cssi/SciSciGPT-SciSciNet huggingface dataset:
Body Dysmorphic Disorder in a Facial Plastic and Reconstructive Surgery Clinic Measuring Prevalence, Assessing Comorbidities, and Validating a Feasible Screening Instrument

Importance Body dysmorphic disorder (BDD) is underrecognized and underdetected among patients undergoing facial plastic and reconstructive surgery. Patients with BDD require psychiatric care, not cosmetic surgery. Objectives To measure the prevalence of BDD in a facial plastic and reconstructive surgery clinic, to validate the Body Dysmorphic Disorder Questionnaire (BDDQ) in that setting, to assess the feasibility of implementing a standardized process for identifying patients with BDD accurately in a busy clinical practice, and to assess the comorbidity of BDD, depression, and anxiety in our patient population. Design, Setting, and Participants We performed a prospective prevalence and instrument validation study in an academic facial plastic and reconstructive surgery clinic. We included 234 consecutive patients 18 years or older presenting to the clinic from March 3 to June 30, 2014. Main Outcomes and Measures Prevalence of BDD as determined by the BDDQ and the criterion-standard BDD Structured Clinical Interview for DSM-IV (BDD SCID). The BDD SCID and a defect severity scale were used to confirm the BDD diagnosis and to validate the BDDQ finding. We also assessed demographic characteristics, depression, and anxiety in all patients. Results As confirmed by the BDD SCID, 13.1% of patients undergoing cosmetic surgery and 1.8% of those undergoing reconstructive surgery had BDD. We found the BDDQ to be an accurate (91.7%), sensitive (100%), and specific (90.3%) screening instrument for BDD. Patients with a positive BDD finding were most commonly concerned with their nose (10 of 18 [56%]), skin (5 of 18 [28%]), hair (1 of 18 [6%]), chin (1 of 18 [6%]), and ears (1 of 18 [6%]), that is, areas commonly addressed by facial plastic surgeons. Furthermore, compared with patients who did not have BDD, patients with BDD had elevated depression scores (mean [SD], 12.6 [10.8] vs 3.2 [4.2]). In the non-BDD population, mean (SD) state and trait anxiety scores resembled the norm (30.0 [7.7] and 30.3 [7.7], respectively, for men; 31.7 [10.0] and 32.1 [8.7], respectively, for women); in the BDD population, these scores were elevated (53.8 [23.4] and 50.4 [19.5], respectively, for men; 47.8 [12.7] and 49.0 [11.6], respectively, for women). Depression and anxiety scores were highly correlated in patients with BDD ( r = 0.84 for patients with a BDDQ-positive screen result; r = 0.94 for patients with a positive BDD SCID finding) compared with those who did not have BDD ( r = 0.51). Conclusions and Relevance Patients with BDD often seek cosmetic treatment. Given the documented risks and harms of surgery for patients with BDD, a systematic process for identifying such patients who seek cosmetic surgery is imperative. We found a BDD screening instrument (BDDQ) followed by the BDD SCID for patients with a BDDQ-positive screen result to be a feasible and effective way to identify patients with BDD. Level of Evidence NA.
Solving ill-posed problems with artificial neural networks

Abstract With many physical problems, measurement of spectral distribution, cosmic radiation, aerial and satellite imaging indirect sensing/recording devices are used. In many of these cases, the recording systems can be modeled by a Fredholm integral equation of the first kind. An inversion of the kernel representing a system, in the presence of noise, is an ill-posed problem. The direct inversion often yields an unacceptable solution. In this paper, we suggest an artificial neural network (ANN) architecture to solve certain kinds of ill-posed problems. The weights in the model are initialized using eigen-vectors and eigen-values of the kernel matrix that characterize the recording system. We assume the solution to be a sample function of a wide sense stationary process with a known auto-correlation function. As an illustration, we consider two problems: a well known Phillips' problem and problem of restoration of a degraded image.
EMERALDS: a microkernel for embedded real-time systems

EMERALDS (Extensible Microkernel for Embedded Real Time Distributed Systems) is a real time microkernel designed for cost conscious small to medium size embedded systems. It not only offers standard OS services like multi threaded processes, real time scheduling, protected address spaces, message passing, semaphores, and timers, but does so in an efficient manner while keeping the kernel size to just tens of kilobytes. For efficiency, EMERALDS uses the novel approach of mapping the kernel into each user level address space, so even with full memory protection, system calls do not need context switches unless a user level server is involved. EMERALDS also provides the flexibility for users to add communication protocol stacks and device drivers as user level servers without modifying the kernel. We have completed a uniprocessor version of EMERALDS for the Motorola 68040 processor whose size is under 13 KBytes. Context switch takes under 12 /spl mu/s and system calls have overhead just 1.8 /spl mu/s more than that of simple subroutine calls.
Nonequilibrium Thermal Plasma Jet Impinging on a Substrate

