cssi/SciSciGPT-SciSciNet huggingface dataset:
Toward a Human–Robot Symbiotic System

Partnership between a person and a robot could be simplified if the robot were intelligent enough to understand human intentions and perform accordingly. During the last decade, we have been developing such an intelligent robot called Intelligent Soft-Arm Control (ISAC). Originally, ISAC was designed to assist the physically disabled, but gradually became a test bed for more robust human-robot teaming (see: http://eecs.vanderbilt.edu/CIS/ ). In this chapter, we will describe a framework for human-robot interaction, a multi-agent based robot control architecture, and short-term and long-term memory structures for the robot brain. Two applications will illustrate how ISAC interacts with humans.
Trust metrics

We expect our access to use outside information to be a simple affair. We know we need specific information … we know someone is collecting or generating it … we know someone is processing it … we know someone is transmitting it to us … we expect it to be perfect. But that is where everything breaks down because each of us comes up with a different conclusion (using similar information). One reason is related to the Qualia argument [1] that “all of our sensors are calibrated to ourselves and that we interpret inputs differently”. There is a quantization-like error, or noise, in all of the inputs we take in that corrupts, or alters, the results of our internal processes. Another reason is that the information we are consuming is corrupted, either unintentionally or intentionally, somewhere between its conception and processing to a final result. Both of these reasons are related to Trust. However, Trust means something different to everyone. The question becomes “how do we measure Trust so we know how the information we want to use will affect the results”? The Autonomic Trusted Sensing for Persistent Intelligence (ATSPI) Technology Office is following a scientific approach to understand, assess, and react to Trust measurements.
A Comparative Analysis of Attitudes of National Courts to Choice of Law and Interpretation of Contracts for International Sale of Goods

As international trade and commerce continues to grow and becomes more diverse and expansive in nature, enforcement of contracts for the international sales of good (CISG) increasingly throw up challenges especially in relation to enforcement of these contracts between parties from different national jurisdictions in cases where the agreement is silent on the applicable governing law and dispute resolution forum. This leads to forum shopping with its attendant consequences on prolonged litigation and even more complexity in the enforcement procedure. The aim of this research is to study the attitudes of national courts in the US, UK and selected European countries to enforcement of CISG in cases where the parties have failed to expressly choose an applicable governing law in their agreement and how this influences the outcome of such cases. The methodology adopted is a comparative analysis of the attitudes of national courts in the stated jurisdictions and an appraisal of its effects on the enforcement of CISG across these jurisdictions.The research finds that the difference in the legal and socio-political settings of these countries account for the variations in the attitudes of their national courts to enforcement of CISG in the absence of express choice of governing law and that generally, in such cases, the national courts of these countries tend to be influenced by local laws and practice in deciding the cases as they subject international transactions to domestic standards, with its unpleasant consequences. In this regard, forum shopping has its advantage as it enables the parties shop for national courts with more liberal approach to enforcement of CISG.
First-principles studies of the electronic properties of native and substitutional anionic defects in bulk iron pyrite

Systematic spin-polarized density functional theory calculations were performed to investigate the formation energies of native and substitutional anionic point defects in iron pyrite (FeS${}_{2}$) and their impact on bulk electronic structure. A detailed analysis indicates that neutral sulfur and iron vacancies do not act as efficient donors or acceptors. We find that substitutional oxygen does not induce gap states in pyrite and can actually passivate gap states created by sulfur vacancies. Most Group V and VII impurities create mid-gap states and produce spin polarization. In particular, Cl and Br are shallow donors that introduce delocalized spin-polarized electrons for potential use in photovoltaic and spintronics applications.
MORPHOLOGY AND TAXONOMY OF PACHNOCYBE FERRUGINEA

Pachnocybe ferruginea from Douglas-fir utility poles in western Oregon occurred in two forms. Both forms consisted of dikaryotic mycelium that gave rise to brown capitate basidiocarps. However, one form had associated blastic-sympodial conidia, larger basidiocarps, chlamydospores, and a slower growth rate. Single uninucleate basidiospores of both forms produced dikaryotic mycelium with simple septal pores and holobasidia in which karogamy and meiosis occurred. Thus, P. ferruginea has a primary homothallic life cycle. Spores from conidial isolates gave rise to both basidiocarps and the conidial form demonstrating that the conidial form is the anamorph of P. ferruginea. Nevertheless, results suggest that the P. ferruginea variants form a single pleomorphic species corresponding to published descriptions of P. ferruginea, but with an anamorphic stage. The species should be placed in the Chionosphaeraceae.
Vertical Distribution of Mexican Rice Borer (Lepidoptera: Pyralidae) Larvae and Tunnels in Lower Rio Grande Valley Sugarcane

Vertical distribution patterns of Mexican rice borer, Eoreuma loftini (Dyar), larvae and tunnels in Lower Rio Grande Valley sugarcane, Saccharum spp., were examined by stalk dissections in commercial sugarcane from late May until early September (1992) or mid-October (1993). Larval age distributions were fairly stable throughout the sampling periods, with small larvae consistently comprising a substantial portion of the larval population infesting millable stalks. Meaningful differences in the vertical distributions of small, medium, and large larvae were not detected. Contrary to earlier reports, most larvae and tunnels were located in the lower, more productive internodes regardless of the degree of stalk development. These results do not support the concept of age-specific internode susceptibility to Mexican rice borer attack, and stress the need to consider season-long population suppression in the development of strategies to manage the Mexican rice borer in sugarcane.
Ecological studies of mites found in sheep and cattle pastures. I. Distribution patterns of oribatid mites.

