cssi/SciSciGPT-SciSciNet huggingface dataset:
INTERPERSONAL CALLOUSNESS TRAJECTORIES ACROSS ADOLESCENCE: Early Social Influences and Adult Outcomes

The current study examined the relation between interpersonal callousness trajectories during adolescence (ages 14 to 18) and characteristics of antisocial personality and internalizing problems in young adulthood (age 26), using a community sample of 506 boys. The influence of several parent and peer factors on callousness trajectories during adolescence was also explored. Although the mean interpersonal callousness trajectory for the entire sample was relatively flat, there was substantial individual variability in both the initial status and rate of change of interpersonal callousness over time. Trajectories of interpersonal callousness were associated with higher levels of antisocial personality features in early adulthood but were unrelated to adult internalizing problems. Conduct problems and parent-child communication difficulties were the best predictors of elevated levels of interpersonal callousness throughout adolescence. However, none of the parenting and peer factors examined predicted substantive changes in interpersonal callousness over time.
Cu(I)Br mediated coupling of alkynes with N-acylimine and N-acyliminium ions in water

Abstract A coupling of alkynes with N -acylimines and N -acyliminium ions mediated by Cu(I) was developed in water to generate propargyl amide derivatives.
Measures of Respiratory Pattern Variability

The possible causes of breath to breath variability in the pattern of breathing have been discussed in a recent review[1]. This variability may be due to stochastic factors (e.g., random disturbances), to the dynamical behaviors of chemoreflex and mechanoreflex feedback loops, or to interactions between these stochastic and dynamical non-stochastic mechanisms. The recognition that the type and structure of breath to breath variability in respiratory pattern may reflect the actions of various underlying respiratory control mechanisms has motivated the desire to quantity this variability. Although some prior work has attempted to separate respiratory variability into its stochastic and various non-stochastic components[2], such a separation is difficult in general and is not considered here. A more fundamental question is whether a change in state or condition of a subject alters overall respiratory pattern variability. This report will discuss this more fundamental question and compare several methods for quantifying overall breath to breath variability in breathing pattern using a specific example.
Normalizing clinical terms using learned edit distance patterns

Background Variations of clinical terms are very commonly encountered in clinical texts. Normalization methods that use similarity measures or hand-coded approximation rules for matching clinical terms to standard terminologies have limited accuracy and coverage. Materials and Methods In this paper, a novel method is presented that automatically learns patterns of variations of clinical terms from known variations from a resource such as the Unified Medical Language System (UMLS). The patterns are first learned by computing edit distances between the known variations, which are then appropriately generalized for normalizing previously unseen terms. The method was applied and evaluated on the disease and disorder mention normalization task using the dataset of SemEval 2014 and compared with the normalization ability of the MetaMap system and a method based on cosine similarity. Results Excluding the mentions that already exactly match in UMLS and the training dataset, the proposed method obtained 64.7% accuracy on the rest of the test dataset. The accuracy was calculated as the number of mentions that correctly matched the gold-standard concept unique identifiers (CUIs) or correctly matched to be without a CUI. In comparison, MetaMap’s accuracy was 41.9% and cosine similarity’s accuracy was 44.6%. When only the output CUIs were evaluated, the proposed method obtained 54.4% best F -measure (at 92.1% precision and 38.6% recall) while MetaMap obtained 19.4% best F -measure (at 38.0% precision and 13.0% recall) and cosine similarity obtained 38.1% best F -measure (at 70.3% precision and 26.1% recall). Conclusions The novel method was found to perform much better than the MetaMap system and the cosine similarity based method in normalizing disease mentions in clinical text that did not exactly match in UMLS. The method is also general and can be used for normalizing clinical terms of other semantic types as well.
Hybrid Electric Vehicle Control Strategy Based on Power Loss Calculations

Defining an operation strategy for a Split Parallel Architecture (SPA) Hybrid Electric Vehicle (HEV) is accomplished through calculating powertrain component losses. The results of these calculations define how the vehicle can decrease fuel consumption while maintaining low vehicle emissions. For a HEV, simply operating the vehicle’s engine in its regions of high efficiency does not guarantee the most efficient vehicle operation. The results presented are meant only to define a literal strategy; that is, an understanding as to why the vehicle should operate in a certain way under the given conditions. The literature review gives a background of hybrid vehicle control publications, and without the SPA HEV addressed or a hybrid analysis based on loss calculations between engine only and hybrid modes, there is a need for this paper. Once the REVLSE architecture and components are understood, the hybrid modes are explained. Then the losses for each hybrid mode are calculated, and both the conversion and assist efficiencies are detailed. The conversion efficiency represents the amount of additional fuel required to store a certain amount of energy in the battery, and this marginal efficiency can be higher than peak engine efficiency itself. This allows electric only propulsion to be evaluated against the engine only mode, and at low torques the electric motor is more efficient despite the roundtrip losses of the hybrid system.
The Effects of Culture and Socioeconomics on the Performance of Global Brand Image Strategies