The interaction of a thermal plasma jet with a substrate is encountered in diverse technological applications, ranging from plasma spraying to toxic waste treatment and plasma gasification. The flow of a jet produced by a nontransferred arc plasma torch impinging on a flat substrate is simulated using a fully coupled thermodynamic nonequilibrium model. The modeling results indicate that the dynamics of the arc inside the torch cause the quasi-periodic movement of the jet, which leads to the formation of complex patterns in the heavy-species and electron temperature distributions, together with significant deviations from thermodynamic equilibrium, near the substrate. It is observed that the evolution of the degree of nonequilibrium near the substrate is strongly correlated with the direction of movement of the jet and, hence, with the arc dynamics inside the torch.
Mion-ASF: Biokinetics of an MR receptor agent

Receptor-directed MR contrast agents are currently being designed to improve sensitivity and specificity of MR imaging and to provide for functional MR imaging. In the current study we have synthesized a conjugate of asialofetuin (ASF), a bovine plasma protein with a known, high affinity for the hepatic asialoglycoprotein receptor, and a well defined, single crystal superparamagnetic label (monocrystalline iron oxide nanoparticle, MION). MION-ASF is cleared from the circulation more than 300 times faster than MION, has a 3.7 times higher hepatic accumulation, increases liver R2 relaxivity 2.8-fold compared to MION, and accumulates in hepatocytes unlike MION, which accumulates only in macrophages. Competition assays indicate that receptor-mediated hepatocyte uptake can be competitively blocked and that this effect can be demonstrated by imaging. These studies indicate that sensitive iron oxide based probes can be developed for functional MR imaging.
Land Trusts and Conservation Easements: Who Is Conserving What for Whom?

Land trusts, partnered with government agencies or acting alone, are working to conserve habitat, open space, and working landscapes on private land. Spending both public and private funds, such institutions frequently acquire less than full title by purchasing or accepting donations of conservation easements. These title and organizational arrangements are evolving so fast that it is difficult to assess their conservation accom- plishments and long-term viability. To understand the contribution of these arrangements to the preservation and restoration of biodiversity, conservation biologists need to identify the biological resources likely to be conserved and those likely to be left unprotected through easements held by land trusts. We describe land trusts and conservation easements and why they are currently an attractive approach to land protection. Our review of the literature showed that little information is available on (1) the resulting pattern of protected lands and resources being conserved, (2) the emerging institutions that hold conservation easements and the landowners they work with, and (3) the distribution of costs and benefits of land trusts and easements to communities and the general public. The prescriptive literature on how to establish land trusts and negotiate easements is extensive. However, easily available information on protected resources is too aggregated to determine what is actually being conserved, and more detailed data is widely scattered and hence difficult to synthesize. The social science literature provides some insight into the motives of landowners who participate but offers little about the variety of institutions or which type of institution works best in particular ecological and political settings. Equally undeveloped is our understanding of the inherent tension between the public and private benefits of this widely used incentive-based conservation strategy. Interdisciplinary research is needed to de- termine the ecological and social consequences of acquiring partial interest in private land for conservation purposes.
Ritmos rurales y conflictos de clases durante el siglo XVIII en Cochabamba

Hace no mas de una decada, en medio de un acalorado debate sobre las contribuciones y omisiones de A. G. Frank, acusado de no prestar suficiente atencion a la dinamica interna de las sociedades1, Enrique Florescano publicaba calladamente su monografia sobre los precios del maiz y las crisis agricolas en Mexico durante el siglo XVIII, donde se revela por primera vez el pulso de la vida agraria en el centro de Mexico2. Se inspira en la metodologia desplegada por la rica tradicion historiografica de Francia con respecto a la historia de los precios agricolas . Al igual que Labrousse, quien lo precedi6, Florescano visualiza el tiempo hist6rico como constituido por multiples periodicidades. De este modo, destaca dos niveles de movimientos recurrentes, uno estacional y otro ciclico. El primero esta representado por las fluctuaciones anuales de la produccion y los precios agrarios: el ciclo de cosechas que marcaha el ritmo de la vida material para la mayor parte de la gente en la sociedad mexicana. El segundo es un movimiento ciclico que solo ocurre con intermitencias, a menudo dejando intervalos de 10 y 20 afios, cuando se producian cambios meteorologicos (a veces de indole malthusiana) que hundian a las economias agrarias en graves crisis de subsistencia. Graficando curvas de precios
Selective increase in monocyte p38 mitogen-activated protein kinase activity in metabolic syndrome:

Objective:Metabolic syndrome is a common disorder that predisposes to both cardiovascular disease and diabetes. There is paucity of data on cellular signal transduction pathways in metabolic syndro...
Normoxic induction of HIF-1α in macrophages is required for protection from the fungal pathogen H. capsulatum. (MPF3P.807)