An undescribed uropodid species was the dominant mesostigmatid mite in 2 well-established Kentucky bluegrass cattle pastures used, respectively, by cattle and by sheep. The second dominant species in the cattle pasture was Lasioseius sp.; in the sheep pasture, Dithinozercon halberti (Berlese). Distribution data approached the negative binomial model, as was true for the Oribatei reported previously from these pastures. In both pastures, significantly higher numbers of mites were found in the pasture floor at 5 PM than at 8 AM; and, correspondingly, significantly lower numbers were found in the grass at 8 AM than at 1 PM or 5 PM. In general, the sampling date had no significant effect on the mite populations in either stratum of either pasture. The “contagious” distribution pattern found in Oribatei was found also in the Mesostigmata, but some differences between the two were noted.
“The Mechanics of Earthquakes and Faulting - Second Edition” by Christopher H. Scholz

Chris Scholz has updated his well respected 1990 publication with the second edition of The Mechanics of Earthquakes and Faulting. The short review: If you are an earthquake or fault mechanics researcher at the faculty or graduate student level, I recommend purchasing the book or requesting that your library purchase the book. The long review: During the past decade our tools for understanding earthquakes and fault mechanics have expanded by leaps and bounds. New advances in recording and observational technology, both in the lab and in the field, have enabled a better understanding of the processes that produce earthquakes on faults. Coupled with these observational advances have been the computational advances that now allow for sophisticated computer modeling of earthquake and …
Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18-64 years old.

We sought to present the epidemiology of idiopathic pulmonary fibrosis (IPF) in adults 18-64 years old in the USA.From adults aged 18-64 years in a large administrative claims data in 2004-2010, patients with IPF were identified using diagnosis codes. We estimated annual incidence and cumulative prevalence of IPF over time, and examined potential risk factors for the IPF diagnosis.The annual cumulative prevalence increased steadily in the first few years (from 13.4 cases per 100 000 persons in 2005 to 18.2 cases in 2010 per 100 000 persons), which is likely due to a methodological reason, while the annual incidence of IPF decreased over time (from 7.9 cases per 100 000 person-years in 2005 to 5.8 cases in 2010 per 100 000 person-years). The overall decrease was mainly driven by a decreasing trend in the younger patients (aged 18-44 years), while the incidence in older patients remained stable. Consistent trends were observed in subgroups defined by previously published more restrictive algorithms for diagnosis. Older age and male sex were associated with a higher incidence of disease (p<0.05).In US adults younger than 65 years, we observed a decreasing incidence of IPF over time which may partially explain the plateau of cumulative prevalence in the last few years of our data.
Financial Supervision in China: Where will Go?

Based on the review of the history of China's financial supervision and the analysis of the situa- tion of market economy,the author thinks that the financial supervision is internal control system and main part of the public money supervision system.China's financial supervision needs to be changed to suit its economy transition.The author further presents some current reform sugges- tions.
Study on Development and Current Status of Chinese Legal Systems of Health Foods

Objective To conclude history and present condition of system of laws,regulations and standards of health foods in China,as well as to provide suggestions for development in future.Method All laws,regulations and standards related to health foods in China were systemically collected,and carried out in longitudinal and parallel comparison to reveal development and current status of the system.Results At the point of administration,two periods of regulations on health foods and register regulations on health foods were experienced.Actually,legislation process of health foods is an embodiment of modern legal idea such as "equity,justness,convenience,efficiency and relief".At present,a basic regulation system including production,market,supervision and assessment has been evolved,and an open stand has been made to novel functions and materials.Conclusion Henceforth,more attention should be paid to build technical regulations and standards,and to develop relative support regulations,and to rationalize supervision functions of government departments,especially to ensure consistency of regulations among them so as to rectify the market order,and to ensure the development of health food industry in a healthy and orderly way.
ON USING RUBBER AS A GUIDE FOR UNDERSTANDING POLYMERIC LIQUID BEHAVIOR

Publisher Summary This chapter discusses the use of rubber as a guide for understanding polymeric liquid behavior. The large elastic recovery property could be one of the most crucial in polymer rheology as a guide to realistic molecular explanations and to the choice of constitutive equations. A rubber band can be stretched to about five times its zero-stress length and, on release, the rubber will return to within a few percent of its original length. Raw rubber exhibits large, rapid recovery although it has no permanent cross-links. The success of the network theory in describing large recovery is attributable to three features: (1) the existence of molecular structures, long flexible polymer molecules, which can sustain large changes of shape without damage; (2) a mechanism, thermal motion of comparatively free strands, which yields large changes of shape when external forces on the sample are removed; and (3) the interconnection of such structures, at a comparatively few points into a three-dimensional network extending throughout the sample, adequate to ensure the transmission of strand recovery to the macroscopic sample as a whole.
Electrically tunable bandpass filtering balun on engineered substrate embedded with patterned Permalloy thin film

