cssi/SciSciGPT-SciSciNet huggingface dataset:
Conscience Wars in Transnational Perspective: Religious Liberty, Third-Party Harm, and Pluralism

Those who believe contraception, abortion, and same-sex relationships are sinful are increasingly seeking religious exemptions from laws protecting these practices. This essay examines the spread of these culture-war conscience claims in the United States and across borders.In the wake of the U.S. Supreme Court’s decision in Obergefell v. Hodges recognizing same-sex couples’ right to marry, government officials have objected to marrying same-sex couples and businesses have objected to providing them goods and services. Opponents of abortion and contraception have also turned to claims of conscience and religious liberty in challenging the Affordable Care Act, as the Court’s recent decisions in Burwell v. Hobby Lobby Stores and Zubik v. Burwell illustrate.Similar claims of conscience and religious liberty are appearing in Europe. These may involve objections to direct participation in the performance of abortion; or they may involve objections to complicity in the sins of another — for example, to laws that oblige the objector to refer for abortion or to sell contraception. In the LGBT context, there are analogous conscience claims involving direct participation conducting marriages or civil partnerships — as with the government registrar’s objection in Eweida and Others v. United Kingdom — or complicity in another’s sinful conduct — as with the innkeepers’ objection to renting a double-bed room to a same-sex couple in Bull v. Hall.Religious liberty claims asserted in these culture-war contexts differ from claims for the accommodation of religious ritual observance in ways that warrant principled legal response. When a person of faith seeks an exemption from legal duties to another in the belief that the citizens the law protects are sinning, granting the religious exemption can inflict material and dignitary harms on those whom the law protects. Complicity-based conscience claims, which have proliferated in conflicts over reproductive rights and LGBT equality, raise special concerns with third-party harm and threaten to undermine a workable system of religious accommodation. Employing cross-borders comparisons to illustrate, we argue that religious accommodation of claims arising in culture-war contexts serves pluralist ends only when the accommodation is structured to shield other citizens from harm.
The spectrum of low-output low-gradient aortic stenosis with normal ejection fraction

Low-flow, low-gradient (LF/LG) severe aortic stenosis (AS) with preserved ejection fraction refers to the condition of AS with aortic valve area ≤1 cm(2), stroke volume index <35 mL/m(2), mean aortic valve gradient <40 mm Hg and left ventricular ejection fraction ≥50%. This mismatch of aortic valve area suggesting severe stenosis and 'low' gradient in some patients has led to confusion as to the severity of stenosis. Conditions previously labelled as LF/LG severe AS include a spectrum, with measurement error probably being the most common cause of marked inconsistency between gradient, valve area and patient presentation. The presence of LG severe AS may be overestimated in petite patients, who may have aortic valve area slightly less than 1 cm(2)with only moderate AS. Concomitant cardiac conditions besides AS, including significant mitral and tricuspid regurgitation, intracardiac shunts and constrictive pericarditis, may contribute to reduced stroke volume, and evidence for these must be sought at the time of echocardiography. True LF/LG severe AS is associated with a unique and probably maladaptive remodelling pattern with smaller ventricles, increasing relative wall thickness, progressive worsening of diastolic function and higher afterload, as demonstrated by lower systemic arterial compliance, higher systemic vascular resistance and higher valvuloarterial impedance. Control of hypertension is essential to the appropriate management of patients with AS. Aortic valve replacement should be considered in patients with compelling evidence of severe AS who remain symptomatic despite optimal treatment of hypertension.
Discovering childhood: using fingerprints to find children in the archaeological record

Experimental replications show that ridge breadth measurements from fingerprints on archaeological artifacts can be used to estimate the age of the individual who produced the prints. While the greatest amount of variability in human ridge breadth is due to the growth during development from birth to adulthood, there is also variability due to hand and body size, sex, and ethnicity. Despite these confounding variables, the variability due to age is great enough to allow the separation of children’s prints from those of adults using ridge breadths. The utility of this measurement is illustrated with a short case study using ceramic vessels and figurines from northern Arizona. This discovery has great potential for illuminating some of the roles that children played in prehistory.
Towards anti-HIV vaccines.

Abstract There is a great deal of experience on the development and testing of antiviral vaccines but, in the case of HIV, it will be necessary to analyse carefully our understanding of the biology of the organism, the natural history and pathology of the disease (in particular immunity or resistance to infection or clinical symptoms), the possible sources of antigens and methods of formulating and administering them. Only then, and after successful initial trials, will it be possible to propose rational for their use. This article indicates how discussions will be structured and the directions in which they might go, but needs to be supplemented by much more factual information and refined with further opinions and judgements on probable outcomes.
Research on Preparation of TiC Powders by Molten Salt Electrolysis

The cathode was synthesized with TiO2,CaO and C as raw materials,and then TiC powders were prepared by electrolysis in CaCl2-NaCl mixed molten salt.The resultant cathode and its electrolytic product were characterized by SEM,EDX and XRD.The results show that under 1 300 ℃ sintering temperature and 2hsintering duration,CaTiO3-C compound with favorable electrical conductivity and strength can be obtained to meet the requirement of molten salt electrolysis for cathode.With the resultant compound as cathode,TiC powders with irregular spheroidal distribution and uniform particle sizes can be obtained by molten salt electrolysis.
Pressure-flow behavior of pulmonary interstitium.