Histoplasma capsulatum (Hc) is the most common cause of respiratory infection among endemic mycoses. Macrophages (MΦ) are the primary phagocytic cell that engulfs Hc. Recent data has demonstrated that the transcription factor hypoxia inducible factor 1α (HIF-1α) can be induced by pro-inflammatory cytokines or LPS in normoxia. Because HIF-1α regulates a number of factors that are potentially vital in MΦ responses to Hc, we hypothesized that myeloid HIF-1α exerts a critical role in conferring protection to Hc. Indeed, the absence of myeloid HIF-1α led to significantly higher fungal burden at 7 days post-infection and a 75% reduction in survival following Hc infection. In vitro, the HIF-1α isoform i.1 (HIFi.1) and downstream target genes were transcriptionally induced in Hc-infected bone marrow derived MΦ in normoxia. To determine if HIFi.1 induction occurs in vivo, mice were infected with a Hc strain expressing GFP. At 7 days post infection, GFP+ (infected) and GFP- (uninfected) MΦ were isolated from lungs; surprisingly both GFP+ and GFP- phagocytes exhibited induction of HIFi.1 and its target genes. Transwell assays demonstrated that a soluble mediator released from infected cells was partly responsible for HIF i.1 induction. Genetic deletion of TNFR1 or dectin-1 abrogated the in vitro induction of HIFi.1. We propose that dectin-1 mediated MΦ TNF-α production is responsible, at least in part, for induction of HIFi.1; myeloid HIF-1α is instrumental in the immune response to Hc.
Rehabilitation in a Red State

Research Summary Based on a 2013 survey of 1,001 likely voters in Texas, public support for correctional reform in a “red state” was examined. Four major conclusions were revealed. First, the respondents displayed strong support for rehabilitation. Second, at least for nonviolent and/or drug offenders, the sample members showed a clear preference for the use of alternatives to incarceration as opposed to imprisonment. Third, when asked about a specific policy reform that used treatment rather than prison for nonviolent drug offenders, more than eight in ten Texans approved of the measure, and strong majorities endorsed various rationales for it. Fourth, with some minor variation, the respondents revealed substantial consensus across demographic groups in their embrace of rehabilitation and correctional reform. Policy Implications With the growth of mass imprisonment arguably at its end, the existence of strong public support for correctional reform even in the major red state of Texas, suggests that a new “sensibility” about crime control has taken hold. There is now an emergent national consensus that the overuse of incarceration is unsustainable and that low-risk offenders no longer should be sanctioned with a prison sentence. The American public, in Texas and beyond, is willing to support a policy agenda that includes offender treatment, prison downsizing, and alternatives to incarceration. The challenge for elected officials is to take advantage of this ideological space and to pursue this agenda. Notably, politicians in Texas and in other red states are using this opportunity to implement correctional policy reforms. The data in this study indicate that they will face no public backlash and, if anything, will gain political capital for their efforts.
Molecular characterization of Tclabial and the 3' end of the Tribolium homeotic complex.

The homeotic selector gene labial is located at the 3′ end of the Antennapedia complex (ANTC) and is required for proper head development in Drosophila. We have cloned and characterized the Tribolium ortholog of labial, Tclabial (Tclab). Similar to Drosophila labial, Tclab contains a single large intron upstream of the homeobox. In contrast, Tclab lacks an intron within the homeobox. The Tribolium ortholog of chaoptic, Tcchaoptic, transcribed from the opposite strand, is located immediately downstream of the homeotic complex, and its 3′UTR overlaps that of Tclab by 50 nucleotides. We have also sequenced the 13.5 kb interval between Tclab and maxillopedia (the Tribolium ortholog of Drosophila proboscipedia). In contrast to Drosophila, there is not a cluster of cuticle genes in this region. Finally, we have examined the expression of Tclab transcripts in Tribolium embryos. As previously described for Drosophila and other insects, the expression of Tclab is specific to the intercalary segment.
Pricing Remanufactured Products Under Stochastic Demand and Backlogging

Independent and small scale product recovery facilities (PRFs) often struggle to achieve profits under inconsistent inflows of discarded products and varying demand patterns for remanufactured products. Inconsistent inflows coupled with the varying demand cause undue fluctuations in inventory levels and holding costs. PRFs can leverage the inventory levels by posting appropriate prices for remanufactured products and procuring the right quantity of discarded products. This work determines the optimal prices of remanufactured products and the optimal procurement quantity of discarded products when (a) PRFs passively accept and proactively acquire discarded products, (b) demand for remanufactured products is stochastic, and (c) backlogging of demand is permitted. The stochastic demand is modeled to consist of an additive random variable. Optimal solutions are established when the additive random variable follows a generic probability distribution.Copyright © 2008 by ASME
From Social Capital to Inequality: Migrant Networks in Different Stages of Labor Incorporation†

