cssi/SciSciGPT-SciSciNet huggingface dataset:
Application of PICC on Intravenous Administration of Children with Hematopathy and Its Nursing

[Objective]To search for the proper venous channel of the children with hematopathy,prevent and diminish the phlebitis caused by chemotherapy.[Methods]8 children with hematopathy were administered through ducts by Peripherally Inserted Central Catheter(PICC).[Results]The success rate of tube insertion was 100%,and all the children were completed the chemotherapy successfully by PICC from 30 days to 390 days.After extubation,the culture of tube cusps all showed negative.2 cases occurred mechanical phlebitis and pipe plugging.[Conclusion]PICC can alleviate pain from repeated puncture and elevate the nursing skill,it is a safe and effective therapy approach for children with hematopathy.
Determination of iodine in transgenic rapeseed with Gas chromatography

Objective:To establish a method for determination of iodine in transgenic rapeseed by gas chromatography.Methods: The rapeseed samples were carbonized,ashed,dissolved and extracted under alkaline condition to convert the organic or inorganic iodine into iodine ion,then combined with butanone to generate iodobutanone and determined by gas chromatography with ECD.Results: Minimum detection for mass concentration was 0.0072 mg/kg;The linear range was 0.02 μg/ml~0.2 μg/ml.The correlation coefficiency was r=0.9994.The recovery was 92%~99%,RSD was 3.8%~5.2%.Conclusion: The method is suitable for the determination of iodine in transgenic rapeseed.
Endocrine Disruption of Reproduction in Reptiles

Publisher Summary The endocrine system controls nearly every aspect of vertebrate life and is instrumental in regulating physiological processes such as metabolism, development, reproduction, tissue function, and behavior. The vertebrate endocrine system regulates many aspects of development, growth, and reproduction. Endocrine-disrupting chemicals (EDCs) are exogenous chemicals that mimic hormones or alter hormonal-signaling processes. These chemicals modify regulation by affecting hormone synthesis, transport, or clearance, or by altering receptor number or binding. Depending on concentration, timing, and duration of exposure, effects on physiological processes can be permanent or transient. Initially, EDC research on reptiles focused on internal concentrations of EDCs, but reptiles are now considered ideal species for the study of endocrine disruption because of their wide range of habitats, diet, parity mode, and modes of sex determination. The majority of research on reptiles focuses on species from aquatic habitats. There is a large and growing body of research on EDC actions in alligators and turtles. Little is known about the effects of EDCs on squamates. The value of reptiles as model species for endocrine disruption is broadening the knowledge of EDCs and how these chemicals affect wildlife and human public health.
A Note on Teaching About Fair Trade

Principles of economics students are often familiar with the term “fair trade” from product packaging and news stories covering ideological issues related to prices and wages paid to producers in d...
Tipos de tirano y resistencia en Francisco Suárez

El presente articulo pretende analizar la discusion que Francisco Suarez mantiene con las tesis contrarias a la distincion entre tipos de tirano en la cuestion del tiranicidio ( Defensio fidei , Libro VI, capitulo IV, numeros 10-13). Para esta vision no le es licito a una persona privada matar a ninguno de los dos tipos de tirano; solo es posible darles muerte en legitima defensa, porque se entiende que en tal caso se actua en ejercicio de autoridad publica. Suarez acaba admitiendo esta tesis en el numero 13, lo que parece contradecirse con lo sostenido en el numero 7, donde se aceptaba la muerte del usurpador por cualquier particular. Sin embargo, en el fondo mantiene la diferencia entre ambos tipos de tirano, por cuanto que en el caso del usurpador sostiene que siempre se dan las condiciones para alegar legitima defensa. Queda sin aclarar que ocurre en tal caso con las condiciones dispuestas en los numeros 8 y 9.
Online child care training in the United States: a preliminary investigation of who participates, what is offered, and on which topics the workforce is focusing

Current US policies call for a child care teacher workforce that can support program quality and enhance infants’, toddlers’, and preschoolers’ learning and development. Given minimal state pre-hire requirements, this context has implications for the workforce’s in-service training. Yet, there is limited research on who participates in training, the focus of what is offered, and variations in participation rates across topics. Also needed is a better understanding of the role online training might play in meeting the workforce’s in-service needs. To address these interrelated issues, I present descriptive analyses of a convenience sample of aggregate data from a US-wide online child care training provider. Enrollees’ ages and education levels reflect the larger child care workforce. The majority of the offered training is at the beginner level and 1 h in duration. Since 2010, enrollees completed an average of 10–12 online training hours annually. Roughly one-third of the completed training was related to planning a safe, healthy learning environment. These findings suggest the need for more rigorous research on child care workforce participation in training, particularly related to the extent to which online training can respond to policies aimed at enhancing workforce capacity to support program quality and young children’s learning and development.
PIE: A prior knowledge guided integrated likelihood estimation method for bias reduction in association studies using electronic health records data.

