cssi/SciSciGPT-SciSciNet huggingface dataset:
Electrocardiographic spatial loops indicate organization of atrial fibrillation minutes before ablation-related transitions to atrial tachycardia

Abstract Background During ablation for atrial fibrillation (AF), it is challenging to anticipate transitions to organized tachycardia (AT). Defining indices of this transition may help to understand fibrillatory conduction and help track therapy. Objective To determine the timescale over which atrial fibrillation (AF) organizes en route to atrial tachycardia (AT) using the ECG referenced to intracardiac electrograms. Methods In 17 AF patients at ablation (58.7 ± 9.6 years; 53% persistent AF) we analyzed spatial loops of atrial activity on the ECG and intracardiac electrograms over successive timepoints. Loops were tracked at precisely 15, 10, 5, 3 and 1 min prior to defined transitions of AF to AT. Results Organizational indices reliably quantified changes from AF to AT. Spatiotemporal AF organization on the ECG was identifiable at least 15 min before AT was established (p = 0.02). Conclusions AF shows anticipatory global organization on the ECG minutes before AT is clinically evident. These results offer a foundation to establish when AF therapy is on an effective path, and for a quantitative classification separating AT from AF.
Carbon Input and Accumulation in Freshwater to Brackish Marshes on the Barrier Islands of Virginia, USA

Barrier island marshes are exceptionally dynamic systems. The objective of this study was to quantify above and belowground net primary production, above and belowground decay, sedimentation rate, and soil carbon pools within four interdunal fresh to brackish marshes on Hog Island, Virginia, USA and to compare carbon input and soil accumulation among marshes with varied susceptibility to overwash. Major carbon fluxes were assessed by the following methods: aboveground net primary production by harvesting biomass throughout the growing season, belowground net primary production with in-growth cores, sedimentation by deposition on sediment plates, and belowground and aboveground decay with litterbags. We expected sites more susceptible to overwash events to have higher carbon inputs and more accumulation in the soil. Sites in the direct overwash path had slower belowground decay rates, and one of these sites also had the slowest aboveground decay rate. The sites most susceptible to overwash had higher ANPP, but did not have higher soil carbon pools. Sites most susceptible to overwash had a higher salinity and bulk density, but did not store more carbon than other sites. As these sites age and the island accretes vertically, it is expected that soil carbon stocks will increase as well.
Kidney transplant after hematopoietic cell transplant in pediatrics: Infectious and immunosuppressive considerations

Pediatric patients requiring kidney transplant after hematopoietic cell transplant receive multiple courses of immunosuppression placing them at risk for infection. To elucidate potential risk factors for infection, we compared the immunosuppressive regimens and infectious complications of pediatric kidney transplant recipients at a single institution who had previously undergone hematopoietic cell transplant from different donors to similar patients reported in the literature. Among the initial four post-hematopoietic cell transplant kidney transplant patients reviewed, viremia episodes were universal, including BK virus, Epstein-Barr virus, and human herpesvirus-6, with one death from presumed BK virus encephalitis. No viremia was reported in five similar cases in the literature. Risk factors for increased infection include use of lymphodepleting serotherapy in HCT conditioning, multiple HCTs, limited immune reconstitution time between transplants, increased pre-KTx viral burden, and use of T-cell-depleting versus -suppressive induction immunosuppression for KTx. These findings suggest that pediatric post-HCT KTx recipients are at increased risk for viral infections, likely benefitting from thorough pre-KTx evaluation of immune reconstitution and preferential use of non-T-cell-depleting induction therapy for KTx. We applied these recommendations to one subsequent post-HCT patient requiring KTx at our institution with excellent outcomes one year post-KTx.
Introduction: The Vieques Story and the Critical Task of a Puerto Rican Decolonial Theology

The story of Vieques, a small territory off the east coast of Puerto Rico, ecologically abused for years by US naval presence, illustrates the oppression Puerto Ricans experience and the hope that comes through the process of resistance by “speaking truth to power.” This chapter situates the reader within the current socio-economic and political climate of the Puerto Rican community in the United States (island and Diaspora) which calls for a theological response to the loss of identity, overwhelming presence of suffering, and forfeiture of hope. Employing interdisciplinary methodology, the author demonstrates how Puerto Rican literature and Puerto Rican theology are prophetic voices calling out for the liberation of a suffering people, using personal Puerto Rican family/community stories as an authoritative contextual reference point. Topics: The death of David Sanes Rodriguez and US naval presence in Puerto Rico. Social movement for justice in Puerto Rico with Vieques as a catalyst. Divide between island and diaspora Puerto Ricans has led to silence. Literature/theology dialogue as an authentic and consistent decolonial methodology.
Prophylactic Negative Pressure Wound Therapy in Obese Patients Following Cesarean Delivery.