How does social capital vary in the distinct stages (prehiring, hiring, and posthiring) of labor incorporation? Based on interviews with 71 Latino migrant workers engaged in residential construction in Las Vegas, Nevada, and 30 transnational migrants who returned to Mexico after working in the United States, I examined two primary issues: first, the structural labor mechanisms that create hyperexploitation, and second, how, in turn, such processes shape social capital. I discovered, at the prehiring phase, social networks connected to subcontractors and those who attempt to form a labor crew function as social capital, despite what may appear to be bonded labor. At the hiring stage, social capital continues to play a role, yet posthiring labor structures create hyperexploitation and immigrants experience inequality in social capital. In such contexts, undocumented Latinos are unable to retain their social capital as U.S. labor structures such as subcontracting and piece-rate compensation lead to the subjugation of workers, who can become “ghost workers” and bonded laborers. I conclude that in the posthiring stage, such labor structures create what Lin (2000, 2001) refers to as capital deficit and return deficit in social capital that greatly limit the economic incorporation of Latino immigrants.
Metabonomics and its growing insights into pharmacology

With the development of chemical analysis technology and data processing technology,metabonomics has become the important method in functional genomics study.In this paper,the definition and advangtages of metabonomics are provided.The implication of metabolomics in pharmacology are summarized and future perspectives are discussed.
An Application of PARAFAC to a Small Sample Problem, Demonstrating Preprocessing, Orthogonality Constraints, and Split-Half Diagnostic Techniques (Appendix)

In this appendix, we present in detail· the procedure involved in a single application of PARAFAC three-way factor analysis to real data. The data are from a pilot marketing study and consist of the ratings of 25 stimuli (names of automobiles and celebrities) made by each of 34 raters, using a set of 39 bipolar ratihg scales. The objective of the analysis is to determine the connota­tive and semantic dimensions describing the celebrities and auto­mobiles in order to decide which celebrity should be chosen as spokesman for a given automobile.
The Use of Sacral Nerve Blocks in the Evaluation and Treatment of Neurologic Bladder Disease

We describe the use of sacral nerve blocks in conjunction with air cystometry and sphincter electromyography to determine the functional innervation of the bladder and sphincters. This technique has aided in the selection of patients for sacral rhizotomy. Phenol sacral nerve blocks have been used successfully in treating hyperactive bladder disease and intractable perineal pain.
AQuA: adaptive quality analytics

Event-processing systems can support high-quality reactions to events by providing context to the event agents. When this context consists of a large amount of data, it helps to train an analytic model for it. In a continuously running solution, this model must be kept up-to-date, otherwise quality degrades. Unfortunately, ripple-through effects make training (whether from scratch or incremental) expensive. This paper tackles the problem of keeping training cost low and model quality high. We propose AQuA, a quality-directed adaptive analytics retraining framework. AQuA incrementally tracks model quality and only retrains when necessary. AQuA can identify both gradual and abrupt model drift. We implement several retraining strategies in AQuA, and find that a sliding-window strategy consistently outperforms the rest. AQuA is simple to implement over off-the-shelf big-data platforms. We evaluate AQuA on two real-world datasets and three widely-used machine learning algorithms, and show that AQuA effectively balances model quality against training effort.
Activity and Individual Human Recognition in Infrared Imagery

In this chapter, we investigate repetitive human activity patterns and individual recognition in thermal infrared imagery, where human motion can be easily detected from the background regardless of the lighting conditions and colors of the human clothing and surfaces, and backgrounds. We employ an efficient spatio-temporal representation for human repetitive activity and individual recognition, which represents human motion sequence in a single image while preserving spatio-temporal characteristics. A statistical approach is used to extract features for activity and individual recognition. Experimental results show that the proposed approach achieves good performance for repetitive human activity and individual recognition.
Proust, Beckett, and Narration: Moran's Way: The forgetful spiral of irony

Molloy's seemingly allegorical narrator, who initially pretends to seek out mother and self, tries to take refuge from allegory in transhistorical irony of irony, and parody of parody, which he already found in Proust. However, this very attempt to be fully ironical produces a repetition of allegory. Molloy narrator thus traces a failed attempt to transform the allegory of his past search for, and deconstruction of, self into a pure present of irony. In the second half of Molloy , Moran narrator, who imagines himself to be purely ironical, recounts the failed process of transforming his past and present ironical selves into an allegorical narration like the one that Molloy initially appears to adopt. Moran narrator has no interest in Proust's remembering narrator. Rather, like Proust's writing narrator, he tries to adopt a purely ironical stance towards allegory. Like Proust and his writing narrator, Moran is an insomniac who writes during the night: “It is midnight. The rain is beating on the windows … I can't sleep. My lamp … will last till morning … My report will be long … I remember the day I received the order to see about Molloy …” ( TN , 92). Moran narrator's reference to his present writing of a report on his past investigation of Molloy creates the impression that he, unlike Molloy, can voluntarily remember the past.
Toward a definition of and linguistic support for partial quiescence

