cssi/SciSciGPT-SciSciNet huggingface dataset:
Alkyl phosphotriester modified oligodeoxyribonucleotides. V. Synthesis and absolute configuration of Rp and Sp diastereomers of an ethyl phosphotriester (Et) modified EcoRI recognition sequence, d[GGAA(Et)TTCC]. A synthetic approach to regio- and stereospecific ethylation-interference studies.

Abstract Protected deoxynucleoside 3'-O-ethyl-N,N-diisopropylphosphoramidite reagents were prepared for use in the automated synthesis of ethyl phosphotriester (Et) modified oligonucleotides. The title diastereomers were separated by reversed-phase HPLC, and chirality at phosphorus was assigned by an improved configurational correlation scheme that was verified by NMR spectroscopic studies (accompanying paper, Part VI). This generally applicable correlation scheme involved enzymatic digestions of each diastereomer to give the corresponding diastereomer of d[A(Et)T]; phosphite triester sulfurization to obtain diastereomeric O-ethyl phosphorothioates, d[AS(Et)T], which were separated by HPLC for stereoretentive oxidation with H2O2 to give d[A(Et)T], and stereoretentive de-ethylation with PhSH-Et3N to give diastereomeric phosphorothioates, d[AST], whose configurations at phosphorus had been assigned previously. Neither the Rp-Rp nor Sp-Sp duplex, (d[GGAA(Et)TTCC])2, was cleaved by EcoRI endonuclease under conditions that led to cleavage of both the unmodified duplex, [d(GGAATTCC)]2, and the mixture of diastereomeric phosphorothioate-modified duplexes, [d(GGAASTTCC)]2. Cleavage of the latter substrates was Sp-selective.
Perspectiva evolucionista de los trastornos de la conducta alimentaria

Background: Evolutionary theory has contributed with physiological, psychological and behavioral explanations to the comprehension and treatment of eating disorders (ED). The aim of this review is to analyze the relationship between ED and the attachment theory and natural selection based hypotheses (famine flight, reproductive suppression and intrasexual competition). Insecure attachment is characteristic of ED and significantly interferes in the individuation developmental process. Maternal attachment is usually ambivalent; mainly avoidant in anorexics and anxious in bulimics. Anorexic syndrome evokes ancestral adaptive mechanisms to face food scarcity, status achievement and threat of group exclusion. Suppression of reproductive capacity in anorexics, favored by family dynamics, represents a self-sacrifice to obtain the benefit of its members through genetic altruism. Feminine intrasexual competence is related to nubile features in order to attract and retain high quality and long-term partners. Therefore, from an evolutionary perspective, ED symptomatology may be described as a self-destructive adaptive state of lack of control, in response to a particular genetic phenotype plasticity, environmental factors and cognitive processes.
Asymmetric Drain Spacer Extension (ADSE) FinFETs for Low-Power and Robust SRAMs

In this paper, we analyze and optimize FinFETs with asymmetric drain spacer extension (ADSE) that introduces a gate underlap only on the drain side. We present a physics-based discussion of current-voltage relationships, short channel effects, and leakage and show the application of ADSE FinFETs in 6T static random access memory (SRAM) bit cell. By exploiting asymmetry in current, we show that it is possible to achieve improvement in both read and write stability for the 6T SRAM bit cell, along with reduction in cell leakage at the cost of negligible increase in access time and area. We also propose a general circuit-aware device optimization methodology for SRAM design. We use this methodology to optimize the underlap in ADSE FinFETs. Compared to conventional FinFETs, we achieve 57% reduction in leakage, 11% improvement in read static-noise margin, and 6% improvement in write margin, with 7% increase in access time and cell area.
Large-Margin Convex Polytope Machine

We present the Convex Polytope Machine (CPM), a novel non-linear learning algorithm for large-scale binary classification tasks. The CPM finds a large margin convex polytope separator which encloses one class. We develop a stochastic gradient descent based algorithm that is amenable to massive datasets, and augment it with a heuristic procedure to avoid sub-optimal local minima. Our experimental evaluations of the CPM on large-scale datasets from distinct domains (MNIST handwritten digit recognition, text topic, and web security) demonstrate that the CPM trains models faster, sometimes several orders of magnitude, than state-of-the-art similar approaches and kernel-SVM methods while achieving comparable or better classification performance. Our empirical results suggest that, unlike prior similar approaches, we do not need to control the number of sub-classifiers (sides of the polytope) to avoid overfitting.
Dimensions of informal support network development in an Asian American community in the new South: A grounded theory