An electrically tunable bandpass filtering balun (BPF-Balun) on engineered substrate embedded with patterned Permalloy (Py) thin film is designed and implemented for the first time. The tunability of the BPF-Balun is realized through tuning RF characteristics of the engineered substrate. Embedded with patterned Py thin film which has high and current-dependent permeability, the developed engineered substrate has electrically tunable equivalent permeability. The center frequency of BPF-Balun on engineered substrate thus becomes tunable with different DC current. Patterning of Py film is analyzed and utilized to increase its FMR up to GHz range. The proposed BPF-Balun is fabricated on Rogers 4350 substrate while the engineered substrate is developed separately with high resistivity silicon embedded with patterned Py thin film. Tunable BPF-Balun is implemented through bonding the Rogers 4350 on the top of engineered substrate. The measured results show that the center frequency of the BPF-Balun can be tuned continuously from 1.49GHz to 1.545GHz with applied DC current adjusted from 0mA to 500mA. The measured magnitude imbalance and phase difference of the two balanced outputs are within 0.5dB and 180°± 5° for the whole frequency range. Larger tunability can be achieved with patterned Py thin film with optimized thickness.
OR2 Variable expression of HLA-C impacts T versus B cell crossmatch outcomes

Aim Flow cytometric crossmatches (FCXM) are used to detect low-level donor-specific antibodies (DSA) and determine eligibility for transplantation and desensitization regimens. We measured HLA class I and HLA-C surface expression on T and B cells from various sources and examined the impact of HLA-C expression on FCXM reactivity in the presence of HLA-C DSA. Methods HLA class I and HLA-C expression was examined on cells isolated from 18 donors using monoclonal antibodies (clone G46.2 and mAb DT9). T and B cells were differentiated using CD3 and CD19 specific monoclonal antibodies. Cells were acquired on a BD FACSCanto II; HLA expression was determined using median channel fluorescence (MCF) values and FCXM reactivity was assessed as a ratio of test serum to negative control serum. Results The mean HLA-C expression was significantly higher on T (11693 MCF) than B cells (5480 MCF, p Conclusions HLA-C expression is known to vary among HLA-C alleles (Apps et al., Science 2013); however, this study shows variability also exists between lymphocyte lineages. HLA-C is expressed higher on T than B cells and this difference impacts crossmatch reactivity. These findings should be considered when interpreting FCXM results. Download : Download high-res image (108KB) Download : Download full-size image
Institutional trust and performance: A study of the police in Ghana:

The primary purpose of this study is to examine the effects of three indicators of police performance on residents’ evaluations of their local police in Ghana. Specifically, the study attempts to address the question “Can performance theory be utilized to explain variations in citizens’ attitudes toward the police?” This question is addressed using cross-sectional data collected on 1024 residents from 25 neighborhoods in five urban cities in Ghana. Findings obtained find evidence to support the applicability of performance theory in the Ghanaian context. Findings from this study have both theoretical and practical implications and provide important insights for the police to enhance their performance and develop better relationship with the public.
Arbitrary void feature control in level set topology optimization

Abstract Feature-driven topology optimization has been extensively studied in the past decade, and the majority of the works have treated it as the multi-component/void layout optimization problem. A major limitation of this treatment is that the number of components/voids should be defined in advance. To overcome this limitation, this paper presents a novel void feature control method, through which the specified void feature (in any geometric form) could be well-contained by each interior void in the finalized topology design, regardless of the quantity. Numerical stability of this method is discussed and an auxiliary algorithm has been developed to enhance it. Other than that, the proposed method also serves the purpose of void length scale control, which is also a hot issue in the topology optimization field. To be specific, by tailoring the specified void feature size, the void length scale is guaranteed to be larger than that. To the authors’ knowledge, the void length scale control was rarely studied under the level set framework. Through a few numerical case studies, it is proven that the void feature control method is effective while only limited compromise of the structural performance has been observed.
Disrupted focal white matter integrity in autism spectrum disorder: A voxel-based meta-analysis of diffusion tensor imaging studies

Abstract Background Autism spectrum disorder (ASD) is a mental disorder that has long been considered to result from brain underconnectivity. However, volumetric analysis of structural MRI data has failed to find consistent white matter alterations in patients with ASD. The present study aims to examine whether there are consistent focal white matter alterations as measured by diffusion tensor imaging (DTI) in individuals with ASD compared with typically developing (TD) individuals. Method Coordinate-based meta-analysis was performed on 14 studies that reported fractional anisotropy (FA) alterations between individuals with ASD and TD individuals. These studies have in total 297 subjects with ASD and 302 TD subjects. Results Activation likelihood estimation (ALE) analysis identified two clusters of white matter regions that showed consistent reduction of FA in individuals with ASD compared with TD individuals: the left splenium of corpus callosum and the right cerebral peduncle. Conclusions Consistent focal white matter reductions in ASD could be identified by using FA, highlighting the cerebral peduncle which is usually overlooked in studies focusing on major white matter tracts. These focal reductions in the splenium and the cerebral peduncle may be associated with sensorimotor impairments seen in individuals with ASD.
Regulation of Cell pH

