cssi/SciSciGPT-SciSciNet huggingface dataset:
Vitamin B12 and folate activity in normal human platelets.

The vitamin B 12 and folate content of human platelets have been determined. The B 12 concentration was sixfold that in red cells and one-sixth that in leukocytes. In normal whole blood, with a platelet count of 300,000 per cu. mm., the B 12 activity contributed by platelets would be 6-21 pg. per ml. The contribution of platelets to the folate activity of normal whole blood averaged 0.4-1.7 ng. per ml. The folate activity in platelets was one-fifth that in an equal volume of red cells, but unlike red cell folate, was not increased by incubating platelet extracts with plasma.
Ring-Opening Metathesis Polymerization (ROMP) Using Maleic Anhydride-Based Monomers

In the 1950s, olefin metathesis reactions were intensely investigated as a new route for carbon–carbon bond formation. These reactions used acyclic dienes that were capable of coupling to each other enabling formation of longer linear olefin molecules. Such approaches could also be employed to form simple hydrocarbon-based polymers. This process was referred to as the acyclic diene metathesis (ADMET) polycondensation process that was further developed by the Wagener group [1]. By the 1960s, ring-opening metathesis polymerization, better known as ROMP, was developed as a derivative of these early olefin metathesis reactions [2].
A Theory of Truthmaker Content I: Conjunction, Disjunction and Negation

I develop a basic theory of content within the framework of truthmaker semantics and, in the second part, consider some of the applications to subject matter, common content, logical subtraction and ground.
The Network Structure of Opioid Distribution on a Darknet Cryptomarket

The current study is the first to examine the network structure of an encrypted online drug distribution network. It examines (1) the global network structure, (2) the local network structure, and (3) identifies those vendor characteristics that best explain variation in the network structure. In doing so, it evaluates the role of trust in online drug markets. The study draws on a unique dataset of transaction level data from an encrypted online drug market. Structural measures and community detection analysis are used to characterize and investigate the network structure. Exponential random graph modeling is used to evaluate which vendor characteristics explain variation in purchasing patterns. Vendors’ trustworthiness explains more variation in the overall network structure than the affordability of vendor products or the diversity of vendor product listings. This results in a highly localized network structure with a few key vendors accounting for most transactions. The results indicate that vendors’ trustworthiness is a better predictor of vendor selection than product diversity or affordability. These results illuminate the internal market dynamics that sustain digital drug markets and highlight the importance of examining how new anonymizing technologies shape global drug distribution networks.
STAFFING EMPOWERMENT PRACTICES IN NURSING HOMES WITH UNIONIZED NURSING ASSISTANTS

A key component of culture change is staffing empowerment supported by nursing home management. On the labor side, collective bargaining is one strategy to improve labor conditions; however, it is unknown if unionized facilities implement staff empowerment practices associated with culture change. In this paper, we examine changes in nursing assistant unionization in U.S facilities, compare staff empowerment practices for unionized and non-unionized facilities, and model the relationship between empowerment practices, leadership practices, and union status. Using a 14-item composite measure to score facilities’ empowerment practices, we find that unionized and non-unionized facilities do not differ significantly. Staff are more often cross-trained in unionized facilities and less likely to work with the same residents or receive rewards for extra training/education. After adjustment, we find that empowerment practices do not differ as a factor of union status (b=.035; 95% CI: -.022, .092), but are linearly associated with higher leadership scores.
Dixon-EDF: The Premier Method for Solution of Parametric Polynomial Systems

Using examples of interest from real problems, we will discuss the Dixon-EDF resultant as a method of solving parametric polynomial systems. We will briefly describe the method itself, then discuss problems arising in geometric computing, flexibility of structures, pose estimation, robotics, image analysis, physics, differential equations, and others. We will compare Dixon-EDF to several respected implementations of Grobner bases algorithms on several systems. We find that Dixon-EDF is greatly superior, usually by orders of magnitude, in both CPU usage and RAM usage.
Altered Penile Caveolin Expression in Diabetes: Potential Role in Erectile Dysfunction