The global quiescence of a distributed computation (or distributed termination detection) is an important problem. Some concurrent programming languages and systems provide global quiescence detection as a built-in feature so that programmers do not need to write special synchronization code to detect quiescence. This paper introduces partial quiescence (PQ), which generalizes quiescence detection to a specified part of a distributed computation. Partial quiescence is useful, for example, when two independent concurrent computations that both rely on global quiescence need to be combined into a single program. The paper describes how we have designed and implemented a PQ mechanism within an experimental version of the JR concurrent programming language. Our early results are promising qualitatively and quantitatively.
Refugee health education: Evaluating a community-based approach to empowering refugee women in Houston, Texas

Although resettlement agencies in the United States assist refugees by offering a variety of local social and health services, refugees are still less likely to access these services. Few studies have evaluated refugee health education interventions focusing on barriers to accessing healthcare and overcoming negative social determinants of health. This study evaluated the feasibility, acceptability, and perceived impact of a yearlong health education intervention to empower Burmese refugee women living in Houston, Texas. The intervention included workshops, community excursions, question and answer (Q&A) sessions, and home visits. The evaluation was a formative qualitative study including interviews with Burmese refugee women who participated in the intervention and local resettlement agency caseworkers. Qualitative content analysis guided the data analysis and was conducted to identify categories and emergent themes. Key findings indicated that motivation to participate in the intervention was impacted by the women’s perceived relevance of health education material to Burmese cultural values and opportunities for hands-on learning to promote self-efficacy. Recommendations for future interventions include the use of community health workers to train refugee health educators, pairing English lessons with health education material to promote development of English language skills, developing teaching materials for refugees with low literacy, establishing bottom-up support from refugee resettlement agencies, and incorporating the social work ecological model to tailor health-focused interventions to the specific needs of the refugee community.
PsyPhy: A Psychophysics Driven Evaluation Framework for Visual Recognition

By providing substantial amounts of data and standardized evaluation protocols, datasets in computer vision have helped fuel advances across all areas of visual recognition. But even in light of breakthrough results on recent benchmarks, it is still fair to ask if our recognition algorithms are doing as well as we think they are. The vision sciences at large make use of a very different evaluation regime known as Visual Psychophysics to study visual perception. Psychophysics is the quantitative examination of the relationships between controlled stimuli and the behavioral responses they elicit in experimental test subjects. Instead of using summary statistics to gauge performance, psychophysics directs us to construct item-response curves made up of individual stimulus responses to find perceptual thresholds, thus allowing one to identify the exact point at which a subject can no longer reliably recognize the stimulus class. In this article, we introduce a comprehensive evaluation framework for visual recognition models that is underpinned by this methodology. Over millions of procedurally rendered 3D scenes and 2D images, we compare the performance of well-known convolutional neural networks. Our results bring into question recent claims of human-like performance, and provide a path forward for correcting newly surfaced algorithmic deficiencies.
The New Space Race

This chapter is an overview to the topic of the changing nature of international space exploration and what drives countries to explore space in the post Space Race environment as well as which countries have entered the space age. Additionally, the chapter outlines the overreaching concept that space exploration is largely determined by political goals within an international framework. Finally, the American space program’s goals of today and where it is headed in the future is identified.
The Catholic Church's Role as Mediator: Bolivia, 1968–1989

In no other Latin American country in recent times has the Catholic Church played the role of mediator to help resolve na tional political and social crises to the degree that it has in Bo livia. Beginning in 1968 and up until the present, the Church has acted as mediator in practically every major clash between the miners and the national government and in the many im passes that were produced by the elections for the presidency. In all of these cases the Church, which was invited by the con tending parties to act as mediator, served as virtually the only nationally acceptable forum in which deep social and political antagonisms could be conciliated. Up until the 1960s the Bolivian Catholic Church, like the Catholic Church in every other Andean country, was small, tra dition-laden, and politically conservative. The impact of the na tional revolution of 1952, and most of all the Second Vatican Council, turned it into one of the most progressive churches in Latin America. Also, the presence of many missionaries from Europe and North America (in the 1970s, 80 percent of all clergy were foreigners) gave progressive groups a clear major ity.1 This shift in the Church was especially noticeable during
Iris volume decreases during pupillary dilation

