cssi/SciSciGPT-SciSciNet huggingface dataset:
Teaching Ethics in Clinic: Keeping You Smart and Honest

The private practice and clinic setting in dermatology offers numerous opportunities to teach ethics and professionalism to both medical students and physicians-in-training. To the student, teaching in ethics provides them with the tools to deal with their own ethical dilemmas in the future, which is an obvious advantage. Trainees learn from role modeling and discussion and feedback, acquiring the tools to make them effective ethical and professional dermatologists. For practicing dermatologists, teaching ethics in this setting provides not only new viewpoints and insights into their beliefs and actions, but forces them to analyze and verbalize their thought processes rather than following ingrained behavior patterns. Four cases that illustrate typical ethical dilemmas seen in day-to-day dermatology practice are used to illustrate how effective teaching in ethics and professionalism can occur in the clinic and private office.
Interplay between Microorganisms and Geochemistry in Geological Carbon Storage

Citation: Kirk, MF, Altman, SJ, Santillan, EFU, Bennett, PC (2016) Interplay between microorganisms and geochemistry in geological carbon storage. International Journal of Greenhouse Gas Control 47, 386-395.
Adaptive Mechanisms of the Raptor Pelvic Limb

THIS study presents some adaptations in the pelvic limb of six North American raptorial species. Bock and von Wahlert (1965) point out the term "adaptation" needs to be defined when used. I studied evolutionary adaptations as I am interested in those structural features that enable raptors to sustain a predatory role within a given environment. I am not concerned with evolutionary pathways. In this regard, I studied closely related and diverse species having similar habits. I investigated the raptorial species from both orders and four of the five families in North America (the nonpredaceous New World vultures, the Cathartidae, were omitted). The species studied were the Cooper's Hawk (Accipiter cooperii), Red-tailed Hawk (Buteo jamaicensis), Prairie Falcon (Falco mexicanus), Sparrow Hawk (Falco sparverius), Screech Owl (Otus asio), Burrowing Owl (Speotyto canicularia), and the Barn Owl (Tyto alba). I compared the raptors to one another, as well as to a generalized nonraptorial species. A "generalized" species is difficult to define, but one that does not use its legs and feet for any particular activity other than walking or standing seems appropriate. I selected the domestic pigeon (Columba livia). The functional aspects of the anatomy of the birds of prey have been little studied. Garrod (1875) described the vinculum connecting the tendons of the flexor digitorum longus and flexor hallicus longus for several genera of Falconiformes. Subsequent workers (Shufeldt, 1887; Hudson, 1937; Ruggeberg, 1960) further discussed the fusion of these tendons. Shufeldt (1909) presented a very general account of the osteology of several species including A. cooperii, B. jamaicensis, and F. mexicanus. Peczely (1964) compared the thoracic vertebrae of several genera of raptors including Buteo, Accipiter, and Falco. Where possible, he related anatomical differences to the habits of the birds. Studies of the pelvic region of various genera of Falconiformes and Strigiformes were made by Hudson (1937, 1948) and Berlin (1963). Accurate determination of muscle forces has long presented a problem to morphologists. Present knowledge of muscle structure and physiology limit severely the traditional techniques of comparing muscle volumes and weights (for a review, see Gans and Bock, 1965). Eccles and Sherrington (1930) demonstrated the dangers of using the weight (and thus volume) of muscles as an indication of tension. They showed that though the medial gastrocnemius of the cat weighs 21/2 to 3 times as much as the soleus, it develops about 6 times as much tetanic tension
The Effectiveness of Sanction Linkages: Issues and Actors

This paper develops an analytical framework to examine the impacts of issues and actors' relations on linkage diplomacy. Three types of issues—substantive, symbolic, and transcendent—are differentiated on the basis of the tangibility of the stakes therein attached in linkages. The effectiveness of sanction linkages is shown to be related to the nature of the linkage issues. On the other hand, three linkage processes—compliance, identification, and internalization, which correspond to the decision-making models of realism, dependency theory, and regime analysis, and are defined by “ideology” and “penetration”—are found useful for predicting the results of sanction linkages.
Der Darm als Sepsisherd bei akuter Pankreatitis

Morbiditat und Letalitat der akuten nekrotisierenden Pankreatitis werden ganz wesentlich durch septische Komplikationen bestimmt. Bei einem hohen Prozentsatz dieser pankreatogenen Septitiden last sich eine Eintrittspforte der Erreger nicht nachweisen. Da es sich in der Regel um typische Darmkeime handelt [1], scheint der Gastrointestinaltrakt als Reservoir dieser Erreger zu dienen. Im Tierexperiment konnte unter verschiedenen Bedingungen wie Schock [2], Verbrennung [3] und parenterale Ernahrung [4] ein Ubertritt darmstandiger Bakterien in die regionalen Lymphknoten und andere Organe beobachtet werden. Dieser Prozes der bakteriellen Translokation wird als ein Mechanismus der Entwicklung der gram-negativen Sepsis betrachtet. Wir untersuchten die Veranderungen des Darmes bei akuter Pankreatitis durch Messung der Darmmotilitat, der Darmflora und der bakteriellen Translokation.
Community Extraction Algorithm for Large-Scale Online Social Networks

