cssi/SciSciGPT-SciSciNet huggingface dataset:
The Compulsive Gambler’s Spiral of Options and Involvement

The material presented in this report is not intended as an explanation of compulsive gambling. I do not pretend to be refuting the psychoanalytic or the personality theorists. Rather, I describe the changes that take place in the career of the person turned compulsive gambler. Some of what is described here adds to the already existing knowledge of the compulsion.
The Vexing Problem of Ventilator-Associated Pneumonia: Observations on Pathophysiology, Public Policy, and Clinical Science

Ventilator-associated pneumonia (VAP) is an acquired infection related primarily to the consequences of prolonged endotracheal intubation. It is considered the most important infectious challenge in the critical care setting. Preventable complications of hospital care are considered an important source of wasted health-care costs believed to consume up to 47% of annual expenditures in the United States. Whether VAP is preventable has become a highly contentious debate since public reporting commenced a decade ago. This selective review focuses on specific aspects of this debate, including the inherent vagaries in the diagnosis of VAP and the marked disparities between VAP rates based on clinical diagnosis versus surveillance data. Also discussed is how this debate has impacted public policy, leading to the new paradigm of ventilator-associated events. The limited ability of artificial airways to prevent microaspiration and biofilm build-up, as well as non-modifiable conditions increasing the risk of VAP, is described in detail. In addition, the origins of the mistaken but widely embraced notion that zero VAP is a realistic achievement are examined.
Moving Operations and Maintenance Practices of Existing Buildings beyond Sustainability: A Case Study of the LENSES Framework during Post Occupancy

ABSTRACTThe Living Environments in Natural, Social and Economic Systems (LENSES) Framework is a tool intended to facilitate building professionals’ ability to look beyond sustainability to more regenerative approaches regardless of the building’s current phase of life. The purpose of this case study is to utilize the LENSES Framework to evaluate the degenerative, sustainable and regenerative (DSR) effects of the operations and maintenance (O/M) of an existing building. The building selected for this case study was Building 41, which is owned and operated by the General Services Administration in Denver, Colorado. Results of this study indicate that Building 41 is most regenerative through the actions of its occupants, most sustainable through its critical systems and technological upgrade integrations, and most degenerative through its original construction measures. DSR differences are found in individual component’s levels’ of agreement when contrasting original design and construction (D/C) measures wi...
Erythroneura (Homoptera, Cicadellidœ) from the Southwest

The Biological Survey Party from the Department of Entomology of the University of Kansas spent the summer of 1927 collecting in the southwest part of the United States. (Arizona, New Mexico and southwestern Texas). The objectives of the party were two fold: first, to make an intensive survey of the aquatic Hemiptera of this region; and second, to visit, as far as time would permit, the localities where Professor F. H. Snow had collected in former years. The trip was a very profitable one, yielding about 25,000 specimens, a number of which are new. The present paper deals with the species of Erythroneura collected in that region.
Direct Eyebrow Lift

Before moving to more complex approaches such as the endoscopic eyebrow lift, the surgeon must master the fundamental concepts of preoperative evaluation, indications for surgery, surgical anatomy, and the basic direct browlift procedure.
The Early Twenties

The nineteen-twenties in America, which experienced a cultural awakening with the work of such rebels as Sinclair Lewis, Sherwood Anderson, H. L. Mencken, Theodore Dreiser, F. Scott Fitzgerald and Ernest Hemingway, also witnessed an enormous outpouring of creative activity by Eugene O’Neill, already in 1920 America’s leading dramatist. His ‘radical’ work — unlike the output of those writers protesting against America’s shallowness and materialistic values and debasement of self-realization — concentrated on the possibilities of his dramatic art rather than on social issues, although he did touch these issues. Prolific to the point of excess, experimenting with new ways to present his tragic themes, O’Neill bewildered those who wished to formulate him in a phrase. Often unsuccessful in the sense that his plays did not produce the desired effects, O’Neill ruthlessly used his medium in ways that pressed against its bounds. Experimental, restless, unable to remain with one kind of success — in fact, distrusting success — he exhibited to the American Twenties a productivity and boldness that has never been matched by any American playwright at any time.
Phylogenetic analysis of Cabombaceae and Nymphaeaceae based on vegetative and leaf architectural characters

Vegetative and leaf architectural characters are used to assess the phylogenetic relationships of species of Cabombaceae and Nymphaeaceae. Twenty-eight species representing all eight genera and the five subgenera of Nymphaea are analyzed. These morphological analyses give robust support to other molecular and morphological analyses of the relationships of the two families. There is strong support for the two families to be monophyletic, and that Euryale and Victoria are closely related. Strict consensus analyses show that within the Nymphaeaceae, Nuphar is the first sister clade, followed by Barclaya and finally by a polytomy of Ondinea, Euryale-Victoria and Nymphaea. The relationships of Ondinea are uncertain, in part due to missing characters. Finally, the genera of each family are monophyletic. Each genus has a suite of distinctive vegetative characteristics that are used to make an identification key of the genera. Although the value of vegetative and leaf architectural characters is shown, inclusion of atypical leaves, for example some types of submerged leaves, results in less resolved or robust trees.
Brief of Amici Curiae Yale Law School Information Society Project and Affiliated Scholars of Intellectual Property and Free Expression Law in Support of Defendant-Appellant Pandora Media, Inc.