Abstract Background The pathophysiology of increased severity of erectile dysfunction in men with diabetes and their poor response to oral pharmacotherapy are unclear. Defective vascular endothelium and consequent impairment in the formation and action of nitric oxide (NO) are implicated as potential mechanisms. Endothelial NO synthase, critical for NO generation, is localized to caveolae, plasma membrane lipid rafts enriched in structural proteins, and caveolins. Type 2 diabetes mellitus (T2DM)-induced changes in caveolin expression are recognized to play a role in cardiovascular dysfunction. Aims To evaluate DM-related changes to male erectile tissue in a mouse model that closely resembles human T2DM and study the specific role of caveolins in penile blood flow and microvascular perfusion using mice lacking caveolin (Cav)-1 or Cav-3. Methods We used wild-type C57BL6 (control) and Cav-1 and Cav-3 knockout (KO) male mice. T2DM was induced by streptozotocin followed by a high-fat diet for 4 months. Penile expressions of Cav-1, Cav-3, and endothelial NO synthase were determined by western blot, and phosphodiesterase type 5 activity was measured using [ 3 H] cyclic guanosine monophosphate as a substrate. For hemodynamic studies, Cav-1 and Cav-3 KO mice were anesthetized, and penile blood flow (peak systolic velocity and end-diastolic velocity; millimeters per second) was determined using a high-frequency and high-resolution digital imaging color Doppler system. Penile tissue microcirculatory blood perfusion (arbitrary perfusion units) was measured using a novel PeriCam PSI system. Outcomes Penile erectile tissues were harvested for histologic studies to assess Cav-1, Cav-3, and endothelial NO synthase expression, phosphodiesterase type 5 activity, and blood flow, and perfusion measurements were assessed for hemodynamic studies before and after an intracavernosal injection of prostaglandin E 1 (50 ng). Results In T2DM mice, decreased Cav-1 and Cav-3 penile protein expression and increased phosphodiesterase type 5 activity were observed. Decreased response to prostaglandin E 1 in peak systolic velocity (33 ± 4 mm/s in Cav-1 KO mice vs 62 ± 5 mm/s in control mice) and perfusion (146 ± 12 AU in Cav-1 KO mice vs 256 ± 12 AU in control mice) was observed. Hemodynamic changes in Cav-3 KO mice were insignificant. Clinical Translation Our findings provide novel mechanistic insights into erectile dysfunction severity and poor pharmacotherapy that could have potential application to patients with T2DM. Strengths and Limitations Use of KO mice and novel hemodynamic techniques are the strengths. A limitation is the lack of direct evaluation of penile hemodynamics in T2DM mice. Conclusion Altered penile Cav-1 expression in T2DM mice and impaired penile hemodynamics in Cav-1 KO mice suggests a regulatory role for Cav-1 in DM-related erectile dysfunction. Parikh J, Zemljic-Harpf A, Fu J, et al. Altered Penile Caveolin Expression in Diabetes: Potential Role in Erectile Dysfunction. J Sex Med 2017;14:1177–1186.
Spatial Temporal Dynamics of Vehicle Stopping Behavior Along a Rustic Park Road

Abstract Visitor use to parks and protected areas is very dynamic. Previous studies have used geospatial models to better understand visitor flow. Geospatial data give a more accurate and precise insight to visitor movements, and investigating both space and time together in one analysis provides a more holistic understanding of visitor use. This study uses a toolbox created for ArcGIS that combines space and time into one analysis to identify space-time hot and cold spots. By entering data of stopping behaviors of visitors driving along a narrow, rustic park road, spatial temporal hot and cold spots were classified and then described by associated demographic data that was collected. The results show statistically significant spatial-temporal trends among stopping behaviors of visitors in vehicles. Such information is valuable to park managers to better understand and manage visitor flows through an area.
Pediatric Stroke and Its Mimics: Limitations of a Pediatric Stroke Clinical Pathway.

Abstract Background Acute stroke protocols improve delivery of care but it is unclear whether these resource intensive protocols are able to differentiate stroke from mimics in children. The aim of this study is to describe our institution's experience with stroke mimics identified through our pediatric stroke clinical pathway (PSCP). Methods The PSCP was implemented in our level 1 pediatric emergency department in June 2014 for children aged one month to 18 years. For patients managed using the PSCP from June 2014 to December 2016, demographic and clinical data were compared for patients diagnosed with stroke or a stroke mimic. Results A total of 59 children were evaluated with the PSCP. Fourteen children were identified as having a stroke and 45 children had stroke mimics. The most common stroke mimics were functional neurological disorders (20.0%), transient neurological deficits (17.8%), migraine (15.6%), and seizure (11.1%). Patient demographics and time to neuroimaging did not differ between patients with and without stroke. Vomiting was commonly reported by patients with stroke (odds ratio: 4.00, 95% confidence interval: 1.12 to 14.35), whereas weakness was not (odds ratio: 0.7, 95% confidence interval: 0.07 to 0.90), but the physical examination did not differ between patients with and without stroke. Conclusions The PSCP ensures timely evaluation of patients presenting with neurological deficits but fails to reliably differentiate between patients with stroke and patients with stroke mimics. Further multicentered studies are needed to develop a "stroke screen" that reliably distinguishes pediatric stroke from its mimics.
The Impact of Regulations and Institutional Quality on Entrepreneurship

This paper examines the impact of start-up regulations and institutional quality on the level of new business activity in a panel of 119 countries between 2001 and 2012. We find robust evidence that new business creation is significantly lower in countries with excessive barriers to entry, a lack of high-quality governmental institutions, or both. Specifically, increasing the number of steps required to start a new business by one step reduces entrepreneurial activity by approximately 9.7 percent. Furthermore, three measures of institutional quality (i.e., political stability, regulatory quality, and voice and accountability) are shown to promote entrepreneurship, whereby an increase of one standard deviation in these measures increases new business activity by 30 percent to 52 percent.
Conjoint Analysis of Treatment Preferences for Nondisplaced Scaphoid Fractures.

