cssi/SciSciGPT-SciSciNet huggingface dataset:
Analysis of surveillance results of hemorrhagic fever with renal syndrome in Tiantai county,Zhejiang province,China from 2001 to 2011

Objective To analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome(HFRS) and the virus-carrying rate of host animals(rodents) in Tiantai county,Zhejiang province,China,and to provide a scientific basis for effective control of HFRS.Methods The data of the epidemic situation of HFRS in Tiantai were analyzed using descriptive epidemiological method.Rodents were captured using traps and then investigated.Indirect immunofluorescence assay was adopted to identify specific IgG antibody.Direct immunofluorescence assay was used to identify hantavirus antigen in the mouse lung.Results A total of 452 cases of HFRS were reported from 2001 to 2011 in the whole county,with 3 deaths,an annual average incidence of 7.27/105,and a mortality rate of 0.66%.Throughout the whole county,the incidence of HFRS was primarily distributed in the towns and villages in the plain region at both sides of Shifeng River.This disease occurred in each month throughout the year,with May to July and October to December as high-incidence periods,accounting for 31.19% and 34.29% of all cases.People aged between 26-64 years were most easily infected,accounting for 86.06% of all cases.As for occupation,peasants constituted the majority of all cases,accounting for 82.52%.The ratio of male cases to female cases was 2.90:1.The coincidence rate of clinical diagnosis in these cases was 82.83%;the recessive infection rate of healthy population was 1.27%.The serological positive rate of mice was 5.20%.Apodemus agrarius was the dominating species in the field mice,followed by Rattus losea.R.norvegicus was dominant species in the house mice.The virus carrying rate of the mouse lung was 10.62%.Conclusion HFRS cases occurred every year in Tiantai county,Zhejiang province,China,and the virus carrying rate of host animals was relatively high.Measures should be taken to enhance surveillance and control of HFRS.
Effects of Diuretics on Renal Glucose Transport in the Dog

1. In order to study the relationship between sodium and glucose transport along the nephron, clearance and micropuncture experiments were performed in 16 dogs before and after administration of diuretics with different sites of action. 2. Administration of acetazolamide, 20 mg (90 μmol)/kg, in nine dogs significantly reduced proximal tubular reabsorption of sodium and glucose and slightly increased ‘distal’ delivery of glucose. Since no glycosuria developed despite significant natriuresis, the increased ‘distal’ load of glucose must have been reabsorbed. 3. The possible site of this ‘distal’ glucose reabsorption was further studied in seven dogs which had received extracellular volume expansion to 10% of body weight and acetazolamide, 10 mg (45 μmol)/kg, to suppress proximal tubule reabsorption. When frusemide, 10 mg (30 μmol)/kg, was added, fractional glucose excretion increased from 0·3 to 2% in the absence of additional proximal tubular effect. However, the frusemide effect on ‘distal’ glucose transport was far smaller than that on sodium since fractional sodium excretion reached 40%. 4. Our results indicate a good correlation between sodium and glucose transport in the proximal tubule since both are inhibited by acetazolamide. Administration of large doses of frusemide leads to a modest glycosuria, probably by inhibition of glucose reabsorption in the loop of Henle. However, frusemide effect on the proximal tubule of deep nephrons cannot be completely excluded. The large discrepancy in the magnitude of natriuresis and glycosuria suggests dissociation of ‘distal’ sodium and glucose transport. Alternative explanations for the frusemide-induced glycosuria are also discussed.
Visual Revelations: Evidence in the 2016 Presidential Campaign

How will history record the actions and claims of contemporary political parties? A look at the past may provide some insight.Consider Wikipedia's summary description of the American (or Nativist) ...
Microstrip T-Junction Power Divider With Exponentially Tapered Transmission Lines

A method is provided for calculating the port parameters of an exponentially tapered power divider. Derived from the general solution for the input impedance of an exponentially tapered line, a design methodology for power dividing ratios from 2–10 dB is shown. An analytic formula for the power dividing ratio is expressed in terms of input impedances of the T-junction. Two devices are fabricated and measured. The resulting measurements are in agreement with the predicted power dividing ratios. The two devices operate over a frequency range 1.5–5 GHz and 1.75–3.5 GHz with power dividing ratios of 7.6 dB and 9.3 dB, respectively.
Who Really Defines National Security

