cssi/SciSciGPT-SciSciNet huggingface dataset:
Quantitative determination of anxiety reduction in PET/CT using a patient call device and the Spielberger State Inventory Assessment

2615 Objectives Patients may feel anxiety for a number of reasons. Being able to reduce anxiety can result in improved imaging and a better experience for the patient. Previous work by our group investigated anxiety reduction in PET through the use of a hand held call device showing that perceived patient anxiety could be reduced using such a device. This study extends that work by using standardized anxiety metrics to assess the impact of such a device on patient anxiety. Methods Patients with various oncological indications, undergoing PET/CT imaging, were asked to participate in the study by completing a survey. Two groups of patients were given a standardized Spielberger State Anxiety Inventory assessment. Group 1 was given the device during imaging and given the survey prior to completion of their scan. Group 2, the control group, was given the survey prior to scan completion but were not given the device. Survey results were scored, collated, and descriptive statistics calculated and compared between groups. Results Survey results for 24 patients (12/group) were scored using the standard Spielberger scoring system. Group 1 (given device) had an average Spielberger score of 23.9, Group 2 (not told of device) had an average score of 27.6. The 95% confidence intervals for each group were 22-26 and 23-32, respectively. Conclusions The data shown currently indicates a reduction in anxiety for those patients given a device that improves their communication with the technologist. Further surveys are needed to statistically validate this effect. Other survey methodologies tested by our group can be found in abstract control ID: 1926707.
Modeling Consumer Decisions on Returning End-of-Use Products Considering Design Features and Consumer Interactions: An Agent Based Simulation Approach

As electronic waste (e-waste) becomes one of the fastest growing environmental concerns, remanufacturing is considered as a promising solution. However, the profitability of take back systems is hampered by several factors including the lack of information on the quantity and timing of to-be-returned used products to a remanufacturing facility. Product design features, consumers’ awareness of recycling opportunities, socio-demographic information, peer pressure, and the tendency of customer to keep used items in storage are among contributing factors in increasing uncertainties in the waste stream. Predicting customer choice decisions on returning back used products, including both the time in which the customer will stop using the product and the end-of-use decisions (e.g. storage, resell, through away, and return to the waste stream) could help manufacturers have a better estimation of the return trend. The objective of this paper is to develop an Agent Based Simulation (ABS) model integrated with Discrete Choice Analysis (DCA) technique to predict consumer decisions on the End-of-Use (EOU) products. The proposed simulation tool aims at investigating the impact of design features, interaction among individual consumers and socio-demographic characteristics of end users on the number of returns. A numerical example of cellphone take-back system has been provided to show the application of the model.Copyright © 2015 by ASME
Enzymatic Modification of Anhydrous Milkfat with n-3 and n-6 Fatty Acids for Potential Use in Infant Formula: Comparison of Methods

A structured lipid (SL) with a high amount of sn-2 palmitic acid was synthesized from anhydrous milkfat and was then enriched with docosahexaenoic (DHA) and arachidonic (ARA) acids using an immobilized lipase. Three different methods were compared including physical blending, enzymatic interesterification, and enzymatic acidolysis. Products were compared with respect to differences in fatty acid profiles, reaction times, antioxidant contents, oxidative stability, melting and crystallization profiles, and reaction yields. The acidolysis method was the least suitable for the synthesis of desired product because of a low reaction yield, low incorporation of DHA, low oxidative stability, and the extra processing steps required. The physical blending and interesterification methods were suitable, but the interesterification product (IE-SL) had higher amounts of ARA at the sn-2 position. The IE-SL contained total ARA and DHA of 0.63 and 0.50 mol%, and 0.55 and 0.46 mol% at the sn-2 position, respectively. The IE-SL also contained 44.97 mol% sn-2 palmitic acid. The reaction yield for the IE-SL was 91.84 %, and its melting completion and crystallization onset temperatures were 43.1 and 27.1 °C, respectively. This SL might be totally or partially used in commercial fat blends for infant formula.
Tattio: Fabrication of Aesthetic and Functional Temporary Tattoos

We present Tattio, a fabrication process that draws from current body decoration processes (i.e., jewelry-like metallic temporary tattoos) for the creation of on-skin technology. The fabrication process generates functional components such as NFC tags, circuitry, to Thermochromic tattoos, while maintaining the aesthetics and user experience of existing metallic temporary tattoos. The fabrication process is low cost, accessible and customizable; we seek to enable individuals to design, make, and wear their own skin technology creations. We present the fabrication flow, fabricated components, and also an initial user study probing perceptions towards wearing Tattio circuitry.
Internalized basic fibroblast growth factor translocates to nuclei of venular endothelial cells