Since the existing community analysis methods cannot be applied in large-scale networks,a community extraction algorithm is proposed. The community structure can be analyzed effectively with the algorithm. The topology of the network is not needed,with the combination of network search and community detection capabilities,the structure of the particular community can be effectively extracted from the social network with unknown topology. The analyzing of the community structure of large scale network is possible with the algorithm.Experiments on simulation data are performed to analyze the influence factor of accuracy,and it is concluded that the accuracy increases with the average degree. Furthermore,it is found that the accuracy of community extraction algorithm is close to existing methods,and the efficiency is much better,the results showthe algorithm is feasible and effective.
Detection Results of Benzene,Toluene and Xylene in the Air of Workplace in Suzhou Industrial Park

[Objective]To understand the contamination degrees of benzene,toluene and xylene in workplace air and the rectifying effect in Suzhou Industrial Park.[Methods]The sampling,testing and analysis were on the basis of national standard method,the control effect of occupational hazards in this project is evaluated.[Results]The over standard rates of benzene,toluene and xylene decreased annually,the detection rate of highly toxic benzene decreased annually too.[Conclusion]In recent years,the efficient prevention and control measures have been adopt.The key to occupational health work in future are strengthening the monitoring of over standard enterprise,decreasing the use of high toxic benzene,reducing over standard rate.
Effects of porcine somatotropin on circulating testosterone concentrations in boars and mechanism of action.

Four experiments were conducted to elucidate the effects of porcine somatotropin (pST, growth hormone) on circulating testosterone concentrations in boars. In Exp. 1, jugular-cannulated obese boars were administered 4 mg recombinant (r) pST/d for 24 d before collection of samples at 15-min intervals over 6 h for measurement of pST, testosterone, and LH. Somatotropin treatment decreased plasma concentrations of testosterone and LH (P < .05). In Exp. 2, White composite boars were administered rpST with implants (4 mg/d) for 10 to 28, 16 to 28, or 22 to 28 wk of age. Reductions in testosterone concentrations were proportional to the length of time rpST was administered; boars treated for 18 wk had the lowest testosterone concentrations. Concentrations of LH declined throughout the study in rpST-implanted boars but remained static in untreated, control boars. In vitro production of testosterone and dehydroepiandrosterone/dehydroepiandrosterone sulfate was unaffected by rpST treatment, and hCG stimulation of in vitro androgen secretion was similar in rpST and control treatments. In Exp. 3, i.v. injection of pituitary pST (USDA-B1; 5 micrograms/kg BW) into jugular-cannulated White composite and Meishan boars resulted in an acute increase in circulating LH followed by an increase in testosterone concentrations, which then declined to below preinjection levels at 6 to 7 h after pST injection. Multiple injections, two or four per day, of 5 micrograms pST/kg BW resulted in decreased testosterone concentrations in White composite boars, whereas in Meishan boars testosterone concentrations were unaffected (Exp. 4). Concentrations of LH were not different from control values in either breed, but in both breeds, four injections of pST per day produced lower LH concentrations than did two injections per day (P < .01). Depression of circulating concentrations of androgens in boars requires extended periods of pST treatment.
The “Madman” and the Dreamer

My thesis, put simply and straightforwardly, is twofold: a. the ethical, problem-solving orientation, which is characteristic of the medical approach to the other, does not do justice to the other as Other, as “the absolutely other” (Levinas, 1969, p. 39); and b. the aesthetic perspective constitutes a less violent approach to the Other, an approach which deserves serious consideration. This view is diametrically opposed to Levinas’ privileging the ethical over the aesthetic (1969). To facilitate contrast and comparison between these two approaches to the Other, ethical versus aesthetic, I examine the role of the other in two different settings: as patient and “madman” in the clinical setting; and as a dreamer in a Chinese poem. The following discussion is divided into five sections: section one examines “madman” as the prototypical Other; section two considers the dreamer as the Other; section three compares the problem-solving approach to the “madman” with the aesthetic approach to the dreamer; section four further elaborates on the aesthetic approach to the Other as “relation without relation”; section five draws some tentative conclusions.
Real-Time Ultrasound Abdominal Imaging

The application of the Thaumascan imaging system has been described in cardiology. This system can also be utilized in producing high quality images of abdominal structures. High resolution, real-time, tomographic images are generated at the rate of 30 frames/sec. in a circular sector format by electronically phasing a linear array of ultrasound transducers. The small, hand held transducer can be placed on any portion of the abdomen and various tomographic sections can readily be obtained. The real-time feature of this imaging system aids in localizing specific anatomic structures by providing immediate visual feedback.
Guided Transportation Systems: Low-Impact, High-Volume, Fail-Safe Travel