This chapter explores the forces behind the formation of foreign policy and the defining of national security. It demonstrates that even within a democratic milieu, this cannot, normally, include independently formulated popular opinion. Nor is the average elected official the final arbiter of such policies. The chapter demonstrates that what really influences foreign policy and the defining of national security is an array of politically powerful special interests with the ability to materially support political parties and campaigns. It is this ability that puts these organizations in a position to substitute their parochial interests for the national interest. This chapter looks at the Zionist lobby as a case study of this power.
Do Maternity Care Coordination Services Encourage Use of Behavioral Health Treatment among Pregnant Women on Medicaid

Abstract Objective Maternity care coordination (MCC) may provide an opportunity to enhance access to behavioral health treatment services. However, this relationship has not been examined extensively in the empirical literature. This study examines the effect of MCC on use of behavioral health services among perinatal women. Methods Medicaid claims data from October 2008 to September 2010 were analyzed using linear fixed effects models to investigate the effects of receipt of MCC services on mental health and substance use–related service use among Medicaid-eligible pregnant and postpartum women in North Carolina (n = 7,406). Results Receipt of MCC is associated with a 20% relative increase in the contemporaneous use of any mental health treatment (within-person change in probability of any mental health visit 0.5% [95% CI, 0.1%–1.0%], or an increase from 8.3% to 8.8%); MCC in the prior month is associated with a 34% relative increase in the number of mental health visits among women who receive MCC (within-person change in the number of visits received 1.7% [95 CI, 0.2%–3.3%], or from 0.44 to 0.46 mental health visits). No relationship was observed between MCC and Medicaid-funded substance use–related treatment services. Conclusions MCC may be an effective way to quickly address perinatal mental health needs and engage low-income women in mental health care. However, currently there may be a lost opportunity within MCC to increase access to substance use–related treatment. Future studies should examine how MCC improves access to mental health care such that the program's ability can be strengthened to identify women with substance use–related disorders and transition them into available care.
Aptamer-Based Potentiometric Measurements of Proteins Using Ion-Selective Microelectrodes

We here report on the first example of an aptamer-based potentiometric sandwich assay of proteins. The measurements are based on CdS quantum dot labels of the secondary aptamer, which were determined with a novel solid-contact Cd2+-selective polymer membrane electrode after dissolution with hydrogen peroxide. The electrode exhibited cadmium ion detection limits of 100 pM in 100 mL samples and of 1 nM in 200 μL microwells, using a calcium-selective electrode as a pseudoreference electrode. As a prototype example, thrombin was measured in 200 μL samples with a lower detection limit of 0.14 nM corresponding to 28 fmol of analyte. The results show great promise for the potentiometric determination of proteins at very low concentrations in microliter samples.
Superomedial pedicle reduction mammaplasty: increased resection weight does not increase nipple necrosis.

Abstract Background The superomedial pedicle (SMP) reduction mammaplasty offers several advantages over more traditional operative techniques, such as retained sensation to the nipple areola complex (NAC) and improved preservation of long-term breast shape. However, many surgeons believe that using the SMP can cause an increase in NAC necrosis rates up to 13.1%, especially in large volume reductions. The aims of this paper are to determine the rate of nipple necrosis when performing an SMP reduction mammaplasty at our institution and establish if there is a difference in those rates based on the weight of tissue removed. We then compared our overall rate of nipple necrosis to those found using a systematic review of literature involving other pedicles to determine if this technique is equivalent to more commonly used methods. Methods We performed a retrospective chart review of patients who underwent breast reduction surgery using SMP at a single institution between May 1, 2013, and May 1, 2015. Each breast was counted separately, and the weight of the tissue removed was recorded. Six-mo follow-up data were analyzed using the chi-square analysis to compare rates of NAC necrosis among our patients and historical cohorts. Results One hundred thirty-five breasts (70 patients) met inclusion criteria. Patients had a mean resection weight per breast of 1016.7 g (±478.3). There was an NAC necrosis rate of 0% in the groups where 1200 g or less of tissue were removed and 2.3% ( n = 1) in the group where greater than 1200 g of tissue were removed. We found no statistically significant difference in the rate of NAC necrosis with increased resection weights, ( P = 0.32). The overall rate of NAC necrosis for this study was 0.7% per breast, which is equivalent to the rates found during the systematic review of literature. Conclusions In this study, the SMP breast reduction technique shows a low rate of NAC. We found no statistically significant increase in NAC necrosis rates as the volume of tissue removed increases, and the SMP appears to have an overall rate of NAC necrosis similar to more commonly used pedicles. Although the results of this study may be related to patient selection or surgical technique, we believe that this pedicle preserves the breast's main blood supply so that less tissue ischemia occurs.
Loss of Aerobic Capacity During Weightlessness