DIMENSIONS OF INFORMAL SUPPORT NETWORK DEVELOPMENT IN AN ASIAN AMERICAN COMMUNITY IN THE NEW SOUTH: A GROUNDED THEORY By SUZIE S. WENG, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2013 Major Director: Dr. Mary Katherine O’Connor Professor, School Of Social Work The continuum of care framework posits that individuals move from one level to the next in seeking resources for help ranging from first using informal support to finally using formal services. Yet, the literature is mostly focused on formal services. It is well-known in the literature that existing formal services are underutilized by the Asian American population. If that is also the case in nontraditional settlement cities like Richmond, Virginia, the continuum of care framework and existing literature suggest that Asian Americans are turning to their informal support networks to meet their needs. Thus far, the literature on informal support networks is very limited and a focus on Asian American communities is nonexistent. Furthermore, there is not an adequate theory to explain and predict this phenomenon. This study uses a grounded theory design to develop a testable theory that could further the understanding of informal support networks in the Asian American community. The theory posits that the Asian culture and community influence how individuals within the community seek help in times of need and, in turn, the helping process developed within the informal support network is a reinforcement of the Asian culture and community. When individuals have needs, they look to the informal support network and the network is developed in response to those needs. However, the informal support network is not able to meet all the needs of the Asian American community. At times, though infrequent, when the informal support network cannot meet the need, individuals are referred to mainstream services. Therefore, the informal support network serves as a gatekeeper to mainstream services. In addition, needs are rarely successfully met directly by mainstream services because of inaccessibility. Consequently, mainstream services provide infrequent help in meeting the needs of the Asian American community. It is important to comprehend how these developing communities in the new South are responding to their own needs. This understanding will allow mainstream services to extend formal systems of care and better partner with existing resources to effectively serve the increasing Asian American population in the South.
Nutritional equivalence of beta-lactoglobulin and its corresponding amino acids.

SummaryIn mouse growth studies crystalline β-lactoglobulin has been compared with a mixture of l amino acids duplicating its composition and these materials were compared with casein and lactalbumin. The pure protein and its amino acid counterpart gave equal growth and efficiency of dietary nitrogen utilization. Casein and lactalbumin provided superior growth rates to both the pure protein and its amino acid counterpart.
Methylmercury Accumulation in Plankton on the Continental Margin of the Northwest Atlantic Ocean

Accumulation of monomethylmercury (MMHg) by plankton is a key process influencing concentrations of this toxic mercury species in marine food webs and seafood. We examined bioaccumulation and biomagnification of MMHg in microseston and four size fractions of zooplankton on the continental shelf, slope, and rise of the northwest Atlantic Ocean. The bioaccumulation factor (BAF, L/kg) for MMHg in microseston averaged 104.3±0.3 among 21 locations, and concentrations were unrelated to those in colocated, filtered surface water. Instead, concentrations and the BAF of MMHg in microseston were related inversely with total suspended solids in surface water, a proxy for planktonic biomass at these remote locations. MMHg was biomagnified by a factor of 4 from microseston to zooplankton, and both concentrations of MMHg and the fraction of total mercury as MMHg increased with larger size fractions of zooplankton. These results suggest that the initial magnitude of MMHg uptake into pelagic marine food webs is influence...
Impact of Extremely Low Frequency Electromagnetic Fields on Soil Arthropods

Populations of springtails and 3 groups of mites—the predominant soil arthropods—were periodically surveyed during summer 1971 by extracting soil samples. These samples were obtained from a plot adjacent to a power substation and from 4 diverse habitats along the Sanguine antenna. The antenna is situated in northern Wisconsin and consists of a north-south and an east-west leg designed to test the environmental impact of operations in the extremely low frequency (ELF) range (45 or 75 Hertz). The “Sanguine effect” is defined to include ground current flow, electromagnetic fields, and ELF radiations produced by the antenna. Control samples were obtained from similar habitats situated 7 to 12 miles from either leg of the antenna. Fourteen of a total of 16 tests showed no significant differences in arthropod abundance at test and control sites. This includes the Main Test which was the most sensitively designed and involved analyses of subplot variations within test and control sites. Differences in the other 2 tests were marginal or of doubtful significance; in both cases, only 1 of 4 arthropod groups was involved. Additional evidence for the absence of a Sanguine effect is the occurrence of a midsummer peak in all 3 mite populations in both test and control plots of a woodland habitat. Ratios between the most numerous groups were compared for 1969 (just before antenna turn-on), 1970, and 1971, and were found to be similar, irrespective of site and date—further evidence that these populations are stabilized and functioning independently of a Sanguine effect after 2 years of antenna operation. Arthropod abundance in the proximity of a power substation was likewise found to he unaffected.
Advance in Studies and Applications of Oxygen Radical Absorbance Capacity

With increasing understanding on the relationship between oxidative stress and the development of various diseases,antioxidants and their antioxidant capacities have received more and more attention in the last two decades.Among the varied methods developed to assess antioxidant capacity,oxygen radical absorbance capacity(ORAC) is one of the widely used methods for in vitro assessment.The principles and advances in analysis methods and applications of ORAC were summarized in this article.
Feasibility Research on Adopting HVDC Centralized Control in China

In this paper firstly the present situation of HVDC power transmission systems in China is analyzed;then the problems such as implementation of automatic management scheme for centralized control of HVDC,structural planning of control system,its technical and economical feasibility,and future development are researched. Research results show that there are conditions for the implementation of centralized control of HVDC,and it is feasible in technology,the further research on its design and implementation is necessary as well. With appropriate centralized control of HVDC,power grid enterprises can obtain benefits in many aspects;lay the foundation for the implementation of advanced auxiliary control strategy;and further give full play of HVDC in the improvement of power grid security and stability.
Full length article: q-Blossoming: A new approach to algorithms and identities for q-Bernstein bases and q-Bézier curves