A method to measure the pressure-flow behavior of the interstitium around large pulmonary vessels is presented. Isolated rabbit lungs were degassed, and the air spaces and vasculature were inflated with a silicon rubber compound. After the rubber had hardened the caudal lobes were sliced into 1-cm-thick slabs. Two chambers were bonded to opposite sides of a slab enclosing a large blood vessel and were filled with saline containing 3 g/dl albumin. The flow through the interstitium surrounding the vessel was measured at a constant driving pressure of 5 cmH2O and at various mean interstitial pressures. Flow decreased with a reduction of mean interstitial pressure and reached a limiting minimum value at approximately -9 cmH2O. The pressure-flow behavior was analyzed under the assumptions that the interstitium is a porous material described by a single permeability constant that increases with hydration and that the expansion of the interstitium with interstitial pressure was due to the elastic response of the surrounding rubber compound. This resulted in an interstitial resistance (reciprocal of permeability constant) of 1.31 +/- 1.03 (SD) cmH2O.h.cm-2 and a ratio of interstitial cuff thickness to vessel radius of 0.022 +/- 0.007 (SD), n = 11. The phenomenon of flow limitation was demonstrated by holding the upstream pressure constant at 15 cmH2O and measuring the flow while the downstream pressure was reduced. The flow was limited at downstream pressures below -10 cmH2O.
Probing Binding Interactions of Agonists with the α6β2 Nicotinic Acetylcholine Receptor

The nicotinic acetylcholine receptor (nAChR) is a ligand gated ion channel and a member of the Cys-loop family, which also contains receptors for serotonin, glycine, and GABA. There are twelve known neuronal subunits which pentamerize in different combinations to form various subtypes, each with a unique function, pharmacology and distribution in the brain. The α6β2-containing subtypes are found mainly in dopaminergic neurons and are thus important targets in the study of Parkinson's disease and addiction. Advanced knowledge of the binding site, which sits at the interface of α6 and β2, could lead toward design of agonists that specifically target this subtype. The α6L9'sβ2_(LFM/AAQA)L9's (α6β2‡) construct enabled heterologous expression and activation of a pure and stoichiometrically controlled population of α6β2 receptors in X. laevis oocytes. Currents were high enough in the α6β2‡ system to tolerate nonsense suppression-based non-canonical amino acid mutagenesis, which allowed for structure function studies between the receptor and several agonists. Initial structure-function studies probed for a cation-π interaction between agonists and the indole side chain of α6 TrpB. This is accomplished using an analog-tryptophan series whereby the negative electrostatic potential on the surface the indole ring was incrementally decreased via electron-withdrawing substituents such as fluorine and measuring the effect that has on binding. Results show that ACh makes a cation-π interaction, but surprisingly nicotine and TC-299423 do not. However, the latter two agonists do make a hydrogen bond interaction with the carbonyl of TrpB. This conclusion was made by substituting the adjacent amino acid with an alpha-hydroxy acid and measuring the corresponding shift in binding due to that amide-to-ester backbone mutation. The result was further quantified for nicotine in a double-mutant cycle analysis utilizing N’-methylnicotinium, which showed the interaction to have a coupling energy of ∼2 kcal/mol.
The Formation of Adaptive Coalitions

This chapter develops a framework for analyzing the interaction between individual players (actors) and collective players (coalitions) who mutually adapt the allocation of investment to their values and each other’s decisions. The dynamic process of coalition formation can be described by a coupled evolutionary game of allocation controls. Potential fields of applications are outlined, and an example analyzing the management of energy and carbon emissions is discussed in more detail.
EuSn2As2: an exfoliatable magnetic layered Zintl–Klemm phase

Despite the immense interest in magnetic, topological, and magnetoelectronic phenomena in isolated layers of 2D materials and their vertically stacked heterostructures, there remains a dearth of 2D magnetic materials that can be readily exfoliated into single layers. Here, we synthesize EuSn2As2, the first exfoliatable, layered magnetic Zintl–Klemm phase that features van der Waals bonding between neighboring layers. In these crystals, Eu2+ 4f7 spins magnetically order at 24 K and are coupled ferromagnetically within each layer and antiferromagnetically, with some potential canting, across adjacent layers. Magnetic ground state DFT calculations and temperature-dependent transport measurements on single crystals together establish that EuSn2As2 is semimetallic. Finally, we show that this material can be thinned down to a few layers having steps corresponding to SnAsEuAsSn layers via micromechanical exfoliation. This work opens up further explorations into the design, synthesis, and layer-dependent magnetic properties of exfoliatable, lanthanide-based magnetic van der Waals Zintl phases.
A Secretion-Amplification Role for Salmonella enterica Translocon Protein SipD.