Objective: To evaluate changes in iris cross-sectional area and volume under dark and lighted conditions using ultrasound biomicroscopy. Patients and methods: Patients underwent ultrasound biomicroscopy imaging using standardized lighting conditions. Imaging was repeated after at least 2 minutes in standardized dark room conditions (physiological dilation) or 30 minutes after instillation of tropicamide 1% (pharmacological dilation). Images were exported to an IBM-compatible computer. Iris volume and cross- sectional area were then measured using an automated software program of our own design capable of calculating iris volume with axial alignment using keratometry and corneal diameter information. Results: Twenty two eyes of 22 healthy people were enrolled. In the pharmacologically dilated eyes, mean iris volume was 41.21 ± 2.64 mm3 before and 35.88 ± 3.92 mm3 after dilation (12.5 ± 11.4% reduction; p = 0.009, paired t-test). For eyes undergoing physiologic dilation, mean iris volume was 39.43 ± 7.83 mm3 using lighted conditions and decreased to 36.80 ± 6.70 mm3 in the dark (6.3 ± 4.8% reduction; p = 0.004). The change in pupillary diameter correlated significantly with iris volume and iris cross-sectional area change after physiological dilation (r2 = 0.41 and 0.35, p = 0.03 and 0.04, respectively, Pearson correlation), but not after pharmacological dilation (p > 0.2). Conclusion: Cross-sectional iris area decreases with pupillary dilation. The iris volume decrease during physiological change was proportionately less than with pharmacological dilation.
Board Review and the Middle-Aged Doctor

Reviewing for her board exam 20 years in, a physician discovers the value of being middle aged — old enough to have suffered or to have witnessed the suffering of loved ones and yet young enough to have the opportunity to pay forward this heightened sensitivity.
Large eddy simulations of erosion of a stratified layer by a buoyant jet

Abstract During a Loss of Coolant Accident (LOCA) accident, leaked hydrogen from the primary circuit can form a stable stratified layer at the top of the containment building. The formation and erosion of a stratified layer is a challenging numerical problem due to the interaction mechanism of the jet flow with the stratified layer. The OECD-NEA conducted an experiment to investigate the erosion of the stratified layer by a vertical air-helium jet from the bottom of the large vessel (height 8 m., diameter 4 m). During the experiment, CFD grade experimental data was generated that could be used for comparative studies. In this study, the LES (Large Eddy Simulation) numerical methodology is used to validate the PANDA experiment for the nuclear reactor containment safety analysis. Specific attention is given to the analysis of the interaction between a buoyant jet and stratified layer. An understanding of the interaction mechanisms will help to quantify turbulent mass transport of the gas components. Good agreement between the numerical results and the experimental data is observed for temporal velocity, gas concentration and temperature data. FFT (Fast Fourier Transform) analysis is applied to check the numerical grid resolution and POD (Proper Orthogonal Decomposition) is applied to investigate coherent flow structures and turbulent mass transport mechanisms. Horseshoe vortices, which has previously been observed experimentally and numerically for buoyant jets, are observed near the round jet.
A new graph triconnectivity algorithm and its parallelization

We present a new algorithm for finding the triconnected components of an undirected graph. The algorithm is based on a method of searching graphs called ‘open ear decomposition’. A parallel implementation of the algorithm on a CRCW PRAM runs inO(log2 n) parallel time usingO(n+m) processors, wheren is the number of vertices andm is the number of edges in the graph.
Portable abdomen radiography: moving to thickness-based protocols

Default pediatric protocols on many digital radiography systems are configured based on patient age. However, age does not adequately characterize patient size, which is the principal determinant of proper imaging technique. Use of default pediatric protocols by inexperienced technologists can result in patient overexposure, inadequate image quality, or repeated examinations. To ensure diagnostic image quality at a well-managed patient radiation exposure by transitioning to thickness-based protocols for pediatric portable abdomen radiography. We aggregated patient thickness data, milliamperes (mAs), kilovoltage peak (kVp), exposure index (EI), source-to-detector distance, and grid use for all portable abdomen radiographs performed in our pediatric hospital in a database with a combination of automated and manual data collection techniques. We then analyzed the database and used it as the basis to construct thickness-based protocols with consistent image quality across varying patient thicknesses, as determined by the EI. Retrospective analysis of pediatric portable exams performed at our adult-focused hospitals demonstrated substantial variability in EI relative to our pediatric hospital. Data collection at our pediatric hospital over 4 months accumulated roughly 800 portable abdomen exams, which we used to develop a thickness-based technique chart. Through automated retrieval of data in our systems’ digital radiography exposure logs and recording of patient abdomen thickness, we successfully developed thickness-based techniques for portable abdomen radiography.
Risk Management Roles of the Public and Private Sector

Insurance is an essential component of household and community resilience. It protects insureds financially against disaster losses, can encourage investments in cost‐effective mitigation measures through premium reductions, and facilitates the rebuilding of property and long‐term recovery. Private insurers face challenges in providing full protection against disasters. This has led governments around the world to create a variety of public insurance entities, often designed as public‐private partnerships. At a November 2016 workshop, “Improving Disaster Financing: Evaluating Policy Interventions in Disaster Insurance Markets,” participants evaluated disaster insurance programs for flood, earthquake, and terrorism losses. This article synthesizes six papers and findings from the workshop and suggests ways to improve public‐private partnerships for disaster financing in three interrelated areas: (1) risk communication, (2) risk reduction, and (3) risk transfer. It concludes with a proposal for a comprehensive insurance program that could harness the benefits of both the public and private sectors.
Women and alcoholic liver disease - warning of a silent danger.