Publisher Summary This chapter describes guided transportation systems. Three types of wholly or partly new transportation systems are described. One is based on human-powered vehicles; one on buses; and one is a replacement for conventional rapid transit called Personal Rapid Transit (PRT), currently being planned for an area of Chicago. These systems are of interest because of problems in the present ground and air transportation systems: while they serve some purposes and some groups of people very well, they serve many other purposes and many other people quite poorly. The reasons for this state of transportation to persist at the end of the 20th century are that overt and concealed subsidies for some forms of transportation have become entrenched in the national lives to such an extent that they are regarded as normal.
Dose optimization in cardiac CT

Rapid progress in the field of Cardiac CT is fostered by the advances in CT scanner technology as well as multiple clinical trials demonstrating its role in coronary artery disease and other indications like congenital heart disease, pulmonary vein assessment and pre transcatheter aortic valve replacement. The cardiovascular imager today is responsible for delivering diagnostic image quality while striking a balance with optimized radiation dose. Radiation dose is the result of multiple scanner and patient related factors. Achieving a justifiable radiation dose according to the ALARA principle requires an adept understanding of the factors affecting radiation dose. We review different scan factors and their effect on radiation dose and present strategies for radiation dose optimization in cardiac CT.
Quantum dot-mediated delivery of siRNA to inhibit sphingomyelinase activities in brain-derived cells.

The use of RNAi to suppress protein synthesis offers a potential way of reducing the level of enzymes or the synthesis of mutant toxic proteins but there are few tools currently available for their delivery. To address this problem, bioconjugated quantum dots (QDs) containing a hydrophobic component (N-palmitate) and a sequence VKIKK designed to traverse across cell membranes and visualize drug delivery were developed and tested on cell lines of brain origin. We used the Zn outer shell of the QD to bind HIS6 in JB577 (W•G•Dap(N-Palmitoyl)•VKIKK•P9 •G2 •H6 ) and by a gel-shift assay showed that siRNAs would bind to the positively charged KIKK sequence. By comparing many peptides and QD coatings, we showed that the QD-JB577-siRNA construct was taken up by cells of nervous system origin, distributed throughout the cytosol, and inhibited protein synthesis, implying that JB577 was also promoting endosome egress. By attaching siRNA for luciferase in a cell line over-expressing luciferase, we showed 70% inhibition of mRNA after 24-48 h. To show more specific effects, we synthesized siRNA for neutral (NSMase2), acid (lysosomal ASMase) sphingomyelinase, and sphingosine kinase 1 (SK1), we demonstrated a dose-dependent inhibition of activity. These data suggest that QDs are a useful siRNA delivery tool and QD-siRNA could be a potential theranostic for a variety of diseases.
PSYCHE–ZEITSCHRIFT FÜR PSYCHOANALYSE UND IHRE ANWENDUNGEN

Behandlungskrisen und die Rolle des Analytikers. [Treatment Crises and the Role of the Analyst.] By Franz Peter Plenker, pp. 25–46.This author focuses on the role of the analyst in the context of t...
Highly Sensitive Wearable Piezoelectric Force Sensor With Quasi-Static Load Testing

This paper proposes the development of a wearable piezoelectric sensor from polyvinylidene fluoride (PVDF) that can be integrated into clothing and measure high forces. Based on the direct piezoelectric effect, good linearity is expected such that there should be an increase in voltage as higher loads are tested. With external circuitry and an interface to a computer via a microcontroller board, measurements include calculations for initial voltage, force, pressure, and normalized voltage as well as measured voltage. Results are analyzed based on two criteria: first, wearable conditions based on no-cloth, rigid-cloth, and smooth-cloth implementations; and second, the maximum force applied by varying sensor dimensions. Two load ranges were also applied: low-force threshold between 2.5 and 10 kN with steps of 0.5 kN and high-force threshold between 10 and 50 kN with steps of 2.5 kN. Given this criteria, all results that have shown great accuracy can be attained, since all percent errors are within the performance error threshold between 2% and 5%.
Noncyanide leaching of an auriferous pyrite ore from Ecuador

Gold leaching of an auriferous pyrite ore from the Portovelo deposit in Ecuador indicates that noncyanide leaching systems, such as thiocyanate and thiourea, are not as effective as the traditional cyanide system. For example, whereas approximately 95% of the gold can be leached from the ore with cyanide, only about 50% gold dissolution can be achieved with a thiocyanate leaching system. Electrochemical measurements indicate that gold is not cathodically protected by pyrite in these systems. Based on the results of preliminary diagnostic experiments, it appears that gold dissolution in thiocyanate and thiourea systems is limited by passivation due to the formation of either elemental sulfur or sulfur compounds on the gold surface.
The Education of Black People: Ten Critiques, 1906-1960

(1974). The Education of Black People: Ten Critiques, 1906-1960. The Journal of Higher Education: Vol. 45, No. 4, pp. 305-308.
“If You Can’t Love Yourself, How in the Hell You Gonna Love Somebody Else?” Drag TV and Self-Love Discourse

This chapter examines the way that RuPaul’s Drag Race (RPDR), as a parody of reality TV can at once, reinforce neoliberal ideals, and destabilize cultural norms. Drag culture has a history of confronting the mainstream in physical, underground spaces. This chapter examines whether or not the shift of drag subcultures into television and online media spaces removes the political potential of that confrontation. Through a comparison of these three spaces and a discussion of the key term “mimicry” (as defined by Homi Bhabha), Daggett concludes that the relationship between these spaces is more entwined and complex than previously assumed in media research. The political potential of RPDR appears in all these spaces and has some correlation with the show’s growing mainstream popularity.
A case study of air quality - Pesticides and odorous phytochemicals on Kauai, Hawaii, USA