Objectives This study proposes a novel Prior knowledge guided Integrated likelihood Estimation (PIE) method to correct bias in estimations of associations due to misclassification of electronic health record (EHR)-derived binary phenotypes, and evaluates the performance of the proposed method by comparing it to 2 methods in common practice. Methods We conducted simulation studies and data analysis of real EHR-derived data on diabetes from Kaiser Permanente Washington to compare the estimation bias of associations using the proposed method, the method ignoring phenotyping errors, the maximum likelihood method with misspecified sensitivity and specificity, and the maximum likelihood method with correctly specified sensitivity and specificity (gold standard). The proposed method effectively leverages available information on phenotyping accuracy to construct a prior distribution for sensitivity and specificity, and incorporates this prior information through the integrated likelihood for bias reduction. Results Our simulation studies and real data application demonstrated that the proposed method effectively reduces the estimation bias compared to the 2 current methods. It performed almost as well as the gold standard method when the prior had highest density around true sensitivity and specificity. The analysis of EHR data from Kaiser Permanente Washington showed that the estimated associations from PIE were very close to the estimates from the gold standard method and reduced bias by 60%-100% compared to the 2 commonly used methods in current practice for EHR data. Conclusions This study demonstrates that the proposed method can effectively reduce estimation bias caused by imperfect phenotyping in EHR-derived data by incorporating prior information through integrated likelihood.
Sparsifying machine learning models identify stable subsets of predictive features for behavioral detection of autism

Autism spectrum disorder (ASD) diagnosis can be delayed due in part to the time required for administration of standard exams, such as the Autism Diagnostic Observation Schedule (ADOS). Shorter and potentially mobilized approaches would help to alleviate bottlenecks in the healthcare system. Previous work using machine learning suggested that a subset of the behaviors measured by ADOS can achieve clinically acceptable levels of accuracy. Here we expand on this initial work to build sparse models that have higher potential to generalize to the clinical population. We assembled a collection of score sheets for two ADOS modules, one for children with phrased speech (Module 2; 1319 ASD cases, 70 controls) and the other for children with verbal fluency (Module 3; 2870 ASD cases, 273 controls). We used sparsity/parsimony enforcing regularization techniques in a nested cross validation grid search to select features for 17 unique supervised learning models, encoding missing values as additional indicator features. We augmented our feature sets with gender and age to train minimal and interpretable classifiers capable of robust detection of ASD from non-ASD. By applying 17 unique supervised learning methods across 5 classification families tuned for sparse use of features and to be within 1 standard error of the optimal model, we find reduced sets of 10 and 5 features used in a majority of models. We tested the performance of the most interpretable of these sparse models, including Logistic Regression with L2 regularization or Linear SVM with L1 regularization. We obtained an area under the ROC curve of 0.95 for ADOS Module 3 and 0.93 for ADOS Module 2 with less than or equal to 10 features. The resulting models provide improved stability over previous machine learning efforts to minimize the time complexity of autism detection due to regularization and a small parameter space. These robustness techniques yield classifiers that are sparse, interpretable and that have potential to generalize to alternative modes of autism screening, diagnosis and monitoring, possibly including analysis of short home videos.
Testing the right skill: Evidence to support testing translation ability

In the United States Government (USG), language-test scores in the various skills are defined by reference to the Interagency Language Roundtable (ILR) Skill Level Descriptions (SLDs). The ILR SLDs for Translation Performance state that reading the source language (SL) and writing the target language (TL) are prerequisites for translating but add that there is a prerequisite third skill, termed “congruity judgement”. Since the Language Testing and Assessment Unit (LTAU) of the Federal Bureau of Investigation (FBI) uses the ILR as the basis for its translation testing, it has conducted several studies on test results to discover the interconnection, if any, of these requisites.
Morphological responses to competition modulated by abiotic factors in two monoculture-forming wetland plants

Abstract We investigated the relative roles of competition and environmental stressors in two wetland plants important for coastal restoration in the northern Gulf of Mexico. Phragmites australis and Schoenoplectus deltarum are ubiquitous in tidal freshwater marshes along the northern Gulf of Mexico coast. Schoenoplectus deltarum and Phragmites australis were grown in both monoculture and competition, and subjected to two levels each of nitrogen, salinity, and soil organic matter in a factorial greenhouse experiment. Productivity in both species was consistently suppressed under competition; the extent of this depended on the abiotic treatments. In monoculture, Schoenoplectus productivity responded negatively to low organic matter and reproduction responded negatively to brackish water; Phragmites productivity responded negatively to increased nitrogen. Schoenoplectus root-to-shoot ratio responded positively to brackish water when grown in soil with high organic matter, and Phragmites root-to-shoot ratio responded negatively to increased nitrogen. The sediment diversion operation strategy that has been recommended by experts familiar with Louisiana coastal wetland restoration may result in marshes characterized by increased nitrogen, periodic brackish water conditions, and increased soil organic matter. Such a strategy may therefore promote species coexistence and increased root production, which are respectively associated with increased ecosystem services and soil stability. The differential responses of the two species to the same conditions illustrates the importance of considering individual species to a restoration project.
The Effect of Plan Type and Comprehensive Medication Reviews on High-Risk Medication Use.