Developing and managing brand image is an important part of a firm's marketing program. However, little research has been done (1) on linking the use of brand image strategies to product performanc...
Abstract C58: Heterotetramers of ERBB2 and ERBB3 generate qualitatively distinct signals from heterodimers and provide most of the neuregulin-induced phosphorylation of ERBB2

The efficient tyrosine phosphorylation of the orphan ERBB2 (HER2) receptor in heterodimer with the kinase-impaired ERBB3 presents a highly potent source of mitogenic signal. However, it is also a conceptual challenge to our established model of dimer-based signal generation through transphosphorylation. Proposed and mutually not exclusive models for ERBB2 phosphorylation in complex with ERBB3 include autophosphorylation in cis after complex formation and allosteric activation of its kinase domain by ERBB3 in trans, phosphorylation of ERBB2 in trans by the low but detectable kinase activity of ERBB3, or phosphorylation of ERBB2 in proxy. Proxy activation refers to phosphorylation between ERBB2 receptors of activated heterodimers in higher order complexes. We previously reported that the ligand-induced activation and growth stimulation through ERBB2/ERBB3 can be efficiently inhibited by an aptamer directed against the extracellular portion of ERBB3. Studies of the exact mode of inhibition now reveal that the aptamer neither acts by interfering with ligand binding nor by suppressing heterodimer formation. Combined biochemical studies and homology models identified the binding site of the aptamer and suggest that it interferes with the transition from activated heterodimers to heterotetramers. This inhibits the proxy activation of ERBB2 and associated MAPK activation while heterodimerization, the phosphorylation of ERBB3, and downstream activation of AKT are largely insensitive to inhibition. The fact that ERBB2 appears to receive most of its tyrosine phosphorylation through a proxy mechanism is consistent with reports of a prevalence of tetramers in the context of EGFR activation. Furthermore, our study demonstrates for the first time that mechanistically definable and dissectible higher order ERBB complexes contribute to signaling in a manner that is qualitatively distinct from the signal that emanates from isolated dimers. This forces us to fundamentally reinterpret approaches to therapeutic intervention that are at present conceptually centered around modulating the formation of dimers but often generate experimental and clinical outcomes that do not readily reconcile with dimer-based models. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the Second AACR International Conference on Frontiers in Basic Cancer Research; 2011 Sep 14-18; San Francisco, CA. Philadelphia (PA): AACR; Cancer Res 2011;71(18 Suppl):Abstract nr C58.
Can personality traits predict the future development of heart disease in hospitalized psychiatric veterans

OBJECTIVE To examine which personality traits are associated with the new onset of chronic coronary heart disease (CHD) in psychiatric inpatients within 16 years after their initial evaluation. We theorized that personality measures of depression, anxiety, hostility, social isolation, and substance abuse would predict CHD development in psychiatric inpatients. METHOD We used a longitudinal database of psychological test data from 349 Veterans first admitted to a psychiatric unit between October 1, 1983, and September 30, 1987. Veterans Affairs and national databases were assessed to determine the development of new-onset chronic CHD over the intervening 16-year period. RESULTS New-onset CHD developed in 154 of the 349 (44.1%) subjects. Thirty-one psychometric variables from five personality tests significantly predicted the development of CHD. We performed a factor analysis of these variables because they overlapped and four factors emerged, with positive adaptive functioning the only significant factor (OR=0.798, p=0.038). CONCLUSION These results support previous research linking personality traits to the development of CHD, extending this association to a population of psychiatric inpatients. Compilation of these personality measures showed that 31 overlapping psychometric variables predicted those Veterans who developed a diagnosis of heart disease within 16 years after their initial psychiatric hospitalization. Our results suggest that personality variables measuring positive adaptive functioning are associated with a reduced risk of developing chronic CHD.
Variations in the application of a budget of uncertainty optimization approach

It is possible to consider uncertainty simultaneously with the design process. In fact, a Budget of Uncertainty(BoU) can be determined alongside the design solution, allowing the determination of uncertainty intervals for selected design variables and problem parameters. This paper presents a new strategy for optimization under uncertainty which provides for this simultaneous design and uncertainty determination. To test the theory, a simple Taylor series expansion strategy is used to propagate uncertainty in a design problem's objectives and constraints and a new BoU design algorithm is formulated. Due to the need for competing objectives, nominal performance and robust design, the new formulation is a multiobjective problem with primary and secondary weights to allow for lexicographic weights of uncertain parameters and variation between optimal and robust solutions. This paper compares and contrasts three different Goal Programming techniques as solutions to the multiobjective problem. Within the paper, the term Budget of Uncertainty (BoU) is used to describe the fundamental idea of uncertainty allocation across design variables and problem parameters as well as for a shorthand to describe the presented formulation. An engineering design problem, that of a helical spring, is presented to further illustrate the new method, and an uncertainty budget is considered which trades uncertainty in coil diameter against uncertainty in wire diameter.
How to Strengthen the Internal Cultural Construction of the Enterprise