The bacterial type III secretion system (T3SS) is an important target for enabling high-titer production of proteins of biotechnological interest as well as for synthetic biology applications that rely on protein delivery to host cells. The T3SS forms a membrane-embedded needle complex that is capped by the translocon proteins and extends into the extracellular space. The needle tip complex in Salmonella enterica consists of three translocon proteins: SipB, SipC, and SipD. It is known that knocking out sipD disrupts T3SS regulation to cause constitutive secretion of native proteins. However, we discovered that complementation of SipD in trans via exogenous addition to T3SS-expressing cultures further improves heterologous protein secretion titers, suggesting a previously unknown but important role for this protein. Building on this knowledge, we have engineered a hyper-secreting strain of S. enterica for a greater than 100-fold improvement in the production of a variety of biotechnologically valuable hete...
Loss of function of the homeobox gene Hoxa-9 perturbs early T-cell development and induces apoptosis in primitive thymocytes.

Abstract Hox homeobox genes play a crucial role in specifying the embryonic body pattern. However, a role for Hox genes in T-cell development has not been explored. The Hoxa-9 gene is expressed in normal adult and fetal thymuses. Fetal thymuses of mice homozygous for an interruption of the Hoxa-9 gene are one eighth normal size and have a 25-fold decrease in the number of primitive thymocytes expressing the interleukin-2 receptor (IL-2R, CD25). Progression to the double positive (CD4+CD8+) stage is dramatically retarded in fetal thymic organ cultures. This aberrant development is associated with decreased amounts of intracellular CD3 and T-cell receptor β (TCRβ) and reduced surface expression of IL-7R and E-cadherin. Mutant thymocytes show a significant increase in apoptotic cell death and premature downregulation of bcl-2 expression. A similar phenotype is seen in primitive thymocytes from adult Hoxa-9−/− mice and from mice transplanted with Hoxa-9−/−marrow. Hoxa-9 appears to play a previously unsuspected role in T-cell ontogeny by modulating cell survival of early thymocytes and by regulating their subsequent differentiation.
The Role of Fatty Acids in Cosmetic Technology

This chapter provides an overview to the use of fatty acids, fatty acid salts, and selected derivatives in cosmetic and personal care products. The important, but somewhat limited, uses of fatty acids and their salts are in soaps and as structurants in alcohol-based sticks. However, an incredibly wide array of materials have been developed over the past approximately 70 years for use in cosmetic and personal care products that are more or less derived from fatty acids—some directly and many indirectly. The selected derivatives discussed in this chapter include fatty alcohols, anionic, and nonionic surfactants based upon fatty acids, fatty amines and quaternary ammonium compounds, and fatty acid esters. An introduction to the several formulation types used in these products such as bars, pressed powders, solutions/gels, suspensions, sticks, emulsions, and aerosols is included as well as descriptions of the primary categories included in this product area. The use of fatty acids, fatty acid salts, and selected derivatives is described in terms of their function in cosmetic and personal care products and includes cleansing, use as vehicles and solvents, rheological modification of suspensions and sticks, emulsion stabilization, and surface modification of skin and hair. This chapter can only provide a brief overview of the variety of materials that have been and are being developed using fatty acids as a raw material and how these are critical to the function and esthetics of the sophisticated cosmetic and personal care products currently available. The emphasis upon sustainability will only increase the importance of plant-based fatty acids as raw materials and precursors for existing and new functional ingredients for cosmetics and personal care products.
Machine Learning Models for Prediction of Reinjury After Penetrating Trauma.

This study compares several machine learning models for prediction of reinjury after penetrating trauma.
Fulbright project focuses on rehabilitation technician education and physiotherapy practice at the Kachere Rehabilitation Centre in Malawi.

Background The aim of this project was to strengthen rehabilitation technician education and physiotherapy practice at the Kachere Rehabilitation Centre in the less-resourced country of Malawi by enlarging and reinforcing the skills of faculty, administrators, and adjunct clinicians, and fostering their continuing professional development. Methods The project was developed through a partnership with the Kachere Rehabilitation Centre (KRC), the Medical Rehabilitation College (MRC), and a US-trained physical therapist (a Fulbright Program Scholar - FPS). The elements were education of staff, faculty, and students, and administrative consultation for rehabilitation managers, educational administrators, and faculty clinicians. Results Formal and informal participant feedback on the project was positive. It indicated a receptive audience who expanded their knowledge and willingly considered ideas to modify teaching, clinical, and management approaches for optimal patient care, enhanced clinician/ student learning, meeting curricular accreditation standards, and solving day-to-day challenges. Conclusions The project made a positive impact on the participants, fostering their goal to parallel clinical practice and educational initiatives used by recognized international standard bearers. Lessons learned emphasized the power of partnerships, networking, flexibility, and creative thinking. For international physiotherapists, it is an underutilized opportunity to extend global outreach, scholarship, clinical practice, and academic knowledge in a less-resourced country eager to upgrade the background and skills of rehabilitation providers.
Data security and risk assessment in cloud computing