We introduce a new variant of the blossom, the q-blossom, by altering the diagonal property of the standard blossom. This q-blossom is specifically adapted to developing identities and algorithms forq-Bernstein bases and q-Bezier curves over arbitrary intervals. By applying the q-blossom, we generate several new identities including an explicit formula representing the monomials in terms of the q-Bernstein basis functions and a q-variant of Marsden's identity. We also derive for each q-Bezier curve of degree n, a collection of n! new, affine invariant, recursive evaluation algorithms. Using two of these new recursive evaluation algorithms, we construct a recursive subdivision algorithm for q-Bezier curves.
The Burden of the Fellowship Interview Process on General Surgery Residents and Programs.

Objectives This study evaluated the effect of the fellowship interview process in a cohort of general surgery residents. We hypothesized that the interview process would be associated with significant clinical time lost, monetary expenses, and increased need for shift coverage. Design An online anonymous survey link was sent via e-mail to general surgery program directors in June 2014. Program directors distributed an additional survey link to current residents in their program who had completed the fellowship interview process. Setting United States allopathic general surgery programs. Participants Overall, 50 general surgery program directors; 72 general surgery residents. Results Program directors reported a fellowship application rate of 74.4%. Residents most frequently attended 8 to 12 interviews (35.2%). Most (57.7%) of residents reported missing 7 or more days of clinical training to attend interviews; these shifts were largely covered by other residents. Most residents (62.3%) spent over $4000 on the interview process. Program directors rated fellowship burden as an average of 6.7 on a 1 to 10 scale of disruption, with 10 being a significant disruption. Most of the residents (57.3%) were in favor of change in the interview process. We identified potential areas for improvement including options for coordinated interviews and improved content on program websites. Conclusions The surgical fellowship match is relatively burdensome to residents and programs alike, and merits critical assessment for potential improvement.
Mutational landscape and underlying mutational processes in chronic lymphocytic leukemia

Sequencing studies have been instrumental in understanding the genetic basis of chronic lymphocytic leukemia (CLL). Our recent whole-genome sequencing study focusing on lower cytogenetic risk CLL demonstrated that CLL mutations can be attributed to 3 key mutational processes-2 types of activation induced-cytidine deaminase (AID) signatures and an aging signature-that operate at different times throughout CLL evolution.
cMyBP-C Phosphorylation Modulates Sarcomere Length-Dependent Changes in Cardiac Muscle Contractile Function

It is well-established that cardiac myosin binding protein-C (cMyBP-C) phosphorylation enhances acto-myosin interactions and also impacts cross-bridge (XB) cycling rates, mechanisms which are known to affect sarcomere length (SL)-dependent contractile function. However, the precise role of cMyBP-C phosphorylation in modulating SL-dependent changes is unknown. Therefore, we measured isometric force, myofilament Ca2+-sensitivity (pCa50), SL-dependent changes in the rates of XB detachment (krel), recruitment (kdf), and the amplitude of the delayed force development (Pdf) in detergent-skinned ventricular preparations isolated from hearts of wild-type (WT) mice and from mice expressing non-phosphorylatable cMyBP-C (Ser to Ala substitutions at residues Ser273, Ser282, and Ser302 (i.e., 3SA)), at SL 1.9µm or 2.1µm both at baseline and following protein kinase A (PKA) treatment. No significant differences in maximal force and pCa50 were noted between WT and 3SA at either SL, at baseline and following PKA treatment. Importantly, however, krel was significantly slower in the 3SA compared to WT at both long (∼40%) and short (∼53%) SL at baseline, and slowed krel in 3SA myocardium was even more pronounced following PKA treatment (krel was ∼135% and ∼67% slower in compared to WT at long and short SL, respectively). No differences in kdf were observed between the WT and 3SA at either SL at baseline, however, PKA treatment accelerated kdf by ∼26% and ∼38% at long and short SL in WT myocardium but not in 3SA myocardium. Moreover, at baseline, Pdf amplitude was significantly lower in 3SA myocardium compared to WT myocardium at either SL, and PKA treatment enhanced Pdf amplitude at both SL in WT but not in 3SA, demonstrating that cMyBP-C phosphorylation modulates the magnitude and rate of XB recruitment. Collectively, our data indicate that cMyBP-C phosphorylation is a key regulator of SL-dependent contractile function.
Metachromatic Leukodystrophy Variants

Clinical, pathological, imaging, and genetic findings in a family with multiple allelic mutations of metachromatic leukodystrophy (MLD) are reported from McGill University, Montreal, and McMaster University, Hamilton, Canada.
Defining Hospitals' Obligation To Stabilize Patients under EMTALA.

