cssi/SciSciGPT-SciSciNet huggingface dataset:
Definition of benign versus malignant ventricular arrhythmias: Targets for treatment☆

The most important characteristics of arrhythmias that determine the need for treatment are the prevalence and clinical significance of the ventricular arrhythmia. Ventricular arrhythmias occur more frequently with advancing age, severity of heart disease and ventricular hypertrophy. Malignant ventricular arrhythmias are of 3 forms: out-of-hospital ventricular fibrillation (VF), recurrent sustained ventricular tachycardia and torsades de pointes ventricular tachycardia in the long QT syndrome. Each condition has a high 1-year mortality rate. Potentially malignant ventricular arrhythmias are ventricular premature complexes (VPCs) of greater than 10 per hour 10 to 16 days after acute infarction and repetitive VPCs. The most malignant arrhythmias occur with severely depressed ventricular function, but VPCs alone have independent prognostic significance. Benign ventricular arrhythmias occur in patients without known heart disease and do not require treatment. The exact effect of frequent and complex VPC in these patients needs further definition.
Synthesis and characterization of tetrakis(μ-hydroxo)tetrakis(2,2′-dipicolylamine)tetranickel perchlorate, a nickel-hydroxy cubane complex

A novel tetranuclear complex, [Ni(l3-OH)(DPA)]4(ClO4)4 (where DPA = 2,2 0 -dipicolylamine) has been synthesized, with characterization including electronic and infrared spectroscopy, elemental analysis, mass spectrometry, crystal structure analysis, and variabletemperature and variable-field magnetic susceptibility measurements. The complex features a 4Ni–4OH cubane-type cluster, displaying both ferromagnetic and antiferromagnetic intracluster interactions in a 2J model (J1 = � 3.4 cm � 1 , J2 = 4.7 cm � 1 , D = 2.0 cm � 1 ). Each
Security for fixed sensor networks

Sensor networks consist of resource-constrained sensors operating in a variety of environments. Given the severe constraints on these sensors, it is a particularly challenging problem to choose and design valid security protocols for such networks. This problem has recently given rise to new research addressing the security issues. This paper presents an overview of the important works, specifically the new mechanisms and protocols, which have been introduced or are still under development in this area.
Role of Ki-67 proliferation index and p53 expression in predicting progression of pituitary adenomas☆

Pituitary adenomas sometimes progress after surgery and can be locally invasive. Ki-67 and p53 expression are referred to as indicators of aggressive behavior in the World Health Organization Classification of Endocrine Tumors. The real value of these markers including an appropriate threshold for Ki-67 labeling index correlating with tumor progression is controversial. We identified 24 consecutive pituitary adenomas from patients who required surgery for recurrence within 5 years of their first procedure and 31 consecutive adenomas with no evidence of postsurgical progression within 5 years of first surgery. Case selection was based upon availability of complete clinical information, blocks, and slides for study. Immunohistochemistry for Ki-67 revealed that the tumors without progression had a proliferation index of 0.41% +/- 0.01% (mean +/- SEM) (n = 31) (range, 0.08%-1.2%) and the first biopsy from those tumors which progressed had a mean proliferation index of 1.45% +/- 0.09% (mean +/- SEM) (n = 24) (range, 0.1%-10.6%) (P = .01). With the use of ROC analysis, a threshold level of Ki-67 expression greater than 1.3% predicts progression with a high specificity. The group with progression had a higher proportion of nonfunctioning tumors (P < .005, chi(2)). There was no significant difference between the 2 groups with regard to invasion, suprasellar extension, size, tumor type, postoperative radiotherapy, extent of resection, sex, and age. Ki-67 labeling index was an independent predictor of progression (multivariate analysis, P < .011). p53 was positive in 12.5% of cases with surgical progression and in 9.6% of cases without progression, but the difference was not significant (P = .7; chi(2), 0.11).
Bilingual Education and Alternative Programs for Limited English Proficient Students: A Policy Analysis Focusing on Four School Districts in Colorado.

Abstact In 1980, the Colorado legislature repealed the state’s Bilingual/Bicultural Education Act, and replaced it with the English Language Proficiency Act, making it the first state to rescind a mandate for bilingual/bicultural education. As the need for services for limited English proficient (LEP) students grows, many other states have also been re-assessing their statutes and considering funding alternatives to bilingual/bicultural programs. The purpose of this study was to examine the effects of the statutory change in Colorado from the perspective of those most directly involved with it and affected by it. School district teachers and administrators were interviewed and provided firsthand observations and insights which they believed were consequences of the state policy change. Colorado Department of Education officials, legislators, parents, and other agency officials were able to support or refute many of these observations as possible statewide effects, as well as suggest ways they feel the leg...
Uniaxial Extension of Surfactant Micelles: Counterion Mediated Chain Stiffening and a Mechanism of Rupture by Flow-Induced Energy Redistribution