Amici's interest is in respecting the balance between the rights of authors to control their creative expression and the public’s interests in free expression. We urge the Court to consider both the First Amendment and the practical consequences for speech when construing state copyright law, and on the basis of these considerations we urge the Court to reject the district court’s reading of California Civil Code Section 980(a)(2) insofar as it makes an unnecessary and unwarranted departure from copyright law’s longstanding commitment to balancing authors’ rights and the public’s speech interests.
TIME TO GET SERIOUS ABOUT INSULIN TIMING

Abbreviations: A1c = glycated hemoglobin BG = blood glucose CGM = continuous glucose monitoring T1D = type 1 diabetes
Apparent breakdown of Raman selection rule at valley exciton resonances in monolayer Mo S 2

The valley degree of freedom in atomically thin transition metal dichalcogenides (TMDCs) has generated great interest due to the possibility of using it to store and control information in analogy to the spin degree of freedom in spintronics. A signature of the valley pseudospin is the selective coupling of valley excitons to photons with defined helicity. This selectivity can have important consequences for a variety of optical phenomena associated with the valley excitons. Here we report that Raman features that seemingly violate the Raman selection rules can become prominent at valley exciton resonances in atomically thin $\mathrm{Mo}{\mathrm{S}}_{2}$. Specifically, the Raman selection rule requires the excitation and scattering photons to have opposite circular polarizations for the in-plane $E$\ensuremath{'} mode phonon, but we observe an apparent $E$\ensuremath{'} Raman peak for excitation and scattered photons with the same circular polarization at exciton resonances. We attribute this peak to a defect-assisted process that involves phonons in the transverse optical $E$\ensuremath{'} branch slightly away from the \ensuremath{\Gamma} point, a process that can be enhanced by the selective coupling of valley pseudospin to photon helicity. Thus, the valley pseudospin, in addition to the crystal symmetry, may be important in understanding the Raman scattering spectra for excitations close to valley exciton resonances.
Characteristics of Neurology Referrals to Pain Management (P3.309)

OBJECTIVE:To Characterize Neurology Referrals to Pain Management BACKGROUND: Up to 75[percnt] of neurology outpatients have significant pain. However, no standards exist regarding referral to pain management and little has been studied regarding the referred patients. The goal of this study is to describe the demographics and clinical characters of these patients. DESIGN/METHODS:A chart review of consecutive pain management referrals from neurologists over 14 months. Anonymized patient data collected included age, gender, referral reason, current medications, and management. Descriptive statistics, t-tests for independent samples and chi-square testing were performed in SPSS version 21. RESULTS: There were 118 distinct referrals. Of these, 48[percnt] of patients appeared for an initial evaluation. 66.7[percnt] of patients who presented were female, mean age 41.1 (SD - 17.9), ranging from 14 to 89. Presenting males were 37.3 (SD - 20.4) years old, ranging from 13 to 73. 61.4[percnt] of patients were referred for intractable head pain (mainly migraines and occipital neuralgia), 19[percnt] for non specific back pain, 8.8[percnt] for polyneuropathy and 12[percnt] patients for other reasons including mononeuropathy, thalamic pain, radiculopathy, penile pain and generalized pain in the setting of muscular dystrophy. 63.9[percnt] of referred patients were on non-TCA neuropathic pain medications, 39.7[percnt] on NSAIDS, 27.6[percnt] on muscle relaxants, 25.9[percnt] on opioids, 29[percnt] on TCA’s, and 29.3[percnt] on triptans. 8.6[percnt] of the individuals referred had a formal psychiatric diagnosis. Over 80[percnt] were felt to be good candidates for subsequent interventional management and over 50[percnt] had medication changes. CONCLUSIONS: Neurology referrals to pain management consist primarily of head/facial pain, painful neuropathy, and back pain. The majority of those referred were being treated with atleast one pharmacological agent, and many were candidates for interventional therapy. Further research to assess the effect of intervention in this setting is warranted. Disclosure: Dr. Bragin has nothing to disclose. Dr. Dvoskin has nothing to disclose. Dr. Zidan has nothing to disclose. Dr. Joseph has nothing to disclose. Dr. Thomas has nothing to disclose.
Formation of rapakivi feldspar in the Deer Isle Granite Complex, coastal Maine: in situ lead isotope and trace-element analysis