Physical activity depends on the cardiorespiratory (CR) system’s ability to deliver energy to the muscles to sustain their action. The g loads of high-performance aircraft also put large stresses on the CR system. But in a matter of days to weeks, cardiorespiratory capacity, usually called aerobic fitness, is sharply reduced by lack of physical activity, whether on Earth, in bed rest or in weightlessness (Fig. 8.1).
Lists Using Arrays

Unlike stacks that have one access point at the top where an item can be pushed or popped and queues which can only have items enqueued at the rear or dequeued from the front, a list can have items inserted or deleted from the front, rear, or anywhere in between. In this chapter arrays are used to implement ordered lists. The insert and delete methods in addition to the search method are discussed. In the complete program recursion is used to print strings stored in the list.
DEPENDENCE IN NON-ADDICT HUMANS AFTER A SINGLE DOSE OF MORPHINE

Naloxone precipitated abstinence symptoms followed single doses of morphine (.14 mg/kg to .21 mg/kg) given to normal volunteer subjects with no prior opiate experience. Naloxone (.14 and .28 mg/kg as a rapid intravenous dose) produces opiate withdrawal signs and symptoms when given 24 hours after morphine. Subjective symptom reports, and physiologic measures sensitive to natural opiate withdrawal were obtained before and following each injection of naloxone or placebo and combined as abstinence scores. Subjective symptoms and mood changes were more prominent than physiologic changes. Individual differences were great but, in general, the naloxone precipitated changes were less at 24 hours after the morphine than during the period from nine to 13 hours. The procedure may be useful for assessing dependence liability and for studying mechanisms of dependence.
Tolectin® DS (McNeil)

Tolectin is an anti-inflammatory agent. It has analgesic and antipyretic activity. Although the mechanism of its anti-inflammatory action is not known, Tolectin inhibits prostaglandin synthetase in vitro and lowers the plasma level of prostaglandin E in humans.
Enhydra lutris (Sea otter)

The classification of the autosomes presented here does not strictly follow that of Rausch and Feltz who consider 3 pairs of acrocentrics. The chromosome pair with short second arm is grouped with submetacentrics by these authors.
Logistics-Intensive Clusters: Global Competitiveness and Regional Growth

Logistics intensive clusters are agglomerations of several types of firms and operations: (1) firms providing logistics services, such as 3PLs, transportation, warehousing and forwarders, (2) the logistics operations of industrial firms, such as the distribution operations of retailers, manufacturers (in many cases after-market parts) and distributors and (3) the operations of companies for whom logistics is a large part of their business. Such logistics clusters also include firms that service logistics companies, such as truck maintenance operations, software providers, specialized law firms, international financial services providers, etc. Logistics clusters exhibit many of the same advantages that general industrial clusters (such as Silicon Valley, Hollywood, or Wall Street) do: increase in productivity due to shared resources and availability of suppliers; improved human networks, including knowledge sharing; tacit communications and understanding; high trust level among companies in the cluster; availability of specialized labor pool as well as educational and training facilities; and knowledge creation centers, such as universities, consulting firms, and think tanks. Logistics clusters, however, exhibit other characteristics which make them unique in terms of cluster formation and their contribution to economic growth. Logistics operations may locate in a logistics cluster due to the cluster’s role in supporting economies of scope (mainly for direct operations transport modes) and economies of density (mainly for consolidated transportation modes); their provision of spill-over capacity for warehousing and transportation; and the ability to cooperate between providers when dealing with demand fluctuations. Such clusters provide a range of employment opportunities—from moving boxes to executive, IT and other professional jobs, and they diversify the economic base since they support many other industries, such as manufacturing as well as a range of “mini-clusters.” This chapter describes such clusters, based on primary research in several large logistics clusters around the world, interviews with dozens of executives in retail, manufacturing and distribution organizations; with transportation and logistics service providers; with infrastructure operators; with public and private development agencies; and with real estate developers.
Complete Mitochondrial Genome Sequences of Five Rockfishes (Perciformes: Sebastes).