Purpose We used conjoint analysis to assess the relative importance of factors that influence a patient's decision between surgical or nonsurgical management of a nondisplaced scaphoid fracture. Our hypothesis was that out-of-pocket costs will have a greater influence on decision making than the time spent in a cast or brace, degree of soreness, or the risk of treatment failure. Methods Two-hundred and fifty participants were recruited using Amazon Mechanical Turk and asked to assume that they had experienced a nondisplaced scaphoid waist fracture. They then indicated their relative preferences among 13 pairs of alternatives with variations in the following attributes: time in a cast, time in a brace, duration of ongoing soreness, risk of treatment failure (by which we meant scaphoid nonunion), out-of-pocket costs based on estimates of direct costs ($500–2,500), and apprehension about surgery. A conjoint analysis was used to determine the relative importance of these factors when choosing between surgical or nonsurgical management. Results The factor with the greatest influence on treatment choice was the cost of the procedure. After assessing the respondent's apprehension to undergo surgery, a sensitivity analysis showed the proportion of respondents who would choose surgery given different outcomes. To make the predicted share of those who are "not worried" about surgery equal to those who are "somewhat worried" or "a little worried" would require that the cost of surgery increase by $2,700. In addition, 2 weeks in a cast, 3 weeks in a brace, 2 months of soreness, or a 2% increase in the risk of fracture nonunion generates the same surgical choice probability as a $2,000 increase in the out-of-pocket cost of surgery. Conclusions As conceptualized in this conjoint analysis, out-of-pocket costs and apprehension about surgery seem to have a greater impact on a decision for surgery than the time spent in a brace or cast and the risk of treatment failure. Type of study/level of evidence Economic and decision analysis III.
Does intra-individual neurocognitive variability relate to neuroinvasive disease and quality of life in West Nile Virus?

West Nile Virus (WNV) can be a neuroinvasive pathogen that may produce persistent mild-to-moderate neurocognitive impairments in some infected persons. Intra-individual variability (IIV) is an index of a person’s performance across a neuropsychological test or battery, which is an indicator of neurocognitive control and integrity of prefrontal systems. The present study examined possible associations of IIV to neurological health and well-being in WNV infection. Participants included 84 adults with a range of clinical WNV disease (31 West Nile Encephalitis, 16 West Nile Meningitis, 37 West Nile Fever) who completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). IIV was operationalized as covariance of variation (CoV), or the intra-individual standard deviation across 5 age-adjusted RBANS standard scores divided by the mean of standard scores. Participants were assessed for health-related quality of life (QoL) using the RAND 36-item short form health survey (SF-36). Analyses revealed that the West Nile Encephalitis group had higher neurocognitive CoV compared to the West Nile Fever group, and this difference was associated with a medium effect size (Cohen’s d = .52). Mixed linear models controlling for estimated IQ, activities of daily living, depression, neuroinvasive disease groups, and fatigue showed that higher RBANS CoV was associated with lower physical, but not mental health QoL. In persons with WNV infection, there is a modest association between elevations in IIV and encephalitis, and even subtle disruptions in neuropsychological functioning show relationships with important self-reported functioning as measured by physical health quality of life. Future studies should examine whether IIV predicts long-term health outcomes (e.g., mortality) in individuals infected with WNV.
Meeting Your Expectations: What to Anticipate Before, During and After Treatment?

Prior to surgery, preparation for your procedure is critical. The following recommendations are suggested to make your procedure less stressful and more uneventful. When considering these options, think of MEDICALLY SAFE:
Credit Risk Capital: More than One Way to Guard a Guarantee

In June 1999, the Basle Committee on Banking Supervision issued a consultative paper that outlines a set of proposed changes to the credit risk capital standards set in the 1988 Basle Accord.1 The consultative paper, “A New Capital Adequacy Framework,” proposes to reclassify bank credits among the Accord’s original 0, 20, 50 and 100 percent risk buckets using external credit ratings to replace the Organization for Economic Cooperation and Development (OECD) membership criteria. It also includes a 150% weight and an asset-backed category that are included to discourage “regulatory arbitrage” activities. The proposal suggests that regulators may consider allowing banks to use internal risk rating systems to allocate credits into the Basle credit risk categories.
Comparing two anesthesia information management system user interfaces: a usability evaluation

Introduction Anesthesia information management systems (AIMS) have been developed by multiple vendors and are deployed in thousands of operating rooms around the world, yet not much is known about measuring and improving AIMS usability. We developed a methodology for evaluating AIMS usability in a low-fidelity simulated clinical environment and used it to compare an existing user interface with a revised version. We hypothesized that the revised user interface would be more useable.
Effects of Methylphenidate on Mobility, Cognition and Fatigue in Multiple Sclerosis: A Pilot Randomized Controlled Trial (P3.341)