Rapakivi and alkali feldspar phenocrysts from the Devonian Deer Isle Granite Complex, Maine were investigated to see if magma mixing or isothermal decompression was responsible for their formation. Pb-isotope and trace-element analyses of alkali feldspar ovoids and their plagioclase inclusions were obtained by LA-ICP-MS to determine the characteristics of the initial magma; these were compared with the plagioclase mantles. Rapakivi grains show a decrease in Pb-isotopic values and an increase in Ba, La, and Ce concentrations from the ovoids and inclusions to the innermost plagioclase mantles adjacent to the ovoids. These variations, along with CL imagery of quartz phenocrysts, indicate an open system with compositional changes in the magma chamber occurring during rapakivi feldspar growth. Repeated episodes of magma mixing/replenishment by Ba and LREE enriched magmas with lower Pb-isotopic ratios (along with hybridized variations with the host magma) created localized dissolution of alkali feldspar and quartz. Alkali feldspar phenocrysts proximal to these zones of thermal perturbation were first resorbed and then mantled by plagioclase that records the more primitive signature of the more mafic melt. Pb-isotopic values and Ba, La, and Ce concentrations trend back to the initial magma composition at the mantle rims as the effects of the mixing event dissipated. For grains that were somewhat more distal to these zones of mixing, resorption of the alkali feldspar crystals did not occur, yet the fresh supply of Ba resulted in Ba-rich alkali feldspar mantles over Ba-poor alkali feldspar cores. Other alkali feldspar crystals were too far from the site of mixing; hence, they lack any evidence of open system crystallization. As crystallization of the chamber continued along solidification fronts, batches of cooler crystal-rich magmas settled en masse to the floor. Disaggregation of these batches during settling, and subsequent accumulation on the reservoir floor, brought grains with disparate crystallization histories together. Filter pressing of the cumulate pile flushed highly evolved melts/fluids out from interstitial pores to the high silica, upper portions of the chamber. The crystallization, transportation, and juxtaposition of disparate types of feldspar phenocrysts suggest that a relatively large and active magma chamber, periodically recharged by localized batches of melt, must have existed. In this case, it is clear that rapakivi mantled feldspars are the result of magma mixing; such interpretations may apply to many other occurrences as well.
Cellular Mechanisms of Secretion

Prior to the advent of electron microscopy, studies of secretory processes were limited primarily to identifying secretory cells and the materials they produce, determining the gross mechanisms of secretion, and delineating the stimuli which cause the release of material to the extracellular environment. The development and refinement of ultrastructural techniques provided an entirely new dimension to the understanding of secretory processes as investigations were made possible into the assembly, intracellular transport, and release of secretory material. Subsequently, from the examination of a wide variety of secretory cells, certain common principles evolved regarding the mechanisms of production and release of secretory products. The importance of cellular membranes in the synthesis, packaging, and intracellular transport of secretory material was recognized, and defects in secretory function were traced to abnormalities in cellular mechanisms. In the ensuing discussion, an attempt will be made to outline the common pathways shared by many different types of secretory cells for producing and releasing their products. Several representative examples of secretory cells and the cellular organelles involved in the manufacture of precursor material will be analyzed in depth. Finally, an effort will be made to describe some of the current controversies, theories, and supporting experimental evidence regarding certain aspects of the intracellular mechanism of secretion.
Measurements of the field-effect electron mobility of the acceptor ITIC

Abstract We report on the fabrication and characterization of organic field-effect transistors using the small molecule electron acceptor 3,9-bis(2-methylene-(3-(1,1-dicyanomethylene)-indanone))-5,5,11,11-tetrakis (4-hexylphenyl)-dithieno [2,3-d:2′,3′-d’]-s-indaceno [1,2-b:5,6-b’]dithiophene (ITIC). These experiments carried out in unipolar n-channel transistors yield an average field-effect electron mobility value of 1.4 × 10−2 cm2/Vs.
Theological Reflections on the Nature of Nature: Revolution, Reformation, Restoration

In his contribution to Habermas’s Stichworte zur ‘geistigen Situation der Zeit’ (1979), Jurgen Moltmann provides a retrospective analysis of reformation, revolution, and liberation within the context of German theology. While Molmann’s lamentations are largely political, the deeper and more fundamental philosophical and theological problem of nature emerges through a closer reading.
From Natural Philosophy and ‘Mixed Mathematics’ to Theoretical and Experimental Physics: Britain, 1830–1870

Most accounts of physics in the mid-nineteenth century focus on the conceptual transformations of the field. The date when conservation of energy and field theory became embedded in the research life of the discipline determines periodization.1 These accounts are closely connected to the sense that the history of physics is written in the lives of the singular individuals that first clarified and stated these concepts.2 Historians recently have focussed on communities of fellow practitioners and their interactions with their fellows rather than a few individuals in their isolated grandeur as thinkers.3 The legacy of intellectual leaders is often seen as less clearcut and more given to diverse interpretation than in earlier depictions. Above all, they are seen more often than not as a product of their time and place. Physics has become a product of many hands.4
THE TRANSPORT OF SUGARS INTO THE LENS.