To begin to understand the molecular mechanisms by which basic fibroblast growth factor (bFGF) stimulates proliferation of coronary venular endothelial cells (CVEC), we have characterized the kinetic interactions of bFGF with various binding sites on CVEC and determined the kinetics of nuclear translocation of bFGF. We report that bFGF rapidly binds to its receptor and is immediately internalized at 37 degrees C with a half-time for receptor binding of 0.9 min. After internalization bFGF is processed by two kinetically and biochemically distinguishable pathways. Up to 40-50% of total internalized bFGF is translocated to the nuclei of serum-starved, quiescent cells at early time points (0-2 h). This proportion declines to less than or equal to 20% by 24 h. Cytoplasmic accumulation continued to increase for up to 24 h. Nuclear-bound 125I-labeled bFGF consisted primarily of the intact 18-kDa species with small amounts of a 16-kDa degradation fragment. Nuclear-bound 125I-labeled bFGF showed little evidence of degradation even after 24 h, whereas cytoplasmic 125I-labeled bFGF showed increased degradation to smaller fragments with time. Nuclear-binding of bFGF reached equilibrium by 8 h, just before initiation of DNA synthesis, which began 9-12 h after growth factor addition. These results suggest that nuclear-bound bFGF may function in triggering division (proliferation) of CVEC subsequent to binding of the growth factor to cell surface receptors.
The nature of synergy between tissue-type and single chain urokinase-type plasminogen activators

Enhancement of thrombolysis with combinations of tissue-type and single chain urokinase plasminogen activators (t-PA and scu-PA) has been demonstrated in vivo but has not been seen consistently in vitro. This study was designed to characterize interactions between t-PA and scu-PA with respect to rate of and extent of thrombolysis in vitro and to delineate mechanisms responsible. Combinations of t-PA and scu-PA at selected concentrations synergistically enhanced thrombolysis in vitro compared with thrombolysis induced by either activator alone. Enhanced thrombolysis did not occur at the expense of fibrin specificity since the extent of fibrinogenolysis and consumption of alpha 2-antiplasmin were significantly less with synergistic combinations of t-PA and scu-PA compared with equi-effective concentrations of either activator alone. Attenuation of complex formation of t-PA and two chain u-PA (tcu-PA), formed from scu-PA, with plasma proteins did not appear to contribute to enhancement of thrombolysis as assessed by fibrin autography. Binding of 125I-t-PA to thrombi was increased by 27% at 1 hr and by 21% at 2 hr in the presence of scu-PA (p less than 0.001 for both). Conversion of scu-PA to tcu-PA was enhanced when thrombi were exposed to scu-PA in the presence of t-PA. Results of this study indicate that t-PA and scu-PA at selected concentrations enhance thrombolysis in vitro synergistically without compromising fibrin specificity. Enhanced binding of t-PA to thrombi in the presence of scu-PA and enhanced conversion of scu-PA to tcu-PA appear to contribute to synergy between t-PA and scu-PA for thrombolysis.
Future trends in optical data storage

Optical data storage has finally emerged as a credible member of the data storage hierarchy. Currently, magnetic recording dominates this approximately $50 billion/yr industry, and many regard optical recording as a replacement for existing magnetic recording devices. However, current limitations in data rates and access times make this unlikely in the near term. Furthermore, while the magnetic recording industry is large, it is estimated that only 1% of current data is on magnetic DASD or tape, and <5% is computer readable. This indicates that there is a huge market for a low cost on-line or near-line data storage technology, and the attributes of optical recording (removability, high areal density, and the ability to publish on it using CD audiolike technology) make it attractive for this application.
Deletion and duplication of 16p11.2 are associated with opposing effects on visual evoked potential amplitude.

Duplication and deletion of the chromosomal region 16p11.2 cause a broad range of impairments, including intellectual disability, language disorders, and sensory symptoms. However, it is unclear how changes in 16p11.2 dosage affect cortical circuitry during development. The aim of this study was to investigate whether the visual evoked potential (VEP) could be used as a noninvasive quantitative measure of cortical processing in children with 16p11.2 copy number variation. Pattern-reversal VEPs were successfully recorded in 19 deletion carriers, 9 duplication carriers, and 13 typically developing children between the ages of 3 and 14 years. The stimulus was a black and white checkerboard (60’) that reversed contrast at 2 Hz. VEP responses were extracted from continuous EEG recorded using a high-density elasticized electrode net. Quantitative analysis of the VEP waveform revealed that, relative to controls, deletion carriers displayed increased amplitude and duplication carriers displayed diminished amplitude. Latencies of the VEP waveform components were unaffected by 16p11.2 status. P1 amplitude did not correlate with age, IQ, or head circumference. The results of this study suggest that recording VEP is a useful method to assay cortical processing in children with 16p11.2 copy number variation. There is a gene dosage-dependent effect on P1 amplitude that merits further investigation. The VEP is directly translatable to animal models, offering a promising way to probe the neurobiological mechanisms underlying cortical dysfunction in this developmental disorder.
Considering Ethnicity and Ethnopharmacology in the Treatment of Patients with Mental Illness