All cells regulate their pH within a relatively narrow normal range. This subserves a number of functions. First, many cell proteins are regulated by pH, and have defined pH optima. In addition, there is evidence that changes in cell pH participate in cell signaling events related to growth and hormonal effects. H/HCO3 transporters and cell pH also play a pivotal role in cell volume regulation. In this chapter we will briefly discuss general concepts of cell pH regulation. We will then concentrate on more recent advances in the field, and issues that are of importance at the present time.
Object-oriented representation model of construction technology information

The expedient introduction of emerging construction technologies into practice is one of the most effective methods for improving product quality and decreasing costs. For advanced technology to be incorporated in the construction industry, it must first be identified and evaluated during the design and construction planning phases. However, the industry still lacks an efficient system for the rapid identification and evaluation of potential technology solutions. Even though information proliferates, it is too unstructured to be readily used at a moment's notice. This lack of organization, when coupled with the natural human tendency to stay with the tried and true, is probably the major cause of the slow rate of technology transfer and adaptation in the construction industry. The situation can obviously be improved by providing the industry with a sufficient information management system. This system must have a convenient user interface and an integrated data structure which encompasses all the technology information that might be required for planning and design decisions, while satisfying the users' needs for various degrees of detail at different design and planning stages. The research proposes a construction technology information system (CTIS) that can meet the above requirements. The semantic data model (SDM) is used for representing the conceptual schemata of construction technology information. It is a first attempt to explicitly specify the technologies and their relationships using an object-oriented approach. There are several benefits to this approach: it is easy to construct a hierarchical structure that can satisfy the various needs at different design and planning stages and a huge, integrated information system can readily be developed by identifying technology objects and their relationships. A CTIS prototype developed in this research demonstrates the sufficiency of the object-oriented approach. The prototype was implemented using a hypertext-structured database system which also adheres to the object-oriented concept. Objects are used to store all possible forms of data types, including text, graphics, etc., and relationships are regarded as explicit links which let users search and browse the "information space". Due to its modularity, future extensions of the system can be done easily.
Review of African Gender Studies, (2005) and Readings in Gender in Africa (2005)

These two recent collections foreground the emergence of gender studies as an ever-growing area within the wide field that is African Studies. While both volumes provide important contextual and historical information on the central theoretical debates in African gender studies, the two volumes seem to posit different approaches to remedy the intellectual and political discourses that have dangerously superimposed monolithic versions of gender relations onto African relations (Cornwall 7).
The Muddy Waters of Multicultural Acceptance: A Qualitative Case Study on Antisemitism and the Israeli/Palestinian Conflict

The Jewish peoples have endured thousands of years of discrimination and subjugation, yet during this new millennium, Jews and antisemitism are conspicuously absent from university ethnic studies classroom discourse in the United States. Those scholars, determined to penetrate the walls of the multicultural education stronghold, are met with an ebb and flow of silence and vociferous resistance. A primary rationale for multiculturalists ignoring antisemitism appears to be the Zionist question and how they, themselves, perceive Israel’s relationship with Palestine. This qualitative case study analyzed interviews of six prominent scholars in the areas of multiculturalism, history, and Judaism through a critical pedagogical lens. Throughout this paper, the author explores his personal experiences in regard to educational multiculturalists and the dismissal of Jews as a persecuted group. From discourse analysis of themes and recurrent meanings in the data, it is evident that the majority of study participants believe that Israel’s behavior toward the Palestinians is unacceptable, yet that does not justify the large-scale generalizations of the Jewish people in the United States. As a result, this paper argues for the inclusion of the Jewish experience into university multicultural discourse.
Image Quality of ECG-Triggered High-Pitch, Dual-Source Computed Tomography Angiography for Cardiovascular Assessment in Children.

Abstract Purpose Evaluate the feasibility and determinants of image quality of ECG-triggered High-Pitch Dual-Source Computed Tomography Angiography (CTA) for cardiovascular assessment in Children. Material and methods All children that underwent ECG-triggered High-Pitch Dual-Source CTA between August 2014 and September 2017 were identified. Scanner parameters and patients' information were retrieved. Objective image quality was evaluated measuring the Hounsfield units (HU) and standard deviation of regions of interests in the left ventricle, ascending and descending aorta. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Qualitative image quality was recorded independently by two pediatric radiologist blinded using a three-point scale: 1 – good image quality, 2 – mild artifacts, 3 – poor image quality. Continuous variables were presented as mean ± standard deviation. The interobserver agreement and non-parametric test were used. Results 93 patients (mean age 5.6 ± 7.1 years) were selected. Average cardiovascular attenuation, SNR and CNR were 406.2 ± 146.3 HU, 24.2 ± 16.0 HU and 52.1 ± 38.6 HU, respectively. Average image quality was 1.51 ± 0.48 and the inter-observer agreement was excellent (k = 0.8). Worse subjective quality scores were associated with lower age, height, weight, BSA, lower contrast dose and slower injection rates (p Conclusions ECG-triggered High-Pitch Dual-Source cardiac CTA is feasible and provides good or excellent image quality for the evaluation of cardiovascular diseases in children.
Risk Analysis for Critical Infrastructure Protection