A review of legal decisions that have interpreted a hospital emergency department's obligation under the Emergency Medical Treatment and Active Labor Act to stabilize a patient. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.
Direct Imide Formation from Thiophene Dicarboxylic Acids Gives Expanded Side-Chain Selection in Thienopyrrolediones

The synthesis of thienopyrroledione (TPD) has been updated to reduce the number of synthetic steps, remove hazardous and toxic reagents, reduce the amount of byproduct waste, and reduce the use of solvents when unnecessary. Diverse functionalization is possible, introducing 16 examples in yields from 34% to 95%. This reaction scheme was shown to be general for thiophene imides, and a more thorough exploration into side chain engineering is presented with TPD acceptors often used in organic electronic applications.
The Upper Bound Conjecture and Cohen‐Macaulay Rings

Let Δ be a triangulation of a (d − 1)-dimensional sphere with n vertices. The Upper Bound Conjecture states that the number of i-dimensional faces of Δ is less than or equal to a certain explicit number ci(n, d). A proof is given of a more general result. The proof uses the result, proved by G. Reisner, that a certain commutative ring associated with Δ is a Cohen-Macaulay ring.
Discriminative Information Retrieval for Question Answering Sentence Selection

We propose a framework for discriminative IR atop linguistic features, trained to improve the recall of answer candidate passage retrieval, the initial step in text-based question answering. We formalize this as an instance of linear feature-based IR, demonstrating a 34%-43% improvement in recall for candidate triage for QA.
Kiyoshi Karl Kawakami and Japanese America between the Two World Wars

Kiyoshi Karl Kawakami was one of the most influential Japanese immigrant journalists to defend Japanese imperialism. He did so at a time when Japanese immigrant communities showed various responses...
Framing the 1980 Coup Films as a Cultural and Cinematographic Discourse

At the time it had taken place, the coup of 1980 was welcomed domestically and internationally due to the political and economic turmoil of the 1970s. The dissonance between historical reality and cultural perception during the 2000s can be explained by normative changes constructed in part by coup films. Tracing the main currents of Turkish history between the 1950s and the 2000s, this chapter highlights the increase of political authoritarianism as a response to the rise of mass culture (e.g. mass migration, mass education, and mass communication). Salient themes include human rights violations, and the unsettling socio-economic transformations which favored market competition and consumerism. The changes encountered by the film industry, the emerging landscape of private broadcasting, and the intersections between cinema and television are discussed in this chapter.
Team Approach: Preventing Surgical Site Infections in Pediatric Scoliosis Surgery

While some segments of the population of patients undergoing pediatric spine surgery are at considerable risk for infection, standardized processes and the involvement of a dedicated team can serve to minimize this risk.A well-functioning perioperative team is a necessary prerequisite for the promot
Effect of Sexual Intercourse on Lower Extremity Muscle Force in Strength-Trained Men.

Abstract Background Sex has been deemed taboo for athletic performance going back to ancient Rome and Greece, as the act of sex was thought to promote ease and a sense of relaxation. Aim This study examined the effect of sexual intercourse completed 12 hours before a bout of isokinetic dynamometry on muscle force production in strength-trained men. Methods 12 Healthy physically active men (age = 25.6 ± 3.8 years) who were sexually active participated in this study. After men completed a familiarization session on day 1, muscle force was measured during 5 sets of maximal unilateral knee extension (KE) and knee flexion exercise at 30 deg/s after men engaged in or abstained from sexual intercourse within the previous 12 hours. The order of this treatment was randomized across participants, and time of day was maintained across all sessions. Outcomes Lower extremity muscle strength and endurance were measured. Results Data showed no significant effect (P = .34 and P = .39) of sexual intercourse on peak or average KE or knee flexion torque. For example, after sexual intercourse, KE torque was similar in set 1 (198.9 ± 39.1 ft/lb vs 190.2 ± 28.7 ft/lb) and set 5 (163.2 ± 30.8 ft/lb vs 159.4 ± 35.2 ft/lb) compared to when men abstained from sexual intercourse. Clinical Translation Engaging in sexual intercourse on the night before exercise is not detrimental to muscular strength in active men. Conclusions This study is strengthened by use of a homogeneous sample of active men as well as precise determination of changes in muscle function via isokinetic dynamometry. However, completion of sexual intercourse was confirmed through self-report rather than direct observation, so it is not certain if participants actually met the requirements of each condition. Results demonstrate that sexual intercourse does not significantly impact lower extremity muscle force, which suggests that restricting sexual activity before short-term, high-force activity is unnecessary. Valenti LM, Suchil C, Beltran G, et al. Effect of Sexual Intercourse on Lower Extremity Muscle Force in Strength-Trained Men. J Sex Med 2018;15:888–893.
Texas Species of Glandularia (Verbenaceae)