With the rapid development of economy in our country,the domestic enterprises lay much emphasis on the internal cultural construction,culture construction of the enterprise was strengthened,but at present there are still many weakpoints in the internal culture construction of many enterprises in our country,we must strive to solve it. This paper briefly discusses the importance of culture construction of the enterprise,and summarizes the outstanding problems existing in the current internal cultural construction of the enterprise,finally puts forward the improvement measures on how to strengthen the internal cultural construction of the enterprise,hope to provide the reference for Chinese enterprises to carry out the internal culture construction.
Ionizing irradiation increases transcription of the von Willebrand factor gene in endothelial cells

Ionizing irradiation damage to the vasculature results in an increase in procoagulant activity of endothelial cells, including elevated von Willebrand factor (vWf) secretion. We investigated the mechanism of irradiation induction of vWf release and demonstrated that vWf mRNA levels were increased when either human or bovine endothelial cells were exposed to 20 Gy irradiation. This response to irradiation was independent to de novo protein synthesis, but required new transcription. Nuclear run-on experiments indicated that increased vWf transcriptional activity was partly responsible for the higher levels of the mRNA accumulation. Transfection analyses with plasmids in which a human growth hormone structural gene was under the control of the endothelial-cell-specific vWf promoter demonstrated that irradiation increased promoter activity. Deletion analyses demonstrated that sequences necessary for irradiation induction of the promoter activity were located within the 112-bp sequences (-90 to +22) that constitute the non-endothelial-cell-specific core promoter region of the vWf gene. Results of gel mobility assays and deletion analyses demonstrated that a site in the vWf promoter other than the putative NF-kB binding site is involved in the mechanism of irradiation induction of the vWf.
Adrenal disorders: know when to act and what tests to give.

Abstract Adrenal diseases are uncommon in older patients but can present insidiously. Adrenal masses are often discovered incidentally on abdominal CT scans and are usually benign, but they should be assessed for hormone production. Cushing's syndrome, or cortisol excess, is usually due to exogenous corticosteroids or a hormonally active tumor. The overnight dexamethasone suppression test is an excellent screening test. Adrenal insufficiency can be caused by hemorrhage, tuberculosis, or metastatic cancer. Maintaining a high index of suspicion of hidden adrenal disease, the primary care physician should apply an efficient approach to the diagnosis and initial management of adrenal diseases in older patients.
Immunity and Potential of Vaccination

This article will focus on current information available on the equine immune response to helminth parasites as it relates to acquired resistance, hypersensitivity reactions, and vaccine development.
Appointment standardization evaluation in a primary care facility

Purpose - The purpose of this paper is to evaluate the performance on standardizing appointment slot length in a primary care clinic to understand the impact of providers' preferences and practice differences. Design/methodology/approach - The treatment time data were collected for each provider. There were six patient types: emergency/urgent care (ER/UC), follow-up patient (FU), new patient, office visit (OV), physical exam, and well-child care. Simulation model was developed to capture patient flow and measure patient wait time, provider idle time, cost, overtime, finish time, and the number of patients scheduled. Four scheduling scenarios were compared: scheduled all patients at 20 minutes; scheduled ER/UC, FU, OV at 20 minutes and others at 40 minutes; scheduled patient types on individual provider preference; and scheduled patient types on combined provider preference. Findings - Standardized scheduling among providers increase cost by 57 per cent, patient wait time by 83 per cent, provider idle time by five minutes per patient, overtime by 22 minutes, finish time by 30 minutes, and decrease patient access to care by approximately 11 per cent. An individualized scheduling approach could save as much as 14 per cent on cost and schedule 1.5 more patients. The combined preference method could save about 8 per cent while the number of patients scheduled remained the same. Research limitations/implications - The challenge is to actually disseminate the findings to medical providers and adjust scheduling systems accordingly. Originality/value - This paper concluded standardization of providers' clinic preference and practice negatively impact clinic service quality and access to care.
Normal or Nearly Normal Liver

Not all liver specimens sent for pathologic examination will show histologic abnormalities. There are several situations that can lead to this. First, the patient may have no disease affecting the liver. This can occur when a patient has “mildly elevated” aspartate transaminase (AST) and alanine transaminase (ALT) levels that are in fact physiologically normal for that patient or are due to an extrahepatic process or when the liver is sampled “just in case” (such as during an exploratory laparotomy). Another scenario is when a patient has a disease affecting the liver in a patchy or haphazard fashion, bringing the possibility of sampling error into play. Finally, a patient may have liver disease that is very early in its course, well controlled on medication, or resolving. (Special situations also exist, such as examining a biopsy from a potential donor liver; see Chap. 14.)
Learning Surgery as a Student

Surgery is a uniquely rewarding career. High-performance on student surgery rotations is important for students who desire to become surgeons. Students must remain self-critical and thoughtful regarding their career choice, analyze the values and styles of surgical trainees and faculty on rotation. Maintain a rigorous schedule of didactic learning and reading while on rotation, never show up for the operating room unprepared. Great students have situational awareness, seek advice from junior house officers regarding ways to add value to patient care on the surgery rotation. Becoming a successful surgeon mandates a life of learning and self critical reflection. These habits begin as a medical student on the surgery service.
Calibration and Uncertainty Analysis of Predictions from Computational Models