We study the configurational dynamics in uniaxial elongational flow of rodlike and U-shaped cationic surfactant micelles of cetyltrimethylammonium chloride (CTAC) in the presence of sodium salicylate (NaSal) counterions in water using molecular dynamics simulations. Above the critical strain rate, approximately equal to the inverse of the micelle relaxation time, hydrodynamic forces overcome the conformational entropy of the micelle and a configurational transition from a folded to a stretched state occurs. As the accumulated strain exceeds a critical value of O(100), the micelle ruptures through a midplane thinning mechanism facilitated by the advection of the counterions toward the micelle end-caps. The change in the total pair-potential energy as a function of micelle elongation is well described by a Hookean spring model that allowed to estimate the stretching modulus of the micelle. Micelle stiffness depends greatly on the degree of screening of electrostatic repulsion among the CTA+ head groups by t...
Growth Factors and Neural Connectivity

The formation of connections in the developing nervous system requires axons to navigate through complex environments to reach their targets. It is the growth cone, a sensory and motor apparatus located at the tip of the developing axon, that senses and responds to the environment. In so doing the growth cone makes decisions about where to grow and when to stop and innervate. Molecular cues in the local milieu of the growth cone control these behaviors. A number of different classes of signaling molecules are involved in axon guidance including cell-cell and cell-substrate adhesion molecules, extracellular matrix (ECM) molecules and their receptors, and soluble factors (see reviews 1–4). Growth factors are one group of soluble molecules that promote neurite outgrowth in vivo and in vitro. Research on growth factors has focused primarily on their role in promoting neuronal survival and differentiation. Only recently have studies suggested that they play a much broader role in patterning neuronal connections during development. This review will discuss recent findings that implicate growth factors in axon guidance and target recognition.
Urban Vegetative Cover Fragmentation in the U.S.: Associations With Physical Activity and BMI.

Introduction Urban vegetative cover provides a range of ecosystem services including contributions to human health and well-being. Urbanization exerts tremendous pressure on this natural resource, causing fragmentation and loss of urban greenspace. This study aimed to examine associations between vegetative cover fragmentation and physical activity and BMI at the county scale in the U.S. metropolitan statistical areas greater than 1 million in population. Methods National Land Cover Database 2006 and Behavioral Risk Factor Surveillance System 2008 provided land cover and human health data, respectively. Analyses were performed in 2013 at the county scale where the health data were reported. Spearman rank correlation and stepwise and hierarchical regression models were applied to estimate relationships between land cover and health variables. Results After controlling for median household income and race, greater forest edge density (β=0.272, p p p p Conclusions Forest land cover and some degree of fragmentation are associated with population physical activity. Future studies should examine how built environments and varying land cover configurations influence physical activity and weight status.
Indigenous Knowledge Realized: Understanding the Role of Service Learning at the Intersection of Being a Mentor and a College-Going American Indian

The article explores the experiences of 13 undergraduate American Indian college students who served as mentors through a service-learning course while attending a 4-year, predominantly White institution (PWI). This chapter elucidates how serving as a mentor allowed participants to draw on three culturally-relevant persistence factors in higher education: relationship, community, and power. Previous research demonstrates that service learning actively involves college students and encourages them to build a connection and a sense of commitment to the community (Lee & Espino, 2011; Rhoads, 1998). Through a Tribal Critical Race Theory lens, the purpose and function of service learning is deconstructed and redefined to fit the needs of North American Indigenous college students. This article reveals that Indigenous undergraduate students tapped into their own supply of Indigenous knowledge in relating their mentoring experience to building meaningful relationships, to being a positive influence in tribal communities, and to recognizing that service is a cyclical power that positively impacts their collective role in society. The article details how relationship, community, and power from Indigenous perspectives are sources of persistence for American Indian students and how social justice-based, service-learning courses provide safe spaces for students to realize their Indigenous knowledge while attending PWIs. Keywords : American Indian college student; service learning; Indigenous knowledge>
Chemical Effects of Plasma Interactions with Thermonuclear Reactor Surfaces

Fusion reactor fuel processing is a critical area of reactor operation because tritium inventory and holdup are vital considerations with respect to safety and economics. Most of the tritium (and deuterium) in the fuel cycle comes directly from the plasma as the “unburned” fraction containing the helium ash. Various schemes have been proposed for thermalizing the energetic, unburned plasma fraction and preparing it for re-injection into the machine. One of these schemes, “chemical” or “reactive” trapping at metal surfaces is discussed in detail in this paper. Requirements on trapping surfaces are examined from the point of view of trapping efficiency as a function of surface temperature and total dose. Limitations on lifetimes imposed by various erosion processes are discussed.
Gunshot Wound to the Left Neck