Evidence has been presented supporting the concept of a mediated transfer of certain sugars into calf and rat lenses. This conclusion was reached from observation of structural requirements for entry of closely related sugars into calf lens, and from a kinetic analysis of the entry of sugars into the rat lens. At high sugar concentrations, saturation of the binding sites and competition between pairs of monosaccharides were demonstrable in the rat lens. Galactose appeared to have the potentiality of penetrating the cells of the rat lens by simple diffusion or by utilizing the binding sites. Glucose and fructose competed for utilization by calf lens with the former appearing to have five to six times the affinity of the latter. A number of carbohydrates apparently pass through the lens capsule but are unable to cross cellular membranes. E, Ifforts to evaluate the uptake of carbohydrates by the lens have been stimulated by the occurrence of diabetic and other forms of sugar cataract, and the recent demonstration of the sorbitol pathway. However, interest has been focused on the metabolism of these substances, and only in the last few years have reports appeared emphasizing the transport of sugars by this tissue. 1 " 3 Although the processes controlling the movement of sugars across the lenticular membranes are of obvious importance, very little is known concerning them. Detailed investigations have been made on other tissues such as kidney and intestine, both of which accumulate sugars 4 ; and a "mediated transfer" of monosaccharides has been demonstrated in muscle, erythrocytes, placenta, and tumor cells. 5 The term, "me
Drought Management and Water Transfer Programs: Recent Developments and Research in California

This paper reviews recent developments in drought management in California. These developments have included increased efforts at agricultural and urban water conservation and shortage management, as well as efforts to reallocate water use via market mechanisms and bilateral agreements between water agencies. Many forms of water transfers actively are being examined and pursued by many water agencies throughout the state. In addition, Water management agencies also must assess how to best integrate transferred water with traditional water supply operations and water demand management efforts. This process is ongoing. An economically-based optimization approach to this problem is presented.
Some Biochemical Studies With SQ 26271: A Stable Partial Prostacyclin Agonist In The Human Platelet

A newly synthesized 9α-homo-9,11-epoxy-5,13-prostadienoic acid analogue, SQ 26271 (8(S)9(S)11(R)12(S)-9,11-epoxy-9α- homo-5(Z),13(E)-15(R)-hydroxyprostadienoic acid) inhibited arachidonic acid (AA)-induced platelet aggregation at concentrations which did not affect thromboxane B2 (TXB2) levels with an I50 value of 0.25 μM. It also was a potent inhibitor of platelet aggregation caused by collagen, 9,11- AzoPGH2, SQ 24810 (9,11-epoxy-9α-homo-5(Z),13(E)-15α- hydroxyprostadienoic acid) and epinephrine (secondary phase). However, it had little or no effect on thromboxane or prostaglandin synthetase activities. Moreover, SQ 26271 also inhibited the primary phase of epinephrine- and ADP- induced aggregation. In addition SQ 26271 caused a 3-fold increase in platelet adenylate cyclase activity, partially blocked prostacyclin stimulated adenylate cyclase activity and caused a 6-fold elevation of cyclic AMP levels in intact platelets, which was blocked by SQ 22536 (9-tetrahy- dro-2-furyl)adenine), an inhibitor of platelet adenylate cyclase activity. Finally, the inhibition of platelet aggregation by SQ 26271 was potentiated by an inhibitor of cyclic AMP phosphodiesterase (SQ 20009, etazolate), and reversed by SQ 22536. The above data indicate that SQ 26271 is a stable partial agonist of the prostacyclin receptor in human blood platelets.
The remains of an empire in ruin: remembering torture and the colonial state of exception in Jérôme Ferrari’s Où j’ai laissé mon âme

Since the turn of the twenty-first century, the use of torture during the Algerian War of Independence has been the subject of renewed controversy in France, raising questions about the traumatic reverberations of France’s colonial past in the present. While scholars often address the violence of torture by analysing what it accomplishes, this article is concerned with the cognitive, discursive and ideological conditions under which torture becomes permissible. This article suggests that the systematic practice of torture is contingent on the construction of a perceptive reality in which the normative dictates of law and morality have been suspended or no longer apply. Drawing on the work of Giorgio Agamben, this article seeks to understand the progressive normalization of torture under the historical paradigm of the state of exception. Thinking paradigmatically about the past not only reveals the concealed sociopolitical coordinates underlying a specific historical experience, but also constitutes a broader historical context, producing forms of intelligibility that cut across temporal and territorial boundaries. Through a reading of Jerome Ferrari’s novel Ou j’ai laisse mon âme (2010), this article addresses the ethical and epistemological issues that arise when torture is remembered as a paradigmatic rendering of the state of exception.
Veterans Affairs patient database (VAPD 2014-2017): building nationwide granular data for clinical discovery.