Abstract:Computer experiments are simulations of physical experiments performed by exercising a mathematical model for a physical or chemical process, to produce model outputs corresponding to sets of values of inputs to the model. They are especially useful when the corresponding physical experiments are difficult or expensive. In these cases one will perform a relatively small number of physical experiments that are used to calibrate the simulation model. This is then employed to explore the space of values of the inputs extensively, in a way that “interpolates” the results of the physical experiments. Quantification of uncertainty for the outputs of such computer experiments is of great interest. The sources of uncertainty are in part due to the experimental measurement uncertainty in the inputs, and in part due to inadequacies of the underlying mathematical model. This paper presents methods for calibration and assessment of both types of uncertainty and demonstrates their use on two simple fire models.
OUTCOMES AND THEIR PREDICTORS IN ACUTE TRANSCATHETER AORTIC HEART VALVE-IN-TRANSCATHETER AORTIC HEART VALVE THERAPY

Background: Transcatheter aortic valve replacement (TAVR) is safe and beneficial for those with severe aortic stenosis (AS) of at least intermediate surgical risk. Despite advances in transcatheter heart valve (THV) technology, some still require urgent/emergent deployment of a second THV. The
Spatiotemporal Modeling of Membrane Receptors

We discuss our approach to the detailed computational modeling of the molecular processes involved in early signaling of membrane-bound receptors, typically exemplified by members of the receptor tyrosine kinase (RTK) family. This includes receptors whose mutations are associated with increased risk of cancers (ErbB2) or are involved in the survival of nascent tumors (Kdr). Current imaging methods can visualize individual molecules in the context of the living cell, allowing the direct observation of molecular movement and transformations. Modeling and simulation are necessary to connect these observations to the cell-level kinetics of signaling and to help reveal connections between molecular properties and cell signaling, under both normal and pathological conditions. We describe the relevant methods and provide a minimal mathematical justification for the reader interested in understanding or applying them. The chapter builds up from the simplest modeling approach to the fully spatial, agent-based simulation that is currently used by our group. This should be useful from a tutorial perspective and also to provide the proper connections between models at different levels of granularity.
His -Story of Mankind

All major timelines of history tell the story of humankind through religion, war, and aggressors seeking power and dominance. And, as the quote above states, when women sought power over their lives and bodies, they have been categorized since the 1990s as man-hating, feminazis (Rudman 2012). It is a story dominated by the warrior male that is encouraged, supported, and repeatedly communicated by a variety of religions to claim the justified path for war, for authority, for dominance, and for power over others, especially women. As with the major world religions, women and children are hardly cited in a world history of creating religions that ensured they were to be dominated and vanquished. Women and children have not waged wars in the name of righteousness for a deity or to gain land or to subjugate others.
Closed Form Solutions for Linear Differential and Difference Equations

Finding closed form solutions of differential equations has a long history in computer algebra. For example, the Risch algorithm (1969) decides if the equation y' = f can be solved in terms of elementary functions. These are functions that can be written in terms of exp and log, where "in terms of" allows for field operations, composition, and algebraic extensions. More generally, functions are in closed form if they are written in terms of commonly used functions. This includes not only exp and log, but other common functions as well, such as Bessel functions or the Gauss hypergeometric function. Given a differential equation L, to find solutions written in terms of such functions, one seeks a sequence of transformations that sends the Bessel equation, or the Gauss hypergeometric equation, to L. Although random equations are unlikely to have closed form solutions, they are remarkably common in applications. For example, if y = ∑n=0∞ an xn has a positive radius of convergence, integer coefficients an, and satisfies a second order homogeneous linear differential equation L with polynomial coefficients, then L is conjectured to be solvable in closed form. Such equations are common, not only in combinatorics, but in physics as well. The talk will describe recent progress in finding closed form solutions of differential and difference equations, as well as open questions.
Reachability Analysis for Safety Assurance of Cyber-Physical Systems Against Cyber Attacks

This technical note proposes an algorithm to assess the safety of the cyber-physical system (CPS) in the presence of cyber attacks, which can be designed intelligently to avoid the detection. The main idea is based on the reachability analysis that computes the reachable set of CPS states possibly reached by all potential cyber attacks regardless of their detection. The reachable set computation typically demands a large computation cost and has mostly relied on the (over) approximation techniques. However, our algorithm analytically derives the exact reachable set solution and further establishes a recursive computation structure that can perform in the real-time CPS operation. This can significantly enhance the quality of the online safety assessment, enabling more reliable, less conservative, and computationally efficient process.
LHCD during current ramp experiments on Alcator C-Mod

United States. Department of Energy. Office of Fusion Energy Sciences (Award DE-FC02-99ER54512)
Barriers to Women’s Power and Agency

This chapter explores the barriers to women’s power and agency. It also reviews some theoretical constructs related to barriers to power. In addition, this chapter juxtaposes these theoretical constructs with those of informants’ narratives and life stories, and argues that there are religio-cultural practices and socio-structural constraints that make women of Chandhara less powerful than men. This chapter mainly engages discourses and theories of power, such as Bachrach and Morton S. Baratz’s, and Steven Lukes’, in discussing barriers to (women’s) power and agency. This chapter engages the religious discourses of the early days of Islam that incorporates folk traditions in interpreting the foundations of the Islamic creed that tend to view women negatively. In addition, it describes institutional, social, and cultural barriers to women’s power and agency.
Toward Better Stewardship: Gaining Control Over Controlled Substances.