The articles in this supplement demonstrate that ethnicity and ethnopharmacology have emerged as important considerations in the treatment of patients with mental illness. Patients from ethnically diverse backgrounds often demonstrate varying levels of response and tolerability to drugs such as atypical antipsychotics. In part, this response may be due to the particular agent itself, yet metabolic differences between populations may also impact these varied effects. Specific isoforms of the cytochrome P450 enzyme system can dictate the rate at which patients metabolize certain medications, thus genotypic variability among these enzymes predicts the phenotypic response or metabolic rate. For example, patients from certain ethnic groups such as Caucasians and Hispanics tend to be extensive metabolizers, while African Americans and Asians tend to be slower metabolizers. Total dose and resulting plasma drug levels are closely related to adverse effects. Thus, patients exhibiting slow or poor oxidative enzyme activity may face increased drug exposure and potentially higher rates of adverse events. The undesirable antipsychotic-induced side effects include metabolic issues such as weight gain, insulin resistance, and dyslipidemia. Certain ethnic groups are at a higher risk for developing these metabolic problems. Side effects such as extrapyramidal symptoms and tardive dyskinesia, which have traditionally been attributed to conventional antipsychotics, may occur with atypicals although much less frequently. Movement disorders caused by the use of an atypical antipsychotic become particularly apparent when plasma drug levels are high. Patients with a slow metabolism will be exposed to high plasma drug levels, even on standard dosages of an atypical antipsychotic. Therefore, given a genetic predisposition and the potential for metabolic side effects with atypical antipsychotics, a careful risk/benefit assessment is crucial for the successful management of patients with mental illness. Other patient factors as well as clinician factors can influence the response and tolerability of treatment. Provider biases can affect access to certain medications, while misconceptions about how to treat certain ethnic groups can affect the initial choice of medication and dosage. Ultimately, sensitivity and an awareness of pharmacologic issues as they relate to an expanding and ethnically diverse population must become a high priority for clinicians treating patients with atypical antipsychotics. Side effects of these medications can be minimized with vigilance and a thorough understanding of the risks and benefits. Continued research is necessary to further understand the field of ethnopharmacology and to lead psychiatry into the future of individualized, metabolically directed therapies.
Serum IL-12:IL-6 Ratio Reliably Distinguishes Infectious from Non-Infectious Causes of Fever during Autologous Stem Cell Transplantation (ASCT).

Abstract Fever occurs commonly in patients (pts) undergoing ASCT, both during neutropenia and after neutrophil engraftment, but infectious etiologies are infrequently identified. A reliable and rapid method to distinguish infectious from non-infectious etiologies of fever may be able to reduce unnecessary diagnostic testing and empiric antimicrobial administration, leading to decreased costs, duration of hospital stays, and treatment related complications. We hypothesized that the serum cytokine profile during fever due to clinically significant infection is distinct from that during non-infectious febrile episodes. In a prospective exploratory study we assessed serum IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12, TNFα, and IFNγ levels by sandwich ELISA in 65 pts undergoing ASCT for non-Hodgkin's lymphoma (n=20), Hodgkin's disease (n=22), multiple myeloma (n=14), or AL amyloidosis (n=9). Cytokine levels were measured at multiple pre-defined times during ASCT; the results presented here are based on measurements upon admission, during the first episode of febrile neutropenia, during the first episode of fever within 72 hours after neutrophil engraftment, and upon discharge. Standard evaluation of fever included chest x-rays and blood and urine cultures. Other diagnostic testing, eg stool cultures and CT scans, were performed at the discretion of the responsible physicians as deemed appropriate by patients' symptoms. 69 febrile episodes occurred in 54 pts: 39 episodes occurred during neutropenia (12 due to documented infections); 30 episodes occurred after engraftment, 17 of which were preceded within 72 hours by fever during neutropenia (5 infectious, 12 non-infectious). Only 2 of the 13 new-onset post-engraftment fevers had an identifiable infectious etiology. Levels of IL-1β, IL-2, IL-8, IL-10, TNFα, and IFNγ did not distinguish infectious from non-infectious etiologies of fever. Mean IL-12 levels at the time of fever were significantly higher among pts without infection compared to pts with infection, regardless of neutrophil count; conversely, mean IL-6 levels were lower in febrile pts without infection. Compared to febrile pts with infection, the mean IL-12:IL-6 ratio was significantly higher in febrile pts without infection, both during neutropenia and after neutrophil engraftment. IL-12 and IL-6 levels and IL-12:IL-6 ratio did not vary significantly by histology, either at diagnosis or at discharge. IL-12:IL-6 ratio during fever Febrile period Infection No infection P-value Neutropenia 1.0 58.7 Post-engraftment 5.28 84.6 0.01 The IL-12:IL-6 ratio on the day of neutrophil engraftment in 11 pts without fever during the entire ASCT course was similar to that of normal healthy volunteers (904.6 vs. 708.0, P=NS) and significantly higher than among pts with infection during neutropenia (P
Peering inside the mind: Imaging brain activity with advanced diffuse optical tomography