BACKGROUND: In 2007, the Centers for Medicare & Medicaid Services (CMS) instituted a star rating system using performance outcome measures to assess Medicare Advantage Prescription Drug (MAPD) and ...
Smartphone-Based in-Gel Loop-Mediated Isothermal Amplification (gLAMP) System Enables Rapid Coliphage MS2 Quantification in Environmental Waters.

Model coliphages (e.g., ΦX174, MS2, and PRD1) have been widely used as surrogates to study the fate and transport of pathogenic viruses in the environment and during wastewater treatment. Two groups of coliphages (F-specific and somatic) are being explored as indicators of viral fecal pollution in ambient water. However, the detection and quantification of coliphages still largely rely on time-consuming culture-based plaque assays. In this study, we developed an in-gel loop-mediated isothermal amplification (gLAMP) system enabling coliphage MS2 quantification within 30 min using standard laboratory devices. Viral particles (MS2) were immobilized with LAMP reagents in polyethylene glycol hydrogel, and then viral RNAs were amplified through a LAMP reaction. Due to the restriction effect of the hydrogel matrix, one viral particle would only produce one amplicon dot. Therefore, the sample virus concentrations can be determined based on the number of fluorescent amplicon dots using a smartphone for imaging. Th...
Polydyne displacement interferometer using frequency-modulated light

A radio-frequency Frequency-Modulated (FM) signal is used to diffract a He-Ne laser beam through an Acousto-Optic Modulator (AOM). Due to the modulation of the FM signal, the measured spectra of the diffracted beams comprise a series of phase-synchronized harmonics that have exact integer frequency separation. The first diffraction side-beam emerging from the AOM is selected by a slit to be used in a polydyne displacement interferometer in a Michelson interferometer topology. The displacement measurement is derived from the phase measurement of selected modulation harmonic pairs. Individual harmonic frequency amplitudes are measured using discrete Fourier transform applied to the signal from a single photodetector. Phase signals are derived from the changes in the amplitudes of different harmonic pairs (typically odd-even pairs) with the phase being extracted using a standard quadrature method. In this study, two different modulation frequencies of 5 and 10 kHz are used at different modulation depths. The measured displacements by different harmonic pairs are compared with a commercial heterodyne interferometer being used as a reference for these studies. Measurements obtained from five different harmonic pairs when the moving mirror of the interferometer is scanned over ranges up to 10 μm all show differences of less than 50 nm from the reference interferometer measurements. A drift test was also used to evaluate the differences between the polydyne interferometer and reference measurements that had different optical path lengths of approximately 25 mm and 50 mm, respectively. The drift test results indicate that about half of the differences can be attributed to temperature, pressure, and humidity variations. Other influences include Abbe and thermal expansion effects. Rough magnitude estimates using simple models for these two effects can account for remaining observed deviations.
Silk nanostructures based on natural and engineered self-assembly

Abstract: Self-assembly processes are ubiquitous in natural systems, and can enable the harnessing of unique properties for engineering new materials from the bottom up. Here we present the current understanding on the self-assembly of silks as exhibited by various silk protein solutions, notably those of silkworms and orb-weaving spiders. Such proteins have been employed to form a variety of nanostructures ranging from random fractal assemblies to well-defined nanoparticles. We discuss mechanisms of natural and engineered self-assembly in silk proteins (native fibroin, sericin and recombinant proteins) and focus on self-assembly research undertaking the fabrication of diverse architectures along with their potential applications.
Dietary fat, eicosanoids, and immunity

Publisher Summary This chapter discusses dietary fat, eicosanoids, and immunity. The immune system is a system of organs, the circulatory lymphatics, the cells comprising these, and the multitude of molecules involved in the immune response. The response has a dual nature, although the two branches of the response are intimately intertwined. The responses are because of two major subclasses of lymphocytes, the T and the B cells, which both arise from the pluripotential cells of the bone marrow. Both have the ability to acquire a memory of encounters with specific antigens. The other branch of the immune response involves the B cells, which are also stem cell in origin and mature in the bone marrow, liver and gut, and in the bursa of Fabricius in the chicken. They are primarily activated by bacteria and undergo further differentiation into mature B cells. The chapter also discusses the role of phagocytes. There are two major classes of phagocytes in man, the circulating phagocytes that include monocytes and granulocytes, and the fixed phagocyte that are mainly macrophages.
Promoting Diversity in the Cytoskeleton through STEM-Structural Transitions and Energetics of Microtubule Subunits.

All microtubules assemble from tubulin subunits, but the functional impact of tubulin isotypes has been unclear. Reporting in Developmental Cell, Chaaban et al. (2018) and Ti et al. (2018) show that tubulin isotypes differ in their conformational flexibility, which alters microtubule dynamics and architecture, yet maintain "lock-and-key" interactions with neighbors.
Adjustments to the Annotated zoogeography of non-marine Tardigrada. Part III: North America and Greenland by Kaczmarek, Michalczyk McInnes (Zootaxa 4203).