AbstractRockfishes of the genus Sebastes rank among the longest-lived vertebrate animals. In order to facilitate comparative genomic research in animal longevity, the complete mitochondrial genome sequences are presented for Sebastes aleutianus, Sebastes minor, Sebastes nigrocinctus, Sebastes rubrivinctus, and Sebastes steindachneri.
Assessment of pediatric bowel and bladder dysfunction: a critical appraisal of the literature.

Summary Objective Bowel and bladder dysfunction (BBD) is a clinical syndrome defined by the coexistence of constipation and lower urinary tract symptoms. Although BBD is a common condition in pediatric urology and can cause significant stress to patients/parents, clinical diagnosis of BBD has not been standardized. Bowel and bladder dysfunction instruments have gained popularity over the past decade to aid in diagnosis. In this review, the currently published BBD symptom questionnaires were summarized and an analysis on their psychometric validation process was provided. Subjects/patients PubMed was searched for articles on BBD symptom questionnaires/instruments/surveys since 2000. Two investigators (R.Y.J. & M.S.K.) conducted the search in duplicate. The search was limited to English language. The included search terms were ‘dysfunctional elimination syndrome’, ‘bowel and bladder dysfunction’, ‘dysfunctional voiding’, ‘voiding dysfunction symptom score’, and ‘dysfunctional voiding symptom scale’. Reference lists of included studies were screened for missed studies. Unpublished abstracts presented at the following scientific meetings were also manually searched for: the American Urological Association, the Society for Pediatric Urology, and the American Academy of Pediatrics Section on Urology. Exclusion criteria included articles in languages other than English, articles not related to BBD questionnaires, and articles not pertaining to pediatric patients. Results After initial search, a total of 54 articles were obtained. Of the seven questionnaires reviewed, only one did not measure sensitivity or specificity. Almost all questionnaires showed excellent discriminative property with an Area under the curve (AUC) >0.85. Criterion validity was not reported in any of the questionnaires. Known-group validation was used as a common method to evaluate construct validity. Internal consistency was reported in 2 studies, and only 1 study measured questionnaire responsiveness during initial validation. Conclusions Although BBD is a common pediatric urology condition; a large amount of heterogeneity exists in the questionnaires' psychometric testing and validation process. To further improve the diagnosis and management of BBD in pediatric patients, there is a need for consensus on the gold standard questionnaire measure.
Associations between lymphovascular space invasion, nodal recurrence, and survival in patients with surgical stage I endometrioid endometrial adenocarcinoma

To investigate the predictive value of lymphovascular space invasion (LVSI) for nodal recurrence and overall survival (OS) in patients with stage I endometrioid endometrial cancer (EC) following surgical staging that included adequate lymph node sampling. Retrospective analyses of patients undergoing surgical staging for FIGO stage I endometrioid EC between 1998 and 2015 were performed using an institutional database and the National Cancer Database (NCDB). Using the institutional database, logistic regression modeling identified predictors of nodal recurrence; Cox proportional hazards modeling was used to predict progression-free survival (PFS). Utilizing NCDB, Cox proportional hazards modeling was used to predict OS. The Kaplan-Meier method was used to estimate hazard ratios (HR). Survival curves were compared using the log-rank test. Among 275 institutional cases, LVSI was present in 48 (17.5%). There were 11 nodal recurrences: 18.8% (9/48) of cases with LVSI had a nodal recurrence compared to 0.88% (2/227) of those without LVSI. In multivariate analysis of institutional data, LVSI was the only significant predictor of nodal recurrence (p = 0.002). Among 28,076 NCDB cases, LVSI was present in 3766 (13.5%). In multivariate analysis of NCDB, grade 3, LVSI, and depth of invasion (all p < 0.001) were prognostic for OS after adjusting for adjuvant radiation. LVSI is an independent prognostic factor for nodal recurrence in stage I endometrial cancer with lymph node assessment. LVSI is associated with lower OS in NCDB. Given these findings, adjuvant therapy could be considered in these patients.
Long-Term Risk of Hip Fracture After Ischemic Stroke.