Until recently, infrastructure owners and operators only had to worry about local acts of nature and the occasional vandal to maintain their services to a prescribed standard. All that changed with the 1995 Tokyo Subway Attacks and 9/11 which ushered in the unprecedented threat of domestic catastrophic destruction by non-state actors. Now infrastructure owners and operators find themselves under almost constant global cyber attack, the consequences of which could be catastrophic. Critical infrastructure protection has been a core mission of the Department of Homeland Security since its foundation in 2002. This chapter examines the work of the Department to protect the nation’s critical infrastructure, and efforts to develop a uniform risk analysis to guide its strategic planning and facilitate cost-benefit-analysis of mitigation measures on the part of infrastructure owners and operators.
Anti-psychotic drugs block meningococcal virulence

A class of drugs approved to treat schizophrenia can cause rapid loss of the pilus, an essential virulence factor necessary for the disease-causing properties in the strict human pathogen Neisseria meningitidis.
A structured histopathology-based analysis of surgical outcomes in chronic rhinosinusitis with and without nasal polyps.

Objectives Structured histopathology reporting has been recently described for detailing immunopathological characteristics of chronic rhinosinusitis (CRS), and can be utilized for subtyping CRS and personalizing management. This study scrutinized elements of structured histopathology to identify characteristics that prognosticate outcomes following endoscopic sinus surgery (ESS) for CRS patients with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). Methods Outcomes following ESS were measured using the patient-reported 22-item sinonasal outcome test (SNOT-22). Changes in total SNOT-22 scores at 6 and 12 months postoperatively were analyzed. Thirteen parameters reported in structured histopathology of sinus surgical tissue were studied for association with outcomes postsurgery. The overall cohort of all CRS patients was studied, along with subgroup analyses of CRSwNP and CRSsNP patients. Results In the entire CRS cohort (n = 171), eosinophil count >10 per high power field (HPF) was associated with greater improvement in SNOT-22 scores at 6 months post-ESS (P = .039). At 12 months follow-up, no histopathological characteristic was associated with change in total SNOT-22 score. In the CRSwNP (n = 66) subgroup, the presence of fibrosis (P = .006) and eosinophil count ≤10 per HPF (P = .025) were associated with less favorable changes in SNOT-22 scores at 12 months follow-up. Fibrosis remained statistically significant in multivariable analysis (P = .007). Conclusions At 6 months post-ESS, tissue eosinophilia is associated with significantly higher improvement in SNOT-22 scores, but this difference is diluted by 12 months. Fibrosis was associated with less favorable outcomes in SNOT-22 scores for CRSwNP patients at 12 months and may be a prognosticator for poorer long-term outcomes. Level of evidence 4.
Playing With Science: An Investigation of Young Children's Science Conceptions and Misconceptions

The purpose of this research was to investigate the conceptions and misconceptions of young children (ages 3 â€“ 8) related to science concepts, skills, and phenomena. These conceptions and misconceptions were investigated within the framework of the Pennsylvania Early Learning Standards for Pre-Kindergarten and the Pennsylvania Standards for Kindergarten as developed and published by the Pennsylvania Department of Education in 2005. In addition, the National Science Education Standards also served as a foundation for our research. Findings reveal the most common conceptions related to matter, magnetism, density, and air. Extrapolations from this research can be used by pre-service teachers, in-service teachers, and teacher educators to implement experiences in the classroom that assist in developing and refining young childrenâ€™s understandings of scientific concepts, skills, and phenomena.
How Much Did Baseball’s Antitrust Exemption Cost Bob Gibson?:

Major League Baseball was granted an exemption to antitrust laws in 1922 by the Supreme Court. This exemption led to the creation of a monopsonistic labor market that prevented baseball players fro...
Clinical Breast Examination After Treatment of Breast Cancer

Clinical breast examination (CBE) is a screening, not a diagnostic test. Under the best of circumstances in healthy patients, it provides only an approximation of what histology might be found in the tissue that is palpated. After breast conservation therapy, the breast exam becomes even more challenging with subtle changes, at a minimum, found in breast size, skin thickness or retraction, and breast tissue density and nodularity. This chapter reviews the findings commonly seen in the breast and chest wall after treatment and serves as a guide to help distinguish normal post-treatment findings versus those worrisome for recurrence.
Potential impact of outpatient stewardship interventions on antibiotic exposures of common bacterial pathogens