A 30-year-old male presents to the ED with a single gunshot wound (GSW) to the left neck. The patient is hemodynamically stable, with a blood pressure of 120/70 mmHg, heart rate of 100/min, respiratory rate of 16/min, and a Glasgow Coma Scale of 15. He denies any weakness or numbness in his arms or legs. There is no stridor or odynophagia. He is able to speak and states that his voice sounds normal to him. On physical examination, he is awake and alert. There is a single entry wound in the left mid-neck between the cricoid cartilage and the angle of the mandible with no bleeding. There is a moderate but nonexpanding hematoma overlying the injury with no exit wound seen. There is no palpable crepitus or audible bruit. Neurological examination is normal.
Effects of Habitat Patch Size and Temperature on the Distribution and Abundance of Ground Beetles (Coleoptera: Carabidae) in an Old Field

The effects of habitat size, patch isolation, and temperature on the distribution and abundance of ground beetles (Coleoptera: Carabidae) were studied within an old field in southwestern Ohio. A grass field was subdivided by mowing to create 16 plots, each containing 9 unmowed habitat patches that differed in size among 4 treatments (1 m2, 4 m2, 9 m2, and contiguous). A total of 177 pitfall traps was placed in unmowed patches and in mowed areas, and 444 beetles were captured from midsummer to fall of 1995. More than 75% of the Harpalus pensylvanicus (DeGeer) captures were in 1-m2 patches during midsummer, but 92 and 87% were in the mowed area during late summer and fall, respectively. Peak captures of Calathus opaculus LeConte changed from 72% in patches >4 m2 during late summer to 81% in 1-m2 patches and mowed areas during fall. Pterostichus atratus (Newman) was abundant in late summer when 76% of the captures were in patches >9 m2 patches. Thus, large vegetation patches (≥4 m2) as well as open areas were important to the distribution and abundance of carabid beetles in an uncultivated habitat. Seasonal changes in captures of H. pensylvanicus and C. opaculus among habitats were consistent with their preferred temperatures. Despite habitat and seasonal differences, all 3 species showed the same positive relationship between distribution and abundance across treatments and months. We suggest that this general distribution-abundance pattern can be explained by species responses to the thermal environment as it varies among habitats and season.
Antinuclear Antibody Testing in a Referral Laboratory

Antinuclear antibody (ANA) testing, consisting of the immunofluorescent ANA (FANA) and ANA profile, is an integral part of the evaluation of the patient who is suspected of having connective tissue disease. We reviewed the results of FANA and ANA profile testing from more than 8,000 serum samples to examine the relationships between these tests. Fifty-two percent of referred serum samples had a positive ANA test result and 19% of samples had a positive ANA profile. Nine percent of the serum samples had a positive ANA profile result despite a negative FANA test result. Although the routine FANA test is considered the “gold standard” for sensitive detection of connective tissue disease, screening with an FANA test may not detect diseases associated with anti-SSA/Ro, anti-double-stranded DNA, or anti-extractable nuclear antigen antibodies. Comparison of subgroups of specific antibodies support the validity of autoantibodies as markers for diseases or subgroups of connective tissue disease.
Extension of the H-2 TLb molecular map. Isolation and characterization of T13, T14, and T15 from the C57BL/6 mouse.

A region of the TL b locus encompassing T11 to T13 contains retroviral sequences TLev1 and TLev2. As part of a study to determine whether the retroviral elements are involved in the expression of TL genes, the genomic organization of this region was reexamined in greater detail. A result of these investigations is the extension of the H-2 TLb molecular map. Two additional TL genes have been isolated from C57BL/6 mice, T14 and T15. The genomic organization of T9 through T15 is presented. The nucleotide sequence has been determined for exons 4, 5, and 6 of T13. As a result of a C to T conversion, a termination codon is introduced into exon 4, indicating that T13 either encodes a secreted protein or is a pseudogene. T13 was found to be more homologous to the H-2 genes outside the TL region. T14 has been physically disrupted by the integration of TLevl , and the H-2 sequences appear to have diverged greatly. The relationship of the TL regions of the b and c haplotypes has been investigated using numerous low copy probes. The genome of BALB/c (TLc) is shown to lack a counterpart of the T13–T15 b region. Homologous regions exist in the two haplotypes; yet considerable polymorphism is observed. TLb mice do not express TLa on the cell surface of normal thymocytes while TLc mice do; TLa expression is activated in many TO leukemias. The diversity seen in the T13–T15 region may provide insights into the phenotypic expression or regulatory mechanisms of TL expression in these two haplotypes.
State appellant cases for testicular torsion: Case review from 1985 to 2015.