Objective. Negative pressure therapy (NPT) offers the potential to reduce infection in obese patients. The goal of this study was to explore the association between NPT use and infection after cesa...
Triadic Participation in Organizational Meeting Interaction

Author(s): Kang, M. Agnes | Abstract: Attention to multi-party' talk has revealed that shifts in participation frameworks can be used to serve social functions in interaction. This paper gives a sequential analysis of a videotaped interaction from an organizational meeting, where participants use a particular interactional exchange to display and even create the personal relationships that exist between them. This is done by using a particular participation framework in what I call a triadic exchange in accomplishing particular social acts that are potentially face-threatening. I argue that this display contributes to how in-group membership is developed in these organizations. The use of triadic exchanges makes public the display of the participants' relationships to each other, making participation more accessible to a general audience and building in-group memberships that can develop over time through interaction.
DEM analysis of failure mechanisms in the intact Brazilian test

Abstract A comprehensive numerical study is conducted to examine the failure behaviors in the intact Brazilian test. Brazilian test is considered a robust laboratory test to obtain an indirect measure of the uniaxial tensile strength of quasi-brittle materials such as rocks. Though validity of the Brazilian test is based on the premise that the diametrical splitting failure is caused by tensile crack growth from the center of the specimen (Scenario I), an alternative indentation-type of failure mechanism (Scenario II), where the splitting failure pattern forms as a result of cracks emanating from the crushed zones adjacent to the loading areas, is often observed experimentally. In this work, how the failure mechanisms and consequently the Brazilian tensile strength are affected by the material properties and the sample size are investigated using the DEM code PFC2D/3D. A novel displacement-softening contact model is implemented in PFC2D/3D so that materials with realistic uniaxial compressive over tensile strength ratios as high as ∼ 30 could be modeled. Formulation of the softening contact model and the effect of the micro-scale softening parameter on the macro-scale mechanical properties are first described. Intact Brazilian test is modeled in both 2D and 3D. We show that the failure scenarios transition from Scenario I to Scenario II, if the compressive over tensile strength ratio decreases or the sample size increases. For a low strength ratio material, if the failure mechanism follows Scenario II, the nominal Brazilian tensile strength could potentially underestimate the intrinsic tensile strength. Implications of this numerical analysis to laboratory testing and to the calibration of material properties in DEM modeling in general are also discussed.
Low Energy Bluetooth Inter-Node Communication Schemes via Randomized Reconfiguration

Low Energy Bluetooth (LowE-BT) communication is becoming more ubiquitous as the number of wireless connectable devices increase. It is also emerging as a communication methodology supporting low energy wireless communication in renewable distributed energy systems. A typical LowE-BT configuration incorporates one fixed configuration client (master) device and one or more fixed configuration server (slave) device(s). For multiple devices in an Ad-hoc network having inter-communication needs where the physical separation cannot accommodate a centralized scheme, a robust and reconfigurable communication topology is desired. In particular, we consider a case where the physical devices are equally spaced along a line (or string) with sufficient distance to necessitate node-to-node communication only. We propose and compare two schemes. The first is an asynchronous scheme in which randomized client/server reconfiguration occurs within a prescribed interval allowing simultaneous message packet transfers along the entire network to occur. The second is a synchronous scheme in which the client/server reconfiguration and packet transfers occur sequentially along the network. Given the data packets from all nodes can be combined to form a block packet transferred from one end of the string to the other, the mean time for network block packet transfers are computed and compared for these two schemes to determine which method minimizes block packet transmission time.
Redesign of an Undergraduate General Microbiology Lab to Include Authentic Discovery-Driven Research on Cucumber Fermentations

Many undergraduate introductory microbiology laboratory courses teach basic principles of bacteriology using classical protocol-based experiments, with limited critical thinking and inquiry-based learning practices. We initiated a comprehensive redesign in our General Microbiology Laboratory course to promote scientific critical and creative thinking, while strengthening core microbiology concepts and skills. As part of the redesign, a series of authentic discovery-driven labs, based on cucumber fermentations, were developed as an independent research module within the course curriculum. Integrating discovery-driven labs allowed students to be engaged problem solvers, applying the scientific process to develop hypotheses, design experiments, utilize quantitative reasoning, and effectively communicate results. The inquiry-guided research project was developed to evaluate the minimum concentration of salt (NaCl) required in fermentation brine to safely, and effectively, ferment cucumbers. Over 5 weeks, students assess different aspects of the fermentation process, including quantifying bacterial populations with differential and selective media, measuring pH and glucose concentration of brine solutions, and characterizing the microbial metabolic potential. Additionally, students isolate an unknown bacterium from their fermentations, identifying and characterizing the isolate using 16S rRNA gene sequencing and metabolic tests. Throughout the research project, students collect, graph, and analyze their observations, culminating in students creating and presenting a scientific research poster. With this lab redesign, students generate new knowledge contributing to our understanding of microbial ecology within food fermentations, learn core microbiology skills and techniques, and develop critical and creative thinking skills. The impact of their research is valuable to science educators, researchers, and industry partners.
Novel Approaches for the Treatment of Schizophrenia