Brain imaging has become central to a host of research and clinical applications, from magnetic resonance imaging (MRI) investigations of consciousness and thought to traumatic brain injury diagnostics. Functional brain imaging can interrogate activity and quantify processes in a spatiotemporal manner throughout the brain and is therefore useful across many clinical and research settings. Functional MRI has been a core research tool in this field, giving researchers and clinicians the ability to map activity throughout the adult brain. Diffuse optical tomography (DOT) is an optical spectroscopy technology that uses light to monitor brain activity. Light can undergo multiple scattering events after entering the tissue, with some photons redirected back towards the tissue surface. The distance this light travels, as well as changes in its intensity and spectrum, carries information that can be decoded to measure events (e.g., absorption) and map their locations within tissue. Some of the first applications using this toolkit to capture brain activity measured hemodynamics via the detection of oxygenated and deoxygenated hemoglobin through the intact skull using red and near-infrared light. Now, Chitnis et al. introduced a new DOT method for imaging brain activity that makes use of a fine meshwork of multiple miniature LED and detector modules. The combination of four modules yields 128 channels over a wide area of the scalp, providing the spatial resolution to map the 3D localization of hemodynamic changes. When subjects performed a thumb-to-finger extension movement, the module system was able to visualize the activated region within the motor cortex by detecting changes in hemoglobin oxygenation. The authors noted that while this measurement was made with four modules, their current method could be scaled theoretically to 75 modules for imaging over the entire scalp. Unlike functional MRI machines, this imaging system is lightweight and highly portable, which has the potential to enable wearable, functional brain imaging in office, field, and low-resource settings. D. Chitnis et al ., Functional imaging of the human brain using a modular, fibre-less, high-density diffuse optical tomography system. Biomed. Opt. Express 7 , 4275–4288 (2016). [[Full Text]][1] [1]: https://www.osapublishing.org/boe/fulltext.cfm?uri=boe-7-10-4275&id=350433
M87. Effects of Exercise and Cognitive Training on the Prefrontal Cortex in First-Episode Schizophrenia Patients.

Abstract Background: There is a critical need to understand neurotheraputic mechanisms in the brain to develop more effective interventions to improve cognitive abilities in schizophrenia. Both aerobic exercise and cognitive training separately have been found to improve brain plasticity and improve cognitive functioning in schizophrenia to a moderate degree. However, animal models have shown that the addition of cognitive training to an exercise program can augment the neuromodulatory effects of exercise. This study is the first to report on the effects of a combined exercise and cognitive training intervention on brain plasticity measures in first-episode schizophrenia patients. Methods: Whole-brain structural MRI scans (MPRAGE) were collected on a 3T MRI scanner at UCLA to extrapolate cortical thickness measures at baseline and at 6-month follow-up in 37 first-episode schizophrenia patients undergoing a pilot RCT of cognitive training and exercise. Patients were randomly assigned to either a combined cognitive training and exercise (CT&E, N = 20) or cognitive training without exercise (CT, N = 17) program for 6 months. We used brain plasticity-based computer programs from Posit Science (BrainHQ and SocialVille) for cognitive training. To examine the hypothesized role of neuroplasticity-inducing physical exercise the CT&E group also participated in an aerobic conditioning exercises for 150 minutes per week, including 45 minutes at UCLA 2 days a week and 30 minutes at home 2 days a week. Both treatment groups participated in these cognitive training sessions at UCLA 2 days a week, 2 hours a day. The MCCB cognitive battery was also administered at baseline and 6 month follow-up. Results: Significant Group × Time interactions for cortical thickness were found only in prefrontal regions and only as increases in the C&TE but not in the CT group. Focal increases were found in the left rostral middle frontal (DLPFC) (F = 5.71, P = .02), right superior frontal (F = 6.35, P = .02) and right medial orbitofrontal (OFC) (F = 4.01, P = .05) cortices. Conclusion: These structural brain findings highlight the role of exercise to bolster increases in volume which can lead to more efficient functional organization in the prefrontal cortex and drive improvements in executive functioning. This research has the potential to elucidate the neurobiological mechanisms driving cognitive improvement in this combined intervention and help to guide treatment development in the early phase of schizophrenia.
The creation and validation of the Measure of Effective Attributes of Trainers (MEAT)

Training is a core component in the implementation of empirically supported treatments, especially in the case of psychosocial interventions targeting mental illness. However, common forms of training are relatively ineffective in producing behavioral changes in providers. Trainers are in a strategic position to influence the success of training, but no research, to our knowledge, has explored whether personal characteristics of trainers (e.g., enthusiasm, charisma) increase effectiveness of training empirically supported treatments in the field of mental health. To address this gap, the current study created a measure of trainer characteristics (the Measure of Effective Attributes of Trainers (MEAT)) and assessed preliminary evidence for its reliability and validity by following gold standard measure development procedures. Measure development consisted of three steps: (1) An initial pool of items was generated based on extant literature, input from the target population, and expert input; (2) target users of the measure interacted with the initial item pool to ensure face validity as well as clarity of measure instructions, response options, and items; and (3) a convenience sample viewed training videos and completed the measure resulting from step 2 to establish preliminary evidence of reliability and validity. An exploratory factor analysis was performed on the measure to determine whether latent factors (i.e., subscales of characteristics) underlie the data. The final solution consisted of two factors that demonstrated preliminary evidence for structural validity of the measure. The first factor, labeled “Charisma,” contained items related to characteristics that facilitate a positive personal relationship with the trainee (e.g., friendly, warm), and the second factor, labeled “Credibility,” contained items related to characteristics that emphasize the qualification of the trainer (e.g., professional, experienced). There was also evidence for face validity, content validity, reliability, and known groups validity of the measure. The MEAT demonstrated preliminary evidence of key psychometric properties. Future research is needed to further explore and contribute to its psychometric evidence, which could be done in conjunction with measures of trainee knowledge, attitudes towards empirically supported treatments, and evaluations of trainee behavior change to delineate key characteristics of trainers to be leveraged for more effective training.
Motor Control Exercise for Chronic Nonspecific Low Back Pain.