Cloud computing has attracted more and more attention as it reduces the cost of IT infrastructure of organizations. In our country, business Cloud services, such as Alibaba Cloud, Huawei Cloud, QingCloud, UCloud and so on are gaining more and more uses, especially small or median organizations. In the cloud service scenario, the program and data are migrating into cloud, resulting the lack of trust between customers and cloud service providers. However, the recent study on Cloud computing is mainly focused on the service side, while the data security and trust have not been sufficiently studied yet. This paper investigates into the data security issues from data life cycle which includes five steps when an organization uses Cloud computing. A data management framework is given out, including not only the data classification but also the risk management framework. Concretely, the data is divided into two varieties, business and personal information. And then, four classification levels (high, medium, low, normal) according to the different extent of the potential adverse effect is introduced. With the help of classification, the administrators can identify the application or data to implement corresponding security controls. At last, the administrators conduct the risk assessment to alleviate the risk of data security. The trust between customers and cloud service providers will be strengthen through this way.
RIGHT ATRIAL PRESSURE TO STROKE VOLUME RATIO PREDICTS ADVERSE OUTCOMES IN ADVANCED HEART FAILURE

The presence of right ventricular (RV) failure portends poor outcomes in heart failure (HF) patients. Right atrial pressure (RAP) to stroke volume (SV) ratio, (RAP/SV), is an index of RV diastolic dysfunction that is associated with adverse outcomes in transplant and pulmonary hypertension patients
Determining representative ranges of point sensors in distributed networks

Distributed networks of stationary instruments provide high temporal scope (i.e., range/resolution) observations but are spatially limited as a set of point measurements. Measurement similarity between points typically decays with distance, which is used to set interpolation distances. The importance of analyzing spatiotemporal data at equivalent spatial and temporal scales has been identified but no standard procedure is used to interpolate space using temporally-indexed observations. Using concurrent mobile and stationary active acoustic, fish density data from a tidal energy site in Puget Sound, WA, USA, six methods are compared to estimate the range at which stationary measurements can be spatially interpolated. Four methods estimate the representative range of the mean using autocorrelation or paired t-test and repeated measures ANOVA. Accuracy of resulting sensor density estimates was modeled as departures from interpolated linear and aerial estimates. Two methods were used to estimate representative range of the variance by comparing theoretical spectra or by determining equivalent spatial and temporal scales. Representative ranges of means extended from 30.57 to 403.9 m. Estimation error (i.e., standard deviation) ranges of linearly interpolated or aerially extrapolated values ranged from 42.5 to 82.3%. Representative ranges using variance measurements differed by a factor of approximately two (scale equivalence = 648.7 m, theoretical = 1388.1 m). A six-step decision tree is presented to guide identification of monitoring variables and choice of method to calculate representative ranges in distributed networks. This approach is applicable for networks of any size, in aquatic or terrestrial environments, and monitoring the mean or variance of any quantity.
Pilot study of the G-protein beta3 subunit gene (C825T) polymorphism and clinical response to Olanzapine or Olanzapine-related weight gain in persons with schizophrenia.

Background Despite advances in schizophrenia treatment, nearly 30% of patients do not respond to atypical antipsychotic agents, such as olanzapine. Furthermore, 30-60% of patients will gain significant weight during the course of olanzapine therapy. Little research has been done to investigate the relationship between antipsychotic treatment outcomes and genetic variability in second messengers coupled to serotonin (5HT) receptors. The purpose of this investigation was examine associations between the second messenger G-Protein Beta3 Subunit Gene (GNB3) C825T polymorphism and olanzapine response and weight gain treatment. Material/methods We conducted a pharmacogenetic association study to examine GNB3 genotypes in relation to olanzapine clinical response (as measured by the Brief Psychiatric Rating Scale or Scale for the Assessment of Negative Symptoms) or weight gain. Subjects included forty-two individuals meeting DSM-IV criteria for schizophrenia that started olanzapine, were titrated to a fixed dose for 6 weeks, and subsequently genotyped for this investigation. Results No statistically significant associations existed between our outcome variables and GNB3 genotypes. However we did observe trends suggesting a potential relationship between the TT genotype, response, and weight gain that warrant further investigation. Conclusions Preliminary results showed no statistical relationship between the C825T polymorphism and olanzapine response or weight gain. Numerical differences in outcome measures between the TT vs. CT/CC genotype groups indicate that G-protein second messenger systems variability coupled to primary targets of atypical antipsychotics may relate to clinical outcomes in persons with schizophrenia and that future research in this area is warranted.
Determinants of Advanced Technological Content in Technology Education Curriculum

Technology is defined and its characteristics are identified. The technological method, its components, and its relationship to other disciplines are addressed. Recommendations for advanced technology education content determination are presented. It is concluded that advanced technology curriculum should focus on the entire technological method rather than just its knowledge organizers and technological process.
Adsorption of Water on Well-Characterized Solid Surfaces