Objective: To estimate the impact of methylphenidate on mobility, cognition and fatigue in multiple sclerosis (MS). Background: Methylphenidate, an amphetamine-like stimulant, is often prescribed off-label for fatigue and cognition in MS and improves balance and walking and reduces fall risk in other populations. The only clinical trial of methylphenidate in MS (n=26) found a single 10mg dose improved performance on the paced serial addition test. Design/Methods: 24 people with MS with impaired walking or balance enrolled in this 6-week double blind placebo controlled pilot trial. They were randomized to receive escalating doses, from 10mg bid to a maximum of 30mg bid, of oral methylphenidate or matched placebo. Walking, balance, cognition, and fatigue were assessed at baseline and at dose escalation every 2 weeks. Changes in measures were compared between groups using a Bayesian approach. Results: At baseline the groups were well matched on all outcomes, with an overall mean age of 49 and median EDSS of 4.5. Overall, performance improved on most measures over time, with greater improvements in the placebo group than in the methylphenidate group. Specifically for mobility, Timed Up and Go: in placebo 12.9 seconds (s) at baseline to 10.3s at week 6, methylphenidate 13.2s to 12.3s; Timed 25 Foot Walk: in placebo 8.4s to 6.7s, methylphenidate 8.8s to 8.7s; Activities-specific Balance Confidence scale: in placebo 58.8 to 63.8, methylphenidate 56.3 to 53.2; Multiple Sclerosis Walking Scale-12: in placebo 42.8 to 42.2, methylphenidate 45.4 to 44.9. For cognition, Symbol Digit Modality Test: placebo 52.4 to 61.3, methylphenidate 47.0 to 46.8. For fatigue, Modified Fatigue Impact Scale: placebo 42.8 to 30.5, methylphenidate 41.4 to 33.7. Conclusions: Although limited by small sample size, this study suggests that methylphenidate up to 30mg bid is likely less effective than placebo for improving mobility, cognition or fatigue in MS. Study Supported by: National Multiple Sclerosis Society Disclosure: Dr. Cameron has received personal compensation for activities with ReWalk and Adamas as a consultant.
Longitudinal study of t‐cell somatic mutations conferring glycosylphosphatidylinositol‐anchor deficiency in gulf war I veterans exposed to depleted uranium

Fifty Veterans of the first Gulf War in 1991 exposed to depleted uranium (DU) were studied for glycosylphosphatidylinositol-anchor (GPIa) deficient T-cell mutants on three occasions during the years 2009, 2011, and 2013. GPIa deficiency was determined in two ways: cloning assays employing aerolysin selection and cytometry using the FLAER reagent for positive staining of GPIa cell surface proteins. Subsequent molecular analyses of deficient isolates recovered from cloning assays (Nicklas JA et al. [2019]: Environ Mol Mutagen) revealed apparent incomplete selection in some cloning assays, necessitating correction of original data to afford a more realistic estimate of GPIa deficient mutant frequency (MF) values. GPIa deficient variant frequencies (VFs) determined by cytometry were determined in the years 2011 and 2013. A positive but nonsignificant association was observed between MF and VF values determined on the same blood samples during 2013. Exposure to DU had no effect on either GPIa deficient MF or VFs. Environ. Mol. Mutagen. 60:494-504, 2019. © 2019 Wiley Periodicals, Inc.
(249) Modulators of Burn Injury-Related Pain in Mice: The Search for Modulators in the Transition from Acute to Chronic Pain

Acute pain is prevalent following burn injury and can transition to chronic pain in over 50% of patients. Prolonged acute pain is an important component that leads to chronic pain. Our research investigates burn injury-related pain and searches for risk factors that influence acute-to-chronic pain transitions. The present work tests whether dietary intervention, genetic background or pre-injury stress affects thermal and mechanical hypersensitivity associated with 2° burn of the mouse hindpaw. Under Avertin anesthesia, (200 µL/10g body weight), the paw of the mouse was placed on a metal block with a surface temperature of 65°C for 15 seconds. A 5-g weighted pouch was placed on the dorsum of the paw to maintain pressure between the heel and the heat source. A visible scar is evident 5-7 days after the injury. Mechanical and thermal thresholds were assessed at baseline, and at 1, 3, 7, 14, 21, 28, and 33 days post-burn injury. Our results reveal that mice which undergo a burn develop significant ipsilateral thermal hypersensitivity and mechanical allodynia that resolves to baseline thresholds by 12 days (thermal) or 30 days (mechanical). Consumption of the high-fat diet did not alter the severity or duration of burn-induced thermal or mechanical hypersensitivity. At sacrifice, mice with a burn injury had a significant increase in degranulated epidermal mast cells (p=0.036). Ongoing experiments are comparing the response of A/J inbred mice that exhibit an anxious phenotype to hindpaw burn injury. Also, repeated foot shock stress in mice induces chronic stress and exacerbates cutaneous and visceral pain. Additional experiments are testing whether A/J mice exposed to foot shock stress for 10 continuous days and undergo burn injury have altered severity or duration of altered thermal and mechanical thresholds. Results from these new studies will be presented and compared to previous findings associated with dietary interventions.
The Curious Case of Section 461(l): Why This Unclear and Unwise New Rule Should Be Construed as Narrowly as Possible