ObjectivesTo evaluate the effectiveness of motor control exercises (MCE) in patients with chronic nonspecific low back pain.Type of ReviewThe authors conducted electronic searches in CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers from their inception up to April 2015: Cochr
Multiregional tumor drug-uptake imaging by PET and microvascular morphology in end-stage diffuse intrinsic pontine glioma

Inadequate tumor uptake of the vascular endothelial growth factor antibody bevacizumab could explain lack of effect in diffuse intrinsic pontine glioma. Methods: By combining data from a PET imaging study using 89Zr-labeled bevacizumab and an autopsy study, a 1-on-1 analysis of multiregional in vivo and ex vivo 89Zr-bevacizumab uptake, tumor histology, and vascular morphology in a diffuse intrinsic pontine glioma patient was performed. Results: In vivo 89Zr-bevacizumab measurements showed heterogeneity between lesions. Additional ex vivo measurements and immunohistochemistry of cervicomedullary metastasis samples showed uptake to be highest in the area with marked microvascular proliferation. In the primary pontine tumor, all samples showed similar vascular morphology. Other histologic features were similar between the samples studied. Conclusion: In vivo 89Zr-bevacizumab PET serves to identify heterogeneous uptake between tumor lesions, whereas subcentimeter intralesional heterogeneity could be identified only by ex vivo measurements. 89Zr-bevacizumab uptake is enhanced by vascular proliferation, although our results suggest it is not the only determinant of intralesional uptake heterogeneity.
Dermatomyositis: Autoantibodies and Their Corresponding Phenotypes

Purpose of Review In dermatomyositis (DM), antibodies have been shown to closely correlate with clinical phenotypes. The focus of this review is to describe the known clinical associations of the different antibodies related to DM. Recent Findings The DM-specific antibodies include anti-Mi-2, anti-NXP2, anti-TIF1-gamma, anti-MDA5, and anti-SAE. They present with varying levels of skin, muscle, and other target organ involvement. The anti-synthetase antibodies can present as DM, but define a distinct subset displaying other features known as the anti-synthetase syndrome. Anti-PM/Scl, anti-Ro, anti-RNP, and anti-Ku are myositis-associated antibodies that can present as DM as well as other overlap syndromes. Summary More homogenous subgroups are created by viewing DM through the filter of antibodies. The demonstration of one of these antibodies in a patient suspected of having DM is valuable for informing the diagnosis, prognosis, and treatment of the disease. As antibody testing becomes more widely available, we expect even better characterization of disease and treatment response based on antibody groups to emerge in the coming years.
Conformational and Motional Properties of Lipids in Biological Membranes as Determined by Deuterium Magnetic Resonance

Membranes attracted the interest of NMR spectroscopists during the late 1960s. The methods applied were essentially those of high-resolution NMR, and the resonances of 1H and 13C were disappointingly broad. Much activity was therefore focused on sonicated lipid dispersions—small single-bilayer vesicles—in which the rates of rotational diffusion of the model membranes were sufficiently rapid to average out the anisotropies responsible for the broad resonances of natural membranes. The problem with this approach was that the information averaged away by rotation was more valuable than that which was left.
Genetics of the Mind and Brain Disorders

In stark comparison to the elegance of mathematics, biology lies right at the edges of relative chaos, evading understanding at every turn often refusing to conform to theoretical hypotheses. To a biologist, this is the root of elegance. In particular, the irony of not being able to understand the mind remains enticing to both professional and amateur neuroscientists. Nevertheless, it would behoove the greater understanding of the mind and the disorders that afflict it to establish physical patterns. These can then be used in predicting the treatments that would be most effective.
First Report of Prenatal Ascertainment of a Fetus With Homozygous Loss of the SOX10 Gene and Phenotypic Correlation by Autopsy Examination.