Background and Purpose:Data are lacking on the long-term risk of hip fracture among patients with ischemic stroke. A better understanding of the contemporary incidence of hip fracture after ischemi...
The short-term impact of unconditional cash transfers: a replication study of a randomized controlled trial in Kenya

Haushofer and Shapiro examined the short-term impacts of Unconditional Cash Transfer (UCT) and the differential impacts by transfer recipient’s gender, timing (monthly versus lump sum) and magnitud...
Non-classical electron transport in the cathode plume of a Hall effect thruster

An experimental investigation is presented into the wave-driven electron transport in the near-field plume of a hollow cathode operating in a 300 V, 4.5 kW magnetically shielded Hall thruster. Correlational analysis of probe measurements in the cathode plume shows two types of electrostatic waves: ion acoustic turbulence propagating along the applied longitudinal magnetic field at frequencies from 500 to 1250 kHz and coherent, azimuthal anti-drift waves with a fundamental frequency of 95 kHz and mode numbers from m = 1 − 4. A quasilinear analysis is applied to quantify the impact of each wave on the electron transport in the near-field plume. It is found that the ion acoustic modes give rise to an enhanced effective collision frequency in the direction parallel to the applied magnetic field that exceeds the classical collision frequency by two orders of magnitude. The anti-drift waves promote an anisotropic collision frequency that depends on the direction of the electron drift. While the enhanced collision frequency from these waves is comparable to the classical frequency for motion along the applied magnetic field, the effective collision frequency in the azimuthal direction exceeds the classical by three orders of magnitude. These results are discussed in the context of their impact on the steady-state plasma gradients in the near-field cathode plume. Closure models for incorporating the effective collision frequencies from both types of waves into fluid-based codes are derived and shown to agree with the measured wave-driven collision frequencies.
Autism genetics perturb prenatal neurodevelopment through a hierarchy of broadly-expressed and brain-specific genes

ABSTRACT Numerous genes are associated with autism spectrum disorder (ASD); however, it remains unclear how most ASD risk genes influence neurodevelopment and result in similar traits. Recent genetic models of complex traits suggest non-tissue-specific genes converge on core disease genes; so we analyzed ASD genetics in this context. We found ASD risk genes partition cleanly into broadly-expressed and brain-specific genes. The two groups show sequential roles during neurodevelopment with broadly-expressed genes modulating chromatin remodeling, proliferation, and cell fate, while brain-specific risk genes are involved in neural maturation and synapse functioning. Broadly-expressed risk genes converge onto brain-specific risk genes and core neurodevelopmental genes through regulatory networks including PI3K/AKT, RAS/ERK, and WNT/β-catenin signaling pathways. Broadly-expressed and brain-specific risk genes show unique properties, wherein the broadly-expressed risk gene network is expressed prenatally and conserved in non-neuronal cells like microglia. However, the brain-specific gene network expression is limited to excitatory and inhibitory neurons, spanning prenatal to adulthood. Furthermore, the two groups are linked differently to comorbidities associated with ASD. Collectively, we describe here the organization of the genetic architecture of ASD as a hierarchy of broadly-expressed and brain-specific genes that disrupt successive stages of core neurodevelopmental processes.
Abstract 14298: Right Ventricular Strain Before and After Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension

Background: Right ventricular (RV) function is impaired in chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) may be an alternative treatment for patients (p...
Holes in the FOAM: An Analysis of Curricular Comprehensiveness in Online Educational Resources.