There are two aspects to the state of water at solid surfaces. One has to do with the structure and thermodynamic properties of the water in the first layers formed as water is adsorbed from the vapor phase. The other is concerned with the water structure, and usual accompanying ionic arrangement (double layer), at solid/water interfaces. The first subject will be investigated in this summary, although some of the conclusions reached no doubt should spill over into the second field, and vice versa. The first layers of adsorbed water often do not contain ions from the solid (even alkali halides are essentially hydrophobic until ions leave the lattice structure), and this absence of any or many ions is a primary difference in character of the two situations.
Residential Radon in U.S. Counties V Lung Cancer in Women Who Predominantly Never Smoked

Previous studies have found that mean-residential-radon (Rn) levels for U.S. counties are negatively associated with age-adjusted county rates of lung-cancer mortality (LCM), after adjustments for potentially confounding factors. Those results may be due to (a) confounding unaddressable by any county-level (‘ecological’) study design, or (b) county-level factors such as Rn/smoking or age/radon correlations or exposure misclassifications from the use of disparate data sources. Possibilities (b) were addressed by comparing age-specific LCM rates for white women in 2821 U.S. counties who died in 1950–54 at age 40+ (∼11% of whom ever smoked), or at age 60+ (∼% of whom ever smoked), to county Rn levels newly estimated from U.S. Rn, climatic and geological-survey data. Significant negative LCM v Rn trends were found for both age groups, after adjusting for age and subsets of 21 county-level socioeconomic, climatic and other factors. Negative trends were largest for counties with ≤ 100 Bq m−3 Rn (p ≤ 0.00087; 420 analyses). Adjusted relative risk (RRadj) for LCM was significantly elevated (1 150 Bq m−3 v 65–100 Bq m−3 Rn, most involving adjustment for climate- and education-related factors likely to have influenced exposure to indoor air contaminants such as Rn and cigarette smoke. Though inconclusive due to potential ecological-fallacy-related confounding that could not be controlled, results from this ecological study are most consistent with a U-shaped dose-response relationship between 1950–54 LCM risk and U.S. residential radon in white women who predominantly never smoked.
The Impact of Consumer Loss Aversion on Returns Policies and Supply Chain Coordination

Product return is a common after-sale service. Existing literature has assumed loss neutral consumers, while in practice consumers are often more sensitive to utility losses than gains, i.e., customers are often loss averse. In this paper, we study the impact of such loss aversion on the retailer's optimal pricing and returns policies. We analyze three scenarios where the seller offers no refund, full refund and partial refund for the returned products. Under each scenario, the seller determines the optimal price, quantity, and refund amount (under partial refund case) in order to maximize the expected profit. Our results demonstrate that consumer loss aversion leads a no-refund retailer to charge lower price and order smaller quantity, has no impact on a full-refund retailer, and results in a more lenient returns policy for a partial-refund retailer. We also find contracts that coordinate supply chains selling to loss averse consumers. Therefore, this article sheds some lights on how the management of returns policies should be adapted when consumers are loss averse.
Chapter 30 Publicly provided education

Abstract Historically, most attention in public programs has been given to the resources devoted to the activity, and resources have been used to index both commitment and quality. Education differs from other areas of public expenditure because direct measures of outcomes are available, making it is possible to consider results and, by implication, to consider the efficiency of provision. Early interpretations of the evidence, emanating from popular interpretations of the Coleman Report that “schools do not make a difference”, are incorrect, but the basic evidence behind the statement suggests serious performance problems of government supply, because purchased inputs to schools are not closely related to outcomes. This paper reviews that evidence along with providing an evaluation of the various controversial aspects including issues of causality, consumer behavior, and estimation approaches. Two detailed policy areas are discussed in terms of the evidence on performance: public versus private provision and the financing of schools.
Teaching recursion via control flow and code comprehension in CS1

This tutorial introduces how to teach recursion in the framework of function calls, assisting with the diagrams similar to dynamic flow graphs. It starts with examples showing the flow of control during a function call, followed by typical recursive examples, based on which the features and definition of recursion will be summarized.
A Nurse-Led Limited Risk Factor Modification Program to Address Obesity and Obstructive Sleep Apnea in Atrial Fibrillation Patients.

Background Obesity and obstructive sleep apnea (OSA) are associated with atrial fibrillation (AF), yet these conditions remain inadequately treated. We report on the feasibility and efficacy of a n...
Realization of Low-Cost Wide Scanning Arrays

A growing need for phased arrays in commercial markets has pushed for lower cost and much smaller arrays. Of particular interest is the delivery of high-data/high-throughput systems, including 5G connectivity. In this paper, we illustrate a design method to enable 75% lower cost aperture for a phased array, while maintaining electrical performance requirements. We are proposing a unique approach with a monolithic dielectric substrate for the aperture. Two feeding techniques are discussed for manufacturing ease and for direct integration with beamforming circuitry. Measurements for a proof-of-concept aperture are provided.
Examining Developmental Patterns of Prison Misconduct: An Integrated Model Approach:

Recent prison scholarship has employed an integrated model of the developmental/life-course perspectives and importation model to examine prison misconduct. Using longitudinal data from a large sam...
No Changes in Patient Selection and Value-Based Metrics for Total Hip Arthroplasty After Comprehensive Care for Joint Replacement Bundle Implementation at a Single Center.