Section 461(l) is one of the more curious provisions of the sweeping Tax Cuts and Jobs Act that was enacted at the end of 2017. Section 461(l) prohibits owners of non-C-corporation businesses from offsetting trade-or-business losses above a certain threshold against nonbusiness income in the taxable year of the loss. Under the new rule, such “excess business losses” are instead carried over to the next taxable year as a net operating loss. The “excess” losses that section 461(l) disallows are active business losses—that is, losses borne by material participants in the business in question. This marks a significant change from prior law, under which active business losses were generally deductible against nonbusiness income without limit. In the first instance, section 461(l) is curious because it introduces a substantial new tax burden on small-business owners—in direct contradiction to Congress’s oft-stated goal of supporting small business. What makes the new loss limitation even more perplexing is that it serves no useful policy purpose whatsoever. Instead, section 461(l)’s excess-business-loss limitation violates a foundational income tax precept by preventing a taxpayer from netting all of the costs of producing income against gross receipts. In so doing, the new rule causes such a taxpayer to be taxed on an amount greater than her economic income. Indeed, in some cases, it requires a taxpayer to pay federal income tax even though she incurs an economic loss for the year. On top of all that, there are myriad ambiguities in section 461(l)’s language, which make it nearly impossible to tell how the rule actually works in a number of situations. After describing the basic mechanics of section 461(l), this Article examines in detail the most significant interpretive uncertainties that plague the provision. Next, the Article explains why section 461(l) is bad public policy. Ultimately, the Article argues that section 461(l) should be repealed as soon as possible—but it also recognizes that an immediate repeal of the provision may be politically unlikely. Thus, in the meantime, the Article suggests specific interpretations that would resolve section 461(l)’s ambiguities and apply the excess-business-loss limitation as narrowly as possible. Adopting the interpretations proposed herein would not be enough to solve all of the problems inherent in section 461(l). Only a complete repeal could do that. But adopting the narrowest reasonable construction of the provision will at least limit the harm that the misguided new rule can do for so long as it remains in effect. ©2019. Published in The Tax Lawyer, Vol. 73, No. 1, Fall 2019, by the American Bar Association. Reproduced with permission. All rights reserved. This information or any portion thereof may not be copied or disseminated in any form or by any means or stored in an electronic database or retrieval system without the express written consent of the American Bar Association or the copyright holder.
Arachidonic Acid, Docosahexaenoic Acid, and Ethanol

Abstract Binge alcohol consumption causes arachidonic acid (20:4, n-6) and docosahexaenoic acid (22:6, n-3) hydrolysis from brain membrane phospholipids by phospholipase A2 isozymes (iPLA2 and cPLA2). Hydrolyzed arachidonic acid within astrocytes are converted into a number of prostaglandins causing inflammatory responses and brain edema with increased levels of aquaporin-4 (AQ4P), poly (ADP-ribose) polymerase-1 (PARP-1), and 4-hydroxynonenal (4-HNE)-conjugated proteins (oxidative stress and apoptosis). Hydrolyzed docosahexaenoic acids, from neuron phospholipids, undergo lipid peroxidation and are degraded into a number of reactive aldehydes causing neural apoptosis and further lipid peroxidation in both adult and embryonic brains. A special emphasis regarding how early exogenous ethanol dosages during early chick embryogenesis causes decreased brain arachidonic acid (20:4, n-6) and docosahexaenoic acid (22:6, n-3) levels during late embryogenesis is discussed coupled with ethanol-induced oxidative stress.
Psychodynamic social science and medical education.

Psychoanalysis and psychodynamics can offer medical education an understanding of unconscious emotional developmental processes. This knowledge can not only guide teachers and mentors in individual teaching tasks, but also enable us to understand medical students' growth and development in the professionalization process. Understanding how students become professionalized can help us understand the effect of medical education on the process. This can then perhaps help us influence medical pedagogy so that our courses and our teaching approaches benevolently steer the professionalization process in directions we value. Medical education is an emotional developmental process and not just a process of information transfer. You don't only learn facts; you become a doctor. Becoming a doctor describes a state of being, a state of feeling about ourselves that suggests a set of self-representations whose organization and content we call professional identity. We are in the infancy of trying to understand the processes at work in the organization of professional identity. Clearly, major aspects of this identity formation occur in medical school. Many of us psychodynamic educators have hypothesized, on the basis of personal experience and observation, that pedagogy in medical school is affecting professional identity through processes of identification in students. If this is true, how we teach is also what we teach and may be more important than content teaching. From the medical students' point of view, medical school experiences are at least as important in professional identity formation as the facts they are taught. What are the developmental vicissitudes of this unconscious professionalization process? How does pedagogy in medical school affect unconscious professionalization? Should we change medical pedagogy, and if so, how? Freud said he hoped psychoanalysis would influence pedagogy but added that whether the result would be for better or worse he could not say!
Examination for Patients with Dental Implants

Implant failure is often preventable, therefore the rationale for maintenance. The examination of implant patients is in many ways similar to the examination performed on natural teeth. Routine and regular evaluation and examination of implants is mandatory. The assumption that implants “will not fail” should be avoided. Right angle radiographs at the time of prosthetic placement are mandatory and should be repeated regularly to evaluate possible bone loss. Implants should be probed routinely and patients should have routine maintenance cleaning and reinforcement of oral hygiene techniques.
Building an adaptable resident curriculum for acute pediatric sexual abuse evaluations: A qualitative needs assessment