Publisher Summary Schizophrenia is a complex psychiatric disorder characterized by the variable expression of three major categories of symptoms—positive, negative, and cognitive symptoms. This chapter describes several new approaches targeting the proposed deficit in N -methyl-D-aspartate (NMDA) receptor-mediated neurotransmission, as this is believed to be the primary neurochemical deficit in schizophrenia. Different approaches targeting altered NMDA receptor function discussed in the chapter include α -amino-3-hydroxy-5-methyl-4-isoxazolepropanoic acid (AMPA) potentiators, glycine transporter 1 (GlyT1), and metabotropic glutamate receptors. Approaches targeting cognition include alpha7 nicotine acetylcholine receptor agonists and positive allosteric modulators; dopamine D1/D5 receptor agonists; and serotonin 5-hydroxytryptamine (5-HT 6 ) antagonists. Approaches primarily targeting psychosis include dopamine D3 receptor antagonists and serotonin 5-HT2C receptor agonists.
Perspectives in the Solid State Coordination Chemistry of the Molybdenum Oxides

The chemistry of polyoxomolybdate anions may be exploited in a building block approach to the synthesis of solid state oxide materials. One strategy controls the oxide microstructure by introducing a secondary metal-ligand subunit as a charge-compensating, space-filling and structure-directing component. The resulting organic-inorganic hybrid materials are representative of solid state coordination chemistry in which the oxide microstructure reflects the geometry of the ligand, the coordination preferences of the secondary metal center, and the synergistic interaction of the coordination complex cation with the polyoxomolybdate component.
Factors influencing appraisal of upset in black caregivers of persons with Alzheimer disease and related dementias

Black caregivers of persons with Alzheimer disease and related dementias (ADRD) have demonstrated significantly lower levels of stress and burden than white caregivers, as measured by instruments that assess caregiving burden and stressfulness of specific problem behaviors. However, the reasons for reported differences are unclear and cannot be attributed solely to race. This descriptive study used content analysis to compare black caregivers' descriptions and interpretations of responses to memory and behavioral issues of relatives with ADRD to 11 explanations for lower levels of upset proposed in the caregiving literature. Findings confirmed only two explanations from the literature, social support and religious orientation, as factors that influenced appraisal of upset. Two new themes emerged, categorized as Making Sense and Using Strategies, as explanatory frameworks. Findings extend current knowledge of black caregivers' emotional responses to caregiving and support the need for future study of the ways in which particular ethnic and racial groups experience caregiving. Understanding the meaning of appraisals may enable service providers and program developers to tailor services and interventions to support the efforts of black and other minority caregivers.
Why Travel for Complex Cancer Surgery? Americans React to 'Brand-Sharing' Between Specialty Cancer Hospitals and Their Affiliates.

Leading cancer hospitals have increasingly shared their ‘brand’ with smaller hospitals through affiliations. Because each brand evokes a distinct reputation for the care provided, ‘brand-sharing’ has the potential to impact the public’s ability to differentiate the safety and quality within hospital networks. The general public was surveyed to determine the perceived similarities and differences in the safety and quality of complex cancer surgery performed at top cancer hospitals and their smaller affiliate hospitals. A national, web-based KnowledgePanel (GfK) survey of American adults was conducted. Respondents were asked about their beliefs regarding the quality and safety of complex cancer surgery at a large, top-ranked cancer hospital and a smaller, local hospital, both in the presence and absence of an affiliation between the hospitals. A total of 1010 surveys were completed (58.1% response rate). Overall, 85% of respondents felt ‘motivated’ to travel an hour for complex surgery at a larger hospital specializing in cancer, over a smaller local hospital. However, if the smaller hospital was affiliated with a top-ranked cancer hospital, 31% of the motivated respondents changed their preference to the smaller hospital. When asked to compare leading cancer hospitals and their smaller affiliates, 47% of respondents felt that surgical safety, 66% felt guideline compliance, and 53% felt cure rates would be the same at both hospitals. Approximately half of surveyed Americans did not distinguish the quality and safety of surgical care at top-ranked cancer hospitals from their smaller affiliates, potentially decreasing their motivation to travel to top centers for complex surgical care.
Effect of Physical Parameters on Outcomes of Total Knee Arthroplasty.