The art of biogeography starts with two basic questions: WHERE has each species been found and WHICH species have been found there. While using the Annotated zoogeography of non-marine Tardigrada. Part III: North America and Greenland (Kaczmarek, et al . 2016) we found that 26 non-standard state and province abbreviations had been used in the WHERE table and that there was no WHICH table. We present an adjusted WHERE table and add a WHICH table as a supplement to the original paper.
Variation in collagenase Clostridium histolyticum practice patterns: a Survey of ISSM Members.

Collagenase clostridium histolyticum (CCH, Xiaflex, Xiapex) is the only FDA-approved medication for treatment of Peyronie’s disease. It is unclear how practitioners actually use CCH in their own practices. The objectives of the study were: (1) to identify variability in practice patterns for CCH among practitioners, (2) to assess adherence to the package insert instructions, and (3) to evaluate whether provider satisfaction was associated with adherence to instructions. A 30-question online survey was distributed to 1270 members of the International Society for Sexual Medicine (ISSM) from the EU, USA, Canada and Australia. Of the 30 questions, 10 survey questions had only one response consistent with the CCH package insert recommendations. An “adherence” score was calculated for each survey participant depending on how many of these questions were answered correctly. The average adherence scores of various groups were compared using a student’s t-test. A chi-squared test was used to determine association between categorical variables. Of 202 total responses, 132 practitioners reported using CCH out of 1270 ISSM members from countries where CCH is available (10.4% response rate). Practitioners from outside the USA were more likely to be satisfied with CCH (p = 0.006), and more experienced users (>20 uses) were more likely to be satisfied than less experienced users (<10 uses) (p = 0.046). Satisfied users of CCH did not have significantly different adherence scores than non-satisfied users. Even though 67% of practitioners believed they followed the package insert guidelines, only 11% adhered to all the recommendations evaluated by the survey. Treatment adherence to package insert guidelines does not appear to be associated with provider satisfaction. We believe there is utility in seeing a snapshot of these practice patterns so practitioners may feel more comfortable adapting their own practice in light of newer data supporting alternative administration methods.
Task Oriented Data Exploration with Human-in-the-Loop. A Data Center Migration Use Case.

Data exploration is a task that inherently requires high human interaction. The subject matter expert looks at the data to identify a hypothesis, potential questions, and where to look for answers in the data. Virtually all data exploration scenarios can benefit from a tight human-in-the-loop paradigm, where data can be visualized and reshaped, but also augmented with missing semantic information - that the subject matter expert can supplement in itinere. In this demo we show a novel graph-based data exploration model where the subject matter expert can annotate and maneuver the data to answer specific questions. This demo specifically focuses on the task of migrating data centers, logically and/or physically, where the subject matter expert needs to identify the function of each node - a server, a virtual machine, a printer, etc - in the data center, which is not necessarily directly available in the data and to be able to plan a safe switch-off and relocation of a cluster of nodes. We show how the novel human-in-the-loop data exploration and enrichment paradigm helps designing the data center migration plan.
Access to colorectal cancer screening and treatment: Rural-urban disparity in availability of gastroenterologists, surgeons, and oncologists.

e17534 Background: Although early detection of colorectal cancer using colonoscopy and its treatment can improve outcomes, geographic proximity may influence access to these services. We sought to ...
Fat, Obesity, and the Endothelium

Endothelial cells line all blood vessels in vertebrates. These cells contribute to whole-body nutrient distribution in a variety of ways, including regulation of local blood flow, regulation of trans-endothelial nutrient transport, and paracrine effects. Obesity elicits dramatic whole-body nutrient redistribution, in particular of fat. We briefly review here recent progress on understanding endothelial fat transport; the impact of obesity on the endothelium; and, conversely, how endothelial function can modulate obesity.
Critical Appraisal of Qualitative Studies of Muslim Females' Perceptions of Physical Activity Barriers and Facilitators.

Muslim women’s perceptions of cultural, religious, and secular determinants of physical activity have been studied for many years, with information typically acquired through focus groups or interviews. Multiple reviews synthesizing the research have been published, however, individual studies have not been scrutinized for their quality/rigor. Therefore, I critically appraised the quality of the body of qualitative research studies that utilized focus groups to identify Muslim women’s perceptions of physical activity barriers and facilitators. I utilized 26 items from the Consolidated Criteria for Reporting Qualitative Research (COREQ) to assess the quality of 56 papers published between 1987 and 2016. Using crosstabulations, I also examined associations between paper quality (low vs. high) and binary categorical variables for impact factor, maximum paper length allowed, publication year, and database the paper was indexed. Overall, papers averaged only 10.5 of 26 COREQ reporting criteria and only two out of 26 items were reported in more than 75% of the papers. Paper quality was not associated with impact factor and length. High quality papers were more likely published more recently (i.e., 2011 or later) and in journals indexed in the PubMed database compared to low quality papers. There is contention among qualitative researchers about standardizing reporting criteria, and while the trend in quality appears to be improving, journal reviewers and editors ought to hold authors to greater accountability in reporting.
Playing in the Non-representational Mode of Thinking: A Comparison of Derrida, Dōgen, and Zhuangzi