Objectives We sought to evaluate Free Open Access Medical Education (FOAM), defined as online educational content available free to anyone, anywhere, at any time, by classifying the most impactful FOAM content per the Social Media Index into the topics and subtopics of the American Board of Emergency Medicine's Model of the Clinical Practice of Emergency Medicine. We then analyzed FOAM's comprehensiveness by describing over- and underrepresentation among these topics and subtopics. Methods First, we searched for FOAM resources based on the most recent 12 months of relevant content for each organ system from the top 50 Social Media Index sites. Next, we classified all 898 posts into its related topics or subtopics per the American Board of Emergency Medicine's Model of the Clinical Practice of Emergency Medicine. Finally, we analyzed how comprehensively FOAM covered each organ system and the frequency of posts that covered each organ system subtopic as well as identified the subtopics with the most frequent coverage. Results The search yielded 898 FOAM posts, of which cardiology and neurology were significantly overrepresented and psychobehavioral; obstetrics and gynecology; and head, ears, eyes, nose, and throat were significantly underrepresented. Among subtopics, acute coronary syndrome had the highest subtopic coverage consisting of 55.5% of all cardiology content. Other highly represented subtopics include renal colic; diabetic ketoacidosis; sepsis; and stroke with 39, 40, 40, and 71% of each of their topic's content, respectively. Conclusions Although residents and programs are frequently incorporating FOAM into the educational curriculum, these materials seem to lack comprehensiveness. Educators and learners must be aware of these deficits in creating comprehensive emergency medicine curricula.
The wealth of nations and the health of populations: A quasi-experimental design of the impact of sovereign debt crises on child mortality.

The wealth of nations and the health of populations are intimately strongly associated, yet the extent to which economic prosperity (GDP per capita) causes improved health remains disputed. The purpose of this article is to analyze the impact of sovereign debt crises (SDC) on child mortality, using a sample of 57 low- and middle-income countries surveyed by the Demographic and Health Survey between the years 1990 and 2015. These surveys supply 229 household data and containing about 3 million childbirth history records. This focus on SDC instead of GDP provides a quasi-experimental moment in which the influence of unobserved confounding is less than a moment analyzing the normal fluctuations of GDP. This study measures child mortality at six thresholds: neonatal, under-one (infant), under-two, under-three, under-four, and under-five mortality. Using a machine-learning (ML) model for causal inference, this study finds that while an SDC causes an adverse yet statistically insignificant effect on neonatal mortality, all other child mortality group samples are adversely affected between a probability of 0.12 to 0.14 (all statistically significant at the 95-percent threshold). Through this ML, this study also finds that the most important treatment heterogeneity moderator, in the entire adjustment set, is whether a child is born in a low-income country.
Branching Time, Perfect Information Games, and Backward Induction

Abstract The logical foundations of game-theoretic solution concepts have so far been explored within the confines of epistemic logic. In this paper we turn to a different branch of modal logic, namely temporal logic, and propose to view the solution of a game as a complete prediction about future play. The branching time framework is extended by adding agents and by defining the notion of prediction. A syntactic characterization of backward induction in terms of the property of internal consistency of prediction is given. Journal of Economic Literature Classification Numbers: C70, C72.
Effect of a virtual self-management intervention for atrial fibrillation during the outbreak of COVID-19.

Abstract Background : As the pandemic continues to unfold, effective, technology-based solutions are needed to help patients with atrial fibrillation (AF) maintain their health and well-being during the outbreak of COVID-19 Methods : This single-center, pilot study investigated the effects of a 4-week (8 sessions) virtual AF self-management program Questionnaires were completed at baseline and 1 week after the intervention, and assessed AF knowledge, adherence to self-management behaviors, mental health, physical function, and disease-specific quality of life in patients with AF Secondary outcomes included knowledge of COVID-19, intervention acceptability and satisfaction Results : Of 68 patients who completed baseline questionnaires, 57 participated in the intervention and were included in the analysis (mean age of 73 4±10 0 years, 60% male) Adherence to AF self-monitoring behaviors, including monitoring their heart rate (p < 0 001), heart rhythm (p = 0 003), and blood pressure (p = 0 013) were significantly improved at the end of the intervention compared with baseline Symptom identification (p = 0 007) and management (p < 0 001) also improved Reductions in sleep disturbance (p < 0 001), anxiety (p = 0 014) and depression (p = 0 046) were also observed Misinformation and inaccurate beliefs about COVID-19 were significantly reduced at the end of the intervention compared with baseline Conclusions : This pilot study suggests that a virtual patient education program could have beneficial effects on adherence to guideline-recommend self-care of AF, emotional wellbeing, physical function and knowledge of COVID-19 in patients with AF Future randomized studies in larger samples are needed to determine the clinical benefits of the intervention This article is protected by copyright All rights reserved
Correlates of analog vs human basal insulin use among individuals with type 2 diabetes: A cross-sectional study.