Abstract Background Residents are undertrained to perform acute pediatric sexual abuse evaluations. The American Academy of Pediatrics has proposed development of an adaptable child abuse curriculum, though no such curriculum exists. Objectives Our goal was to perform a needs assessment for pediatric residents performing acute sexual abuse evaluations in an emergency department setting, thus laying groundwork for an adaptable curriculum. The objective was to explore pediatric resident training, knowledge, confidence, expectations, learning needs, and educational goals. Participants and Setting We conducted a qualitative exploratory study of pediatric residents, faculty, and program directors at two academic health centers in New York City. Methods Using purposive and convenience sampling, we conducted focus groups and semi-structured interviews until saturation of ideas was achieved. Through an iterative process using constructivist grounded theory, themes were organized into a curricular model. Results We conducted 3 resident focus groups (n = 21) and 7 interviews with emergency medicine, pediatric, and child abuse faculty. Themes emerged in three categories: barriers (e.g., knowledge deficits), facilitators (e.g., pre-learning), and educational goals. Despite recognizing the importance and increased availability of subspecialists, participants supported gradual autonomy for pediatric residents in the evaluation of suspected sexual abuse, with a goal of independent competency in history and examination skills, and supervised competency of forensic evidence collection. Conclusions Our data support a multimodal, blended curriculum for the acute sexual abuse evaluation, including: (1) asynchronous pre-learning; (2) live workshops; (3) reference tools; and (4) modeled clinical experiences. Our proposed curricular model may be utilized by a variety of frontline clinicians.
Temperature and Estrogen Alter Predator-Prey Interactions between Fish Species.

A variety of environmental estrogens are commonly detected in human-impacted waterways. Although much is known about the effects of these environmental estrogens on the reproductive physiology and behavior of individuals within species, comparatively less is known about how these compounds alter the outcomes of interactions between species. Furthermore, few studies have considered how the effects of contaminants are modulated by natural variation in abiotic factors, such as temperature. To help fill this knowledge gap, we conducted a factorial experiment to examine the independent and combined effects of estrone (E1) and temperature on the outcome of predator-prey interactions between two common North American freshwater fishes, fathead minnows (Pimephales promelas) and bluegill sunfish (Lepomis macrochirus). Larval fathead minnows and adult sunfish were exposed to either a low (mean±standard deviation, 90.1 ± 18 ng/L; n = 16) or high (414 ± 147 ng/L; n = 15) concentration of E1 or to a solvent control for 30 days at one of four natural seasonal temperatures (15°C, 18°C, 21°C, and 24°C) before predation trials were performed. Exposure to E1 was associated with a significant increase in larval predation mortality that was independent of temperature. Across all temperature treatments, approximately 74% of control minnows survived; this survivorship significantly exceeded that of minnows exposed to either concentration of E1 (49% and 53% for minnows exposed to the low and high concentrations, respectively). However, exposure to E1 also impaired the prey-capture success of sunfish, partially mitigating predation pressure on exposed minnows. Overall prey-capture success by sunfish showed an inverted U-shaped distribution with temperature, with maximal prey consumption occurring at 21°C. This study illustrates the vulnerability of organismal interactions to estrogenic pollutants and highlights the need to include food web interactions in assessments of risk.
"My Eyes Have Nothing to Do With How My Legs Move": Individuals With Visual Impairments' Experiences With Learning to Run.

The purpose of this study was to describe the reflections of adults with visual impairments about learning to run during K–12 physical education. An interpretative phenomenological analysis research approach was used, and eight adults (age 22–35 years) with visual impairments served as participants. Primary data sources were semistructured, audiotaped telephone interviews and reflective interview notes. Based on a thematic data analysis process, two themes were developed: (a) “I wouldn’t expect anything better from you”: running instruction in physical education and (b) “You look like the guy in the crosswalk signal”: making up for the shortcomings of physical education. The narratives portraying these themes highlight the lack of instruction that took place in physical education, and the fact that no running instruction occurred at all. These findings indicate that professionals working with individuals with visual impairments should use instructional strategies that will allow for maximum access to learning fundamental movement skills such as running.
Fostering ethical integrity in nursing: An ongoing examination of diverse perceptions

Abstract In this qualitative replication study (Phase II), nursing faculty perceptions related to student academic integrity were explored at a public university in the Midwest. A comparison with the Phase I study findings conducted at a similar private university determined nursing faculty at both are concerned about the corrosion of ethical values among nursing students. Furthermore, faculty proactively seek to promote academic honesty and ethical professional practice. Provided is a list of strategies from faculty for use in nursing educational settings.
Practice-Based Politicization: Planning Reports as Actants in a University–Community Partnership:

We look at a yearlong university–community partnership’s potential to create more equitable planning practices through an analysis of the sub-genres of student-generated planning reports. Using an ...
A Study of Some Important Issues for a Muslim in the Month of Ramadan

The month of Ramadan is associated with many worships that might exhaust the weak body. The most important worships in Ramadan are fasting and prayer. Some prayers require the length of sitting and standing, in addition to prayer movements. Many Muslims are spending a long time in the mosque; sitting on the ground for reading or standing for prayer. The questionnaire is focused on those who spend a long time in the mosque. Seven attributes were considered for the understanding of what affects the worshiper's health, especially those who with chronic diseases. We found that there is a strong relationship between age and chronic diseases that may increase with the age. Also, the elderly cannot continue to pray for more than half an hour, and this is if balanced standing and sitting on a chair when is needed to prevent the disorder of the body and the emergence of symptoms of chronic disease.
Prevalence and Clinical Characteristics of Patients With Sepsis Discharge Diagnosis Codes and Short Lengths of Stay in U.S. Hospitals.