The relationship between antibiotic stewardship and population levels of antibiotic resistance remains unclear. In order to better understand shifts in selective pressure due to stewardship, we use publicly available data to estimate the effect of changes in prescribing on exposures to frequently used antibiotics experienced by potentially pathogenic bacteria that are asymptomatically colonizing the microbiome. We quantify this impact under four hypothetical stewardship strategies. In one scenario, we estimate that elimination of all unnecessary outpatient antibiotic use could avert 6% to 48% (IQR: 17% to 31%) of exposures across pairwise combinations of sixteen common antibiotics and nine bacterial pathogens. All scenarios demonstrate that stewardship interventions, facilitated by changes in clinician behavior and improved diagnostics, have the opportunity to broadly reduce antibiotic exposures across a range of potential pathogens. Concurrent approaches, such as vaccines aiming to reduce infection incidence, are needed to further decrease exposures occurring in 'necessary' contexts.
Exercise Performance at Increased Altitude After Fontan Operation: Comparison to Normal Controls and Correlation with Cavopulmonary Hemodynamics

Exercise performance declines as patients who have undergone Fontan operation enter adolescence. However, the effect of altitude on functional capacity after Fontan remains inadequately studied. Our aim was to describe exercise performance in a cohort of patients with Fontan physiology living at increased altitude and compare to a normal control group and relate these data to invasively derived hemodynamics. We hypothesized that peak oxygen consumption ($$V_{{{\text{O}}_{2} {\text{peak}}}}$$) would be decreased, in association with elevated mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVRi). Patients were evaluated in a multidisciplinary clinic for patients with Fontan physiology. Evaluation included cardiopulmonary exercise test and cardiac catheterization at predetermined intervals. Descriptive statistics were calculated. Associations of catheterization and exercise testing measures with $$V_{{{\text{O}}_{2} {\text{peak}}}}$$ were estimated with Spearman correlation coefficients. One hundred patients with age- and gender-matched controls were included in the analysis. The mean age was 13.3 ± 3.9 years, with mean weight of 47.1 ± 18.4 kg. The mean $$V_{{{\text{O}}_{2} {\text{peak}}}}$$ was 29.0 ± 7.8 ml/kg/min, significantly lower than the control group, 40.2 ± 8.4 ml/kg/min (p < 0.0001). There was no statistically significant linear correlation between $$V_{{{\text{O}}_{2} {\text{peak}}}}$$ and mPAP or PVRi. We characterized exercise performance in a large cohort with Fontan physiology living at increased altitude and showed a decrease in $$V_{{{\text{O}}_{2} {\text{peak}}}}$$ compared to controls. Our data do not support the hypothesis that moderately increased altitude has a detrimental effect on exercise performance, nor is there a substantial link between poor cavopulmonary hemodynamics and exercise in this setting.
Sports-Related Cervical Spine Fracture and Spinal Cord Injury: A Review of Nationwide Pediatric Trends.

STUDY DESIGN Retrospective cohort study. OBJECTIVE Assess trends in sports-related cervical spine trauma using a pediatric inpatient database. SUMMARY OF BACKGROUND DATA Injuries sustained from sports participation may include cervical spine trauma such as fractures and spinal cord injury (SCI). Large database studies analyzing sports-related cervical trauma in the pediatric population are currently lacking. METHODS The Kid Inpatient Database was queried for patients with external causes of injury secondary to sports-related activities from 2003 to 2012. Patients were further grouped for cervical spine injury (CSI) type, including C1-4 and C5-7 fracture with/without spinal cord injury (SCI), dislocation, and SCI without radiographic abnormality (SCIWORA). Patients were grouped by age into children (4-9), pre-adolescents (Pre, 10-13), and adolescents (14-17). Kruskall-Wallis tests with post-hoc Mann-Whitney U's identified differences in CSI type across age groups and sport type. Logistic regression found predictors of TBI and specific cervical injuries. RESULTS A total of 38,539 patients were identified (12.76 years, 24.5% F). Adolescents had the highest rate of sports injuries per year (P < 0.001). Adolescents had the highest rate of any type of CSI, including C1-4 and C5-7 fracture with and without SCI, dislocation, and SCIWORA (all P < 0.001). Adolescence increased odds for C1-4 fracture w/o SCI 3.18×, C1-4 fx w/ SCI by 7.57×, C5-7 fx w/o SCI 4.11×, C5-7 w/SCI 3.63×, cervical dislocation 1.7×, and cervical SCIWORA 2.75×, all P < 0.05. Football injuries rose from 5.83% in 2009 to 9.14% in 2012 (P < 0.001), and were associated with more SCIWORA (1.6% vs. 1.0%, P = 0.012), and football injuries increased odds of SCI by 1.56×. Concurrent TBI was highest in adolescents at 58.4% (pre: 26.6%, child: 4.9%, P < 0.001), and SCIWORA was a significant predictor for concurrent TBI across all sports (odds ratio: 2.35 [1.77-3.11], P < 0.001). CONCLUSION Adolescent athletes had the highest rates of upper/lower cervical fracture, dislocation, and SCIWORA. Adolescence and SCIWORA were significant predictors of concurrent TBI across sports. The increased prevalence of CSI with age sheds light on the growing concern for youth sports played at a competitive level, and supports recently updated regulations aimed at decreasing youth athletic injuries. LEVEL OF EVIDENCE 3.
Vascular calcifications and calciphylaxis in a patient on concurrent haemodialysis and Coumadin therapy.