Abstract Background Alternative payment models for total hip arthroplasty (THA) were initiated by the Center for Medicare and Medicaid Services to decrease overall healthcare cost. The associated shift of financial risk to participating institutions may negatively influence patient selection to avoid high cost of care (“cherry picking,” “lemon dropping”). This study evaluated the impact of the Comprehensive Care for Joint Replacement (CJR) model on patient selection, care delivery, and hospital costs at a single care center. Methods Patients undergoing a primary THA from 2015-2017 were stratified by insurance type (Medicare and commercial insurance) and whether care was provided before (pre-CJR) or after (post-CJR) CJR bundle implementation. Patient age, gender, and body mass index, Elixhauser comorbidities and American Society of Anesthesiologists scores, were analyzed. Delivery of care variables including surgery duration, discharge disposition, length of stay, and direct hospital costs were compared pre- and post-CJR. Results A total of 751 THA patients (273 Medicare and 478 commercial Insurance) were evaluated pre-CJR (29%) and post-CJR (71%). Patient demographics were similar (age, gender, BMI); however, commercially insured patients had less comorbidities pre-CJR (P = .033). Medicare patient post-CJR length of stay (P = .010) was reduced with a trend toward discharge to home (P = .019). Surgical time, operating room service time, 90-day readmissions and direct hospital costs were similar pre- and post-CJR. Conclusion There was no differential patient selection after CJR bundle implementation and value-based metrics (surgical time, operating room service time) were not affected. Patients were discharged sooner and more often to home. However, overall direct hospital expenses remained unchanged revealing that any cost savings were for insurance providers, not participating hospitals.
Stereotactic Radiosurgery in Large Intracranial Meningiomas: A Systematic Review.

Gross total resection of large intracranial meningiomas (LIMs) can be challenging and cause significant morbidity and mortality. The aim of this systematic review is to determine the clinical effectiveness and safety of stereotactic radiosurgery (SRS) either as primary or adjuvant therapy for LIMs with tumors ≥2.5 cm in maximum dimension (tumor volume ≥8.1 cm3). A total of 452 tumors in 496 patients (350 female [69.3%] and 146 male [30.6%]) with median age 60 years (48–65 years) were included. The median tumor volume at the time of diagnosis was 16.7 cm3 (10–53.3 cm3). The tumors typically were located in the skull base (77.2%), whereas only 14.6% were in the supratentorial space. The median follow-up after SRS was 54 months (18–90 months). In total, 87.8% of patients were treated with single-session (SS) Gamma Knife radiosurgery (GKS), whereas the remaining 12.1% patients received non-SS GKS. Of 452 LIMs assessed for clinical response, 45.1% showed improvement and 15.7% deteriorated after SRS. Radiographic tumor control at last follow-up (2–7.5 years) ranged from 84% to 100%. Overall, radiation-induced toxicity occurred in 23% of patients, with the most common adverse effect being cranial nerve neuropathy (5.5%) and peritumoral edema (5.3%). Subgroup analysis revealed that there is 2-fold greater likelihood of improvement in clinical symptoms in patients with non-SS GKS than SS GKS (odds ratio 2.47; 95% confidence interval 1.38–4.44; P = 0.002). SRS is safe and effective in the treatment of LIMs as primary or adjuvant treatment. Further prospective studies are required to validate our results.
Physical and Functional Constraints on Viable Belowground Acquisition Strategies

Since their emergence onto land, terrestrial plants have developed diverse strategies to acquire soil resources. However, we lack a framework that adequately captures how these strategies vary among species. Observations from around the world now allow us to quantify the variation observed in commonly-measured fine-root traits but it is unclear how root traits are interrelated and whether they fall along an "economic" spectrum of acquisitive to conservative strategies. We assessed root trait variation and mycorrhizal colonization rates by leveraging the largest global database of fine-root traits (the Fine-Root Ecology Database; FRED). We also developed a heuristic model to explore the role of mycorrhizal fungi in defining belowground exploration efficiency across a gradient of thin- to thick-diameter roots. In support of the expectations of the "root economic spectrum," we found that root diameter was negatively related to specific root length (Pearson's r=-0.76). However, we found an unexpected negative relationship between root diameter and root tissue density (Pearson's r = -0.40), and we further observed that root nitrogen content was largely unrelated to other economic traits. Mycorrhizal colonization was most closely associated with root diameter (Pearson's r = 0.62) and was unrelated to root tissue density and root nitrogen. The heuristic model demonstrated that while thinner roots have inherently greater capacity to encounter soil resources based on higher surface area per unit mass, the potential for increased associations with mycorrhizal fungi in thicker roots, combined with greater hyphal growth, can result in equally acquisitive strategies for both thin- and thick roots. Taken together, our assessments of root trait variation, trade-offs with mycorrhizal fungi, and broader connections to root longevity allowed us to propose a series of fundamental constraints on belowground resource acquisition strategies. Physical tradeoffs based on root construction (i.e., economic traits) and functional limitations related to the capacity of a root to encounter and acquire soil resources combine to limit the two-dimensional belowground trait space. Within this trait space there remains a diversity of additional variation in root traits that facilitates a wide range of belowground resource acquisition strategies.
Ethical Truths in the Discipline of Nursing