To study patient physiology throughout a period of acute hospitalization, we sought to create accessible, standardized nationwide data at the level of the individual patient-facility-day. This methodology paper summarizes the development, organization, and characteristics of the Veterans Affairs Patient Database 2014–2017 (VAPD 2014–2017). The VAPD 2014–2017 contains acute hospitalizations from all parts of the nationwide VA healthcare system with daily physiology including clinical data (labs, vitals, medications, risk scores, etc.), intensive care unit (ICU) indicators, facility, patient, and hospitalization characteristics. The VA data structure and database organization represents a complex multi-hospital system. We define a single-site hospitalization as one or more consecutive stays with an acute treating specialty at a single facility. The VAPD 2014–2017 is structured at the patient-facility-day level, where every patient-day in a hospital is a row with separate identification variables for facility, patient, and hospitalization. The VAPD 2014–2017 includes daily laboratory, vital signs, and inpatient medication. Such data were validated and verified through lab value range and comparison with patient charts. Sepsis, risk scores, and organ dysfunction definitions were standardized and calculated. We identified 565,242 single-site hospitalizations (SSHs) in 2014; 558,060 SSHs in 2015; 553,961 SSHs in 2016; and 550,236 SSHs in 2017 at 141 VA hospitals. The average length of stay was four days for all study years. In-hospital mortality decreased from 2014 to 2017 (1.7 to 1.4%), 30-day readmission rates increased from 15.3% in 2014 to 15.6% in 2017; 30-day mortality also decreased from 4.4% in 2014 to 4.1% in 2017. From 2014 to 2017, there were 107,512 (4.8%) of SSHs that met the Center for Disease Control and Prevention’s Electronic Health Record-based retrospective definition of sepsis. The VAPD 2014–2017 represents a large, standardized collection of granular data from a heterogeneous nationwide healthcare system. It is also a direct resource for studying the evolution of inpatient physiology during both acute and critical illness.
Experiments in detecting obscured objects using longwave infrared polarimetric passive imaging

Polarization has been shown to improve object-clutter discrimination in longwave infrared imaging, particularly if the object and clutter have the same apparent surface temperature and the viewing angle relative to an object's surface is off normal. This work describes experimentation to investigate the feasibility of using polarimetric infrared imagery to enhance object-clutter discrimination when the object is hidden by foliage. Many obscurations have small gaps where optical signatures from background objects can be partially seen. In long range imaging, large pixel size typically creates heterogeneous pixel mixtures consisting of multiple material surfaces. This mixture degrades an object's signature; however, due to the significant polarization contrast from the materials, object-clutter discrimination is still possible. Methodology and results from controlled experiments are presented herein which demonstrate the potential capability of object detection using polarization sensitive imagery.
Detecting Cannabis-Associated Cognitive Impairment Using Resting-State fNIRS

Functional near infrared spectroscopy (fNIRS), an emerging, versatile, and non-invasive functional neuroimaging technique, promises to yield new neuroscientific insights, and tools for brain-computer-interface applications and diagnostics. In this work, we consider the novel problem of detecting cannabis intoxication based on resting-state fNIRS data. We examine several machine learning approaches and present an innovative data augmentation technique suitable for resting-state functional data. Our experiments suggest that a recurrent neural network model trained on dynamic functional connectivity matrices, computed on sliding windows, coupled with the proposed data augmentation strategy yields the best accuracy for our application. We achieve up to 90\(\%\) area under the ROC on cross-validation for detecting cannabis associated intoxication at the individual-level. We also report an independent validation of the best performing model on data not used in cross-validation.
Adverse Experience Reports of Seizures in Youth and Young Adult Electronic Nicotine Delivery Systems Users.

Abstract Purpose Electronic nicotine delivery systems (ENDS) use poses significant and avoidable health risks to young people. Until recently, seizures were most often associated with cases of liquid nicotine ingestion. Methods We examined 122 voluntary reports of seizures (n = 114) and neurological symptoms (syncope, n = 7; and tremor, n = 1) in 123 ENDS users (one report contained information on two users) received by the Food and Drug Administration between December 1, 2010, and June 30, 2019. Results The median age (interquartile range) of users was 20 years (17–27); 67% of reports were in youth and young adults aged 14–24 years. Fifty-one (41%) reported other underlying medical conditions, including previous history of anxiety (n = 11), attention deficit hyperactivity disorder (n = 7), seizure (n = 6), and depression (n = 5). Of the 79 reports with available information, 67 (85%) reported seizure occurred within 24 hours of last use; 49 (62%) reported seizure within 30 minutes. The potential impact of concomitant use of marijuana or cannabidiol oil could not be evaluated from the eight reports that mentioned concomitant use. Conclusions Findings suggest an association between ENDS use and seizures. Additional information will help to clarify the relationship between ENDS use and seizures and to understand how product attributes such as nicotine content, formulation, quantity, and other ingredients or contaminants may contribute to seizures. It is important that health care providers ask about ENDS use when evaluating neurological symptoms and that users, parents, school personnel, and health care providers report adverse experiences involving tobacco products to Food and Drug Administration via the Safety Reporting Portal ( www.safetyreporting.hhs.gov ).
Ethics from the Start: Exploring Student Attitudes and Creating Interventions in Intro Programming Classes

The role of ethics in computing is a topic gaining more interest in the SIGCSE community in recent years. Our work is motivated by the idea that there is benefit to integrating ethics throughout undergraduate CS curriculum from the start. Therefore, we focus on students in introductory programming classes, seeking to understand both what students' existing attitudes are about the role of ethics in computing and how intervention at this early stage might impact them. We are conducting pre and post surveys in courses for both CS majors and non-majors, as well as working with instructors to replace existing assignments with new ones that guide students to consider ethical concerns as they learn introductory programming concepts. Discussions at SIGCSE around this topic can further discussions around appropriate norms and ideal strategies for ethics integration into CS courses.
Structure and mechanism of a redesigned multidrug transporter from the Major Facilitator Superfamily