Abstract This study was conducted after a series of incidences occurred at Waimea Canyon Middle School on Kauai, Hawaii. Some students and staff members exhibited symptoms such as throat irritation, tearing, and dizziness. These symptoms could be associated with natural causes or human activities, which include exposures to pesticides and odorous phytochemicals. At the time of the occurrences, Cleome gynandra (known locally as stinkweed) was growing in the fields near the school and might be a potential cause of the reported symptoms. This work was designed to study pesticides and phytochemicals in ambient air around Waimea Canyon Middle School in comparison with other locations on Kauai. Among many chemicals, top 29 were selected for the analysis of stinkweed-emitted chemicals in a chamber study. One out of the 29 chemicals was methyl isothiocyanate (MITC) that is a highly foul-smelling, noxious chemical at high concentrations. Approximately half of the 29 chemicals produced by stinkweed and trace amounts of five pesticides were detected in indoor and outdoor air samples collected from the passive and high volume air samplers. The average concentrations of MITC in Waimea outdoor air during daytime and nighttime were 13.1 and 5.6 ng m−3, respectively. The average concentrations of the five pesticides DDTs, HCHs, chlorpyrifos, bifenthrin, and metolachlor in Waimea outdoor air were respectively 2.5, 2.3, 35, 43, and 23 ng m−3during daytime and 2.4, 1.7, 33, 29, and 19 ng m−3 during nighttime. The concentrations of the pesticide and phytochemicals found in air on Kauai were below health concern levels.
Clinical staging of Fibrodysplasia Ossificans Progressiva (FOP)

Fibrodyplasia ossificans progressiva (FOP) is an ultra-rare genetic condition of heterotopic ossification (HO) that results in progressive loss of joint function, ultimately rendering movement impossible. Death is most commonly the result of thoracic insufficiency syndrome, or complications related to recurrent respiratory infections. There are no current treatments for FOP, but early and emerging clinical trials offer hope for this devastating disease. With the recent reporting of a comprehensive global natural history study, scales to assess joint dysfunction, and a more accurate prediction of joint survival, it is now possible to construct a conceptual framework for the clinical staging of FOP. Based on assessment of FOP features in seven areas, it is possible to assign five clinical stages. FOP features include flare-up activity, body regions affected, thoracic insufficiency, other complications, activities of daily living (ADLs), ambulatory status, and the cumulative joint involvement scale (CAJIS) score. Assessments of these features assign an individual with FOP to early/mild, moderate, severe, profound, or late-stage disease. These criteria seek to be flexible enough to be used by clinicians without reliance on advanced imaging or specialized testing, as well as by investigators involved in research or clinical trial studies who would have these tools available. These staging measures for FOP assess the influence of HO and accelerated joint dysfunction (due to congenital abnormalities) on the ability to perform common functional activities, and thus a delay or lack of progression from one stage to the next represents the ultimate test of efficacy for drug trials. This framework will serve both as a prediction tool for FOP progression as well as a critical opportunity to substantiate therapeutic interventions. The staging system proposed here will permit an accurate assessment of severity to appropriately develop or revise clinical plans of care, define operational research criteria, and identify the effectiveness of interventions. Ultimately, this clinical staging will aid the field in moving toward earlier intervention at a stage where disease-modifying therapies may be most efficacious.
Natural Sensations Evoked in Distal Extremities Using Surface Electrical Stimulation

Background Electrical stimulation is increasingly relevant in a variety of medical treatments. In this study, surface electrical stimulation was evaluated as a method to non-invasively target a neural function, specifically natural sensation in the distal limbs. Method Electrodes were placed over the median and ulnar nerves at the elbow and the common peroneal and lateral sural cutaneous nerves at the knee. Strength-duration curves for sensation were compared between nerves. The location, modality, and intensity of each sensation were also analyzed. In an effort to evoke natural sensations, several patterned waveforms were evaluated. Results Distal sensation was obtained in all but one of the 48 nerves tested in able-bodied subjects and in the two nerves from subjects with an amputation. Increasing the pulse amplitude of the stimulus caused an increase in the area and magnitude of the sensation in a majority of subjects. A low frequency waveform evoked a tapping or tapping-like sensation in 29 out of the 31 able-bodied subjects and a sensation that could be considered natural in two subjects with an amputation. This waveform performed better than other patterned waveforms that had proven effective during implanted extra-neural stimulation. Conclusion Surface electrical stimulation has the potential to be a powerful, non-invasive tool for activation of the nervous system. These results suggest that a tapping sensation in the distal extremity can be evoked in most able-bodied individuals and that targeting the nerve trunk from the surface is a valid method to evoke sensation in the phantom limb of individuals with an amputation for short term applications.
Dynamic transitions between marijuana use and cigarette smoking among US adolescents and emerging adults.