Summary Objective Testicular torsion is one of the most common diagnoses involved in lawsuits in the pediatric patient. Missed diagnosis and diagnostic delays put patients at risk for testicular loss and have resulted in malpractice litigation. Using a national database, we sought to describe testicular torsion malpractice cases tried at the state and federal level and investigate factors associated with successful defense by the provider. Method We reviewed the Lexis Nexis academic legal database. We searched all cases using the terms “testicular torsion” and “medical malpractice” from 1985 to 2015. From this search, we compiled various medical and legal aspects of the case including the outcome of the trial. We performed multivariate logistic regression to determine which factors were associated with successful defense at the state level. Results Fifty-three malpractice cases of testicular torsion were included. State appeals were in favor of providers in 26 (50%) of cases. The average time between initial presentation of the patient and the state verdict decision was 5 years. Emergency room (ER) physicians were the most common provider sued (35%). Approximately half of the patients (26, 51%) first presented to the ER, and atypical presentations were common, as 16 (31%) presented with abdominal pain only. The proportion of patients with false-negative ultrasounds was 16 of 25 (64%). If the patient first presented to the ER, the doctor was less likely to have a successful defense (OR = 0.23; 95% CI 0.06–0.79]). Most verdicts (8/9, 89%) were in favor of urologists. One urologist lost at the state level because of delayed time to the operating room. Conclusions Atypical clinical presentations and false-negative ultrasound findings are common in testicular torsion malpractice litigation at the state and federal level. Providers who used ultrasound were not more likely to win the state appeal, and providers whose patients presented to the ER were less likely to have a successful defense. Although 50% of providers won the state appeal, the time from initial patient presentation and final state verdict decision was substantial. Table . State cases for testicular torsion by US census regions. Cases, N (%) Years to final verdict, mean (SD) Region Northeast 14 (26.4) 6.0 (4.1) Midwest 7 (13.2) 3.6 (1.6) South 23 (43.4) 4.9 (2.3) West 9 (17.0) 4.5 (1.9)
Equivalent modeling and topological optimization for the conditioning unit of an energy harvesting converter

Energy scavenging technology could provide an efficient method to solve a wireless sensor nodes' power supply problem in a smart grid.The energy conditional unit's performance directly affected the quality and efficiency of the energy scavenging system.The model of the typical energy conditioning unit was established,the formula of conditional circuit average power was deduced and the factors which would influence efficiency of the circuit and switch control strategy were analyzed.A new type of conditioning circuit topology design was proposed,which could improve the waveform of output voltage through inductance free-wheeling.An impact factor β was defined and the feasibility of the advanced structure was certificated.The selection principle of the components parameter was proposed and the results of simulation and experiments both indicated that the improved topologies could overcome shortcomings such as output waveform,and could improve the work efficiency of an energy scavenging system.
Innovative strategies to improve diabetes outcomes in disadvantaged populations

Diabetes disproportionately affects disadvantaged populations. Eighty percent of deaths directly caused by diabetes occurred in low- and middle-income countries. In high-income countries, there are marked disparities in diabetes control among racial/ethnic minorities and those with low socio-economic status. Innovative, effective and cost-effective strategies are needed to improve diabetes outcomes in these populations. Technological advances, peer educators and community health workers have expanded methodologies to reach, educate and monitor individuals with diabetes. In the present manuscript we review the outcomes of these strategies, and describe the barriers to and facilitators of these approaches for improving diabetes outcomes.
Getting medicine right: overcoming the problem of overscreening, overdiagnosis, and overtreatment.

Introduction to AFP’s series of editorials on overscreening, overdiagnosis, and over-treatment, providing practical guidance on reducing unnecessary medical practices.
Immunology and Immunopathology of the Intestines: Recombinant Avirulent Salmonella Vaccine Strains with Stable Maintenance and High Level Expression of Cloned Genes in Vivo

Salmonella typhimurium strains with deletion (delta) of the adenylate cyclase (cya) and cyclic AMP receptor protein (crp) genes are avirulent for mice and induce a high level of protective immunity to oral challenge with up to 10,000 times what would be a lethal dose of wild-type virulent S. typhimurium cells. This immunity begins as early as seven days after immunization and lasts for at least four months. S. typhimurium delta cya delta crp mutants stably maintain plasmids and give high-level expression of cloned gene products; in this they appear superior to other avirulent S. typhimurium strains. S. typhimurium delta cya delta crp strains with a delta asd mutation (abolishing production of aspartate beta-semialdehyde dehydrogenase), have an obligate requirement for diaminopimelic acid (DAP). This strain can be used in conjunction with plasmid vectors lacking antibiotic resistance markers but having the wild-type asd+ gene from Streptococcus mutans to complement the delta asd chromosomal mutation. The Asd+ plasmid vector can be used to express a diversity of colonization and virulence antigens from other pathogens. In the delta cya delta crp delta asd S. typhimurium vaccine strain, the plasmid is completely stable in the absence of any exogenous selective pressure either in vitro or in vivo.
Vibration of the Abdomen in Non-Pregnant Sheep: Effect of Dynamic Force and Surface Area of Vibrator:

Vibration exposure is a growing concern for increasing numbers of working pregnant women. The coupling between vibrating machines and the body determines to a great extent the degree of exposure an...
USING AGENCY THEORY TO MODEL COOPERATIVE PUBLIC PURCHASING