Eight species of Glandularia are recognized as native to Texas: G. bipinnatifida (having two morphogeographical infraspecific categories, G. b. var. bipinnatifida and G. b. var. ciliata [Benth.] B. L. Turner, comb. nov.); G. canadensis; G. delticola; G. polyantha; G. pulchella (introduced and escaped from cultivation); G. pumila; G. quadrangulata; and G. tumidula. The latest monographer of the genus (R. E. Umber, 1979) recognized 10 species as occurring in Texas. Of these I cannot accept G. wrightii, which is treated as synonymous with G. bipinnatifida var. ciliata, or G. verecunda and G. racemosa, both of the latter treated as synonymous with G. quadrangulata. In addition, Umber's G. bipinnatifida var. brevispicata is treated as synonymous with G. b. var. ciliata. Further, G. quadrangulata, having appendiculate nutlets is also believed to possess forms with exappendiculate nutlets, the latter treated as G. racemosa and/or G. verecunda in his monograph. A key to the Texas taxa is provided, along with partial illustrations, synonymies and distribution maps.
The Increased Complexity of Public Services: Curricular Implications for Schools of Public Affairs

In the last two and a half decades, the tools of government and methods of public service provision have markedly diversified. The increased complexity of the policy and organizational environment ...
Localization of autoepitopes on the PCM-1 autoantigen using scleroderma sera with autoantibodies against the centrosome.

Characterization of epitope domains of autoantigens is important for deducing the cellular functions of autoantigens and may be important for understanding the autoimmune response. In the reported studies, epitope analysis of the centrosome autoantigen PCM-1 was performed. For these investigations, portions of the PCM-1 cDNA were subcloned into the pMAL expression plasmid, fusion proteins were induced, and aliquots of the extracts were probed by immunoblot analysis using two human autoimmune anticentrosome autoantisera. Immunoblotting identified three individual autoepitopes of 26-40 amino acid residues, amino acids 506-545, 1434–1465, and 1661–1686, within the PCM-1 protein. ELISA assays using non-denatured proteins did not identity any additional autoepitopes in the remainder of the PCM-1 molecule. To analyze the identified autoepitopes further, synthetic peptides were generated that covered each of the three autoepitopes and the synthetic peptides then were probed using the scleroderma sera. Peptides that covered the antigenic regions from amino acids 506-545 and 1434–1465 failed to react with the anticentrosome autoantisera suggesting that overall protein conformation may be important for the formation of those two autoepitopes. Peptides derived from the sequence of the third autoepitope were recognized by autoantibodies present in the anticentrosome autoantisera allowing the identification of the tripeptide KDC as the autoepitope in this region of the PCM-1 molecule. These studies lay the foundation for future investigations of the autoimmune response in scleroderma patients that are producing anticentrosome autoantibodies and should allow an investigation of the cellular role of the PCM-1 protein.
Safety Management of Large Operations

The discipline of risk management for large scale operations involves a variety of activities, skills, and judgments, in addition to risk assessment. The essential activities in effective risk management include: the continuous monitoring and evaluation of known and potential hazards; decision-making on protective actions or remedies together with marshaling the resources required; managing and tracking of the effectiveness of implementation with feedback to the decisions taken. The general elements of successful risk management activities are described and are subject to explicit functional descriptions and organizational procedures. However, the implicit issues of risk management pose many subtle issues involving the integration of: value systems; safety criteria; real world limitations on timely access to human and material resources; and the ability to achieve timely closure on making decisions and implementing them. Practices in several industries are compared; aerospace, dams, chemicals, EPA on carcinogens, nuclear safety.
AUTONOMIC NERVOUS SYSTEM MARKERS OF DIAGNOSIS AND PROGNOSIS IN SCHIZOPHRENIA

ABSTRACT Measurement of autonomic nervous system (ANS) activity in schizophrenia has frequently been by means of skin conductance and heart rate. These variables have the advantages of being noninvasive and noncumbersome and allow measurement of both levels and momentary changes in ANS activity to changes in environment. Disadvantages are that they assess directly neither psychotic behavior nor its biological substrates and their central determinants are not well understood at present. A recent study has shown that unmedicated acute schizophrenics compared to controls, are characterized by high ANS arousal indices, slow adaptation and habituation and low ANS response to environmental stimuli, especially meaningful or demanding ones. These markers have also been found in unmedicated chronic schizophrenics. In addition, this pattern was found to predict poor treatment outcome vs. remission of symptoms in patients who were indistinguishable by usual clinical assessment. A similar pattern of ANS activity has been produced in normal men by dextroamphetamine. This suggests the pattern of ANS activity characteristic of schizophrenia may be a marker for poorly regulated dopaminergic neurotransmission.
Quintilian and the Pedagogy of Argument

Originating in the Sophistic pedagogy of Protagoras and reflecting the sceptical practice of the New Academy, Quintilian's rhetorical pedagogy places a special emphasis on the juxtaposition of multiple, competing claims. This inherently dialogical approach to argumentation is referred to here as controversia and is on full display in Quintilian's own argumentative practice. More important to this paper, however, is the role of controversia as an organizing principle for Quintilian's rhetorical curriculum. In particular, Quintilian introduces the protocols of controversia through a series of progressively more complex exercises in imitation, role-playing, and declamation (now referred to as situational games). All of these exercises are open for adaptation by contemporary teachers who would promote a dialogical approach to argument, i.e. argument with its methods of inquiry, invention, and judgment based on direct interaction with opposing parties.
Evaluation of Endocrine Disorders of the Hypothalamic-Pituitary-Gonadal (HPG) Axis