The SOX10 gene plays a vital role in neural crest cell development and migration. Abnormalities in SOX10 are associated with Waardenburg syndrome Types II and IV, and these patients have recognizab...
Lunati and the island of towers: Obsidian in Nuragic Sardinia

Abstract This paper discusses Bronze Age Nuragic obsidian exploitation by combining raw material sourcing with techno-typological analysis of a total of 363 obsidian artifacts from two sites in west-central Sardinia. The results are then combined with previously published data to make broader interpretations about obsidian reduction strategies and island-wide exchange networks, making it one of the largest compilations of data on Nuragic obsidian procurement, production, and consumption to date. These new data add nuance to prior generalizations of Nuragic obsidian consumption as an expedient flake-based technology centered on the exploitation of one primary outcrop of obsidian, in turn highlighting the presence of bladelet production as well as regional differences in source exploitation that are distinct from earlier time periods. Despite such diversity, lunates of SC obsidian are ubiquitous and may have circulated as finished products. In this context, the exchange of obsidian likely acted as a means of regulating social relations across space, in turn structuring the flow of goods, information, and ideas that were key to the creation and maintenances of Nuragic identity.
Women’s Sexualities

Positive sexual experiences contribute to women’s personal and relationship satisfaction throughout life (Brecher, 1984; Spector & Fremeth, 1996). Until recently, however, women’s sexuality either has been seen as a problem or ignored (Ussher, 1993). Therefore, we lack a comprehensive understanding of how women develop a sense of themselves as sexual beings. We also know little about the meaning and importance to women of their sexual identities and experiences. Particularly lacking is information about women’s sexuality after the reproductive years of 15 to 44 (di Mauro, 1995). What we do know about women’s sexuality is fragmented, problem focused, often biomedical in nature, and based primarily on the experiences of white women. Summarizing the results of a comprehensive assessment of sexuality research in the United States, di Mauro (1997) might have been talking about women’s sexuality specifically when she noted that:
Chronic Idiopathic Diarrhea

Chronic diarrhea is defined as passage of loose stools for more than 4 weeks. In most instances the cause of chronic diarrhea can be discovered and treated effectively. A few less common causes also play a role: laxative abuse, small bowel bacterial overgrowth, and even bile acid malabsorption. Rarer syndromes account for a much smaller percentage of chronic diarrheas but may be more difficult to identify and treat. In a small number of patients, a cause for chronic diarrhea cannot be found and they are said to have chronic idiopathic secretory diarrhea, a fairly homogeneous disorder that can be sporadic or epidemic. This disorder can be diagnosed after excluding other causes of chronic diarrhea; it is associated with moderate weight loss and gradually subsides after 1.5–3 years. A sensible approach to the patient with chronic diarrhea of unexplained cause is based on a comprehensive history, focusing on the stool characteristics (watery, bloody, fatty), the occurrence of weight loss, aggravating and mitigating factors (with special emphasis on the diet); on a thorough physical examination and on the careful use of selected laboratory investigations such as complete blood count, comprehensive metabolic panel, thyroid tests, and of course stool tests such as bacterial cultures and extensive search for parasites; electrolytes, pH, occult blood test, leukocytes (or lactoferrin/calprotectin) and fat assessment. Subsequent analysis will depend on the findings from history, physical exam, and stool analysis and may or may not include more aggressive investigations such as CT enterography, small bowel follow-through radiograms, and videocapsule enteroscopy. Additional tests may have to be occasionally utilized, including plasma peptides (chromogranin, gastrin, calcitonin, VIP, somatostatin) and urine chemistry tests (5-HIAA, metanephrines, histamine).
An Anion Exchange Process for Americium-Curium Recovery from Plutonium Process Waste

S>An anion exchange process for the recovery of americium, curium, and rare earths contained in the waste effluent from plutonium processing was developed and tested on a laboratory scale. In the process the waste, which is a solution of americium, curium, aluminum, and fission products, in concentrated nitric acid, is concentrated by evaporation until a temperature of 140 deg C is reached. This removes excess acid, and the proper feed concentration of 2,34 M Al(NO/sub 3/)/sub 3/ is obtained by dilution. The americium, curium, and rare earths are sorbed on Dowex 1-10X resin; aluminum is washed from the column with 8 M LiNO/sub 3/; and the americium, curium, and rare earths are eluted with 0.65 M HNO/sub 3/. In laboratory demonstrations of the process made with americium tracer and macro amounts of rare earths, americium losses were undetectable, aluminum decontamination factors were 250, and rare earth concentration in the product was as great as 8.5 gm/liter. (auth)
The genetic landscape of anaplastic pleomorphic xanthoastrocytoma