BACKGROUND Increasing body mass index (BMI) has been shown to correlate with increased rates of complications after total knee arthroplasty. To our knowledge, body surface area, body mass, and height have not been investigated in this manner. BMI and body surface area are affected differently by changes in height, and they are affected similarly by changes in weight. The purpose of this study was to quantify revision for any reason, mechanical failure, aseptic loosening, polyethylene wear, reoperation, and any infection after total knee arthroplasty using BMI, body surface area, body mass, and height as continuous variables. METHODS Prospectively collected data from a single institution's total joint registry were used to analyze 22,243 consecutive knees, in 16,106 patients, treated with a primary total knee arthroplasty from 1985 to 2012. The Kaplan-Meier survival method was used to evaluate revision and other common complications, with outcomes assessed using Cox regression analysis. Smoothing spline parameterization was used on physical parameters in these models. RESULTS Increasing BMI, body surface area, body mass, and height were associated with an increased risk of any revision surgical procedure, mechanical failure, and aseptic loosening after total knee arthroplasty. The risk of a revision surgical procedure was directly associated with each 1 standard deviation increase in BMI (hazard ratio [HR], 1.19; p < 0.01), body surface area (HR, 1.37; p < 0.01), body mass (HR, 1.30; p < 0.01), and height (HR, 1.22; p < 0.01). This association was especially demonstrated with revision for mechanical failure (BMI: HR, 1.15; p < 0.01; body surface area: HR, 1.35; p < 0.01; body mass: HR, 1.27; p < 0.01; and height: HR, 1.23; p < 0.01). The risk of failure in the subgroups of mechanical failure including a revision surgical procedure for aseptic loosening or polyethylene wear was also associated with increasing body surface area, body mass, and height. Increasing BMI (HR, 1.22; p < 0.01), body surface area (HR, 2.56; p < 0.01), and body mass (HR, 2.54; p < 0.01) were also associated with increased risk of any infection. CONCLUSIONS Increasing BMI, body surface area, body mass, and height were strongly associated with the rates of revision, aseptic loosening, and other common complications following total knee arthroplasty. Body surface area and body mass appear to correlate more strongly with mechanical failure outcomes than BMI or height. LEVEL OF EVIDENCE Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
The Burden of Caring for a Child or Adolescent With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): An Observational Longitudinal Study

Objective To describe the longitudinal association between disease severity, time established in clinical treatment, and caregiver burden in a community-based patient population diagnosed with pediatric acute-onset neuropsychiatric syndrome (PANS). Methods The study included an observational longitudinal cohort design, with Caregiver Burden Inventories (CBIs) collected between April 2013 and November 2016 at the Stanford PANS multidisciplinary clinic. Inclusion criteria for this study were as follows: pediatric patients meeting strict PANS/pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) diagnostic criteria (n = 187), having a caregiver fill out at least 1 complete CBI during a disease flare (n = 114); and having family who lives locally (n = 97). For longitudinal analyses, only patients whose caregiver had filled out 2 or more CBIs (n = 94 with 892 CBIs) were included. In the study sample, most primary caregivers were mothers (69 [71.1%] of 97), the majority of PANS patients were male (58 [59.8%] of 97), and mean age at PANS onset was 8.8 years. Results In a patient's first flare tracked by the clinic, 50% of caregivers exceeded the caregiver burden score threshold used to determine respite need in care receiver adult populations. Longitudinally, flares, compared with quiescence, predicted increases in mean CBI score (6.6 points; 95% CI, 5.1 to 8.0). Each year established in clinic predicted decreased CBI score (-3.5 points per year; 95% CI, -2.3 to -4.6). Also, shorter time between PANS onset and entry into the multidisciplinary clinic predicted greater improvement in mean CBI score over time (0.7 points per year squared; 95% CI, 0.1 to 1.3). Time between PANS onset and treatment with antibiotics or immunomodulation did not moderate the relationship between CBI score and time in clinic. Conclusions PANS caregivers suffer high caregiver burden. Neuropsychiatric disease severity predicts increased caregiver burden. Caregiver burden tends to decrease over time in a group of patients undergoing clinical treatment at a specialty PANS clinic. This decrease could be independent of clinical treatment.
Chapter 13 - Effects of nutrients on brain function

While many of the above examples support a role of these dietary components in modifying the synthesis, storage, release and actions of various neurotransmitter molecules in the central nervous system, most of the responses to eating everyday foods are expected to produce subtle changes in physiological and/or behavioral parameters. However, the observed subtle changes may have significant consequences when present in individuals with altered homeostasis as might be present in various disease states or certain environmental situations (e.g. depression, PMS, stress). Studies in the future should investigate the effects of various diets, e.g., vegetarian, macrobiotic, traditional Eastern, etc. on physiological and psychological functioning. Care should be taken to differentiate between the responses of subgroups of subjects, e.g. male vs. female, old vs. young, and lean vs. obese, as some differences in the rate of neurotransmitter synthesis and receptor dynamics have been reported in some studies. Chronic consumption of these diets may lead to long-term alterations in the neurotransmitter systems' dynamics, or as is often the situation with long-term pharmacological treatments, may result in adaptive changes to minimize the acute effects of such treatments. To date, no such studies have been performed that have systematically addressed many of these issues. Future studies will require careful design so as to enhance the chances of detecting such alterations in function. However, the most significant alterations in function occur when a dietary component is administered in a purified form, separate from the normal diet. In this case the compound should be treated more like a pharmacological agent than a nutrient since adverse (i.e. antinutritive) effects may result. The most difficult studies however will use everyday foods with the aim of detecting changes based on the underlying biochemical changes.
Intensive care unit admissions and in-hospital mortality in patients admitted through the emergency department of a comprehensive cancer center.