The rapid increase of multidrug resistance poses urgent threats to human health. Multidrug transporters prompt multidrug resistance by exporting different therapeutics across cell membranes, often by utilizing the H+ electrochemical gradient. MdfA from Escherichia coli is a prototypical H+ -dependent multidrug transporter belonging to the Major Facilitator Superfamily. Prior studies revealed unusual flexibility in the coupling between multidrug binding and deprotonation in MdfA, but the mechanistic basis for this flexibility was obscure. Here we report the X-ray structures of a MdfA mutant E26T/D34M/A150E, wherein the multidrug-binding and protonation sites were revamped, separately bound to three different substrates at resolutions up to 2.0 A. To validate the functional relevance of these structures, we conducted mutational and biochemical studies. Our data elucidated intermediate states during antibiotic recognition and suggested structural changes that accompany the substrate-evoked deprotonation of E26T/D34M/A150E. These findings help to explain the mechanistic flexibility in drug/H+ coupling observed in MdfA and may inspire therapeutic development to preempt efflux-mediated antimicrobial resistance.
Development and evaluation of a palliative care curriculum for cystic fibrosis healthcare providers

Abstract Background Primary palliative care refers to basic skills that all healthcare providers can employ to improve quality of life for patients at any stage of disease. Training in these core skills is not commonly provided to clinicians caring for cystic fibrosis (CF) patients. The objective of this study was to assess change in comfort with core skills among care team members after participation in CF-specific palliative care training focused on management of burdensome symptoms and difficult conversations. Methods A qualitative needs assessment was performed to inform the development of an 18-hour curriculum tailored to the chronicity and complexity of CF care. A 32-question pre- and post-course survey assessed CF provider comfort with the targeted palliative care skills in 5 domains using a 5-point Likert scale (1=very uncomfortable, 3=neutral, 5=very comfortable). Results Among course participants (n=16), mean overall comfort score increased by 0.9, from 3 (neutral) to 3.9 (comfortable) (p Conclusions CF-specific palliative care training was well received by participants and significantly improved self-assessed comfort with core skills.
Magnetoelastics of High Field Phenomena in Antiferromagnets UO 2 and CeRhIn 5

We use a recently developed optical fiber Bragg grating technique, in continuous and pulsed magnetic fields in excess of 90T, to study magnetoelastic correlations in magnetic materials at cryogenic temperatures. Both insulating UO 2 and metallic CeRhIn 5 present antiferromagnetic ground states, at $\mathrm{T}_{N}= 30.3\mathrm{K}$ and $\mathrm{T}_{N}= 3.85\mathrm{K}$ respectively. Strong coupling of the magnetism to the crystal lattice degrees of freedom in UO 2 is found, revealing piezomagnetism as well as the dynamics of antiferromagnetic domain switching between spin arrangements connected by time reversal. The AFM domains become harder to switch as the temperature is reduced, reaching a record value $\mathrm{H}_{pz} (\mathrm{T} = 4\mathrm{K}) \sim 18\mathrm{T}$ . The effect of strong magnetic fields is also studied in CeRhIn 5 , where an anomaly in the sample crystallographic c-axis of magnitude Δc/c ≃ 2 ppm is found associated to a recently proposed electronic nematic state at $\mathrm{H}_{en} \sim 30\mathrm{T}$ applied 11° off the c-axis. Here we show that while this anomaly is absent when the magnetic field is applied 18° off the a-axis, strong magnetoelastic quantum oscillations attest to the high quality of the single crystal samples.
Incidence and Risk Factors for Flap Coverage After Total Ankle Arthroplasty

Background:Wound complications following total ankle arthroplasty (TAA) can have a significant impact on patient morbidity, particularly when they require flap coverage. We sought to determine the ...
Hybrid Grey Wolf Optimizer Sine Cosine Algorithm based Maximum Power Point Tracking Control of PV Systems under Uniform Irradiance and Partial Shading Condition

Non-uniform irradiance levels, and drastically changing weather and climate conditions cause PV systems to fall in partial shading (PS) category. Under uniform irradiance conditions, conventional MPPT techniques provide a viable solution, however under PS conditions, such techniques fail to perform. Many bio-inspired MPPT control techniques are presented in literature but drawbacks observed in these techniques are high tracking time, oscillations at global maxima (GM) and falling in local maxima (LM) trap under PS. A novel hybrid grey wolf optimizer sine cosine algorithm (HGWOSCA) based MPPT control technique is presented in this paper. Enhancement in performance of PV systems, less convergence time, little or no oscillations around global maxima (GM) are improvements observed in the proposed technique during comparative analysis with other bio inspired techniques. These enhancements are also validated with experimental setup by implementing proposed technique on low cost microcontroller. Comparison also shows the tracking of GM of proposed technique with high efficiency greater than 99.9%, 10-40% less tracking time and less than 0.5 W oscillations at GM under PS conditions. Superiority of proposed technique in terms of sensitivity, solidity and cogency is presented using statistical analysis.
Community is key: estimating the impact of living learning communities on college retention and GPA

The retention of students is a challenge faced by many universities in countries where participation rates are high. Living learning communities (LLCs) have been adopted by college administrators t...
Rare case of Sjögren's syndrome antibody (SSA-Ro52kDA)-associated interstitial lung disease and myositis with pipe stem capillaries.