Cooperative purchasing is beginning to receive renewed attention by scholars and practitioners alike in both the private and public sectors. Generally, cooperative purchasing arrangements have been reported to reduce costs, expedite transactions, and increase product knowledge. In the public sector, cooperative purchasing has been reported to reduce political risk, minimize “red-tape,” and, in some cases, avoid all reported social equity goals that are reported to increase costs. In this article, we contend that the lack of conceptual clarity has marred the literature on cooperative public sector purchasing, and as a result public sector purchasers have no theoretical guidelines to help them decide upon this purchasing mechanism. Therefore, the purpose of this article is to use agency theory to analyze, define, and establish a conceptual framework of cooperative public purchasing to help guide academics and practicing public sector purchasing professionals.
Numerical Simulation of Flow Field and Heat Transfer of Streamlined Cylinders in Crossflow

The use of streamlined tubes to reduce pressure drop across polymer tube bundles is considered because of the relative ease of fabrication. The drag and convective heat transfer coefficients along the outer surface of lenticular and elliptical tubes with minor-to-major axis ratios of 0.3, 0.5, and 0.8 are determined numerically for cross-flow Reynolds numbers from 500 to 10,000. An isothermal surface is assumed. The two-dimensional, unsteady Navier-Stokes equations and energy equation are solved using the finite volume method. Laminar flow is assumed from the front stagnation point up to the point of separation. Turbulent flow in the wake is resolved using the shear stress transport k-omega model. Local heat transfer, pressure and friction coefficients as well as a total drag coefficient and average Nusselt number are presented. The results for streamlined tubes are compared to published data for circular and elliptical cylinders. Drag of the elliptical and lenticular cylinders is similar and lower than a circular cylinder. Reductions in drag may be increased by making the streamlined cylinders more slender. Over the range of Reynolds number considered, an elliptical cylinder with an axis ratio equal to 0.5 reduces pressure drop by 30 to 40 percent compared to that of a circular cylinder. The lenticular and elliptical geometries have nearly identical average of Nusselt number. The average Nusselt number of an elliptical or lenticular cylinder with axis ratio of 0.5 and 0.3 is 15 to 35% lower than that of a circular cylinder. A case study for an automotive radiator is presented to illustrate comparison of shaped and circular tubes in terms of both heat transfer and pressure drop.© 2005 ASME
Nanomechanics of slip avalanches in amorphous plasticity

Abstract Discrete stress relaxations (slip avalanches) in a model metallic glass under uniaxial compression are studied using a metadynamics algorithm for molecular simulation at experimental strain rates. The onset of yielding is observed at the first major stress drop, accompanied, upon analysis, by the formation of a single localized shear band region spanning the entire system. During the elastic response prior to yielding, low concentrations of shear transformation deformation events appear intermittently and spatially uncorrelated. During serrated flow following yielding, small stress drops occur interspersed between large drops. The simulation results point to a threshold value of stress dissipation as a characteristic feature separating major and minor avalanches consistent with mean-field modeling analysis and mechanical testing experiments. We further interpret this behavior to be a consequence of a nonlinear interplay of two prevailing mechanisms of amorphous plasticity, thermally activated atomic diffusion and stress-induced shear transformations, originally proposed by Spaepen and Argon, respectively. Probing the atomistic processes at widely separate strain rates gives insight to different modes of shear band formation: percolation of shear transformations versus crack-like propagation. Additionally a focus on crossover avalanche size has implications for nanomechanical modeling of spatially and temporally heterogeneous dynamics.
Biomechanical Characterization of Single Chondrocytes

Normal cartilage functions to cushion and distribute loads throughout the joint. The tissue’s constitutive cells, chondrocytes, experience a variety of stresses as a result of these functional aspects, but the effects of these stresses on the individual cells are largely unknown. To understand the mechanical integrity of chondrocytes and how these properties change in response to various stimuli, mechanical testing systems for single cells have been developed. These systems are able to apply a wide variety of load types to characterize cellular biomechanics, and must rely on complex mathematical models to calculate these properties. This chapter reviews the five major mechanical testing systems that are used to test single chondrocytes, their distinct advantages, and discusses the salient results they have produced relating to chondrocyte mechanics and mechanosensitivity. Using these testing systems, it is clear that mechanical signals play a major role in chondrocyte gene expression, and these changes are essential to understand when developing functional cartilage replacements.
Synthesis of Polyolefins with a Terminal Functional Group

This chapter summarizes three general methods used in the preparation of polyolefins with a terminal functional group. They are based on living transition metal coordination polymerization, in situ chain transfer reaction during transition metal coordination polymerization, and chemical modification of the polymer having an unsaturated chain end. The combination of metallocene catalysis and in situ chain transfer reaction is the most effective and convenient route. Chemistry can be easily extended to many polyolefin structures, including copolymers and terpolymers. This drop-in technology only needs minor modifications of current commercial polymerization processes. The chapter reveals that it would be convenient and beneficial to replace the current hydrogen chain transfer agent with borane or p-methylstyrene (p-MS)/H 2 chain transfer agents. Such a process not only allows the control of polymer molecular weight and chain-end saturation, it also provides a reactive functional group at the polymer chain end for further reactions. The chapter further mentions that living polymerization is a very expensive process from the commercial viewpoint. One catalyst site can only produce one polymer chain.
Change in Policy Allowing Overlapping Surgery Decreases Length of Stay in an Academic, Safety-Net Hospital.