9562 Background: The National Cancer Policy Forum advocated for improving quality of end life care, and reducing cost for cancer patients. Identifying those at high risk for Intensive Care Unit (IC...
Characterization and comparison of pyrolysis products from fast pyrolysis of commercial Chlorella vulgaris and cultivated microalgae

Abstract Chlorella vulgaris algae is comprised of a complex mixture of compounds such as carbohydrates, lipids, and proteins and is a suitable feedstock for biofuels. The aim of this study was to convert commercial and a low cost field cultivated algae, via pyrolysis, to produce bio-oil, synthesis gas, and biochar products. The thermal degradation behaviour of algae was investigated by thermogravimetric analysis. Proximate, ultimate, fatty acid methyl ester and carbohydrates analyses, and pyrolysis–GCMS were further employed to characterize the chemical components of algae. Commercial and field cultured C. vulgaris algae was pyrolyzed (450, 500, and 550 °C) and their pyrolysis products were collected and characterized. The highest biochar yield was 42% at 450 °C and the highest bio-oil yield was 47.7% at 550 °C. The biochar physical and chemical properties were assessed using proximate and ultimate analysis, calorific value, specific surface area, butane absorption activity, Raman spectroscopy, and electron microscopy. Algae biochar was found to be mostly composed of condensed phenolic compounds and majorly disordered amorphous carbon. The bio-oils were characterized by the combination of GC–MS, high-pressure liquid chromatography, and electrospray ionization mass spectrometry. Fatty acids, carbohydrates, nitrogen-containing compounds, and aromatic hydrocarbons were abundantly found in the algae bio-oil.
What’s the value of a degree? Evidence from Egypt, Jordan and Tunisia

The Middle East and North Africa region has the world’s lowest returns to education. This paper examines what the value of a degree is using nationally representative labour market surveys from Egy...
On polyquadratic twists of X0(N)

Let K = Q( √ d1,..., √ dk) be a polyquadratic number field and N be a squarefree positive integer with at least k distinct factors. The Galois group, Gal(K/Q) is an elementary abelian two group generated byi such that gi( √ di) = − √ di. Let � : Gal(K/Q) → Aut(X0(N)) be the cocycle that sendsi to wmi where wmi are the Atkin-Lehner involutions of X0(N). In this paper, we study the Qp-rational points of the twisted modular curve X �(N) and give an algorithm to produce such curves which has Qp-rational points for all primes p. Then we investigate violations of the Hasse Principle for these curves and give an asymptotic for the number of such violations. Finally, we study reasons of such violations.
Alopecia totalis and universalis long‐term outcomes: a review

Alopecia totalis (AT) and universalis (AU) represent the most severe subtypes of alopecia areata with more dramatic features and worse prognosis. The goal of this review is to identify all studies with long-term prognostic data on patients with AT and AU and provide a long-term outcome estimate. The PubMed database was queried to identify all articles discussing the long-term prognosis of AT and AU. A total of nine articles discussing long-term recovery rates of AT and AU were identified. The articles described 689 (162 = AT, 245 = AU, 282 = not specified) total patients. Six of the nine studies identified complete recovery as a potential end point in a total of 375 (39 = AT, 75 = AU, 261 = not specified) patients. According to these studies 8.5% (32/375) of AT and AU patients achieved complete recovery. A larger proportion of patients will obtain at least transient recovery periods of partial or total hair regrowth. The poor long-term outcomes of AT and AU may cause patients to lose hope with treatment. Response to treatment is often unpredictable, and physicians should be aware of the prognosis and its effects in order to properly counsel patients.
Conditional Analysis Cakewalk

Abstract Summary Sequential conditional analysis is an important tool for identifying the unique signals in single-variant association analysis between genomic variants and various phenotypic outcomes. With large datasets, it is tedious and time-consuming to manually run the sequential steps which require the association analysis, computation of linkage disequilibrium (LD) between the variants, generation of a visualization graphic, and identification of the “top hit” to be inserted as an additional covariate for the next iteration. The Conditional Analysis Cakewalk automates this process, making it easy and fast, while only requiring user input in the initial configuration steps. Availability and Implementation The Conditional Analysis Cakewalk is implemented as a Linux shell script utilizing MMAP or PLINK and LocusZoom. Source code and documentation are available at https://github.com/jennetics/Cakewalk.
Liquefaction Characteristics of Sand With Polypropylene Fiber at Low Confining Stress

The present study evaluates the liquefaction characteristics of Ottawa sand with polypropylene fiber using cyclic triaxial test. A series of stress-controlled cyclic triaxial tests were performed at 34.47 kPa (5 psi) effective confining pressure. Specimens of clean Ottawa sand, and sand containing 0.05, 0.075, 0.1, and 0.3% polypropylene fiber by dry weight of sand were tested at 0.2, 0.25, 0.3, and 0.4 Cyclic Stress Ratio (CSR). Results show that a significant improvement in liquefaction resistance when the polypropylene fiber content exceeded beyond 0.075% at 34.47 kPa effective confining stress.
Factors Influencing Nonadherence to Recommended Postdischarge Follow-Up After Trauma.