Alcohol use and 'social' drinking are increasing among the young and particularly in women. However, gender equity does not extend to the risk of alcohol-associated liver disease and alcoholic hepatitis, which are increased and often caused by as little as half as much cumulative alcohol consumption in women compared with men.
Ethics of End of Life Decisions in Pediatrics: A Narrative Review of the Roles of Caregivers, Shared Decision-Making, and Patient Centered Values.

Background: This manuscript reviews unique aspects of end of life decision-making in pediatrics. Methods: A narrative literature review of pediatric end of life issues was performed in the English language. Results: While a paternalistic approach is typically applied to children with life-limiting medical prognoses, the cognitive, language, and physical variability in this patient population is wide and worthy of review. In end of life discussions in pediatrics, the consideration of a child’s input is often not reviewed in depth, although a shared decision-making model is ideal for use, even for children with presumed limitations due to age. This narrative review of end of life decision-making in pediatric care explores nomenclature, the introduction of the concept of death, relevant historical studies, limitations to the shared decision-making model, the current state of end of life autonomy in pediatrics, and future directions and needs. Although progress is being made toward a more uniform and standardized approach to care, few non-institutional protocols exist. Complicating factors in the lack of guidelines include the unique facets of pediatric end of life care, including physical age, paternalism, the cognitive and language capacity of patients, subconscious influencers of parents, and normative values of death in pediatrics. Conclusions: Although there have been strides in end of life decision-making in pediatrics, further investigation and research is needed in this field.
The use of subfascial drains after multi-level anterior cervical discectomy and fusion: does the data support its use?

Background: Subfascial drains are routinely used after multi-level anterior cervical discectomy and fusion (ACDF) procedures despite little evidence to support their use. Proponents of drain use argue that drain placement reduces the incidence of post-operative hematomas and surgical site infections (SSI). The aim of this study is to determine whether the use of subfascial drains after multi-level ACDFs are associated with a decreased incidence of hematomas and SSIs. Methods: This is a retrospective study of 321 consecutive adult patients (18 years and older) with degenerative cervical stenosis that undergoing an index multi-level ACDF procedure. Only patients undergoing multilevel ACDF were included in the study. Patients were separated into one of two groups depending whether a subfascial drain was placed during surgery. The decision to place a drain was based on surgeon preference. Baseline characteristics, operative details, as well as rates of hematoma formation and SSIs were gathered by direct medical record review. Results: Of the 321 patients enrolled in the study, 58 (18%) patients had subfascial drains placed at the time of surgery. Baseline demographics and co-morbidities were similar between both cohorts; however, on average, patients in the “Drain Use” cohort were older when compared to those in the “No Drain” cohort (64 vs . 56 years old, P vs . “No Drain”: 1.58 days, P Conclusions: The use of subfascial drains after multi-level ACDF procedures were not associated with a decreased incidence of hematoma formation or SSIs. In fact, patients in which a subfascial drain was used were 14 times more likely to require a post-operative blood transfusion and with an almost 2-fold increase in the duration of in-hospital stay.
Mathematical modelling of biomass pyrolysis phenomena: Introduction

Processes designed to exploit the unique properties of biopolymers will be most likely to enjoy profitable commercial development in the future. The governing equations for pyrolysis of a single biopolymer particle are presented and discussed.
Cost-Effectiveness of Cardiac Rehabilitation in the Elderly: Misaligned Incentives

Cardiovascular disease is the leading cause of death in both developed and developing countries worldwide, with ischemic heart disease the major subcategory. Randomized trials have found that cardiac rehabilitation (CR), a program of supervised exercise, nutritional education, and other services significantly lowers mortality from IHD.. Although Medicare has covered cardiac rehabilitation since the 1980s for beneficiaries with stable angina, heart attack, or bypass surgery, no cost-effectiveness studies of this service in the elderly have been published. To study the cost-effectiveness of this service in the Medicare population, we conducted a 5-year retrospective follow-up on the 601,099 Medicare seniors eligible for CR after surviving a cardiac hospitalization. In studying the impact of CR on survival, both propensity score and instrumental variables (IVs) were used to correct for selection effects with the density of CR facilities (number per 10,000 elders) and distance to the nearest CR facility in the patient's state of residence serving as instruments. CR proved very effective for those who receive it; participation in the program boosted the 5-year survival rate by 6.0 percentage points (p To conduct a cost-effectiveness analysis of CR, we first compared Medicare payments on behalf of the 70,040 CR recipients and an equal number of matched controls without CR, derived from inpatient costs. These costs proved virtually identical, with the small difference being statistically insignificant. Based on the additional 5-year survival, we estimated that members of the CR cohort would live 45,859 more person years but cost Medicare $411 million more over its remaining lifetime (adjusted to 2005 prices) than their matched controls due to the improved survival. The resulting cost-effectiveness ratio is $12,361 per discounted life year. Compared to the often-used threshold value of $50,000 per healthy life year gained, CR is highly cost-effective. On the other hand, the analysis found that CR is underutilized, with only 13% of the cohort with a possible indication for CR (coronary-related hospitalization in the past year) or only 19% with a definite indication (recent heart attack or bypass surgery) initiating outpatient (Phase II) CR. Numerous medical, personal, and organizational factors inhibited the use of CR. These factors seemed to be exacerbated, however, by misaligned financial incentives. Typical payment per CR session of $35 is below the $42 cost of the program as it currently operates, and even further below the projected cost of delivering a more intensive type of CR care based on 2006 regulations from the Medicare Program. These findings suggest that providers and insurers may wish to implement organizational and financial measures to boost utilization of a highly cost-effective service.
Ernst Mayr's 'ultimate / proximate' distinction reconsidered and reconstructed