Necrotising myopathy with pipestem capillaries is a distinct form of inflammatory myopathy exhibiting only sparse inflammation on biopsy, with clinical presentation and histopathological profile entirely different from dermatomyositis, polymyositis or inclusion body myositis. A 51-year-old non-diabetic man presents with progressively worsening shortness of breath and myalgias with only mild proximal muscle weakness and elevated serum creatine kinase. Autoimmune workup, ordered after ruling out infectious and cardiac aetiologies, returned positive for Sjogren's syndrome antibody (SSA/Ro-52). Lung imaging and biopsy were suggestive of cryptogenic organising pneumonia and muscle biopsy showed myositis with pipestem capillaries and abnormal deposition of membrane attack complex with only sparse inflammation. The patient received high-dose steroids, mycophenolate mofetil, intravenous immunoglobulin and rituximab with improvement in muscle symptoms. However, his pulmonary findings progressed, requiring evaluation for a lung transplant. This case emphasises the need for further research to better understand this disease entity and improve mortality and morbidity in these patients.
Human Resource Availability Situation of Airline Companies in Thailand

The issue of human resource availability has always affected operations. This study then aims to assess the human resource availability situations, problems and preventive measures of the airline companies in Thailand. This research utilized a survey type of research using the mixed method involving 50 respondents of three airline companies. The data gathered were analyzed using descriptive statistics and Pearson correlation to test the hypothesis. It was found that most of the employees were the cabin crew and that most of them were willing to work overtime due to lack of employees. The most serious problem encountered was on the insufficient number who can speak other languages. There is no significant relationship between human resource availability and the problems encountered. Each airline company implemented preventive measures to solve problems. It is concluded that the human resource availability situation is still within the control of the company; however, training needs enhancement to include learning foreign languages.
Influence of the Atlantic meridional overturning circulation on the U.S. extreme cold weather

Due to its large northward heat transport, the Atlantic meridional overturning circulation influences both weather and climate at the mid-latitude Northern Hemisphere. Here we use a state-of-the-art global weather/climate modeling system with high resolution (GFDL CM4C192) to quantify this influence focusing on the U.S. extreme cold weather during winter. We perform a control simulation and the water-hosing experiment to obtain two climate states with and without a vigorous Atlantic meridional overturning circulation. We find that in the control simulation with an overturning circulation, the U.S. east of the Rockies is a region characterized by intense north-south heat exchange in the atmosphere during winter. Without the northward heat transport by the overturning circulation in the hosing experiment, this channel of atmospheric heat exchange becomes even more active through the Bjerknes compensation mechanism. Over the U.S., extreme cold weather intensifies disproportionately compared with the mean climate response after the shutdown of the overturning circulation. Our results suggest that an active overturning circulation in the present-day climate likely makes the U.S. winter less harsh and extreme. A shutdown of the Atlantic Meridional Overturning Circulation could lead to a disproportionate increase in the occurrence of extremely cold weather in the U.S. via enhanced north-south heat exchange in the atmosphere, suggest simulations with and without a vigorous overturning circulation.
Multidisciplinary Consensus and Evaluation of Gynecological High-Dose-Rate (HDR) Brachytherapy.

Purpose/Objective(s) To improve the consistency and quality of gynecological HDR brachytherapy through multidisciplinary evaluation of implants and treatment plans. Materials/Methods A quality assurance (QA) task force initiated in 2020 consisting of radiation oncologists, physicists, and radiation therapists reviewed applicator implant and treatment plan quality convened monthly for 48 gynecology patients undergoing high-dose-rate (HDR) brachytherapy. Each implant was scored based on the location and symmetry of applicators (tandem and ovoids/ring), interstitial needle location (if applicable), and packing quality as previously described (PMID: 22193645, 29705049). Treatment plans were evaluated based on contouring quality and dosimetry (target dose and OAR doses). Each quality measure was scored from 0 (inadequate) to 1 (excellent) to and a mean score for implant and treatment plan was calculated for each patient. The assigned scores represent a consensus among task force members who provided feedback according to their areas of expertise. Individual measures, implant types and mean scores were analyzed at the mid-year-mark. Results QA evaluation proved more beneficial for implant placement compared to treatment planning. Mean implant scores increased by 15% with significant improvements in needle positions (P = 0.02) and nonsignificant increases in packing scores (P = 0.09). In contrast, mean treatment plan scores remained unchanged throughout the year (P = 0.56). No differences were noted in the scores assigned for dosimetry, contouring, OAR doses or target doses after the mid-year mark. Conclusion The QA initiative enabled the interprofessional team to share knowledge and resources to facilitate immediate mid-course changes in implant and planning strategy. The feedback generated encouraged members to alter practices and expand their understanding of treatment goals and limitations. Specific criteria for the scoring of individual quality measures should be developed to improve objectivity. The utility of HDR QA should be correlated with tumor control, recurrence, and OAR toxicity to bolster patient safety and treatment outcomes. QA sessions require quantifiable measures such as team member satisfaction and ongoing assessment due to the multidisciplinary nature of the process. Author Disclosure C.Y. Mollings Puentes: Independent Contractor; UWorld. T. Banks: Develop/vet educational website content; AAPM.B.A. Hrycushko: None. X. Jia: None. C.R. Nwachukwu: Scientific Advisory board; Boston Scientific. K.V. Albuquerque: Research Grant; Astra Zeneca. Honoraria; ACR, ARRT. Travel Expenses; ACR, ARRT, ASCO.
Autonomous Classification via Self-Formation of Collections in AuInSys