Calciphylaxis is a rare life-threatening condition, with calcification of small and medium-sized vessels leading to skin necrosis. It has a high morbidity and mortality, and most of the patients die from wound superinfection and sepsis. A 48-year-old man with a history of end-stage renal disease on haemodialysis and Coumadin therapy for venous thromboembolism presented with pulmonary oedema after missing two haemodialysis treatment. At examination, he had bilateral lower extremity dark brown, possibly necrotic, painful ulcers. He was diagnosed with calciphylaxis and treated with sevelamer hydrochloride, low calcium dialysate and sodium thiosulfate with haemodialysis. He received daily wound care with topical collagenase. After daily wound care treatment for 4 months, the patient’s ulcers completely healed. The patient had been followed for 8 months, which included 29 additional readmissions, 3 admissions related to bacteraemia and 26 admissions with the diagnosis of pulmonary oedema and hyperkalaemia requiring haemodialysis.
Philosophical or empirical incommensurability of frequentist versus Bayesian thinking

Frequentists and Bayesians disagree about the soundness of performing calculations based, in an important part, on prior information. The disagreement goes back to a basic philosophical disagreement about how to conceptualize the meaning of probability. As frequentists and Bayesians use the term differently, there is a basic philosophical incommensurability. However, this philosophical incommensurability need not imply an empirical incommensurability. It is possible for there to be, simultaneously, philosophical incommensurability and empirical commensurability. This possibility implies consequences that this article discusses
Sleep quantity and variability during the first semester at university: implications for well-being and academic performance

Research has demonstrated the importance of sleep quality for university students, although work is limited with respect to how sleep during the first semester of school impacts well-being and acad...
A Phase II Trial of Adjuvant Durvalumab Following Trimodality Therapy for Locally Advanced Esophageal and Gastroesophageal Junction Adenocarcinoma: A Big Ten Cancer Research Consortium Study

Background Most patients with resectable locally advanced esophageal and gastroesophageal junction (GEJ) adenocarcinoma (AC) receive concurrent chemoradiation (CRT) followed by esophagectomy. The majority of patients do not achieve pathologic complete response (pCR) with neoadjuvant CRT, and the relapse rate is high among these patients. Methods We conducted a phase II study (ClinicalTrials.gov Identifier: NCT02639065) evaluating the efficacy and safety of PD-L1 inhibitor durvalumab in patients with locally advanced esophageal and GEJ AC who have undergone neoadjuvant CRT followed by R0 resection with evidence of persistent residual disease in the surgical specimen. Patients received durvalumab 1500 mg IV every 4 weeks for up to 1 year. The primary endpoint was 1-year relapse free survival (RFS). Secondary endpoint was safety and tolerability of durvalumab following trimodality therapy. Exploratory endpoints included correlation of RFS with PD-L1 expression, HER-2 expression, and tumor immune cell population. Results Thirty-seven patients were enrolled. The majority (64.9%) had pathologically positive lymph nodes. The most common treatment related adverse events were fatigue (27%), diarrhea (18.9%), arthralgia (16.2%), nausea (16.2%), pruritus (16.2%), cough (10.8%), and increase in AST/ALT/bilirubin (10.8%). Three (8.1%) patients developed grade 3 immune mediated adverse events. One-year RFS was 73% (95% CI, 56-84%) with median RFS of 21 months (95% CI, 14-40.4 months). Patients with GEJ AC had a trend toward superior 1-year RFS compared to those with esophageal AC (83% vs. 63%, p = 0.1534). There was a numerical trend toward superior 1-year RFS among patients with PD-L1 positive disease compared to those with PD-L1 negative disease, using CPS of ≥10 (100% vs. 66.7%, p = 0.1551) and ≥1 (84.2% vs. 61.1%, p = 0.1510) cutoffs. A higher relative proportion of M2 macrophages and CD4 memory activated T cells was associated with improved RFS (HR = 0.16; 95% CI, 0.05-0.59; p = 0.0053; and HR = 0.37; 95% CI, 0.15-0.93, p = 0.0351, respectively). Conclusions Adjuvant durvalumab in patients with residual disease in the surgical specimen following trimodality therapy for locally advanced esophageal and GEJ AC led to clinically meaningful improvement in 1-year RFS compared to historical control rate. Higher PD-L1 expression may have a correlation with the efficacy of durvalumab in this setting. Higher proportion of M2 macrophages and CD4 memory activated T cells was associated with superior RFS.
Evaluation of Electron Microscopic Information Available from Clinical Samples