ABSTRACTBackground: Marijuana and tobacco are considered two closely related substances. It is of great significance to understand the mutual impact of marijuana and cigarette use when more states ...
The Homotopy Theory of (∞,1)-Categories

The notion of an (∞,1)-category has become widely used in homotopy theory, category theory, and in a number of applications. There are many different approaches to this structure, all of them equivalent, and each with its corresponding homotopy theory. This book provides a relatively self-contained source of the definitions of the different models, the model structure (homotopy theory) of each, and the equivalences between the models. While most of the current literature focusses on how to extend category theory in this context, and centers in particular on the quasi-category model, this book offers a balanced treatment of the appropriate model structures for simplicial categories, Segal categories, complete Segal spaces, quasi-categories, and relative categories, all from a homotopy-theoretic perspective. Introductory chapters provide background in both homotopy and category theory and contain many references to the literature, thus making the book accessible to graduates and to researchers in related areas.
Indications, Techniques, Outcomes for Matrix-Induced Autologous Chondrocyte Implantation (MACI)

Symptomatic cartilage defects of the knee are a common problem facing orthopaedic surgeons. Several operative treatments exist for patients who have failed nonoperative management. These treatments can be broadly broken down into reparative and restorative procedures. While reparative procedures can be used on very small defects with moderate to good results, restorative procedures are more effective for larger lesions, and for longer lasting improvements in outcomes over time. Matrix-induced autologous chondrocyte implantation (MACI) is a third generation autologous chondrocyte implantation product in which the patient's previously harvested chondrocytes are expanded in culture and seeded onto a collagen scaffold. The technique is indicated for symptomatic articular cartilage defects with minimal subchondral bony involvement. The seeded collagen scaffold is used to cover the articular cartilage defect, using fibrin glue to secure it into place, thus simplifying the technique and addressing some of the issues seen with the first and second generation autologous chondrocyte implantation. Clinical results, including patient satisfaction, pain reduction, and ability to return to sport following MACI have been encouraging in short, medium, and long-term studies. MACI is a reliable option for treatment of symptomatic cartilage defects.
Sepsis Protocol Design Project

Sepsis is a systemic infection that is the 10th leading cause of death in the United States. The sooner that the antibiotic protocols are started, the better is the patient’s outcome. This case study applied the Lean Six Sigma methodology and tools to develop and implement Sepsis protocols in the Emergency Department of a community-based hospital to improve patients’ sepsis mortality by 9.6 %, while improving the time that the sepsis protocols were administered from the time that the patient arrived to the Emergency Department. There is still improvement to be made in the consistency of administering the sepsis protocols for suspected sepsis patients in the ED. This chapter is not intended to provide medical advice or recommendations.
Lessons from Catholic High Schools on Renewing our Educational Institutions

During the 1980s, a spate of research studies and newspaper stories chronicled the unusual effectiveness of Catholic high schools. These accounts claimed that Catholic schools do a better job of engaging students in schooling, have lower dropout rates, and show higher levels of academic achievement, especially for disadvantaged students.2 Moreover, Catholic schools use only very modest fiscal resources to produce these desired outcomes. Although these reports have been subject to rigorous critique and considerable reanalysis, the basic pattern of results has been sustained.
Resistance to 5-Nitroimidazoles in Pathogenic Microorganisms

Resistance (lowered susceptibility) to metronidazole and other 5-nitroimidazoles occurs, albeit infrequently, in clinical isolates of the normally susceptible anaerobic microorganisms, Trichomonas vaginalis and Bacteroides spp. Such resistance has been induced by in vivo drug pressure in T. vaginalis and Tritrichomonas foetus and by in vitro drug pressure in B. fragilis. All organisms studied showed cross-resistance to other 5-nitro-imidazoles expressed to a different degree. The detection of resistance depends on the assay method used. The mechanism of resistance in natural isolates and in strains of trichomonads developed in vivo is unknown but seems to be connected with aerobic conditions. Resistance of in vitro developed T. foetus strains and of all B. fragilis strains studied is related to a decreased activity of pyruvate:ferredoxin oxidoreductase, responsible for the metabolic activation of 5-nitroimidazoles.
Transfer of tumor specific immunity with "immune" RNA: prospects for the treatment of human cancer.

Ribonucleic acids extracted from specifically sensitized lymphoid cells (I-RNA) have been shown to transfer specific immunoreactivity to normal non-immune lymphoid cells. Evidence for the transfer by I-RNA, of immune responses to tumor-associated antigens of animal and human neoplasms, in vivo and in vitro, is reviewed. Results obtained in our laboratory and in other laboratories indicate that xenogeneic, allogeneic and syngeneic I-RNA extracts mediate specific cytotoxicity to tumor cells, in vitro, and mediate transplantation resistance and tumor rejection responses in vivo. Our results suggest that I-RNA preparations fail to elicit immune responses directed against “self” antigens. By contrast, I-RNA's directed against “non-self” tumor-associated antigens appear to induce lymphocytes to effect specific anti-tumor immune responses. The mechanisms responsible for the failure of I-RNA to initiate immune responses against “self” antigens are not known at present and demand investigation.
Asymmetric Half-Bowtie Antennas With Tilted Beam Patterns