Background The practice of surgeons running overlapping operating rooms has recently come under scrutiny. Objective To examine the impact of hospital policy allowing overlapping rooms in the case of patients admitted to a tertiary care, safety-net hospital for urgent neurosurgical procedures. Methods The neurosurgery service at the hospital being studied transitioned from routinely allowing 1 room per day (period 1) to overlapping rooms (period 2), with the second room being staffed by the same attending surgeon. Patients undergoing neurosurgical intervention in each period were retrospectively compared. Demographics, indication, case type, complications, outcomes, and total charges were tracked. Results There were 59 urgent cases in period 1 and 63 in period 2. In the case of these patients, the length of stay was significantly decreased in period 2 (13.09 d vs 19.52; P = .006). The time from admission to surgery (wait time) was also significantly decreased in period 2 (5.12 d vs 7.00; P = .04). Total charges also trended towards less in period 2 (${\$}$150 942 vs ${\$}$200 075; P = .05). Surgical complications were no different between the groups (16.9% vs 14.3%; P = .59), but medical complications were significantly decreased in period 2 (14.3% vs 30.5%; P = .009). Significantly more patients were discharged to home in period 2 (69.8% vs 42.4%; P = .003). Conclusion As a matter of policy, allowing overlapping rooms significantly reduces the length of stay in the case of a vulnerable population in need of urgent surgery at a single safety-net academic institution. This may be due to a reduction in medical complications in these patients.
Potential of CO2-EOR for Near-Term Decarbonization

This paper provides an overview of carbon dioxide enhanced oil recovery (CO2-EOR) and its ability to reduce greenhouse gas (GHG) emissions (even to the point of negative emissions), the role it needs to play in the challenge of decarbonization, and the need to scale up implementation and deployment in order to meet climate goals. Limitations in current legal and regulatory frameworks for CO2 injection are explored for both economic and environmental purposes, as well as the economic implications of combining CO2-EOR with geologic carbon storage. Results from a recent study, which demonstrate that all CO2-EOR operations produce negative emissions oil during the first several years of production, are analyzed in the context of the urgency of climate change mitigation. Acknowledging that fossil fuels currently provide the energy foundation upon which global societies function, and that a sudden shift in the composition of that foundation can potentially destabilize the global economy and key elements of modern society, we bring CO2-EOR to the fore as it can supply reduced carbon oil to support the current energy foundation as it steadily transitions toward decarbonization. In order to meet this urgent transition, greater fiscal and regulatory incentives are needed to begin scaling CO2-EOR with storage around the globe. A viable and large-scale CO2-EOR/storage industry depends upon significant capital investments for CO2 capture and transportation infrastructure. Policy consistency and predictability, combined with targeted subsidies, will help to achieve this goal.
Midbrain and cerebral inflammatory and glutamatergic adaptations during chronic hypercapnia in goats

Abstract Cognitive impairment is associated with multiple human diseases that have in common chronic hypercapnia. However, the mechanisms leading to chronic hypercapnia-induced cognitive decline are not known. We have previously shown chronic hypercapnia through exposure to increased inspired CO2 (6% InCO2) in conscious goats caused an immediate (within hours) and sustained decline in cognitive performance during a shape discrimination test. Herein, within the same goats, we assessed markers of neuroinflammation and glutamate receptor expression/phosphorylation within CNS regions important for cognitive function following 24 hours (h) or 30 days (d) of chronic hypercapnia. Within 24 h, chronic hypercapnia increased expression of the inflammatory cytokine IL-1β in the orbitofrontal cortex and medial prefrontal cortex, but at 30d IL-1β levels were not different relative to time-matched goats exposed to room-air. Additionally, Iba1 expression (a marker of microglial activation) was unaltered by chronic hypercapnia in all regions tested. Finally, levels of the total and phosphorylated AMPA receptor subunit GluR2 were reduced within the hippocampus at both 24 h and 30 d of hypercapnia, and reduced following 30 d within the anterior insular cortex. These data suggest that chronic hypercapnia leads to CNS site-dependent acute inflammatory responses and shifts in select glutamate receptor expression/phosphorylation in brain regions contributing to cognitive function. Such changes may be indicative of alterations in glutamatergic receptor-mediated signaling and neuronal dysfunction that contribute to declines in cognitive function associated with human diseases defined or marked by chronic CO2 retention.
An adaptive local discontinuous Galerkin method for nonlinear two-point boundary-value problems