Objectives Some patients diagnosed with sepsis have very brief hospitalizations. Understanding the prevalence and clinical characteristics of these patients may provide insight into how sepsis diagnoses are being applied as well as the breadth of illnesses encompassed by current sepsis definitions. Design Retrospective observational study. Setting One-hundred ten U.S. hospitals in the Cerner HealthFacts dataset (primary cohort) and four hospitals in Eastern Massachusetts (secondary cohort used for detailed medical record reviews). Patients Adults hospitalized from April 2016 to December 2017. Interventions None. Measurements and main results We identified hospitalizations with International Classification of Diseases, 10th Edition codes for sepsis (including sepsis, septicemia, severe sepsis, and septic shock) and compared "short stay sepsis" patients (defined as discharge alive within 3 d) versus nonshort stay sepsis patients using detailed electronic health record data. In the Cerner cohort, 67,733 patients had sepsis discharge diagnosis codes, including 6,918 (10.2%) with short stays. Compared with nonshort stay sepsis patients, short stay patients were younger (median age 60 vs 67 yr) and had fewer comorbidities (median Elixhauser score 5 vs 13), lower rates of positive blood cultures (8.2% vs 24.1%), lower rates of ICU admission (6.2% vs 31.6%), and less frequently had severe sepsis/septic shock codes (13.5% vs 36.6%). Almost all short stay and nonshort stay sepsis patients met systemic inflammatory response syndrome criteria at admission (84.5% and 87.5%, respectively); 47.2% of those with short stays had Sequential Organ Failure Assessment scores of 2 or greater at admission versus 73.2% of those with longer stays. Findings were similar in the secondary four-hospital cohort. Medical record reviews demonstrated that physicians commonly diagnosed sepsis based on the presence of systemic inflammatory response syndrome criteria, elevated lactates, or positive blood cultures without concurrent organ dysfunction. Conclusions In this large U.S. cohort, one in 10 patients coded for sepsis were discharged alive within 3 days. Although most short stay patients met systemic inflammatory response syndrome criteria, they met Sepsis-3 criteria less than half the time. Our findings underscore the incomplete uptake of Sepsis-3 definitions, the breadth of illness severities encompassed by both traditional and new sepsis definitions, and the possibility that some patients with sepsis recover very rapidly.
Genocide and the Brain: Neuroscience, Mental Harm, and International Law

Genocide scholarship rarely gives direct consideration to the Genocide Convention’s description of “causing serious bodily and mental harm” as an act of genocide. This article examines the historic...
Post-vaccination SARS-CoV-2 infections and incidence of presumptive B.1.427/B.1.429 variant among healthcare personnel at a northern California academic medical center.

Background Although mRNA-based SARS-CoV-2 vaccines report ≥90% efficacy, breakthrough infections occur. Little is known about the effectiveness of these vaccines against SARS-CoV-2 variants, including the highly-prevalent B.1.427/B.1.429 variant in California.. Methods In this quality improvement project, we collected demographic and clinical information from post-vaccine SARS-CoV-2 cases (PVSCs), defined as health care personnel (HCP) with positive SARS-CoV-2 NAAT after receiving ≥1 vaccine dose. Available specimens were tested for L452R, N501Y and E484K mutations by RT-PCR. Mutation prevalence was compared among unvaccinated, early post-vaccinated ( 14 days after dose 1 and ≤14 days after dose 2) and fully vaccinated (>14 days after dose 2) PVSCs. Results From December 2020-April 2021, >=23,090 HCPS received at least1 dose of an mRNA-based SARS-CoV-2 vaccine, and 660 HCP cases of SARS-CoV-2 occurred of which 189 were PVSCs. Among the PVSCs, 114 (60.3%), 49 (25.9%) and 26 (13.8%) were early post-vaccination, partially vaccinated, and fully vaccinated, respectively. Of 261 available samples from vaccinated and unvaccinated HCP, 103 (39.5%), including 42 PVSCs (36.5%), had L452R mutation presumed to be B.1.427/B.1.429,. When adjusted for community prevalence of B.1.427/B.1.429, PVSCs did not have significantly elevated risk for infection with B.1.427/B.1.429 compared with unvaccinated HCP. Conclusions Most PVSCs occurred prior to expected onset of full, vaccine-derived immunity. Presumptive B.1.427/B.1.429 was not more prevalent in post-vaccine cases than in unvaccinated SARS-CoV-2 HCP. Continued infection control measures, particularly ≤14 days post-vaccination, and continued variant surveillance in PVSCs is imperative to control future SARS-CoV-2 surges.
Health Care, Rationing of

Health care rationing is ubiquitous. It varies from formal approaches designed to allocate limited organs for transplantation to more common strategies and processes that constrain demand for care. Many countries seek to explicitly formulate priorities and translate these through benefit design and other explicit managerial decisions but much rationing is implicit, lacks transparency, and occurs in the routine provision of care. Given unlimited possibilities for expenditure, rationing is inevitable but remains a source of ethical and political controversy.
Specificity of thrombin: I. Esterolytic properties of thrombin, plasma, trypsin, and chymotrypsin with Nβ-substituted guanidino derivatives of p-nitrophenyl-p′-guanidinobenzoate☆