Carey and colleagues' study examined the relationship between various opioid prescription patterns and opioid overdose and all-cause mortality. The editorialists discuss the findings and the need t...
Denaturation-Enhanced Droplet Digital PCR for Liquid Biopsies.

BACKGROUND: Although interest in droplet-digital PCR technology (ddPCR) for cell-free circulating DNA (cfDNA) analysis is burgeoning, the technology is compromised by subsampling errors and the few clinical targets that can be analyzed from limited input DNA. The paucity of starting material acts as a “glass ceiling” in liquid biopsies because, irrespective how analytically sensitive ddPCR techniques are, detection limits cannot be improved past DNA input limitations. METHODS: We applied denaturation-enhanced ddPCR (dddPCR) using fragmented genomic DNA (gDNA) with defined mutations. We then tested dddPCR on cfDNA from volunteers and patients with cancer for commonly-used mutations. gDNA and cfDNA were tested with and without end repair before denaturation and digital PCR. RESULTS: By applying complete denaturation of double-stranded DNA before ddPCR droplet formation the number of positive droplets increased. dddPCR using gDNA resulted in a 1.9–2.0-fold increase in data-positive droplets, whereas dddPCR applied on highly-fragmented cfDNA resulted in a 1.6–1.7-fold increase. End repair of cfDNA before denaturation enabled cfDNA to display a 1.9–2.0-fold increase in data-positive signals, similar to gDNA. Doubling of data-positive droplets doubled the number of potential ddPCR assays that could be conducted from a given DNA input and improved ddPCR precision for cfDNA mutation detection. CONCLUSIONS: dddPCR is a simple and useful modification in ddPCR that enables extraction of more information from low-input clinical samples with minor change in protocols. It should be applicable to all ddPCR platforms for mutation detection and, potentially, for gene copy-number analysis in cancer and prenatal screening.
Socrates as an Analyst: A Reading of “Transference in the Present” Commentary on Session XII

This commentary shows how Lacan’s precise articulation between love and desire, as well as his understanding of transference in terms of fiction, permits him to provide an unprecedented reading of the last scene of the Symposium, making of Alcibiades an analysand unaware of his own desire, and of Socrates’s interpretation of Alcibiades’ speech, the first analytic intervention in history.
Energy metabolism in the lens during development of galactose cataract in rats

When young rats are fed a diet containing 50 per cent galactose, the beginning of cataract development is detected as a vacuolization of the equatorial cortex on the second day. By this time the rates of glycolysis and respiration in the lens are decreased one third below the control levels, and the lactic ackl concentration in the lens water is lowered to the range found in the surrounding fluids of the eye. The corresponding barely detectable decrease in the total ATP content of the lens is interpreted to be the restdt of the inhibition of carbohydrate metabolism affecting only the small fraction of lenticular ATP in active turnover. Further vacuolization and subsequent opacification of the lens does not markedly change the rate of energy production but is accompanied by the disappearance of 75 per cent of the ATP. This fraction probably is located in the deeper cortex and nucleus and presumably is in less active metabolic exchange. It may escape from the lens fibers during the progressive destruction of the fiber membranes as the effect rather than cause of cataractous changes.
Catching CAUTIs Midstream: Impact of a Nurse-driven Infection Prevention Initiative in a Neurotrauma Intensive Care Unit

Background A preventable hospital-associated condition, Catheter-Associated Urinary Tract Infection (CAUTI) increases morbidity, mortality, and hospital length of stay and cost. Neurologic and injured patients are at high-risk for adverse outcomes associated with bladder dysfunction. Thus, higher utilization, reinsertion and infection rates related to indwelling urinary catheter use is reported in these complex populations. What is the impact of an innovative nurse-driven initiative to reduce CAUTI incidence in a neurotrauma intensive care unit (NTICU) to a Standardized Infection Ratio (SIR) Methods A nurse-led interprofessional team utilized a Define-Measure-Analyze-Improve-Control model to implement an evidence-based CAUTI prevention initiative. A 12-bed unit providing care to neurologic and injured patients in a level one trauma, academic medical center was the study setting. Cornerstone interventions included conduct of a staff culture of safety survey; revision of ICU Fever and Bladder Management Guidelines; interprofessional education; and use of a trial without catheter (TWOC) checklist to assess for catheter removal readiness. To sustain improvements, a nursing clinical team leader (CTL) driven initiative included daily patient rounds and audits of catheter care bundle and guideline compliance over a two-year period. Infection rates, device utilization rates and SIR were compared pre and post intervention. Results CAUTI rates reduce post intervention by nearly 40% (CAUTI rate 2017, 5.48; 2018, 2.91) and sustained through 2019 (2.97). The SIR for CAUTI reduce nearly 50% from 2.0 in 2017 to 1.06 in 2018 and sustained at 0.92 in 2019. No significant change in the utilization rate was noted (2017, 0.49; 2018, 0.55; 2019, 0.50). Conclusions At the unit level, a CTL driven initiative sustains quality improvements in catheter care bundle and guideline compliance, significantly reducing CAUTI incidence in a NTICU. Innovative use of an additional assessment checklist for catheter removal readiness may further support CAUTI reduction in high-risk neurologic and injured ICU populations.
A novel design for beamforming the Breakthrough Starshot laser array