In this paper, we propose an adaptive mesh refinement (AMR) strategy based on a posteriori error estimates for the local discontinuous Galerkin (LDG) method for nonlinear two-point boundary-value problems (BVPs) of the form $u^{\prime \prime }=f(x,u),\ x\in [a,b]$ subject to some suitable boundary conditions at the endpoint of the interval [a, b]. We first use the superconvergence results proved in the first part of this paper as reported by Baccouch (Numer. Algorithm. 79(3), 697–718 2018) to show that the significant parts of the local discretization errors are proportional to (p + 1)-degree Radau polynomials, when polynomials of total degree not exceeding p are used. These new results allow us to construct a residual-based a posteriori error estimators which are obtained by solving a local residual problem with no boundary conditions on each element. The proposed error estimates are efficient, reliable, and asymptotically exact. We prove that, for smooth solutions, the proposed a posteriori error estimates converge to the exact errors in the L2-norm with order of convergence p + 3/2. Finally, we present a local AMR procedure that makes use of our local and global a posteriori error estimates. Our proofs are valid for arbitrary regular meshes and for Pp polynomials with p ≥ 1. Several numerical results are presented to validate the theoretical results and to show the efficiency of the grid refinement strategy.
Contests of devotion in Nepal: music and civic rivalry in the Buddhist communitas

ABSTRACTThrough musical pilgrimage in Nepal, diverse groups come together at sacred Buddhist centres, unified, at one level, by an infectious sense of devotional fervour and shared purpose: a spiri...
Opportunities for Photovoltaics and Other DER to Improve Energy Resiliency in the U.S. Virgin Islands

Hurricanes Irma and Maria devastated the United States Virgin Islands (USVI), and emphasized the importance of electric grid resiliency. Increased integration of photovoltaics (PV) and other distributed energy resources (DERs) such as storage represent an opportunity to reduce dependency on fossil fuel deliveries and distribution networks with single points of failure, and to increase energy resiliency through local generation and storage of power. However, there are technical challenges including voltage fluctuations and balancing load and generation which must be addressed when integrating PV. In this paper, we provide background on the USVI electric system, discuss the opportunity for PV, and present some technical analysis related to PV integration.
The impact of low back pain systematic reviews and clinical practice guidelines measured by the Altmetric score: Cross-Sectional study.

Abstract Background Although Altmetric has been widely used by researchers to monitor the audience of their articles, there are no studies that have analysed factors associated with Altmetric score for systematic reviews and clinical practice guidelines. Objectives 1) To analyse factors that could be associated with Altmetric scores for low back pain systematic reviews and clinical practice guidelines. 2) To describe the characteristics of these articles and their Altmetric scores. Methods We searched for all low back pain systematic reviews and guidelines indexed on the Physiotherapy Evidence Database published between 2015 and 2017. We extracted data related to the published paper, the publishing journal, and Altmetric scores. Results A total of 66 systematic reviews and 5 guidelines were included. The variable impact factor (independent variable) was associated with Altmetric mentioned score (dependent variable) with a β coefficient of 15.4 (95% CI: 0.97, 29.7) ajusted to all remaining variables. The variable number of citations normalized by year of publication (independent variable) was associated with Altmetric reader score (dependent variable) with a β coefficient of 6.4 (95% CI: 4.03, 8.72) ajusted to all remaining variables. We also found that the majority of the systematic reviews and guidelines were published in English, had a descriptive title, were published as open access, included multicenter studies, and had media release generated by the publishing journal. Conclusion Metrics related to the number of citations, such as the impact factor are associated with Altmetric scores.
Joint Identities?: A Self-Case Study of the Professional Identity Development of J.D./Ph.D. Professionals in Education Law

Professionals in education law often hold both law and advanced education research degrees, and yet the education law field knows little about how joint-degree programs prepare future professionals in the field. Using a self-case study method, this study provides an in-depth examination of the professional identity development of joint-degree students in law and education. Specifically, this study examines whether joint-degree students and early professionals experienced conflicts as they developed their professional identities and what role social networks played as they developed their identities. The findings show that developing professionals experienced three types of conflicts: (a) siloed bureaucracies, (b) bifurcated epistemologies and ontological differences, and (c) (de)valued expertise in opposing markets. Social network partners were a crucial source of support as the developing professionals navigated professional conflicts. The divided professional identities led the joint-degree students to develop a professional double consciousness, in which they identified their professional identities as divided and difficult or impossible to integrate. This Article provides recommendations for programs offering joint degree programs in law and education.
Abstract MP47: Clinicoradiological Outcomes of Surgical Revascularization for Moyamoya Disease With Minimum 10-Year Follow-Up

Introduction: The long-term progression of disease and recurrence rate of symptomatic events after surgical revascularization for moyamoya disease (MMD) are unknown. Method: Patients with MMD opera...
Is Outpatient Management of Mandibular Fractures Associated With Inflammatory Complications? An ACS-NSQIP Study