Abstract Thrombin exhibits a restricted specificity, relative to plasmin, trypsin, and chymotrypsin, for a series of derivatives of the titrant substrate p-nitrophenyl-p′-guanidinobenzoate (NPGB). Substitution on the beta guanidino nitrogen of NPGB with an n-butyl, n-hexyl, cyclo-hexyl, or benzyl residue does not prevent the esterolytic cleavage of these derivatives but does markedly alter their substrate properties with the four enzymes investigated. All four enzymes cleave NPGB at equivalent concentrations by releasing p-nitrophenol as pre-steady-state burst reactions followed by its steady-state production. Both chymotrypsin and trypsin similarly display burst reactions with the derivatives at corresponding concentrations. The acyl-enzyme intermediates formed with chymotrypsin, however, are more stable for the derivatives than for NPGB, and those formed with trypsin are less stable. In contrast, plasmin and thrombin exhibit incomplete burst reactions with the derivatives at these concentrations. Except for the cyclo-hexyl derivative, with which plasmin does not react, the derivatives relative to NPGB were cleaved faster by plasmin than by thrombin. These cleavages with thrombin, moreover, were competitively inhibited by benzamidine. Kinetic data obtained for thrombin further indicated that the substituent groups of derivatives hindered the initial formation of enzyme-substrate complexes. These results suggest that thrombin and, most likely, plasmin have restricted primary binding-site regions for small molecule substrates which do not readily accommodate bulky substituent groups. In addition, increasing concentrations of glycerol were found to greatly alter the esterolytic properties of thrombin for the compounds studied. This effect was demonstrated by increased deacylation rates with NPGB and by decreased cleavage rates with the n-butyl derivative.
Web Regulation Battles Heat Up

This year alone, state legislators have introduced more than 1,500 bills seeking some type of Internet regulation. wo recent incidents involving the Internet and software caused hardly a ripple in the mainstream press, but what happened could have far-reaching implications for publishers, li braries, and the public. In June, a judge ruled that a federal agency's attempt to regulate publishers of online newsletters and software was unconstitutional. That same month in Texas, Gov. George W. Bush signed legislation that overturned a ban on self-help legal software in the state.
Orbital hybridization: a key electronic factor in control of structure and reactivity

This review outlines fundamental factors responsible for hybridization trends in organic and main group compounds. Hybridization is a classic chemical concept that transcends textbook organic chemistry. Hybridization effects are omnipresent, and their understanding is essential for the unraveling of many structural and reactivity puzzles. Even when they are masked by a stronger effect (e.g., allylic delocalization), they still lurk below the surface. Overriding such effects comes with a penalty, whereas incorporation into reaction design provides an efficient tool for the control of reactivity. Copyright © 2014 John Wiley & Sons, Ltd.
An examination of the day-of-the-week effect in junk bond returns over business cycles

Abstract While many investors consider junk bonds to be part of a well-diversified portfolio, the literature defining these securities is inconclusive. In particular, the day-of-the-week effect , widely documented in other financial markets, has not yet been carefully examined in the junk bond market. Thus, to significantly extend the research on the day-of-the-week effect , this paper tests for the existence of this anomaly in the junk bond market, the investment-grade bond market, and the CRSP equity index over different business cycles. The findings of this study tend to confirm the uniqueness of the junk bond market, which differs significantly from the other markets. Also, the results suggest that the distinction by business cycle has important implications on the existence of the day-of-the-week effect .
Structure of a safflower steroid cellobioside

Abstract Structural identification of a steroid diglucoside from Carthamus tinctorius whose aglycone is 15α-20β-dihydroxy-Δ 4 -pregnen-3-one has been completed. We have analyzed the sugar moiety of the glycoside and found it to be cellobiose, β-linked to C-20 of the aglycone.
Comprehensive assessment of genetic variants within TCF4 in Fuchs' endothelial corneal dystrophy.

Purpose. The single nucleotide variant (SNV), rs613872, in the transcription factor 4 (TCF4) gene was previously found to be strongly associated (P = 6 × 10−26) with Fuchs' endothelial corneal dystrophy (FECD). Subsequently, an intronic expansion of the repeating trinucleotides, TGC, was found to be even more predictive of disease. We performed comprehensive sequencing of the TCF4 gene region in order to identify the best marker for FECD within TCF4 and to identify other novel variants that may be associated with FECD.
Levamisole-induced occlusive necrotising vasculitis in cocaine abusers: An unusual cause of skin necrosis and neutropenia

We present three cases describing the various skin manifestations of presumed levamisole-contaminated cocaine use. Antibody-mediated vasculitis and neutropenia were consistent findings in these cases and repeat exposure resulted in distinct dermatologic complications. This phenomenon of levamisole-induced vasculitis and neutropenia is being increasingly described and has characteristic wound manifestations that must be recognised and treated early.
A novel optical label swapping scheme for DPSK data transmissions using optical carrier suppression and separation technique without requiring a conventional wavelength converter

We demonstrate a novel all-optical label swapping scheme using optical carrier suppression and separation technique without requiring any conventional wavelength converter in an OLS network carrying DPSK payload and OOK label over 140 Km SMF fibers.