Pleomorphic xanthoastrocytoma (PXA) is an astrocytic neoplasm that is typically well circumscribed and can have a relatively favorable prognosis. Tumor progression to anaplastic PXA (WHO grade III), however, is associated with a more aggressive biologic behavior and worse prognosis. The factors that drive anaplastic progression are largely unknown. We performed comprehensive genomic profiling on a set of 23 PXAs from 19 patients, including 15 with anaplastic PXA. Four patients had tumor tissue from multiple recurrences, including two with anaplastic progression. We find that PXAs are genetically defined by the combination of CDKN2A biallelic inactivation and RAF alterations that were present in all 19 cases, most commonly as CDKN2A homozygous deletion and BRAF p.V600E mutation but also occasionally BRAF or RAF1 fusions or other rearrangements. The third most commonly altered gene in anaplastic PXA was TERT, with 47% (7/15) harboring TERT alterations, either gene amplification (n = 2) or promoter hotspot mutation (n = 5). In tumor pairs analyzed before and after anaplastic progression, two had increased copy number alterations and one had TERT promoter mutation at recurrence. Less commonly altered genes included TP53, BCOR, BCORL1, ARID1A, ATRX, PTEN, and BCL6. All PXA in this cohort were IDH and histone H3 wildtype, and did not contain alterations in EGFR. Genetic profiling performed on six regions from the same tumor identified intratumoral genomic heterogeneity, likely reflecting clonal evolution during tumor progression. Overall, anaplastic PXA is characterized by the combination of CDKN2A biallelic inactivation and oncogenic RAF kinase signaling as well as a relatively small number of additional genetic alterations, with the most common being TERT amplification or promoter mutation. These data define a distinct molecular profile for PXA and suggest additional genetic alterations, including TERT, may be associated with anaplastic progression.
A quality improvement intervention to enhance performance and perceived confidence of new internal medicine residents.

ABSTRACTBackground: Orientation for new medical residents is challenging due to the diversity of prior experiences and cultural backgrounds and is compounded by a lack of orientation curricula that adequately addresses the needs of the medical residents to allow them to perform their duties in an efficient manner from the start. The beginning of residency training is associated with reduced quality of healthcare widely referred to as the ‘July effect’.Objective: To assess the impact of a peer-led orientation for new interns on (a) self-reported confidence level, (b) improvement in performance of first-year residents in appropriate clinical documentation and efficient discharge procedures and protocols.Design/methods: In June 2016, a hybrid of interactive teaching and simulation exercises was used to teach documentation of critical information, such as discharge medication reconciliation and discharge summary. A handout of an intern guide/manual was also provided. The previous year’s data served as compari...
Frequency and phenotype consequence of APOC3 rare variants in patients with very low triglyceride levels.

High levels of triglycerides (TG ≥200 mg/dL) are an emerging risk factor for cardiovascular disease. Conversely, very low levels of TG are associated with decreased risk for cardiovascular disease. Precision medicine aims to capitalize on recent findings that rare variants such as APOC3 R19X (rs76353203) are associated with risk of disease, but it is unclear how population-based associations can be best translated in clinical settings at the individual-patient level. To explore the potential usefulness of screening for genetic predictors of cardiovascular disease, we surveyed BioVU, the Vanderbilt University Medical Center’s biorepository linked to de-identified electronic health records (EHRs), for APOC3 19X mutations among adult European American patients (> 45 and > 55 years of age for men and women, respectively) with the lowest percentile of TG levels. The initial search identified 262 patients with the lowest TG levels in the biorepository; among these, 184 patients with sufficient DNA and the lowest TG levels were chosen for Illumina ExomeChip genotyping. A total of two patients were identified as heterozygotes of APOC3 R19X for a minor allele frequency (MAF) of 0.55% in this patient population. Both heterozygous patients had only a single mention of TG in the EHR (31 and 35 mg/dL, respectively), and one patient had evidence of previous cardiovascular disease. In this patient population, we identified two patients who were carriers of the APOC3 19X null variant, but only one lacked evidence of disease in the EHR highlighting the challenges of inclusion of functional or previously associated genetic variation in clinical risk assessment.
Reliability of the Modified Clavien-Dindo-Sink Complication Classification System in Pediatric Orthopaedic Surgery.

Background:There is no standardized complication classification system that has been evaluated for use in pediatric or general orthopaedic surgery. Instead, subjective terms such as major and minor are commonly used. The Clavien-Dindo-Sink complication classification system has demonstrated high int
Adipose-only sentinel lymph nodes: a finding during the adaptation of a sentinel lymph node mapping algorithm with indocyanine green in women with endometrial cancer

Objective To identify factors that affect successful adaptation of sentinel lymph node mapping and those that lead to unintended adipose-only sentinel lymph node identification. Methods Surgical and pathological data were prospectively collected on patients with endometrial cancer who underwent sentinel lymph node mapping with indocyanine green with or without pelvic and/or para-aortic lymph node dissection between November 2013 and April 2017. All mapping cases were performed with the robotic system. Adipose-only specimens were defined as a sentinel lymph node without a pathologically identified lymph node after ultrastaging. Results A total of 202 patients were included: 83% had endometrioid pathology, 12% serous, 3% carcinosarcoma, and 2% clear cell, with mixed pathology noted in 2%. The bilateral sentinel lymph node detection rate was 66%, and the rate of mapping at least a unilateral sentinel lymph node was 86%. Neither the bilateral nor the unilateral sentinel lymph node mapping rate changed with increased surgeon experience. The rate of adipose-only sentinel lymph node identification was more frequent when comparing the first 10 cases (37%), cases 11 – 30 (28%), and > 30 cases (9%) (P = 0.006). Body mass index > 30 kg/m2, uterine fibroids, The International Federation of Gynecology and Obstetrics (FIGO) grade, and histology were not found to have a statistically significant impact on either sentinel lymph node identification or adipose-only sentinel lymph node identification. Adipose-only sentinel lymph nodes were more likely with increased time from cervical injection to identification of the sentinel lymph node in the right hemipelvis. The median range was 28 min (14–73) for true sentinel lymph node identification vs 33 min (23–74) for adipose-only sentinel lymph node identification (P = 0.02). Conclusion Patient and surgeon factors did not impact the identification of sentinel lymph nodes over time. Adipose-only sentinel lymph nodes were more frequently identified in the initial cases and represent a potential complication to adapting sentinel lymph node biopsy without lymphadenectomy. The increase in adipose-only sentinel lymph node identification that was associated with time from cervical injection may represent delayed or disrupted uptake of indocyanine green.
The Returns to Repeat Acquirers