Abstract Introduction Historically, trauma patients have low adherence to recommended outpatient follow-up plans, which is crucial for improved long-term clinical outcomes. We sought to identify characteristics associated with nonadherence to recommended outpatient follow-up visits. Methods This is a single-center retrospective examination of inpatient trauma survivors admitted to a level 1 trauma center (March 2017-March 2018). Patients with known alternative follow-up were excluded. All outpatient visits within 1 y from the index admission were identified. The primary outcome was nonadherence, which was noted if a patient failed to follow-up for any specialty recommended in the discharge instructions. Factors for nonadherence studied included age, injury severity score, mechanism, length of stay, number of referrals made, and involvement with a Trauma Recovery Services program. Bivariate and logistic regression analyses were performed. Results A total of498 patients were identified (69% men, median age 43 y [range, 26-58 y], median injury severity score 14 [range, 9-19]). Among them, 240 (47%) were nonadherent. The most common specialties recommended were orthopedic surgery (56% referred, 19% nonadherent), trauma (54% referred, 35% nonadherent), and neurosurgery (127 referred, 35% nonadherent). Lowest levels of follow-up were seen for nonsurgical referrals. In adjusted analysis, a higher number of referrals made (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.95-3.05) and older age (OR, 1.01; 95% CI, 1.00-1.02) were associated with nonadherence. Trauma Recovery Service participants and penetrating trauma patients were more likely to be adherent (OR, 0.60; 95% CI, 0.37-0.97). Conclusions The largest contributor to nonadherence was the number of referrals made; patients who were referred to multiple specialists were more likely to be nonadherent. Peer support services may lower barriers to follow-up.
Perceptions of Internet Shopping: An Experimental Comparison of New Entrant and Established Catalogers

There is considerable optimism for the future of Internet catalog shopping. However, there are few empirical studies designed to help electronic catalogers. One of the primary objectives of the present study is to investigate the following research question: do individuals’ perceptions of Internet catalog shopping differ by established catalogers and new entrant catalogers.
Stop, reflect, replace: Renovating our foundation for inclusive participation

As in many academic libraries all over the country, attracting and retaining people of color has been a continuous, uphill battle.” “It is a troubling reality that our current librarian ranks do not represent the communities served by libraries.” Sadly, both of these statements, from 2001 and 2003, still hold true today. Sustained attempts to lower barriers for BIPOC (Black, Indigenous, and People of Color), such as through residency programs, have not resulted in their long-term retention, and white librarians still make up the vast majority of degreed librarians. Now is the time to stop this cycle and change the narrative in academic librarianship.
Low Carbon Industries and the Built Environment

Here, we investigate the underlying key concepts in energy efficiency, energy conservation, and green design that could help shape energy systems in the use of energy in the production of commodities, residential and commercial buildings, and other critical infrastructure and industries. These sectors use a lot of energy for heating and cooling, so we start with the importance of the concept of comfort, while focusing on the key concepts and technologies that will lead to these energy transitions in industries and the built environment. This includes solar hot water heaters and water-source heat pumps for hot water and radiant heat and geothermal heat pumps. Other key concepts described in this chapter include green chemistry, biomimicry, extended producer responsibility, design for the environment, and sustainable supply chains, all of which can contribute to greener built environments.
Identification of social engagement indicators associated with autism spectrum disorder using a game-based mobile application

ObjectiveAutism spectrum disorder (ASD) is a widespread neurodevelopmental condition with a range of potential causes and symptoms. Children with ASD exhibit behavioral and social impairments, giving rise to the possibility of utilizing computational techniques to evaluate a childs social phenotype from home videos. MethodsHere, we use a mobile health application to collect over 11 hours of video footage depicting 95 children engaged in gameplay in a natural home environment. We utilize automated dataset annotations to analyze two social indicators that have previously been shown to differ between children with ASD and their neurotypical (NT) peers: (1) gaze fixation patterns and (2) visual scanning methods. We compare the gaze fixation and visual scanning methods utilized by children during a 90-second gameplay video in order to identify statistically-significant differences between the two cohorts; we then train an LSTM neural network in order to determine if gaze indicators could be predictive of ASD. ResultsOur work identifies one statistically significant region of fixation and one significant gaze transition pattern that differ between our two cohorts during gameplay. In addition, our deep learning model demonstrates mild predictive power in identifying ASD based on coarse annotations of gaze fixations. DiscussionUltimately, our results demonstrate the utility of game-based mobile health platforms in quantifying visual patterns and providing insights into ASD. We also show the importance of automated labeling techniques in generating large-scale datasets while simultaneously preserving the privacy of participants. Our approaches can generalize to other healthcare needs.
Columbine pollination success not determined by a proteinaceous reward to hummingbird pollinators