Among male adolescents, lack of spontaneous pubertal development is a common reason for presenting for endocrine evaluation. Among adult men, symptoms of androgen deficiency, sexual dysfunction and/or infertility are chief complaints that often motivate patients to seek reproductive endocrine consultation. Obtaining a comprehensive medical history, performing a clinical examination and conducting laboratory diagnostic testing are cornerstones for evaluating the hypothalamic-pituitary-gonadal (HPG) axis. Sexuality and reproduction can be sensitive topics and some patients may find it challenging to discuss such matters. Herein we present best nursing practices for history taking and review the clinical competencies for physical examination. The rationale and value of specific hormone assays and the role of stimulation testing will be reviewed in relation to clinical decision-making as well as the appropriate use of imaging studies. Male reproductive disorders may span several domains including endocrinology, andrology, urology and genetics. Thus, appropriate referrals and coordination of care are important factors for management. This chapter is a mini-review for endocrine nurses providing a synopsis of the approach to and evaluation of patients with hypogonadism, sexual dysfunction and infertility. Particular emphasis is placed on providing comprehensive coordinated care that includes patient education, anticipatory guidance and addressing patients’ psychosocial concerns.
Pitfalls of using numerical predictive checks for population physiologically-based pharmacokinetic model evaluation.

Comparisons between observed data and model simulations represent a critical component for establishing confidence in population physiologically-based pharmacokinetic (Pop-PBPK) models. Numerical predictive checks (NPC) that assess the proportion of observed data that correspond to Pop-PBPK model prediction intervals (PIs) are frequently used to qualify such models. We evaluated the effects of three components on the performance of NPC for qualifying Pop-PBPK model concentration–time predictions: (1) correlations (multiple samples per subject), (2) residual error, and (3) discrepancies in the distribution of demographics between observed and virtual subjects. Using a simulation-based study design, we artificially created observed pharmacokinetic (PK) datasets and compared them to model simulations generated under the same Pop-PBPK model. Observed datasets containing uncorrelated and correlated observations (± residual error) were formulated using different random-sampling techniques. In addition, we created observed datasets where the distribution of subject body weights differed from that of the virtual population used to generate model simulations. NPC for each observed dataset were computed based on the Pop-PBPK model’s 90% PI. NPC were associated with inflated type-I-error rates (> 0.10) for observed datasets that contained correlated observations, residual error, or both. Additionally, the performance of NPC were sensitive to the demographic distribution of observed subjects. Acceptable use of NPC was only demonstrated for the idealistic case where observed data were uncorrelated, free of residual error, and the demographic distribution of virtual subjects matched that of observed subjects. Considering the restricted applicability of NPC for Pop-PBPK model evaluation, their use in this context should be interpreted with caution.
A Person-Centered Approach to the Study of Black Adolescent Religiosity, Racial Identity, and Sexual Initiation.

Decreasing the number of adolescents who have never had sexual intercourse is one way to address sexual health disparities. We used intersectionality to explore the joint effects of religiosity and racial identity on Black adolescent sexual initiation. Data originated from the National Survey of American Life-Adolescent (n = 1,170), a nationally representative study of Black adolescents. Latent profile analysis and survival analysis were used to evaluate study hypotheses. Results showed four distinct profiles of religiosity and racial identity. These profiles explained 19% of the variability in sexual initiation. Additional analyses revealed sociodemographic differences in profile membership. Findings contribute to understanding ethnic heterogeneity among Black adolescents and racial identity and religiosity as sociocultural factors that influence sexual initiation; and support reconceptualizing Black adolescent religiosity.
New Ideas and Approaches by Aging Artists

The 60-80-year-old artists of some repute who completed a questionnaire on the quality and quantity of their work (Chapter 9) also responded to two other kinds of changes in their creativity with age (Lindauer, Orwoll, & Kelley, 1997): (1) in the sources of their ideas, or the “creative process”; and (2) the approach taken to their work, or style.
Predictors of permanent pacemaker requirement after cardiac surgery for infective endocarditis.

Background:Infectious endocarditis is often complicated by conduction abnormalities at the time of presentation. Cardiac surgery is the treatment of choice for many infectious endocarditis patients...
Effect of substrate depth on plant community development on a Michigan green roof

Abstract Green roofs are gradually being accepted and implemented across North America as they can mitigate many of the negative effects that urban areas have on humans and the environment. As rooftops are filled with living plants, individual species need to be tested for longevity and suitability. Twenty-two plant species including herbaceous perennials, grasses, and sedum were evaluated on a green roof at substrate depths of 4.5, 10, and 20 cm over an eight-year period in East Lansing, Michigan. Plants were irrigated when needed during the first two years, but had to rely on natural rainfall thereafter. All five species of sedum were still present at the end of the eight-year period, but only seven of the 17 herbaceous perennials and grasses survived. Of the herbaceous perennials and grasses, Allium cernuum was by far the dominant species in both the 10 and 20 cm deep zones. Sporobolus heterolepis and Koeleria macrantha also established themselves in the 20 cm zone, but all other species were either only present in trace amounts or had completely disappeared. Substrate moisture was probably the major factor in terms of species survival and a drought during 2016 was likely the cause for the large loss of species. Deeper substrates supported a larger variety of species, but plant species diversity decreased over time at all substrate depths. This study emphasizes the fact that if herbaceous perennials and grasses are to be successful on green roofs, then irrigation may be critical to mitigate drought and maintain species diversity. It also points out the importance of long-term studies to accurately evaluate green roof plant communities and provides the framework for a continuation of the same study in other areas of the world.
Utilization of an interprofessional integrated clinical education experience to improve medical and physical therapy student comfort in treating patients with disabilities.