Why are repeat acquirers' early abnormal returns higher than those from later acquisitions? This paper argues that acquirers minimize integration and transaction costs by choosing an optimal target size. As acquirers get larger, they optimally choose targets of larger absolute size, but smaller relative size, leading to declining returns. Using a panel dataset of repeat acquirers over two decades, empirical tests support this argument. In contrast, I find no support for alternative explanations of declining returns based on hubris and diminishing opportunity sets, and only weak support for agency explanations. In addition, using new econometric techniques, I reject the popular theory that declining returns result from market anticipation of later deals.
Numerical evaluation of steel-rubber isolator with single and multiple rubber cores

Abstract Seismic base isolators are used extensively in buildings, bridges, and critical infrastructure. During a seismic event, these isolators simultaneously experience the service loads and the base shear loads. It is therefore critical to understand their mechanical response under combined loading. In previous studies, researchers designed base isolators with the assumption that the axial loading is compressive. However, the baser isolators may also experience a tensile axial load during a seismic event. Few researchers have investigated the behavior of base isolators with combined axial tensile stress and base shear. This paper uses the finite element method to model the behavior of steel-rubber base isolators under combined axial tension or compression and base shear. The effect of the magnitude and direction of the axial load is investigated for base isolators subject to 375% shear strain. The numerical models suggest that the apparent stiffness of the base isolator increases when the axial load is tensile. The influence of the number and size of rubber cores in the steel-rubber base isolator is also investigated. The results suggest that base isolators with multiple radially-distributed rubber cores outperform those with a single central rubber core.
Tell it to Me Straight: The Benefits (and Struggles) of a Consumer‐driven Assessment Process

Community-based Participatory Research (CBPR), where consumers participate in the design and execution of an evaluation, holds promise for increasing the validity and usefulness of evaluations of services. However, there is no literature comparing methods and outcomes of studies conducted by professional evaluators with those conducted through a consumer-driven evaluation process. We attempt to fill this gap by presenting the methods and results from a qualitative evaluation conducted by professional evaluators along with one conducted by a team of consumer researchers who engaged in a CBPR process. This paper includes: (a) methods, and findings that emerged from these evaluations each tasked with examining similar issues within the same community; (b) description of the process used to train the team of consumer researchers whose economic and educational backgrounds are different than most evaluators; and (c) lessons learned about how to prepare for and work with common barriers to implementing a CBPR evaluation.
All Optical GSPS Analog-Digital Converters (ADC)

Direct digital receivers operating up to millimeter wave frequencies are desired for telecommunications, instrumentation, and surveillance, as analog received signals are digitized for high performance signal processing. All optical GSPS ADC with high ENOB is presented using stable clock, spatial light modulator, and quantizer.
Bridging the great divide: toward a comparative understanding of coproduction

Thus, let me recommend that the bridging of gulf between the analysis of private activities apart from those of government agencies needs to be high on the agenda of development theorists and activ...
10 – Testing Hypotheses about Differences between the Means of Two Populations

Publisher Summary This chapter explains how to conduct hypotheses test for differences between the means of two populations… The test procedure is appropriate when several conditions are met, such as, the samples are independent.
A Proposed Forward Silicon Tracker for the Future Electron-Ion Collider and Associated Physics Studies

The future Electron-Ion Collider (EIC) will explore several fundamental questions in a broad Bjorken-x ($x_{BJ}$) and $Q^{2}$ phase space. Heavy flavor and jet products are ideal probes to precisely study the tomography of nucleon/nuclei structure, help solve the proton spin puzzle and understand the hadronizaton processes in vacuum or in the QCD medium. Due to the asymmetric collisions at the EIC, most of the final state hadrons are produced in the nucleon/nuclei beam going (forward) direction. A silicon vertex/tracking is critical to precisely measure these forward hadrons at the EIC. Details of different conceptual designs of the proposed Forward Silicon Tracker (FST) and the relevant detector performance are presented in this technical note. The associated heavy flavor and jet studies with the evaluated FST performance are discussed as well.