A novel geometrical change is introduced to a broadband bowtie antenna to allow radiation beam tilting without the use of an engineered material. By halving the bowtie arms along their horizontal axis of symmetry and judicially removing parts of it, the phase line of the antenna can be controlled to achieve various magnitudes of tilted radiation patterns. Further bandwidth improvements are realized when the traditional triangular antenna is replaced with an elliptical equivalent. Using either geometry, the amount of tilt in free space across its bandwidth could vary from 0° to 60°. For the printed case, a unidirectional antenna pattern is tilted to approximately 40° along the useable bandwidth of 32% with a peak gain of about 5 dBi and a front-to-back ratio greater than 10 dB. A prototype antenna is fabricated and tested. The measured results satisfactorily validate the numerical ones.
Cost-Effectiveness of Chimeric Antigen Receptor T-Cell Therapy in Pediatric Relapsed/Refractory B-Cell Acute Lymphoblastic Leukemia

Background Chimeric antigen receptor T-cell (CAR-T) therapy is a promising new class of cancer therapy but has a high up-front cost. We evaluated the cost-effectiveness of CAR-T therapy among pediatric patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL). Methods We built a microsimulation model for pediatric patients with relapsed/refractory B-ALL receiving either CAR-T therapy or standard of care. Outcomes included costs, quality of life (health utility), complications, and survival. We measured cost-effectiveness with the incremental cost-effectiveness ratio (ICER), with ICERs under $100 000 per quality-adjusted life-year (QALY) considered cost effective. One-way and probabilistic sensitivity analyses were used to test model uncertainty. Results Compared to standard of care, CAR-T therapy increased overall cost by $528 200 and improved effectiveness by 8.18 QALYs, resulting in an ICER of $64 600/QALY. The model was sensitive to assumptions about long-term CAR-T survival, the complete remission rate of CAR-T patients, and the health utility of long-term survivors. The base model assumed a 76.0% one-year survival with CAR-T, although if this decreased to 57.8%, then CAR-T was no longer cost effective. If the complete remission rate of CAR-T recipients decreased from 81% to 56.2%, or if the health utility of disease-free survivors decreased from 0.94 to 0.66, then CAR-T was no longer cost effective. Probabilistic sensitivity analysis found that CAR-T was cost effective in 94.8% of iterations at a willingness to pay of $100 000/QALY. Conclusion CAR-T therapy may represent a cost-effective option for pediatric relapsed/refractory B-ALL, although longer follow-up of CAR-T survivors is required to confirm validity of these findings.
Cold-induced cutaneous vasoconstriction in humans: Function, dysfunction and the distinctly counterproductive.

New findings What is the topic of this review? This review presents an update and synthesis of normal mechanisms of human cutaneous vasoconstriction in response to cold stress. It then discusses conditions in which cutaneous vasoconstrictor responses are excessive or insufficient and cases in which cold-induced vasoconstrictor responses become counter to maintaining thermal and haemodynamic homeostasis. What advances does it highlight? The review highlights our current understanding of the mechanisms that mediate alterations in cold-induced cutaneous vasoconstriction in pathology and environmental extremes, which has important clinical implications for preventing cold- and cardiovascular-related deaths. Abstract In humans, cold-induced peripheral vasoconstriction is an essential element of body temperature regulation. Given that the thermoregulatory system responds rapidly to changes in skin temperature, sympathetically mediated cutaneous vasoconstriction represents a crucial 'first line of defense' against excessive reduction in body temperature. Sympathetic noradrenergic vasoconstrictor nerves cause a rapid decrease in skin blood flow, thus increasing the insulative capacity of the skin and decreasing heat loss from the body. Small changes in the activity of these nerves are also responsible for the subtle changes in skin blood flow that occur with normal daily activities or minor changes in environmental temperature. With ageing, hypertension and other conditions, the cutaneous reflex vasoconstrictor response can become excessive or insufficient. Healthy older adults have impaired reflex vasoconstriction, which may result in an impaired ability to defend body temperature in some circumstances. Hypertension is associated with augmented vasoconstriction, which could have pathological implications for left ventricular afterload in individuals already at risk for cardiovascular events. Finally, in some cases, the reflex vasoconstrictor response becomes distinctly counterproductive to its own goals of maintaining cardiovascular and thermoregulatory homeostasis. Examples include Raynaud's phenomenon, in which exaggerated vasoconstriction can produce ischaemia in the periphery, and the cutaneous vasoconstrictor response to therapeutic body cooling in severe hyperthermia, which can limit the heat exchange necessary to prevent serious heat illness.
Abstract 4071: A novel combination therapy of high intensity focused ultrasound and PDL1 blockades against advanced breast cancer