There are different paradigms in the discipline of nursing that contain theories that guide the practice, research, and education for members of the discipline. Each paradigm and nursing theory espouses ethical truths differently. The author in this article introduces the notion of teaching the ethos of humanbecoming dignity through uncovering the abiding truths of presence, existence, trust, and worth. A suggested situational teaching-learning tool is introduced to illustrate the potential uncovering of ethical truths for students of the discipline.
Kinematic Validation of Postural Sway Measured by Biodex Biosway (Force Plate) and SWAY Balance (Accelerometer) Technology

Background. The Biodex Biosway® Balance System and SWAY Balance® Mobile smartphone application (SBMA) are portable instruments that assess balance function with force plate and accelerometer technology, respectively. The validity of these indirect clinical measures of postural sway merits investigation. Purpose. The purpose of this study was to investigate the concurrent validity of standing postural sway measurements by using the portable Biosway and SBMA systems with kinematic measurements of the whole body Center of Mass (COM) derived from a gold-standard reference, a motion capture system. Study Design. Cross-sectional; repeated measures. Methods. Forty healthy young adults (21 female, 19 male) participated in this study. Participants performed 10 standing balance tasks that included combinations of standing on one or two legs, with eyes open or closed, on a firm surface or foam surface and voluntary rhythmic sway. Postural sway was measured simultaneously from SBMA, Biosway, and the motion capture system. The linear relationships between the measurements were analyzed. Results. Significant correlations were found between Biosway and COM velocity for both progressively challenging single and double leg stances (τb = 0.3 to 0.5, to ). SBMA scores had near-maximal values with zero to near-zero variance in double leg stances, indicating a ceiling effect. Conclusion. The force plate-based Biodex Biosway is valid for assessing standing postural sway for a wide range of test conditions and challenges to standing balance, whereas an accelerometer-based SWAY Balance smartphone application is valid for assessing postural sway in progressively challenging single leg stance but is not sensitive enough to detect lower-magnitude postural sway changes in progressively challenging double leg stances.
Polyphenolic Profiles of Yellow Bean Seed Coats and Their Relationship with Iron Bioavailability

Previous work with Caco-2 cell cultures has shown that individual polyphenols can either promote or inhibit iron uptake. This investigation was designed to characterize the relationship between iro...
Alveolar soft part sarcoma mimics prostate cancer metastasis.

A 61-year-old man presented to the oncology clinic with Gleason 9 (4 + 5) prostate cancer. Staging CT showed multiple nodules in both lungs. Since the lung lesions were too small for biopsy, he was started on anti-androgen therapy for suspected metastatic, hormone-sensitive prostate cancer. While his prostate-specific antigen decreased from 32 to <0.1 ng/ml, the multiple lung lesions showed no response on subsequent imaging. The patient presented during follow-up with severe right leg pain, at which time magnetic resonance imaging revealed a large, hyperintense mass in the femur. The mass was resected along with two lung nodules, with pathology demonstrating metastatic alveolar soft part sarcoma. This serves as an important reminder that lesions suspicious for metastases may be due to cancers of multiple primary origins, particularly if the pattern of metastasis is atypical or there is varied response to therapy.
Western Esotericism in Brazil: The Influence of Esoteric Thought on the Valley of the Dawn

The Brazilian religion known as the Valley of the Dawn is an international new religious movement known for its eclectic cosmology and collective rituals performed by adepts dressed in ornate garments. Headquartered outside of Brasilia, the Valley of the Dawn was founded in the 1960s by Neiva Chaves Zelaya (1925–85) a clairvoyant medium affectionately referred to as Aunt Neiva. This article highlights the work of Mario Sassi (1921–94) and the significance of esoteric thought in the development of the movement’s Doctrine. An early convert who became Aunt Neiva’s life partner, Sassi was an intellectual seeker who drew selectively on esoteric ideas popularized through theosophical and spiritist texts to interpret and systematize Aunt Neiva’s visions. Together Aunt Neiva and Mario Sassi created a Brazilian form of Western esotericism that today includes over 600 affiliated temples across Brazil and worldwide.
Physical Health, Medical Care Access, and Medical Insurance Coverage of Youth Returning Home After Incarceration: A Systematic Review

Youth reentry following incarceration is a subject of active health care policy innovation and debate. We systematically searched PubMed, CINAHL, Cochrane Library, and Google Scholar for research a...
Playing Chess with Limited Look Ahead.