It's been 41 years since the publication of Ernst Mayr's “Cause and Effect in Biology” wherein Mayr most clearly develops his version of the influential distinction between ultimate and proximate causes in biology. In critically assessing Mayr's essay I uncover false statements and red-herrings about biological explanation. Nevertheless, I argue to uphold an analogue of the ultimate/proximate distinction as it refers to two different kinds of explanations, one dynamical the other statistical.
Grasses and Sedges

Abstract The grasses described in this section provide wide range of ecosystem services ranging from livestock feed, health and integrity of grassland ecosystems, restoration of disturbed landscape (coal mining, over grazing, phytoremediation), moderate weather extremes and their impacts, cycle and move nutrients, contribute to biodiversity, protect soils and improve soil fertility, protect landscape and river banks, to mention a few. In addition, some of the grasses described in the chapter can be used to beatify landscape, sport (turfgrasses), ornamentals, and greenroofs. The adaptation, use and potential problems associated with each species are thoroughly described in the chapter.
Reduced intensity vs. myeloablative conditioning with fludarabine and PK-guided busulfan in allogeneic stem cell transplantation for patients with AML/MDS.

Conditioning regimens contribute significantly to outcomes following allogeneic stem cell transplantation (allo-SCT). Reduced-intensity conditioning (RIC) regimens provide lower toxicity at the cost of reduced efficacy compared with myeloablative conditioning (MAC) regimens. However, because pre-transplant prognostic variables often determine the conditioning regimen, studies of RIC vs. MAC have been inconclusive. We present a retrospective analysis of 242 acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) patients, 112 of whom were in 56 pairs matched using propensity scores, to account for variation that may confound clinical outcomes. The uniform conditioning regimens consisted of fludarabine with pharmacokinetic (PK)-guided intravenous busulfan (Bu). The RIC and MAC regimens were dosed at the average daily area under the concentration-vs-time curve (AUC) of 4000 µMol min and 5000–6000 µMol min, or total course AUC of 16,000 µMol min and 20,000–24,000 µMol min, respectively; PK-guided dosing removes overlap in systemic Bu exposure. When patients’ data were propensity-matched, there was a trend toward significantly increased full donor chimerism and decreased chronic graft vs. host disease in RIC, and no significant differences in progression free survival and overall survival between RIC and MAC. Our results also elucidate the efficacy of PK-guided-dosing in the setting of allo-SCT for AML and MDS.
Influence of Gender on Surgical Residency Applicants' Recommendation Letters.

Background Implicit bias has been documented in candidate selection within academic medicine. Gender bias is exposed when writers systematically use different language to describe attributes of male and female applicants. This study examined the presence of gender bias in recommendation letters for surgical residency candidates. Study Design Recommendation letters for 2016 to 2017 surgery resident applicants selected for interview at an academic institution were analyzed using qualitative text analysis, quantitative text mining, and topic modeling. Dedoose, QDA Miner, and RStudio analytic software were used for analysis. Results There were 332 letters of recommendation for 89 applicants (51% male) analyzed. Of 265 letter writers, 86% were male, 21% chairs, and 50% professors. Average word count was 404. Letter writers for male compared with female applicants had a significantly higher average word count (male = 421, SD 144; female = 388, SD 140, p = 0.035). Standout adjectives (eg exceptional), reference to awards, achievement, ability, hardship, leadership, scholarship, and use of applicant's name were most often applied to male applicants. Comments on positive general terms (eg delightful), grindstone words (eg hard-working), physical description, doubt raisers, and work ethic were most often applied to female applicants. Topic modeling and term frequencies revealed achievement words (performance, career, leadership, and knowledge) used more often with male applicants, while caring words (care, time, patients, and support) were used more often with female applicants. Conclusions Gendered differences examined through language and text exist in surgical residents' recommendation letters. Implementing tools to help faculty write recommendation letters with meaningful content and editing letters for reflections of stereotypes may improve the resident selection process by reducing bias.