Purpose: The purpose of this study is to examine the impact of an interprofessional education (IPE) clinical experience for medical and physical therapy students on students' comfort levels and attitudes toward patients with disabilities. Methods: Forty students were recruited for this study, 20 from the College of Medicine and 20 from the Doctor of Physical Therapy Program at University of Central Florida with 10 students from each program self-selected into a control group or an experimental group. The experimental group attended an IPE clinical experience that included an encounter with a patient with a disability. Students completed standardized inventories on their perceptions of difficult rehabilitation situations, comfort levels, and attitudes prior to, and immediately following, the clinical experience. The control group completed the same standardized assessments. Results: Using the rehabilitation situations inventory (RSI) statistically significant changes in scores from the pre- to the post-intervention (P 0.05). Conclusion: Both medical and physical therapy students reported increased comfort in dealing with rehabilitation situations after attending the IPE clinical experience. This supports the use of clinical encounters with individuals with disabilities as component of education on treating patients with disabilities.
Single-Use Flexible Ureteroscopes

Flexible ureteroscopy is one of the most commonly performed procedures in urology. Modern flexible ureteroscopes are narrow in diameter, highly maneuverable, and provide the surgeon with high-quality images of the urinary tract. Unfortunately, reusable ureteroscopes are expensive to obtain and often require frequent, costly repairs. Single-use flexible ureteroscopes now offer equivalent, and in some categories, superior performance to reusable scopes but without the need for repairs. They offer additional advantages regarding sterile processing and intraoperative structural failure. The cost analysis for the use of a reusable versus single-use scope is institution specific and will continue to change as new scopes enter the market.
A Comparison of Cancer Detection Rates Between Template Systematic Biopsies Obtained Using Magnetic Resonance Imaging-Ultrasound Fusion Machine and Freehand Transrectal Ultrasound-Guided Systematic Biopsies.

Introduction: There are reports that the 12-core template systematic biopsies (SBx) obtained by using software registration machines (e.g., Artemis) have higher cancer detection rates (CDRs) of pro...
Das Prinzip der Mittelmäßigkeit

Gemas der Vorstellung von der Welt als Multiversum variieren die Naturkonstanten in den verschiedenen Teilen des Universums. In einigen Regionen lassen die Konstanten die Existenz von Leben zu, und dort werden sich Beobachter entwickeln und diese Konstanten messen.
Arteriovenous Fistula Maturation, Functional Patency, and Intervention Rates.

Importance National initiatives have emphasized the use of autogenous arteriovenous fistulas (AVFs) for hemodialysis, but their purported benefits have been questioned. Objective To examine AVF usability, longer-term functional patency, and remedial procedures to facilitate maturation, manage complications, or maintain patency in the Hemodialysis Fistula Maturation (HFM) Study. Design, setting, and participants The HFM Study was a multicenter (n = 7) prospective National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases cohort study performed to identify factors associated with AVF maturation. A total of 602 participants were enrolled (dialysis, kidney failure: 380; predialysis, chronic kidney disease [CKD]: 222) with AVF maturation ascertained for 535 (kidney failure, 353; CKD, 182) participants. Interventions All clinical decisions regarding AVF management were deferred to the individual centers, but remedial interventions were discouraged within 6 weeks of creation. Main outcomes and measures In this case series analysis, the primary outcome was unassisted maturation. Functional patency, freedom from intervention, and participant survival were summarized using Kaplan-Meier analysis. Results Most participants evaluated (n = 535) were men (372 [69.5%]) and had diabetes (311 [58.1%]); mean (SD) age was 54.6 (13.6) years. Almost two-thirds of the AVFs created (342 of 535 [64%]) were in the upper arm. The AVF maturation rates for the kidney failure vs CKD participants were 29% vs 10% at 3 months, 67% vs 38% at 6 months, and 76% vs 58% at 12 months. Several participants with kidney failure (133 [37.7%]) and CKD (63 [34.6%]) underwent interventions to facilitate maturation or manage complications before maturation. The median time from access creation to maturation was 115 days (interquartile range [IQR], 86-171 days) but differed by initial indication (CKD, 170 days; IQR, 113-269 days; kidney failure, 105 days; IQR, 81-137 days). The functional patency for the AVFs that matured at 1 year was 87% (95% CI, 83.2%-90.2%) and at 2 years, 75% (95% CI, 69.7%-79.7%), and there was no significant difference for those receiving interventions before maturation. Almost half (188 [47.5%]) of the AVFs that matured had further intervention to maintain patency or treat complications. Conclusions and relevance The findings of this study suggest that AVF remains an accepted hemodialysis access option, although both its maturation and continued use require a moderate number of interventions to maintain patency and treat the associated complications.
The Greater Cincinnati/Northern Kentucky Stroke Study Preliminary First-Ever and Total Incidence Rates of Stroke Among Blacks