This paper describes a mechanism, called SIF, for autonomous and unsupervised hierarchical classification of information items in AuInSys, a pro-interactive information system, where each single information element is represented by a compact software agent. The classification is carried out through the self-organization of information items which form the collections incrementally. The information items compete with each other through the self-interactions of their agents which lead to incremental grouping of items into collections. The proposed mechanism provides an automatic, more flexible, and dynamic partitioning of information compared with what is used in traditional file systems.
The Value of Multiple Proxies

Direct measurements of climate data such as temperatures are rare before the 20th century. Climate reconstructions for earlier centuries and millenia rely on a range of different climate indicators or proxies. In his Perspective, [Mann][1] explains how these proxies can be used in multiproxy climate reconstructions to obtaina reliable record of climatic variations over the last millenium. [1]: http://www.sciencemag.org/cgi/content/full/297/5586/1481
The "Voice Effect" in Groups

This study looks at how collaborative technology, proximity choices, and group size can affect voicing in groups. Results of the study, involving two experiments with 550 participants, show that collaborative technology can improve an individual’s desire to voice, instrumental motives to voice, non-instrumental motives to voice, and the opportunity to voice in face-to-face groups. The results also show that the use of collaborative technology can lesson individual voice losses as groups increase in size especially in distributed environments. These findings have important implications in group interactions using technology.
A continuous operations workschedule implementation

IBM'S semiconductor facility near Burlington, Vermont, adopted continuous operation (ContOps) in 1990 by implementing a variation of the 12-h work schedule for their production employees. The author discusses that work schedule and how it was implemented. The foundation studies that proved the business need, the analysis of work schedule alternatives, the key business measurements, and the personnel relations activities required for each phase of the changeover are discussed. Some of the lessons learned, including what to expect (and not expect) from implementing a ContOps work schedule, are reviewed. Concepts and principles are presented in broad terms to facilitate the conversion to ContOps for any enterprise. >
A comprehensive optimization methodology for designing charge pump voltage multipliers

This paper proposes a comprehensive optimization methodology to simultaneously determine the clock frequency, area ratio of pump capacitor to switching circuit, number of stages, and capacitor size of integrated switched-capacitor charge pump voltage multipliers. Power efficiency of the charge pump is also discussed in various views. How the top and bottom plate parasitic capacitance and the threshold voltage of the switching circuit affect power efficiency is reviewed. The optimization methodology is demonstrated. Comparisons of the model with SPICE simulation results are also provided for validation.
Conceptual Design of Thermal Energy Storage Systems for Near-Term Electric Utility Applications

Promising thermal energy storage systems for midterm applications in conventional electric utilities for peaking power generation are evaluated. Conceptual designs of selected thermal energy storage systems integrated with conventional utilities are considered including characteristics of alternate systems for peaking power generation, viz gas turbines and coal fired cycling plants. Competitive benefit analysis of thermal energy storage systems with alternate systems for peaking power generation and recommendations for development and field test of thermal energy storage with a conventional utility are included. Results indicate that thermal energy storage is only marginally competitive with coal fired cycling power plants and gas turbines for peaking power generation.
'What He Did Was Lawful.' Divorce Litigation and Gender Inequality in Rural China

How do women fare as they embark on a journey in search of justice? What shapes their experiences of legal mobilization? Do they come out ahead in courtroom battles or not? Through a mixed-methods study of divorce litigation in rural China, I underscore three critical junctures in women’s interactions with the civil justice system. First, I show that court decisions in the judgment stage generate highly unequal outcomes for women and men. Taking litigation outcomes as a point of departure, I then shift to investigate an earlier moment in divorce litigation: the suit-filing stage. I find that the legal profession — a key agent of dispute transformation — frequently fails to convert women’s marital grievances and rights into formal claims. Finally, I trace back to the initiation stage in which divorcing women approach the legal profession for help. Findings from this stage indicate that, in everyday divorce law practice, the legal profession routinely dismisses and violates women’s custodial, property, and spousal rights. Consequently, women’s marital grievances and rights claims fall through the cracks long before they can make way into court proceedings. By illuminating gender disparities in litigation outcomes and dispute processing, this study highlights the multistage process whereby legal mobilization engenders inequality between women and men. It also exposes a great irony in contemporary China: as women turn to law in hopes of obtaining redress, the court system and the legal profession reinforce their subordination at home and beyond.