The representational mode of thinking assumes a correspondence between appearance and reality that is supported by a metaphysical edifice. This way of thinking uses the metaphor of the mirror, whic...
Anterior Cruciate Ligament Reconstruction in High School and College-Aged Athletes: Does Autograft Choice Influence Anterior Cruciate Ligament Revision Rates?

Background:Physicians’ and patients’ decision-making process between bone–patellar tendon–bone (BTB) and hamstring tendon autografts for anterior cruciate ligament (ACL) reconstruction (ACLR) may b...
Real-time associations between discrimination and anxious and depressed mood among sexual and gender minorities: The moderating effects of lifetime victimization and identity concealment.

Background Sexual and gender minorities (SGM) experience higher rates of depression and anxiety, which are linked to higher rates of discrimination and victimization. SGM individuals may conceal their SGM identities to decrease discrimination and victimization exposure; however, these experiences still occur, and concealment itself is often associated with greater anxiety and depression. However, it remains unclear whether lifetime victimization and identity concealment moderate the effect of day-to-day discrimination, which we evaluated in the current study using ecological momentary assessment (EMA). Methods Fifty SGM participants (Mage=21.82, SD=4.70; 84% White) completed baseline assessment (e.g., concealment and lifetime victimization) followed by EMA of daily discrimination and anxious and depressed mood for 14 days. Results As hypothesized, daily discrimination predicted momentary increases in anxious and depressed mood, b = .34, p < .001. Notably, these effects were more pronounced among individuals who reported higher levels of identity concealment, b = .25, p < .001, and previous SGM-based victimization experiences (marginally), b = .18, p = .05. Main effects of cumulative lifetime victimization and identity concealment, measured at baseline, were associated with higher ratings of anxious and depressed mood over the two-week study. Discussion While identity concealment may reduce exposure to discrimination and victimization, we found that concealment and prior victimization predict heightened reactivity to daily discrimination experiences. Additional research is needed to further explicate real-time effects of minority stress exposure, and to develop interventions that may mitigate risk among SGM individuals with prior victimization exposure and higher levels of identity concealment in particular.
Deterring rodent seed-predation using seed-coating technologies

With many degraded environments undergoing restoration efforts, there is a growing need for the optimization of direct seeding practices. Seeds planted on wildlands are often consumed by rodents, leading to reduced plant establishment. Coating seeds in rodent aversive products may prevent seed‐predation. We tested 10 seed‐coating formulations containing products expected to deter rodents, namely: ghost and cayenne pepper powders; essential oils from bergamot, neem, and pine; methyl‐nonyl‐ketone, anthraquinone, activated carbon, beta‐cyclodextrin, and a blank coating containing no rodent deterrents to serve as a control treatment. Each treatment was applied to Pseudoroegneria spicata (bluebunch wheatgrass) seeds. These seeds germinated similarly to uncoated control seeds unless the coating contained methyl‐nonyl‐ketone which reduced germination. When seeds were offered to Ord's kangaroo rats (Dipodomys ordii), they strongly avoided the treatments in favor of uncoated control seeds. Notably, the blank coating, lacking active ingredients, still elicited 99% avoidance. However, these results indicated behavior when alternative food sources are readily available, a scenario rare in nature. To address this, a second feeding experiment was conducted to observe D. ordii's behavior under calorie‐restricted conditions. D. ordii were subjected to a fast period, then offered only one treatment. Under these conditions, many subjects chose to consume coated seeds, but to a lesser degree than subjects offered control seeds. Seeds coated in ghost pepper, neem oil, and activated carbon reduced consumption by 47–50%. Given these lab results, we would expect these treatments to increase native plant establishment following the direct seeding of wildlands by protecting seeds from rodent predation.
Service utilization and chronic condition outcomes among primary care patients with substance use disorders and co-occurring chronic conditions.

