/GASTRO/marsh_ramshorn.html
Acoustics and dynamic materials

Abstract The governing equations for small-amplitude acoustic disturbances are derived by combining an admissible background flow or medium, balance laws, an equation of state and perturbation theory. This standard approach is used here when the background medium can vary in both space and time, thus defining a dynamic material. When the background velocity is zero, the background density cannot vary with time, assuming that the usual balance laws (such as conservation of mass) are obeyed. When mass conservation is discarded, perhaps replaced by a growth model, a time-dependent background density is permitted, leading to new equations governing acoustic disturbances in certain dynamic materials.
Retro Is Cool: Structure of the Versatile Retromer Complex.

In this issue of Structure, Kendall et al. (2020) reveal the cryo-EM structure of the mammalian retromer complex, which is essential in sorting membrane proteins in endosomes. The retromer heterotrimer can oligomerize in multiple conformations; this versatility is promoted by a flexible interface of electrostatic residues on the VPS35 subunit.
Narrated Dissection Videos and Peer-Mentoring to Enhance Anatomy Performance of Underrepresented Minority Students in Physical Therapy Education.

Three-dimensional virtual technology (3DVT) educational tools and peer-tutoring have proven to be effective teaching strategies in improving student learning outcomes. The purpose of this study was threefold: (1) compare the anatomy academic performance between underrepresented minority (URM) and non-minority (non-URM) students, (2) compare the voluntary use of 3DVT dissection videos and peer-mentoring between these two cohorts, and (3) estimate the association between the use of these teaching strategies on anatomy examinations and course grades at a school of physical therapy. Three-dimensional virtual technology narrated dissection videos and peer-mentoring were made available to all students. Time accessing the video and attending peer-mentoring sessions was measured throughout the course for all students. Three practical and four written examinations and the final course grade were calculated. Numerous one-way ANOVAs were used to compare examination/course grades between student cohorts (URM and non-URM) and usage of the two educational strategies (3DVT and peer-mentoring). Multiple linear regressions were performed with teaching strategies as predictors and grades as outcomes. Underrepresented minority students demonstrated significantly lower practical examination scores (P = 0.04), lower final course grades (P = 0.01), and a greater use of mentorship hours (P = 0.001) compared to non-URM. The regression models with both predictors (3DVT and peer-mentoring) combined demonstrated the greatest association with grades for both URM and non-URM. For both groups of students, the association between predictors and practical examination scores, although fair, was not statistically significant. Peer-mentoring seems to be the most effective teaching strategy in helping URM students succeed in anatomy.
Intravenous Magnesium Sulfate for Acute Asthma Exacerbation in Adults.

Asthma is a common chronic respiratory disease with acute exacerbations recognized clinically by the signs and symptoms of dyspnea, cough, chest tightness, and wheezing. In the United States approximately 25 million individuals currently have asthma and in 2017, asthma exacerbations accounted for approximately 1.8 million emergency department (ED) visits and 3,500 deaths.
A probabilistic conditional adversarial neural network to reduce imaging variation in radiography

Medical images can vary due to differences in imaging equipment and conditions. This variability negatively can impact the consistency and accuracy of diagnostic processes. Hence, it is critical to decrease the variability in image acquisition to achieve consistent analysis, both visually and computationally. There are three main categories that can contribute to image variability: equipment, acquisition protocol, and image processing. The purpose of this study was to employ a deep neural network (DNN) method to reduce variability in radiography due to these factors. Given radiography images acquired with different settings, the network was set up to return harmonized images, targeting a reference standard. This was implemented via a virtual imaging trial platform, utilizing an X-ray simulator (DukeSim) and 77 anthropomorphic, computational phantoms (XCAT). The phantoms were imaged at 120 kV at four different dose levels with DukeSim emulating a typical flat panel radiography system. The raw radiography images were then post-processed using a commercial algorithm at eight different settings resulting in a total of 2464 radiographs. For each XCAT, the reference standard was defined as the noise-less and scatter-less radiography image with image processing parameters based on a radiologist’s preference. The simulated images were then used to train and test the DNN. The test set resulted an average structural similarity index greater than 0.84, and an 𝐿1 error less than 0.02, indicating the harmonized images were visually and analytically more consistent and closer to the desired reference appearance. The proposed method has great potential to provide for effective and uniform interpretation of radiographic images.
Banal nationalism and global connections: The 23rd World Scout Jamboree as a site for cosmopolitan learning

The article explores the possibilities for cosmopolitan learning within a site such as the 23rd World Scout Jamboree. The approach is interdisciplinary, combining a theoretical conceptualisation of...