We outline a laser array beam forming concept that is capable of meeting the laser power requirements of Breakthrough Starshot, a concept aimed at propelling spacecraft to extremely high velocities via laser radiation pressure. Our laser beam forming design offers solutions to the required laser power, optical radiance, beam steering, beam focusing, and atmospheric turbulence compensation specifications. The design consists of a large array of hexagonally close-packed optical modules. Each module contains a collimating lens illuminated by a single fiber from a coherent array of fiber amplifiers. Beam steering is accomplished by transverse micromotion of the fiber amplifier tip illuminating each collimating optic, coupled with a phase shift applied to each module by an electrooptic modulator. Overall array focus is performed by adjusting the transverse and longitudinal fiber positions of each module. Thus, by simply manipulating the position of the fiber feeds of each module and applying the appropriate phase shifts, the beam shape of the entire array can be conditioned to meet the focusing and tracking requirements of the Breakthrough Starshot concept. The same hardware can compensate for the atmospheric aberrations of piston, tilt, and quadratic curvature. For our strawman design, we calculate the overall Strehl ratio reduction of the entire array resulting from incomplete array fill factors, errors in the array phasing, finite laser bandwidth and atmospheric turbulence to be 0.36.
Engineered Biomaterials for Tissue Regeneration of Innervated and Vascularized Tissues: Lessons Learned from the Brain

Spontaneous healing and recovery of innervated and vascularized tissues are limited. In particular, the complexity of the central nervous system's anatomy, physiology, and pathobiology make efforts to develop effective therapeutic strategies exceptionally challenging. Repairing the brain after injury implies restoring the tissue architecture of the neural and vascular networks both morphologically and functionally. The substantial clinical burden and disability after a central nervous system injury urges the need to explore therapeutic solutions outside the confine of conventional approaches used in regenerative medicine. Recent advances in tissue engineering and material sciences have developed biomimetic materials that can be injected or implanted directly to the site of damage to provide physical support to cell infiltration and growth, promoting tissue development and de novo formation of vascular and axonal networks through cell transplantation and/or controlled release of bioactive cues. These approaches have shown promise in promoting the endogenous repair machinery of the brain and controlling the growth and development of functional vascular and neural networks in the lesion to promote long-term functional recovery. This narrative review presents a comprehensive look at recent advances using proangiogenic engineered materials and drug delivery systems for brain repair after stroke.
Analysis and Control of Grid-Tied Quad-PV LLC Converter with MPPT

This paper proposes a multi input DC-DC converter that integrates four photovoltaics (PV) panels that is typically followed by a second stage of grid-tied inverter. This topology uses single LLC resonant tank to supply the output using four half-bridge converters. Maximum power point tracking (MPPT) algorithm for all four PV module is designed using four degrees of freedom. The switching frequency and three phase shifts ensures the accurate pulse width modulation (PWM) for all switches while achieving zero-voltage switching (ZVS) across all the switches for a wide input range and load variations. The dc link voltage is maintained at 300V by using outer voltage loop of the inverter controller. To reduce the harmonic distortion in injected current, a phase locked loop (PLL) with proportional resonant (PR) based controller is developed to regulate the power with single phase grid. Finally, a 1.2kW quad-PV model has been simulated and the gain equation is derived for the proposed model. The simulation results ensure that the proposed converter with closed loop control successfully agree with the derived mathematical model.
Research on Insulation Damp Diagnosis of Synchronous Motor Stator Winding

The insulation of synchronous motor is easily affected by its operation state and structure. Because the insulation of synchronous motor can only use solid insulation medium, which is embedded in the core groove, it can not be immersed in insulating oil like transformer, nor can it be sealed in metal shell full of SF6 like GIS, and the insulation of synchronous motor can only be exposed to air. In some cases, it is easy for the winding to get damp. In this paper, the frequency-domain dielectric spectroscopy method is used to detect the moisture of stator winding. The test results of several groups of samples are compared, and the cause analysis is given.
It All Begins with You: Improving Law School Learning Through Professional Self-Awareness and Critical Reflection