Background and Purpose —The Greater Cincinnati/Northern Kentucky Stroke Study was designed to be the first large, population-based metropolitan study of temporal trends in stroke incidence rates and outcome within a biracial population. Methods —We are identifying all hospitalized and autopsied cases of stroke and transient ischemic attack (TIA) among the 1.3 million inhabitants of a five-county region of Greater Cincinnati/Northern Kentucky for the period 7/1/93–6/30/94. We have already prospectively monitored for out-of-hospital stroke and TIAs for this same time period at 128 screening sites, including a random sample of all primary care physicians and nursing homes in the region. We have already identified all hospitalized and autopsied cases of stroke and TIA among blacks for 1/1/93–6/30/93 and report preliminary incidence rates for this 6-month period. Results —The overall incidence rate for all first-ever hospitalized or autopsied stroke (excluding TIAs) among blacks in the Greater Cincinnati region was 288 per 100 000 (95% CI, 250 to 325, age- and sex-adjusted to 1990 US population). The overall incidence rate for first-ever and recurrent stroke (excluding TIAs) was 411 per 100 000 (95% CI, 366 to 456). By comparison, the overall incidence rate of first-ever stroke among whites in Rochester, Minn, during the period 1985–1989 was 179 per 100 000 (95% CI, 164 to 194, age- and-sex adjusted to 1990 US population). The incidence rates among blacks in Greater Cincinnati were substantially greater than the rates among whites in Rochester, Minn, for all age categories except ages 75 and older, for which the rates were similar. Conclusions —We conservatively estimate that 731 100 first-ever or recurrent strokes occurred in the United States during 1996. Studies of first-ever as well as total stroke among biracial and representative populations are critical for understanding temporal trends in the incidence rate and the burden of stroke in the US population.
Using deliberative democracy to identify energy policy priorities in the United States

Abstract Energy policies to mitigate and adapt to climate change need public support to be successful. Deliberative democracy forums serve to both better inform the public of the available options and provide a way for policymakers to assess support for proposed policies. This work uses a pilot study in Pittsburgh to generate hypotheses regarding how a deliberative democracy process affects residents’ perceptions of and support for City-wide energy policies to address climate change. A convenience sample completed pre and post-surveys during a deliberative forum: “Building a Resilient Pittsburgh: Climate Challenges and Opportunities”. The surveys focused on knowledge, perceptions, and opinions related to the existence of climate change as well as energy policies to mitigate and adapt to climate change. Results suggest that the forum was useful in shifting perceptions, but did not significantly influence objective knowledge or policy support. Participants had a slight preference for energy efficiency strategies over renewable energy and public information. More research is needed to evaluate deliberative democracy approaches and expand these findings to a more diverse population.
A note on a combinatorial interpretation of the e-coefficients of the chromatic symmetric function

Stanley has studied a symmetric function generalization X_G of the chromatic polynomial of a graph G. The innocent-looking Stanley-Stembridge Poset Chain Conjecture states that the expansion of X_G in terms of elementary symmetric functions has nonnegative coefficients if G is a clawfree incomparability graph. Here we give a combinatorial interpretation of these coefficients by combining Gasharov's work on the conjecture with Egecioglu and Remmel's combinatorial interpretation of the inverse Kostka matrix. This gives a new proof of a partial nonnegativity result of Stanley. As an interesting byproduct we derive a previously unnoticed result relating acyclic orientations to P-tableaux.
Transistor and pin reordering for gate oxide leakage reduction in dual T/sub ox/ circuits

Gate oxide tunneling current (I/sub gate/) is emerging as a key roadblock for device scaling in nanometer-scale CMOS circuits. A practical means to reduce I/sub gate/ is to leverage dual T/sub ox/ processes where non-critical transistors are assigned a thicker T/sub ox/. In this paper, we generate a leakage/delay tradeoff curve for dual T/sub ox/ circuits, and propose a transistor and pin reordering technique that has a minimal layout impact to further reduce the total leakage current up to 18% and I/sub gate/ up to 26% without incurring any delay penalty.
John Dewey’s legacy to China and the problems in Chinese society

At the turn of the twenty-first century, when the call for democracy in China once again becomes intense, it is crucial to pause and to think over what democracy means and in what ways the significances of democracy resonates with Chinese people. Almost a century ago, John Dewey elaborated his understandings of democracy to the Chinese people and made a number of suggestions about how they might work towards democracy. This article examines Dewey's notion of democracy and his legacy to Chinese people, the circumstances that restricted the wider acceptance of Dewey’s ideas in China, and some problems in Chinese society that militate against their uptake.