Abstract Background Patients with a substance use disorder (SUD) often present with co-occurring chronic conditions in primary care. Despite the high co-occurrence of chronic medical conditions and SUD, little is known about whether chronic condition outcomes or related service utilization in primary care varies between patients with versus without documented SUDs. This study examined whether having a SUD influenced the use of primary care services and common chronic condition outcomes for patients with diabetes, hypertension, and obesity. Methods A longitudinal cohort observational study examined electronic health record data from 21 primary care clinics in Washington and Idaho to examine differences in service utilization and clinical outcomes for diabetes, hypertension, and obesity in patients with and without a documented SUD diagnosis. Differences between patients with and without documented SUD diagnoses were compared over a three-year window for clinical outcome measures, including hemoglobin A1c, systolic and diastolic blood pressure, and body mass index, as well as service outcome measures, including number of encounters with primary care and co-located behavioral health providers, and orders for prescription opioids. Adult patients (N = 10,175) diagnosed with diabetes, hypertension, or obesity before the end of 2014, and who had ≥2 visits across a three-year window including at least one visit in 2014 (baseline) and at least one visit occurring 12 months or longer after the 2014 visit (follow-up) were examined. Results Patients with SUD diagnoses and co-occurring chronic conditions were seen by providers more frequently than patients without SUD diagnoses (p's Discussion Despite the higher visit rates to providers in primary care, a majority of patients with SUD diagnoses and chronic medical conditions in primary care did not get seen by co-located behavioral health providers, who can potentially provide and support evidence informed care for both SUD and chronic conditions. Patients with chronic medical conditions also were more likely to get prescribed opioids if they had an SUD diagnosis. Care pathway innovations for SUDs that include greater utilization of evidence-informed co-treatment of SUDs and chronic conditions within primary care settings may be necessary for improving care overall for patients with comorbid SUDs and chronic conditions.
Blood transfusions in mass casualty events: recent trends.

BACKGROUND AND OBJECTIVES The US AABB disaster task force recommends estimating 3 RBC units per admission (UPA) for mass casualty events (MCEs). In a previous analysis, median MCE UPA were 2·7 RBCs, 1·2 plasmas and 0·27 platelet doses (Vox Sang 2017; 112:648). Additional recent data were sought from the current era of balanced massive transfusion protocols (bMTPs). MATERIALS AND METHODS Publications in English from 1980 to 2020 were reviewed for MCEs using ≥50 RBCs/event and with numbers of admissions available. MCE reports were stratified by era and event-wide or trauma-centre source. The bMTP era included all MCEs since 2010 plus a 2008 bMTP military report. STATISTICS Mann-Whitney test. RESULTS Thirty-two MCEs met analysis criteria. Event-wide reports used medians [interquartile ranges] of 1·8 [1·2-3·9] RBC, 0·6 [0·3-0·9] plasma and 0·14 [0·06-0·26] platelet-dose UPA. Trauma centres transfused 3·4 [2·7-6·3] RBC, 2·4 [1·3-4·1] plasma and 0·41 [0·34-0·50] platelet-dose UPA, all P < 0·05 vs event-wide. Same-event median post-day-1 transfusions were 50% of day-1 use for RBC, 28% for plasma and 16% for platelets. Compared to prior years, the median plasma/RBC transfusion ratio rose from 0·28 to 0·67 in the bMTP era (P < 0·01). In recent mass shootings, trauma centres transfused up to 42 platelets (range 0·45-0·57 UPA) on day 1. CONCLUSION Based on available mass casualty data, we recommend planning for 3 RBC, 1 plasma and one-fourth platelet-dose units per admission for blood centres (event-wide), and 6, 4 and one-half UPA, respectively, for trauma centres, which have seen rising plasma usage and large mass-shooting platelet needs.
Midterm Outcomes for Valve-in-Valve Transcatheter Aortic Valve Replacement in the Failed Freestyle Bioprosthesis

Background Valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) is acceptable in patients at high risk for reoperation. Studies suggest that ViV TAVR in stentless valves may be technically more challenging. This study sought to evaluate midterm outcomes for ViV TAVR in the degenerative Freestyle ((Medtronic, Minneapolis, MN)) stentless bioprosthesis. Methods Between October 2014 and January 2019, 56 patients underwent ViV TAVR for a failed Freestyle valve at a single institution using a commercially available self-expanding transcatheter aortic valve. Patient baseline characteristics and clinical outcomes data were collected retrospectively. Valve Academic Research Consortium-2 definitions were applied. Results Mean patient age was 75 ± 8 years and The Society of Thoracic Surgeons mean risk score was 9% ± 8%. The predominant mode of Freestyle valve failure was regurgitation (77%), and 36 patients (64%) required urgent intervention for refractory acute heart failure. Device success using a self-expanding TAVR was 82%, with 6 cases (11%) requiring deployment of two transcatheter valves. There were 3 operative mortalities (5%). At 30-day follow-up, no patient had greater than moderate perivalvular regurgitation. Device success was higher in the later patients compared with patients done earlier (P = .02). Mean aortic valve gradients at 30 days and 1 year were 11 ± 8 and 9 ± 8 mm Hg, respectively. For patients alive beyond day 30, 3-year survival was 82%. Conclusions Performing ViV TAVR in the Freestyle valve using a self-expanding transcatheter valve presents a technical challenge, but may be feasible with good midterm results. Procedural success is associated with an early hazard learning curve.
Introduction: Establishing National Identity and the Purpose of Higher Education in the United States