Purpose Timing of mandibular fracture repair has long been debated. The purpose of the present study was to assess the incidence of postoperative inflammatory complications (POICs) following open repair of mandibular fractures managed non-urgently in the outpatient setting versus urgently in the inpatient setting. Methods The authors utilized the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to enroll a sample of patients with mandibular fractures who underwent open repair. The primary independent variable was treatment protocol: outpatient (elective) versus inpatient (urgent/non-elective). The primary dependent variable was POIC (yes/no). Descriptive, bivariate, and multiple logistic regression statistics were utilized to evaluate the relationship between treatment protocol and POICs. Results The study cohort was comprised of 1,848 subjects with 1,134 outpatients and 714 inpatients. The incidence of POICs was 6.53% for the outpatient group compared to 8.96% for the inpatient group, with no significant difference between groups (P= .052). However, subjects treated as inpatients were 1.51 times more likely to experience any complication (P = .008) due to an increase in non-POICs (P = .028), in particular urinary tract infections (P = .035). After adjusting for age, hypertension requiring medical treatment, and smoking, classification as ASA II (P = .046, OR = 2.21, 95% CI 1.01 to 4.83), ASA III (P = .020, OR = 2.88, 95% CI 1.18 to 7.02), diabetes (P = 0.004, OR = 3.11, 95% CI 1.43 to 6.74), and preoperative hematocrit (P = 0.010, OR = 0.950, 95% CI 0.913 to 0.988) were independent predictors of POICs. Length of stay was 0.83 ± 2.61 days compared to 2.36 ± 3.63 days for the outpatient and inpatient groups, respectively (P ≤ .001). Conclusions There was no significant difference in POICs between patients treated as outpatients versus inpatients, though outpatients had fewer non-POICs and a shorter length of hospital stay.
National and State-Specific Estimates of Settings of Receiving Human Papillomavirus Vaccination Among Adolescents in the United States

Abstract Purpose Human papillomavirus (HPV) vaccination in the United States has been recommended for girls since 2006 and for boys since 2011. However, settings of receiving HPV vaccination have not been assessed. The purpose of this study is to assess settings of receiving HPV vaccination among adolescents in order to understand what strategies are needed to improve vaccination uptake. Methods Data from the 2018 National Immunization Survey–Teen (NIS–Teen) were analyzed to assess place of HPV vaccination overall, and by gender, quarter, and other selected variables among adolescents in the United States. The 2016–2018 NIS–Teen data were combined to assess state-specific place of HPV vaccination. Results Among vaccinated adolescents aged 13–17 years, a doctor's office was the most common place where HPV vaccination was received (79.2%), followed by clinics, health centers, or other medical facilities (13.5%), health department (4.1%), hospital or emergency room (2.3%), schools (.5%), and pharmacies or stores (.4%). Overall, 99.1% of adolescents aged 13–17 years received HPV vaccination at medical settings and only .9% at nonmedical settings. Reported vaccination in nonmedical settings by state ranged from less than .1% in Delaware, Florida, and New Hampshire to 4.1% in North Dakota, with a median of 1.0%. Conclusions Doctor's offices were the most common medical setting for adolescents to receive HPV vaccination. Less than 1% of adolescents received vaccination at nonmedical settings. Continuing work with medical and nonmedical settings to identify and implement appropriate strategies are needed to improve HPV vaccination coverage among adolescents.
Coupled Climate Responses to Recent Australian Wildfire and COVID-19 Emissions Anomalies Estimated in CESM2

Multiple 50-member ensemble simulations with the Community Earth System Model version 2 are performed to estimate the coupled climate responses to the 2019-2020 Australian wildfires and COVID-19 pandemic policies. The climate response to the pandemic is found to be weak generally, with global-mean net top-of-atmosphere radiative anomalies of +0.23 +/- 0.14 W m(-2) driving a gradual global warming of 0.05 +/- 0.04 K by the end of 2022. While regional anomalies are detectable in aerosol burdens and clear-sky radiation, few significant anomalies exist in other fields due to internal variability. In contrast, the simulated response to Australian wildfires is a strong and rapid cooling, peaking globally at -0.95 +/- 0.15 W m(-2) in late 2019 with a global cooling of 0.06 +/- 0.04 K by mid-2020. Transport of fire aerosols throughout the Southern Hemisphere increases albedo and drives a strong interhemispheric radiative contrast, with simulated responses that are consistent generally with those to a Southern Hemisphere volcanic eruption.
Best Practices to Assuage COVID-19 Risk in Jails and Prisons

Carceral settings have been disparately impacted by the spread of the 2019 novel coronavirus (SARS-CoV-2, which causes the disease COVID-19). Many of those who are incarcerated have a high burden of poor health outcomes and/or are aging, making them likely to suffer severely from COVID-19. In addition, the built environments of prisons and jails makes social distancing, a key practice in the prevention of the spread of COVID-19, virtually impossible. In order to stop the swift, deadly spread of COVID-19 throughout correctional facilities, efforts must be made to decarcerate via compassionate release and the elimination of cash bail. At minimum, mass testing practices, as well as humane methods for medical quarantine and isolation, must be implemented in prisons. COVID-19 has ultimately shed light on the intersection of public health and hyperincarceration in the United States, as well as the connectedness between prisons and jails and their surrounding communities.