Plants provision pollinators with a variety of nutritious or otherwise beneficial rewards. Hummingbirds (primarily Calypte anna ) pollinate the columbine Aquilegia eximia . In addition to drinking nectar, they glean entrapped insects from its sticky surfaces. To test the hypothesis that this insect carrion, an abundant and easily-collected protein source, serves as a provision to the pollinator and increases pollination I experimentally manipulated this reward and measured pollination success. I set up three treatments - an insect carrion addition, carrion removal, and an unmanipulated control - on small patches of the plant in each of five populations of A. eximia . Pollination success, measured by seed set in emasculated flowers, was unaffected by carrion level. Pollination success positively correlated with average floral display in each patch; this suggests that local nectar reward in an area is more important than this proteinaceous reward in determining pollination success. Stickiness in this system may function as an effective exclusion mechanism for smaller-bodied pollinators. While this study did not demonstrate that captured insects increased reproductive success of this columbine, this interaction (and pollinator exclusion) may play a role in other hummingbird-plant interactions, as hummingbird pollination and insect-entrapment occur together in at least nine species of six plant families.
L/G/B and T: Queer Excisions, Entailments, and Intersections

Narratives about LGBTQ+ lives and concerns in our field have not historically attended equally to all segments of the acronym. The simultaneous uniting of articulations of queerness (under LGBTQ+) and the excision of gender from sexuality is due, in part, to tenuous historical alliances that have existed among LGB and trans communities. As a field, we rarely ask what it means to be a language teacher or learner who is gay and trans, lesbian and trans, queer and trans, or any such intersections. This lack of intersectional awareness leaves blind spots in how we think about treating both the representation and inclusion of queerness in language classrooms. This chapter explores both what is lost when gender and sexuality are considered separately from one another and what is risked when the LGBTQ+ acronym is treated holistically, drawing on the idea of third spaces, to advance new approaches to queering language teaching/learning.
Minimum Threshold of Bariatric Surgical Weight Loss for Initial Diabetes Remission.

OBJECTIVE There are few studies testing the amount of weight loss necessary to achieve initial remission of type 2 diabetes mellitus (T2DM) following bariatric surgery and no published studies with use of weight loss to predict initial T2DM remission in sleeve gastrectomy (SG) patients. RESEARCH DESIGN AND METHODS With Cox proportional hazards models we examined the relationship between initial T2DM remission and percent total weight loss (%TWL) after bariatric surgery. Categories of %TWL were included in the model as time-varying covariates. RESULTS Of patients (N = 5,928), 73% were female; mean age was 49.8 ± 10.3 years and BMI 43.8 ± 6.92 kg/m2, and 57% had Roux-en-Y gastric bypass (RYGB). Over an average follow-up of 5.9 years, 71% of patients experienced initial remission of T2DM (mean time to remission 1.0 year). With 0–5% TWL used as the reference group in Cox proportional hazards models, patients were more likely to remit with each 5% increase in TWL until 20% TWL (hazard ratio range 1.97–2.92). When categories >25% TWL were examined, all patients had a likelihood of initial remission similar to that of 20–25% TWL. Patients who achieved >20% TWL were more likely to achieve initial T2DM remission than patients with 0–5% TWL, even if they were using insulin at the time of surgery. CONCLUSIONS Weight loss after bariatric surgery is strongly associated with initial T2DM remission; however, above a threshold of 20% TWL, rates of initial T2DM remission did not increase substantially. Achieving this threshold is also associated with initial remission even in patients who traditionally experience lower rates of remission, such as patients taking insulin.
Parallel Broadcasting Scheme for Approximate String Matching with K-Mismatches

Parallel broadcasting provides an efficient parallel hardware solution to the k-mismatches problem which is a version of the approximate string matching problem. The scheme is a parallelization of the dynamic programming method of evaluating minimum edit distances between the pattern and any substring of the reference string. Implicit parallelism based on dataflow and explicit parallelism based on parallel broadcasting mechanism exploit the maximum parallelism. Time complexity of the proposed parallel scheme is O(((n−m)/d) + m), where n and m represent lengths of the reference and the pattern strings respectively, and d is the degree of parallelism that is controllable. The proposed scheme is suitable for the VLSI implementation. The design is based on the linear systolic array of a simple basic cell, and is extendible for any pattern size and any parallelism degree. For serial and parallel designs, m and d*m identical processing elements are needed.
Deck Slab Repaired by Fibrous Concrete Overlay

The concrete deck on the visitors' overlook facility at Libby Dam became badly cracked and in need of repair. It was decided to overlay the existing surface with 0.75-in. to 2-in. (18 mm to 50 mm) of fibrous concrete. Cracks in the original surface and some expansion joints were overlain without special treatment. Union workers with no special training used standard tools and techniques to successfully place the overlay. By magnesium floating the surface they obtained excellent /0.125-in. per 10-ft (3 mm per 3 m)/ grade control and produced a skid resistant surface with virtually all fibers covered. A mix design procedure based on workability was developed for this placement. The simple procedure is available from the U.S. Army Corps of Engineers, Walla Walla District, and is good for mixes from mortar to 0.75-in. (18 mm) aggregates. After a couple years of service an evaluation of the overlay shows 90% reduction in cracking, 100% reduction in water leakage through the surface, and essentially no rusting or evidence of fibers at the surface.
Translocation (9;22) is associated with extremely poor prognosis in intensively treated children with acute lymphoblastic leukemia