The goal of this research is to reveal the relegation of the public into specific social classes based on the expectations of the capital produced in two- and four-year institutions respectively, the differences and ultimate bifurcation across class lines that replicate and reinforce an inequitable national identity, ultimately creating a discrepancy in the purpose of higher education by institution type. To uncover the varieties of roles prescribed to tertiary institutions and the resulting inequality, the discourse historical approach, a method employed by critical discourse analysts to uncover the ideological nature of language to understand the influence and power of discourse, is used to analyze 1793 texts. Texts analyzed include public speeches regarding higher education by US presidents from 1946 to 2016 and articles regarding institutional purpose from the American Association of Community Colleges and the Association of American Colleges and Universities’ respective publications which serve as representations of institution types studied.
Emergence and Evolution of a Prevalent New SARS-CoV-2 Variant in the United States

Abstract Genomic virus surveillance can lead to early identification of new variants and inform proper response during a pandemic. Using this approach, we have identified a new variant of the SARS-CoV-2 virus that emerged in the United States (U.S.) early in the coronavirus disease (COVID-19) pandemic and has become one of the most prevalent U.S variants. This new variant within the B.1.2 lineage referred to here as 20C-US, has not yet spread widely to other countries. The earliest 20C-US genomes can be traced to the southern U.S. in late May of 2020. A major early event was the rapid acquisition of five non-synonymous mutations. The changes carried by 20C-US include mutations to genes involved in virus particle maturation and release, processing of viral proteins, and RNA genome integrity and translation genes, all important for efficient and accurate virus production. In addition, 20C-US has since acquired two new non-synonymous mutations that highlight its ongoing evolution, one of which is a Q677H mutation in the spike protein adjacent to the furin cleavage site. We predict that 20C-US may already be the most dominant variant of SARS-CoV-2 in the U.S. The ongoing evolution of 20C-US, as well as other dominant region-specific variants emerging around the world, should continue to be monitored with genomic, epidemiologic, and experimental studies to understand viral evolution and predict future outcomes of the pandemic.
Defining risk factors for adding-on in Lenke 1 and 2 AR curves

To identify curve/correction characteristics associated with adding-on at 2 years after posterior spinal fusion (PSF) in Lenke 1/2 AR curves. A prospective multicenter registry was queried to identify patients with adolescent idiopathic scoliosis (AIS), Lenke 1/2 AR curves, who underwent PSF with a minimum of 2-year follow-up. Patient characteristics as well as pre- and post- operative radiographic variables were evaluated using Classification and Regression Tree (CART) analysis to determine which factors contribute to adding-on. 253 patients treated with PSF were assessed for adding-on, of which 50 met our adding-on criteria. Univariate analysis revealed adding-on was associated several factors including: post-operative thoracic and lumbar curve magnitude (p > 0.001), first erect (FE) end instrumented vertebra (EIV) angulation (p = 0.009) and EIV translation (p = 0.001), younger age (p = 0.027), Risser stage (p = 0.024), and a more proximal lowest instrumented vertebra (LIV) (p 0.5°). In Lenke 1 and 2 AR curves, pre-operative LIV translation appears to be an independent risk factor for adding-on; and in those with < 2.7 cm of LIV translation, FE LIV angulation also seems to increase the risk of adding-on. These factors are relevant in determining appropriate LIV selection and aid in identifying patients at risk for developing adding-on.
Editorial Comment: Contrast-Enhanced Ultrasound of the Brain-Potential Applications in the Neonatal ICU.

This Editorial Comment discusses the following AJR article: Feasibility and Safety of Neonatal Brain Contrast-Enhanced Ultrasound: A Prospective Study Using MRI as Reference Standard.
Visualization of Material Flow in Friction Extrusion

Friction extrusion is a solid state process which can produce high quality wire or fully consolidated bulk material from metal chips or powders. In order to improve understanding of consolidation and extrusion and help to validate numerical simulations, material flow visualization experiments were conducted using a marker insert technique (MIT). Results show that marker material can be traced when it is placed in an initially consolidated charge. The deformation is consistent with the extrusion ratio at the center of the extruded wire and considerably larger away from the center.
Not Too Hot to Handle

The properties of hot melts--from volcanic lava to liquid steel--are difficult to investigate with standard techniques. In his Perspective, [Kieffer][1] stresses the advantages of modern spectroscopic methods for elucidating the properties of such melts. He highlights the report by [ Sinn et al .][2] of inelastic x-ray scattering on levitated samples, which overcomes many of the experimental problems. Together with computer simulations, these experiments are providing detailed insights into the molecular properties of hot melts. [1]: http://www.sciencemag.org/cgi/content/full/299/5615/1998 [2]: http://www.sciencemag.org/cgi/content/full/299/5615/2047
Temperature profile around a basaltic sill intruded into wet sediments