From the author's introduction: This paper grows out of my reflections on my own introduction to learning theory. In it, I hope to accomplish two things. First, I present a modest proposal for becoming a better teacher. My thesis is simple: by knowing more about ourselves and our own learning processes, preferences, and inclinations, we will become better teachers. We will discover why we have elected to teach as we do, and we will also uncover when we have been on automatic pilot, blithely accepting the role of law professor, as conceived by our institutions, our students' expectations, and our preconceived assumptions. Second, this paper is a kind of phenomenology of discovery about learning theory. This is not a didactic essay. It is a self-report of my own reading of the literature of applied learning theory. It is a story of self-discovery, a starting place for the harried law professor who needs a map of the learning theory terrain.
Management of Internal Carotid Artery and Intracranial Anterior Circulation Tandem Occlusion with Stenting versus No Stenting: A Multicenter Study

Background Tandem occlusion (TO) describes not only occlusion of the middle cerebral artery but a contemporaneous occlusion of the cervical internal carotid artery. There is a paucity of data over whether mechanical thrombectomy (MT) alone, MT with angioplasty, or MT with carotid artery stent placement is superior. We aim to address a gap in the literature comparing carotid stenting with mechanical thrombectomy (CSMT) and carotid angioplasty with mechanical thrombectomy (CAMT) in patients presenting with acute anterior circulation TOs. Methods This is a multicenter, retrospective study from 2012 to 2020 comparing CSMT and CAMT presenting with acute anterior circulation TOs. Primary outcomes of interest were functional status, perioperative stroke, mortality, and symptomatic intracranial hemorrhage (sICH). A total of 92 patients (66 vs. 26 in CSMT and CAMT, respectively) met inclusion criteria for analysis. Results There was no statistically significant difference in functional outcomes at 90-day follow-up (adjusted odds ratio [aOR] 0.82; 95% confidence interval [CI] 0.20–3.5; P = 0.46). In addition, there was no statistically significant difference in 90-day mortality (aOR 0.361; 95% CI 0.016–2.92; P = 0.532) and perioperative stroke rate (aOR 1.76; 95% CI 0.160–15.6; P = 0.613). However, sICH risk was significantly greater in the stent-treated cohort (aOR 3.94; 95% CI 0.529–37.4; P = 0.003). Conclusions Functional outcomes, mortality, and perioperative stroke rates do not significantly differ in CSMT and CAMT procedures in the acute setting. However, CSMT-treated patients do appear to have an increased risk of sICH, potentially due to the use of additional antiplatelet agents following stent placement.
Improving Secondary Fracture Prevention After Vertebroplasty: Implementation of a Fracture Liaison Service.

Abstract Objective The aim of our study was to evaluate a multidisciplinary fracture liaison service (FLS) to improve osteoporosis treatment and secondary fracture prevention for patients after vertebroplasty. Methods A retrospective chart review of consecutive vertebroplasty patients from January 2016 to January 2020. FLS began in December 2016 allowing for before-and-after comparison. Statistical analysis included patient demographics and procedure characteristics. Proportion of patients evaluated by the FLS clinic and treatment modification were evaluated. Opt-in versus opt-out referral strategies were compared. Dual energy x-ray absorptiometry scans or vitamin D levels within 3 months before or after vertebroplasty were assessed. Time to event analysis was used to evaluate secondary fracture occurrence. Results There were 137 vertebroplasty patients, 39 before FLS and 98 after FLS, included. Only 15% of all patients were already being treated in a bone health clinic. Of those referred and evaluated by the FLS, 73.0% had their osteoporosis treatment modified. Patients evaluated by the FLS were more likely to have a dual energy x-ray absorptiometry scan or a vitamin D level drawn (P Discussion A multidisciplinary FLS can be implemented for patients after vertebroplasty to evaluate osteoporotic risk factors and optimize osteoporosis therapy, both of which are important factors in preventing secondary vertebral fractures.
Associations of Body Mass Index and Waist Circumference in Young Adulthood with Later Life Incident Diabetes.

CONTEXT The independent contribution of young adult exposure to overweight and obesity to later-life incident diabetes is not well studied. OBJECTIVE To assess the associations of exposures to elevated body mass index (BMI) and waist circumference (WC) in young adulthood (ages 18-39 years) with incident diabetes later in life (≥40 years). DESIGN Pooled data from 6 US prospective cohorts (Atherosclerosis Risk in Communities Study, Cardiovascular Risk Development in Young Adults Study, Cardiovascular Health Study, (4) Framingham Heart Study Offspring Cohort, (5) Health, Aging and Body Composition Study, and (6) Multi-Ethnic Study of Atherosclerosis. SETTING Population-based cohort studies. PARTICIPANTS 30 780 participants (56.1% female, 69.8% non-Hispanic white) without a diagnosis of diabetes by age 40. INTERVENTIONS We imputed BMI and WC trajectories from age 18 for every participant and estimated time-weighted average exposures to BMI or WC during young adulthood and later life. MAIN OUTCOME MEASURE(S) Incident diabetes defined as fasting glucose ≥126 mg/dL, nonfasting glucose ≥200 mg/dL, or use of diabetes medications. RESULTS During a 9-year median follow-up, 4323 participants developed incident diabetes. Young adult BMI and WC were associated with later-life incident diabetes after controlling for later-life exposures [hazard ratios (HR) 1.99 for BMI ≥ 30 kg/m2 and 2.13 for WC > 88cm (women)/>102cm (men) compared to normal ranges]. Young adult homeostatic model of insulin resistance mediated 49% and 44% of the association between BMI and WC with later-life incident diabetes. High-density lipoproteins and triglycerides mediated a smaller proportion of these associations. CONCLUSIONS Elevated BMI and WC during young adulthood were independently associated with later-life incident diabetes. Insulin resistance may be a key mediator.
Mitigating mass transport limitations: hierarchical nanoporous gold flow-through electrodes for electrochemical CO2 reduction