The prognostic implications of t(9;22)(q34;q11) were assessed at a median follow-up of 3.5 years in 434 children receiving intensive treatment for acute lymphoblastic leukemia (ALL). Four-year event-free and overall survivals were 81% and 88%, respectively, in 419 children lacking t(9;22), but were 0% and 20%, respectively, in 15 children with t(9;22) (P less than .001). Poor outcome for children with t(9;22)- positive ALL was particularly notable because we have reported improved survival in other historically poor prognosis ALL cytogenetic categories when treated with similarly intensive therapy. We recommend that very intensive treatment approaches, including bone marrow transplantation in first remission, be considered for all children with t(9;22)-positive ALL.
Reliability properties of models for flexible design and run-time analysis

Development and analysis of complex systems embedded in physical environments requires special modeling techniques. Development aids involve abstraction on multiple levels of representation in order to connect cross-cutting constraints and facilitate involvement of various stakeholders. Alternatively, run-time analysis requires type of modeling that is based on representation of interactions and behaviors. We discuss the Documentation Driven Development (DDD) approach for software development and Agent Based Systems for run-time analysis. We show that despite differences in architectures and functions both approaches possess important properties of reliability and flexibility and allow easy upgrading of their elements.
Outer layers of the Azotobacter vinelandii cyst.

Abstract Ruthenium red stained a capsule external to the exine of the Azotobacter cyst. The central body is therefore surrounded by three layers, the intine, the exine, and the capsule, all containing acid mucopolysaccharide. Vesicles that appear to originate from the contracting cell membrane of the central body may account for the lipid content of the intine. The exine is composed of laminated sheets that tend to fragment into hexagonal pieces.
Effects of vacuum suctioning and strategic drape tenting on oxygen concentration in a simulated surgical field.

Abstract Study objective To investigate the isolated and combined effects of vacuum suctioning and strategic drape tenting on oxygen concentration in an experimental setting. Design Experimental. Setting Clinical simulation center of a university-affiliated hospital. Participants Mannequin simulation of a patient undergoing facial surgery under sedation anesthesia. Supplemental oxygen was delivered via nasal cannula. Interventions Vacuum suctioning and strategic drape tenting. Measurements The experimental trials entailed measuring oxygen concentration around the nasal cannula continuously either in the presence or absence of a standard operating room vacuum suction system and strategic tenting of surgical drapes. The primary outcome was the time required for oxygen concentration to reach 21%. Main results In the control group (without suction or strategic tenting), a mean time of 180 seconds elapsed until the measured oxygen concentration reached 21% after cessation of oxygen delivery. Use of a vacuum suction device alone (110 seconds; P P P Conclusion Use of a vacuum suction device during surgery will lower local oxygen concentration, and this in turn may decrease the risk of operating room fires. Although strategic tenting of surgical drapes has a theoretical benefit to decreasing the pooling of oxygen around the surgical site, further investigation is necessary before its routine use is recommended.
The effect of altering pulmonary blood flow on pulmonary gas exchange in the turtle Trachemys (Pseudemys) scripta

In resting reptiles, the PO2 of pulmonary venous return (PLAO2; left atrial blood) may be 20 mmHg (1 mmHg = 0.1333 kPa) lower than the PO2 of gas in the lung. This level of PO2 is considerably higher than that observed in resting mammals and birds and results from ventilation-perfusion (V/Q) heterogeneity, pulmonary diffusion limitation and intrapulmonary shunting. However, the relative contribution of each of these factors is unknown. Many reptiles, particularly chelonians, exhibit an intermittent ventilation pattern where pulmonary blood flow (QL) increases during the ventilatory periods and, therefore, we hypothesized that V/Q matching would improve with increasing QL. We applied the multiple inert gas elimination technique in anaesthetized turtles at 22 degrees C. Turtles were continuously ventilated at a rate of 140 ml kg-1 min-1, equivalent to the rate of ventilation within a ventilatory period. Trace amounts of six inert gases were infused through the jugular vein. Blood samples from the pulmonary artery and the left atrium and mixed expired gases were collected for analysis. QL was reduced by a factor of six (low flow) using a vascular occluder placed around the common pulmonary artery or increased by a factor of two (high flow) through bolus injection of adrenaline. V/Q heterogeneity was significantly reduced with increasing pulmonary blood flow (P < 0.05). Consistent with these changes, the effective lung-pulmonary artery PO2 difference (PLO2-PLAO2) was reduced (P < 0.05) from 58 +/- 16 mmHg to 29 +/- 5 mmHg (means +/- S.E.M.) and PLAO2 increased significantly (P < 0.05) from 88 +/- 17 mmHg (low flow) to 120 +/- 14 mmHg (high flow). There was evidence of pulmonary diffusion limitation under all conditions, which was unchanged with increasing blood flow. These findings suggest that increased pulmonary blood flow during a ventilatory period results in both temporal and spatial matching of ventilation and perfusion, without altering pulmonary diffusion limitation.