Abstract The transfer of heat into wet sediments from magmatic intrusions or lava flows is not well constrained from field data. Such field constraints on numerical models of heat transfer could significantly improve our understanding of water–lava interactions. We use experimentally calibrated pollen darkening to measure the temperature profile around a basaltic sill emplaced into wet lakebed sediments. It is well known that, upon heating, initially transparent palynomorphs darken progressively through golden, brown, and black shades before being destroyed; however, this approach to measuring temperature has not been applied to volcanological questions. We collected sediment samples from established Miocene fossil localities at Clarkia, Idaho. Fossils in the sediments include pollen from numerous tree and shrub species. We experimentally calibrated changes in the color of Clarkia sediment pollen and used this calibration to determine sediment temperatures around a Miocene basaltic sill emplaced in the sediments. Results indicated a flat temperature profile above and below the sill, with T > 325 °C within 1 cm of the basalt-sediment contact, near 300 °C at 1–2 cm from the contact, and ~ 250 °C at 1 m from the sill contact. This profile suggests that heat transport in the sediments was hydrothermally rather than conductively controlled. This information will be used to test numerical models of heat transfer in wet sediments on Earth and Mars.
Cortisol modification of HeLa 65 alkaline phosphatase. Decreased phosphate content of the induced enzyme.

Alkaline phosphatase activity of HeLa cells is increased 5–20-fold during growth in medium with cortisol. The increase in enzyme activity is due to an enhanced catalytic efficiency rather than an increase in alkaline phosphatase protein in induced cells. In the present study the chemical composition of control and induced forms of alkaline phosphatase were investigated to determine the enzyme modification that may be responsible for the increased catalytic activity. HeLa alkaline phosphatase is a phosphoprotein and the induced form of the enzyme has approximately one-half of the phosphate residues associated with control enzyme. The decrease in phosphate residues of the enzyme apparently alters its catalytic activity. Other chemical components of purified alkaline phosphatase from control and induced cells are similar; these include sialic acid, hexosamine and sulfhydryl residues.
A neural network approach to 3D object identification and pose estimation

A multistage concurrently processing artificial neural network is proposed to identify 3D unoccluded objects from arbitrary viewing angles and to estimate their poses. 3D moment invariants are used to generate feature vectors from 2-1/2D range images. Objects are recognized via moment invariants which are invariant to translation, scaling, and rotation. The proposed network is divided into two stages, the feature extraction stage and the feature detection stage, to generate moment invariants and detect the input features, respectively. Experimental results show that objects coded by 3D moment invariant features can always be satisfactorily classified and estimated by the proposed neural network. >
Empowering Students for Community Organization Practice

Abstract Community organization courses often focus on discussions of collaboration and campaign strategies. Seldom are students taught how to carry out the tactics needed to enact these strategies. In addition, community organization courses typically minimize the importance of the confrontation tactics that are often necessary to achieve social change. The author describes methods used for classroom instruction in power analysis and confrontation politics.
Trustworthy services and the biological analogy

Biological systems survive through a combination of redundancy, diversity and modularity. It has been argued that these principles can also be applied to construct information services that survive a variety of hostile attacks, including even the compromise of computers that help implement the service. Despite nearly 30 years of research to advance these principles and to apply them to the construction of trustworthy services, each remains an active and fruitful topic of research. In this talk we will describe recent progress in achieving redundancy, diversity and modularity, and in using these to implement trustworthy services. This progress, we will argue, is paving the way to next-generation services that are significantly more resilient than today's. We will also discuss challenges that remain in achieving this goal.
Abstract 9387: A Better Personalized Prediction for International Normalized Ratio Levels in Inpatients Receiving Warfarin

Objectives: The objectives of this study were: 1) to test the effectiveness of a novel prediction method for International Normalized Ratio (INR) levels in inpatients receiving warfarin therapy; 2) to compare the prediction accuracy between this method and existing methods. Methods: We developed a novel personalized pharmaco-kinetic and pharmaco-dynamic (PKPD) model to predict the trajectory of INRs over time. We tested this model on 60 inpatient cases in New York Presbyterian Hospital from 2012 to 2013 using two different methods. The first method (fixed horizon) predicts future INR levels by the initial five observed INRs; the second method (rolling horizon) makes predictions based on the latest five observed INRs on a rolling basis. Prediction accuracy is evaluated by the Absolute Percentage Prediction Error (PAPE), which is |Predicted INR - Actual INR|/Actual INR. Results: A personalized INR prediction example: Summary statistics for prediction errors: Conclusions: The rolling horizon method continuou...
Independent isolates of the emerging subgroup J avian leukosis virus derive from a common ancestor.

A new subgroup of avian leukosis virus (ALV) that includes a unique env gene, designated J, was identified recently in England. Sequence analysis of prototype English isolate HPRS-103 revealed several other unique genetic characteristics of this strain and provided information that it arose by recombination between exogenous and endogenous virus sequences. In the past several years, ALV J type viruses (ALV-J) have been isolated from broiler breeder flocks in the United States. We were interested in determining the relationship between the U.S. and English isolates of ALV-J. Based on sequence data from two independently derived U.S. field isolates, we conclude that the U.S. and English isolates of ALV-J derive from a common ancestor and are not the result of independent recombination events.