The reaction rates for electrochemical CO2 reduction in aqueous electrolytes can be limited by the low concentration and diffusion rate of the reactant CO2. To overcome this limitation, we fabricated and tested hierarchical nanoporous gold (hnpAu) flow-through electrodes that enable pumping CO2 saturated potassium bicarbonate electrolyte directly through the macropores of hnpAu. The hnpAu flow-through electrode was fabricated by ink casting followed by annealing and dealloying to generate a bimodal pore distribution where macropores (5–10 μm) act as flow channels and nanopores (∼40 nm) provide high surface area. To minimize local CO2 depletion at the electrolyte–electrode interface we selected flow rates that warranted diffusion lengths exceeding the macropore diameter dimensions. We observed that the CO2 reduction rate increases with increasing flow rate through the electrode, but even for the highest overpotentials and flow rates, less than 20% of the dissolved CO2 was utilized despite the absence of diffusion limitations. We find that the competing hydrogen evolution reaction becomes increasingly suppressed with increasing flow rate, specifically in the low overpotential regime. These observations suggest that, beyond diffusion limitations, the CO2 reduction rate in aqueous electrolytes may become limited by the availability of free reaction sites, and that flowing the electrolyte through the electrode increases the CO2 reduction rate by facilitating the removal of the CO product.
Idiopathic Polyhydramnios and Neonatal Morbidity at Term.

Objective Idiopathic polyhydramnios is among the most common etiologies of polyhydramnios. However, conflicting evidence exists regarding the relationship between polyhydramnios and neonatal morbidity. We investigated the association between pregnancies with and without idiopathic polyhydramnios and neonatal morbidity at term. Study design This is a retrospective cohort study of singleton, term (i.e., ≥370/7 weeks) pregnancies from 2014 to 2018. Pregnancies complicated by fetal anomalies, pregestational diabetes, and multifetal gestation were excluded. Pregnancies complicated by idiopathic polyhydramnios were defined by the deepest vertical pocket (DVP) ≥8 cm or amniotic fluid index (AFI) ≥24 cm after 20 weeks' gestation and were compared with women without polyhydramnios at time of delivery. These groups were matched 1:2 by gestational age within 7 days at delivery and maternal race. The primary outcome was a composite neonatal morbidity (neonatal death, respiratory morbidity, hypoxic-ischemic encephalopathy, therapeutic hypothermia, seizures, and umbilical artery pH Results Idiopathic polyhydramnios was diagnosed in 192 pregnancies and were matched to 384 pregnancies without polyhydramnios. After adjustment for obesity, women with pregnancies complicated by idiopathic polyhydramnios had an increased risk of composite neonatal morbidity 21.4 versus 5.5% (adjusted risk ratio [aRR] = 4.0, 95% confidence interval [CI]: 2.3-6.7). Term neonatal respiratory morbidity was the primary driver 20.3 versus 4.2%, (aRR = 4.8, 95% CI: 2.7-8.7) and included higher use of continuous positive airway pressure 19.8 versus 3.4%, p 12 hours of newborn life 6.8 versus 1.8%, p Conclusion Idiopathic polyhydramnios is associated with term neonatal respiratory morbidity at delivery and during the subsequent hours of newborn life, compared with pregnancies without idiopathic polyhydramnios. Further studies are needed to minimize neonatal morbidity at term. Key points · Idiopathic polyhydramnios is associated with increased risk of neonatal morbidity at term.. · Increasing idiopathic polyhydramnios severity was associated with a trend toward worsening morbidity at term.. · Idiopathic polyhydramnios at term requires respiratory support at delivery and during neonatal care..
Anti-viral and pro-inflammatory functions of Toll-like receptors during gamma-herpesvirus infections.

Toll-like receptors (TLRs) control anti-viral responses both directly in infected cells and in responding cells of the immune systems. Therefore, they are crucial for responses against the oncogenic γ-herpesviruses Epstein-Barr virus and Kaposi’s sarcoma-associated herpesvirus and the related murine virus MHV68, which directly infect immune system cells. However, since these viruses also cause lifelong persistent infections, TLRs may also be involved in modulation of inflammation during latent infection and contribute to virus-driven tumorigenesis. This review summarizes work on both of these aspects of TLR/γ-herpesvirus interactions, as well as results showing that TLR activity can drive these viruses’ re-entry into the replicative lytic cycle.