Background: Previous studies have reported that tumor debris and inflammation made by high-intensity focused ultrasound (HIFU) therapy induced the antitumor immune response, however, HIFU as a monotherapy is still not potent enough to eradicate tumors and treat distant metastasis. We have reported that mechanical HIFU (M-HIFU), that will mechanically destroy tumor cells/tissues through acoustic cavitation, induced stronger antitumor immune response compared to conventional thermal HIFU (T-HIFU) that will cause thermal ablation of tumors. In the present study, we established an immune based combination therapy of M-HIFU and immune checkpoint blockade to enhance systemic antitumor immune response and treated distant/metastatic tumors in murine breast cancer models. Methods and Results: HER2 oncogene-dependent murine breast cancer cell line, MM3MG-HER2, was established in our lab. In mice with bilateral implantation of MM3MG-HER2 tumors, M-HIFU monotherapy induced stronger HER2-specific cellular response and inhibited the growth of HIFU-untreated distant tumors as well as HIFU treated-tumors, more potently than T-HIFU. Flow cytometry and immunohistochemical analysis of tumor microenvironment revealed significantly stronger accumulation of activated T cell and NK cells in M-HIFU-treated tumors. On the other hand, M-HIFU induced stronger expression of programmed death-ligand 1 (PD-L1) on various immune cells in both sides of tumors than T-HIFU therapy or no treatment control. Based on these findings, we investigated the combination therapy of M-HIFU and PD-1/PD-L1 axis blockades, and found significantly enhanced tumor-specific cellular immune response compared to each monotherapy, which resulted in improved therapeutic effect against distant tumors as well as HIFU treated-tumors. Furthermore, immune cell depletion studies demonstrated that both CD8+ T cells and NK cells played an essential role for the antitumor efficacy in this combinatory therapy against both HIFU-treated tumors and untreated distant tumors. Conclusion: this study provides strong rational evidence that M-HIFU combined with PD-1/PD-L1 axis blockades could be a promising treatment strategy against advanced breast cancer with metastatic lesion. Citation Format: Shinya Abe, Takuya Osada, Kensuke Kaneko, Pei Zhong, Herbert K. Lyerly. A novel combination therapy of high intensity focused ultrasound and PDL1 blockades against advanced breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4071.
A Bayesian Inversion Approach for Site Characterization Using Surface Wave Measurements

This paper presents a Bayesian inference method for the characterization of soil properties and stratigraphy for site response analysis using surface wave measurements. The method is evaluated using numerically simulated data for surface wave methods (e.g. SASW) and ambient noise methods (e.g. H/V) using horizontal, homogeneous, layered soil models. Wave propagation—both vertically propagating shear waves and horizontally propagating surface waves—through one-dimensional horizontally layered media and a linear soil constitutive model are assumed for the simulation of measured data. The inversion process is performed using error functions defined as the difference between selected features of model-predictions and measurements. The considered features include dispersion curves obtained from surface wave propagation and the estimated transfer functions from H/V spectral ratios of ambient noise assuming vertically propagating shear waves. The numerical study was performed to evaluate the proposed approach for horizontally layered sites where the number of layers, layer thicknesses, and layer properties are varied. Different levels of measurement noise, modeling errors, number of updating parameters, number of data sets, and error functions are considered. The numerically simulated sensor data are polluted with independent Gaussian white noise vectors at three different noise levels (0.5%, 1%, and 2% in terms of response root-mean-square) and their effects on bias and covariance of updating parameters are studied. Furthermore, the sensitivity of the results to the updating parameters (e.g., layer height, density, damping, and stiffness), available measurements (type, quantity, quality) and the used error functions (e.g., selected points on dispersion curves or H/V transfer function) are investigated. The value of information will be assessed for the inclusion of the ambient noise data in the Bayesian inversion in terms of reduction in site parameter uncertainty.
The Effects of Leadership on Employee Trust: A Longitudinal Study of United States Federal Agencies

This study examines the effects of leadership on employee trust in leaders using a longitudinal dataset of 396 US federal subagencies from 2006 to 2015. Through an instrumental variable approach, t...
1968 Cole's paradox resolved by environmental variation

Abstract Cole's paradox ( Chapter 13 ) had been festering for nearly 18 years when Garth Murphy (Murphy, 1968) developed a simple genetic model in which a semelparous genotype competed with an iteroparous genotype. He found that if juvenile survival was highly variable, the iteroparous genotype would increase and eliminate the semelparous genotype. In a particularly bad year there would be few surviving progeny and thus very few semelparous individuals would make it to the next round of reproduction. However, iteroparous adults might survive these bad years and have another opportunity to reproduce. Iteroparous individuals could be viewed as hedging their bets and in a variable environment this turns out to be an advantageous reproductive strategy.
Contraceptive care best practices

These 5 practice-changing initiatives can help reduce the number of unwanted pregnancies and allow women to take more control of their reproductive health.
Multiple instance learning for predicting necrotizing enterocolitis in premature infants using microbiome data

Necrotizing enterocolitis (NEC) is a life-threatening intestinal disease that primarily affects preterm infants during their first weeks after birth. Mortality rates associated with NEC are 15-30%, and surviving infants are susceptible to multiple serious, long-term complications. The disease is sporadic and, with currently available tools, unpredictable. We are creating an early warning system that uses stool microbiome features, combined with clinical and demographic information, to identify infants at high risk of developing NEC. Our approach uses a multiple instance learning, neural network-based system that could be used to generate daily or weekly NEC predictions for premature infants. The approach was selected to effectively utilize sparse and weakly annotated datasets characteristic of stool microbiome analysis. Here we describe initial validation of our system, using clinical and microbiome data from a nested case-control study of 161 preterm infants. We show receiver-operator curve areas above 0.9, with 75% of dominant predictive samples for NEC-affected infants identified at least 24 hours prior to disease onset. Our results pave the way for development of a real-time early warning system for NEC using a limited set of basic clinical and demographic details combined with stool microbiome data.
Older adults on involuntary hold status in the emergency department.