Much has been written on the procedures for using electron microscopy (EM) in diagnostic virology (Almeida, 1983; Kapikian et al. 1976; Miller, 1986, 1988, 1989; Oshiro and Miller, in press) and the viruses likely to be found in clinical samples (Hsiung, 1982; Lennette, 1985). Excellent atlases are also available for identifying virions (Doane and Anderson, 1987; Palmer and Martin, 1988). This information will not be repeated here. Rather, we will elaborate on characteristics of viruses that allow them to be recognized by EM, interpretation of EM observations, i.e., what do the results tell the physician, what tests are most appropriate for which specimens, and what action can be taken based on that information.
Abstract MP15: Innovative Self-Regulation Strategies Reduce Weight Gain in Young Adults

Introduction: Young adults gain an average of 2 pounds per year, increasing their risk for obesity and co-morbidities. To date, no approaches have successfully reduced this weight gain. The Study of Novel Approaches to Prevention of Weight Gain (SNAP) is a randomized clinical trial testing two innovative self-regulation interventions. Hypothesis: We hypothesized that both interventions would reduce weight change over an average follow-up of 3 years relative to a control. Methods: Participants age 18-35 with a BMI of 21-30 were recruited in Raleigh-Durham, NC and Providence, RI. The 599 participants included 27% from minority groups and 22% males, mean age 28.4 (SD 4.4) yrs and BMI 25.4 (2.6). The interventions were based on a self-regulation model, involving frequent self-weighing and changes in eating and activity if weight gain occurred. The SMALL changes approach focused on making small (100 calorie) changes in daily eating and exercise; LARGE changes emphasized larger initial changes in eating and exe...
Green surfboards: Investigation of product biodegradability at end of life

As the world becomes more environmentally conscious, companies find ways to make products and manufacturing processes greener. This work examines an innovative surfboard product that uses bio-based fiber-reinforced polymers to address product disposal issues and to lower the toxicity associated with some of its components and manufacturing processes. The goal of this work is to characterize the biodegradability of the “green” surfboards at end of life, focusing on the fiber-reinforced composite laminate covering the surfboard and the core of the board. Different laminate types, with various combinations of resins (polyester, epoxy and a bio-resin) and reinforcing fibers (fiberglass, organic hemp and organic cotton), were tested. Polyurethane core was compared with the green alternative balsa wood core. Degree and rate of biodegradability of materials were evaluated by measuring weight change and material hardness over 56 days under controlled composting conditions. The results suggest that the resin compo...
Serum sickness-like reaction associated with cefazolin

Although rare, serum sickness-like reactions have been documented to occur following the administration of many antibiotics. Cefazolin, a first generation cephalosporin, is a commonly prescribed antibiotic which is considered to be generally safe and well tolerated. There have been no prior reports linking this drug with sickness-like reactions. We report a probable case of serum sickness-like reaction following a single dose of cefazolin. A 23 year old man with no significant past medical history was admitted to undergo a laparoscopic donor nephrectomy as part of a living-related renal transplant. One gram of intravenous cefazolin was administered perioperatively. The surgery was completed without complication and the remainder of his hospital course was uneventful. Ten days following discharge the patient developed fevers, painful and swollen joints, and a cutaneous eruption overlying his trunk and extremities. There was no evidence of systemic vasculitis. These clinical findings were most consistent with a serum sickness-like reaction. A brief course of corticosteroids and antihistaminergic therapy was initiated, and complete resolution of the patient's symptoms followed. The Naranjo probability scale indicated that this adverse drug event was probable. Serum sickness-like reaction may be associated with cefazolin therapy.
Generic adaptation mechanism for the support of context-aware service provision in 3G networks

The forthcoming era of 3/sup rd/ generation (3G) mobile communications is heralded to change the wireless telecommunication experience dramatically. User expectations are raised to a significantly higher level, towards the demand for terminal-, network- and location-aware provision of ubiquitous, personalized multimedia services. Under this perspective, the need for adaptability of services and systems to largely diverse contexts is clearly identified. Generic, dynamically extensible adaptation mechanisms that are independent of the subject and criteria of adaptation can be a significant step in this direction. We introduce a mechanism aiming to fulfill these requirements. The proposed adaptation system has been designed, implemented and successfully integrated and tested in a distributed software platform for provision of value added services to 3G mobile users.
Should I Stay or Should I Go? Factors that Influence the Retention, Turnover, and Attrition of K–12 Music Teachers in the United States

The purpose of this study was to construct a profile of K–12 music teachers in the United States and develop a model to predict their retention, turnover, and attrition. Responses to the Schools and Staffing Survey from 47,857 K–12 public and private school teachers, including 1,903 music teachers, were analyzed using comparative statistics, factor analysis, logistic regression, and structural equation modeling. Results indicated that music teachers were far more likely than other types of teachers to hold itinerant or part-time positions, and were less likely to receive support for working with special needs students. Music teachers changed teaching positions because of dissatisfaction with workplace conditions and for better teaching assignments. Music teachers left the teaching profession for better salary or benefits, and were generally more satisfied in their new field. Music teachers’ perceived level of administrative support had the most prominent influence on both music teacher satisfaction and re...