We have seen numerous machine learning methods tackle the game of chess over the years. However, one common element in these works is the necessity of a finely optimized look ahead algorithm. The particular interest of this research lies with creating a chess engine that is highly capable, but restricted in its look ahead depth. We train a deep neural network to serve as a static evaluation function, which is accompanied by a relatively simple look ahead algorithm. We show that our static evaluation function has encoded some semblance of look ahead knowledge, and is comparable to classical evaluation functions. The strength of our chess engine is assessed by comparing its proposed moves against those proposed by Stockfish. We show that, despite strict restrictions on look ahead depth, our engine recommends moves of equal strength in roughly $83\%$ of our sample positions.
Mirrors for petawatt lasers: Design principles, limitations, and solutions

High intensity and high energy laser facilities place increasing demands on optical components, requiring large surface area optics with exacting specifications. Petawatt lasers are high energy, short-pulse laser systems generally based on chirped-pulse amplification, where an initial low energy short pulse is stretched, amplified, and then recompressed to produce fs to ps high-power laser pulses. In such petawatt lasers, the highest demands are placed on the final optics, including gratings which compress the pulses and mirrors which direct and focus the final high-power beams. The limiting factor in these optical components is generally laser-induced damage. Designing and fabricating these optical components to meet reflection, dispersion, and other requirements while meeting laser-induced damage requirements is the primary challenge discussed in this tutorial. We will introduce the reader to the technical challenges and tradeoffs required to produce mirrors for petawatt lasers and discuss current research directions.
Challenges to Understanding and Compliance Among Surgical Patients in Low-Income Urban Teaching Hospitals:

Financial and educational barriers significantly impact low socioeconomic status racial and ethnic minority groups in their pursuit of health care, though less is known about the interplay of these factors in the pursuit of surgical care. This study was designed to uncover the challenges to patient understanding and compliance with pre- and postsurgical clinical advice in low-income urban environments. The data for this study were collected in spoken survey with eighty patients in 9 surgery clinics at Temple University Hospital in Philadelphia. Survey responses were coded into various groups until categories emerged. Relationships among categories were identified to generate themes and subthemes. Key facilitators of patient understanding and compliance were physician likeability and communication. Eighty (100%) patients reported that the physician always treated them with respect, which was important in their interpretation of their experience with the physician. Eighteen (23%) patients identified a language other than English as their primary language and 57 (71%) patients completed high school or less schooling, which likely influenced their communication with the physician. Eighty (100%) patients expressed that the physician always explained things in a way they could understand, focusing on clarity and thoroughness. Challenges to patient understanding and compliance were finances and social resources. Patients noted difficulty paying for medical care and a lack of support at home. Agency could facilitate use of surgical care while a lack thereof could challenge motivation. Ultimately, these themes showed how patients in this environment interact with surgical care.
Digital background calibration for pipelined ADCs

Pipelined ADCs with more than 12 bits of resolution typically require linearity enhancement. This paper shows that the gain errors of both the sub DACs and interstage amplifiers in a pipelined ADC can be digitally corrected. A background calibration method is developed employing an energy free methodology for both single and multi stage errors and simulation results are presented to demonstrate the effectiveness of the proposed method.
Improving Compliance with Dyslipidemia Screening Guidelines in a Single-center U.S. Outpatient Pediatric Cardiology Clinic.

The development of atherosclerotic cardiovascular disease begins in childhood. The American Academy of Pediatrics (AAP) endorsed guidelines recommending universal hyperlipidemia screening of children ages 9-11 and again at 17-21 years. An AAP Periodic Survey of Fellows demonstrated less than half of pediatricians report adherence to these guidelines. This quality improvement initiative's objective was to improve compliance with AAP hyperlipidemia guidelines in an outpatient pediatric cardiology clinic at a single academic center to 80% over a 2-month time frame. Methods We report the results of an IRB-approved chart review at a single-center outpatient pediatric cardiology practice. We defined pediatric cardiologists' compliance as documented prior lipid screening, ordering a lipid panel, or documented recommendation for follow-up screening. Two plan-do-study-act (PDSA) cycles were undertaken. The first intervention included an informational session to provide pediatric cardiologists with AAP recommendations. The second intervention involved weekly email reminders and a statement for physicians in the electronic medical record. Results We collected data from 600 individual charts of patients seen over 35 clinic days. We received charts before the first PDSA intervention. Baseline compliance with outpatient hyperlipidemia screening was 0%. After the first PDSA cycle, the average screening rate improved to 49%. After the second PDSA cycle, the average screening rate improved to 89%, and there was a centerline shift in the data, indicating improvement. Conclusion We improved the pediatric cardiologists' compliance with the AAP-recommended hyperlipidemia screening guidelines from 0% to 89% through 2 intervention cycles. Further efforts may be required to sustain this change.