Abstract Background As the United States' population ages, the health care system will experience overall change. This study aims to identify factors in the older adult that may contribute to involuntary hold status in the ED. Methods This study is a retrospective review conducted at a suburban acute-care hospital ED of adult patients evaluated while on involuntary hold from January 1, 2014, through November 30, 2015. Older adults (patients born on or before 06/31/1964) were compared to younger adults (born on or after 07/01/1964) according to demographic and clinical variables including medical comorbidity, ED length of stay, reason for involuntary hold, psychiatric disorder, suicide attempt, substance use disorder, serum alcohol level, urine drug testing, medical comorbidity, violence in the ED, 30-day ED readmission, and 30-day mortality. Results Of 251 patients, 90 (35.9%) were older adults. The most common reason for involuntary hold in both cohorts was suicidal ideation. Medical comorbidities were more prevalent in older adults [60 (66.7%) vs. 64 (39.8%), P ≤.0001]. Older adults were less likely to report current drug abuse [31 (34.4%) vs. 77 (47.8%), P = .04]. The most commonly misused substance in both groups was alcohol; however, despite similar rates, blood alcohol levels (BAC) and urine drug screen (UDS) were performed less often in older adults. Cohorts were not significantly different with respect to sex, race, violence in the ED, psychiatric diagnosis, and ED LOS. Conclusions Involuntary older adult patients present with medical comorbidities that impact mental health. In the ED, they are less likely report substance use, and drug screening may be underutilized. Medical needs make their care unique and may present challenges in transfer of care to inpatient psychiatric facilities.
Structure of cyanobacterial phycobilisome core revealed by structural modeling and chemical cross-linking

In cyanobacteria and red algae, the structural basis dictating efficient excitation energy transfer from the phycobilisome (PBS) antenna complex to the reaction centers remains unclear. The PBS has several peripheral rods and a central core that binds to the thylakoid membrane, allowing energy coupling with photosystem II (PSII) and PSI. Here, we have combined chemical cross-linking mass spectrometry with homology modeling to propose a tricylindrical cyanobacterial PBS core structure. Our model reveals a side-view crossover configuration of the two basal cylinders, consolidating the essential roles of the anchoring domains composed of the ApcE PB loop and ApcD, which facilitate the energy transfer to PSII and PSI, respectively. The uneven bottom surface of the PBS core contrasts with the flat reducing side of PSII. The extra space between two basal cylinders and PSII provides increased accessibility for regulatory elements, e.g., orange carotenoid protein, which are required for modulating photochemical activity.
Testing Mosquitoes for Student Inquiry: Husbandry Lessons in the Lab

Because mosquitoes are a public health concern, several chemical insect repellents have been created and used for many years. While some of these products, such as DEET and permethrin, are effective at controlling mosquito populations, their excessive use may lead to animal, human, and environmental harm if applied improperly. Understanding the life cycles of mosquitoes, their feeding preferences, and their responses to natural plant extracts could enable scientists to develop more environmentally safe but still effective insect repellents. Various types of plant extracts (e.g., American beautyberry, Callicarpa americana) hold promise. In order to study such plant–mosquito interactions, we had to establish basic husbandry practices for successfully rearing and maintaining mosquito populations in the lab. We discuss the protocols we have used for housing mosquitoes and creating plant extracts and offer suggestions for how students can use both for inquiry.
Bidding for Firms: Subsidy Competition in the U.S.

In the U.S., states compete to attract firms by offering discretionary tax breaks and subsidies, but little is known about (1) the way states choose their subsidy bids, and (2) whether such subsidies affect firms' location choices. If subsidies cause firms to locate in states where they have larger positive spillovers, subsidy competition can increase total welfare. In this paper, I develop a model of state governments bidding for firms, where states value both the direct and indirect (spillover) job creation of firms. States compete for each firm in an oral ascending auction, and firms take both subsidies and state characteristics into account when choosing their location. To estimate my model, I hand collect a unique dataset on state incentive spending and subsidy deals from 2002-2016. I estimate both the distribution of states' valuations for firms that rationalizes observed subsidy offers, and firms' valuations for state characteristics. I provide the first empirical evidence that states use subsidies to help large firms internalize the positive externality, in the form of indirect job creation, they have on states. Moreover, these subsidies have a sizable effect on firm locations. I estimate that without subsidies approximately 68% of firms would locate in a different state, and the number of anticipated indirect jobs created would decrease by 32%.