Abstract Background Given the shift from use of less expensive human to costlier analog insulins for treatment of type 2 diabetes (T2D), we examine characteristics and glycemic control associated with type of basal insulin use. Methods We analyzed respondents with T2D in six consecutive National Health and Nutrition Examination Survey (NHANES) cycles (2005–2016). Logistic regression models examined associations between demographics, socioeconomic factors, and NHANES cycle with (1) type of basal insulin use and (2) hemoglobin A1c Findings: Basal insulin use increased from 9.6% to 17.2% of respondents with T2D between 2005 and 2016. Among 723 respondents meeting inclusion criteria, the proportion using analog basal insulin rose from 58% to 88%. African American (aOR 0.42, 95% CI 0.24–0.74) and Hispanic (aOR 0.54, 95% CI 0.30–0.96) respondents had lower odds of analog basal insulin use than non-Hispanic White respondents in adjusted and unadjusted models. Older age and having health insurance, but not type of basal insulin use, associated with meeting HbA1c targets. Interpretation: Non-White NHANES respondents were less likely to use analog basal insulin than White respondents. Increased analog basal insulin use between 2005 and 2016 was not associated with improved glycemic control.
Guß- und Maschinenteile für Brücken

Die in diesem Abschnitt behandelten Gus- und einfachen Maschinenteile sind solche, wie sie bei den verschiedenen Arten beweglicher Brucken Verwendung finden und in Verbindung mit der Eisenkonstruktion geliefert werden. Es soll hierfur keine allgemeine Beschreibung maschineller Einrichtungen gegeben werden, die in anderen umfangreichen Buchern eingehend behandelt worden sind, sondern es sollen hier nur einige fur den Konstrukteur beweglicher Brucken wunschenswerte Angaben gemacht werden, die sich auf die Maschinenteile von Drehscheiben, Dreh-, Hub- und Klappbrucken sowie auf die Gelenke und Auflager fester Brucken beziehen. Alle von Spezialfirmen hergestellten Teile sind daher nicht berucksichtigt.
Probability Distributome: a web computational infrastructure for exploring the properties, interrelations, and applications of probability distributions

Probability distributions are useful for modeling, simulation, analysis, and inference on varieties of natural processes and physical phenomena. There are uncountably many probability distributions. However, a few dozen families of distributions are commonly defined and are frequently used in practice for problem solving, experimental applications, and theoretical studies. In this paper, we present a new computational and graphical infrastructure, the Distributome, which facilitates the discovery, exploration and application of diverse spectra of probability distributions. The extensible Distributome infrastructure provides interfaces for (human and machine) traversal, search, and navigation of all common probability distributions. It also enables distribution modeling, applications, investigation of inter-distribution relations, as well as their analytical representations and computational utilization. The entire Distributome framework is designed and implemented as an open-source, community-built, and Internet-accessible infrastructure. It is portable, extensible and compatible with HTML5 and Web2.0 standards (http://Distributome.org). We demonstrate two types of applications of the probability Distributome resources: computational research and science education. The Distributome tools may be employed to address five complementary computational modeling applications (simulation, data analysis and inference, model-fitting, examination of the analytical, mathematical and computational properties of specific probability distributions, and exploration of the inter-distributional relations). Many high school and college science, technology, engineering and mathematics (STEM) courses may be enriched by the use of modern pedagogical approaches and technology-enhanced methods. The Distributome resources provide enhancements for blended STEM education by improving student motivation, augmenting the classical curriculum with interactive webapps, and overhauling the learning assessment protocols.
9 Synthesis of Optimal Controls

Publisher Summary Optimization problems for linear systems with bounded controls are generally easy to formulate using the maximum principle but from a computational standpoint, they are often difficult to solve. Many ideas have been put forward for synthesizing minimum time and minimum effort controllers for linear systems but only a few of these have proved successful when applied to actual computation. This chapter presents an introductory account of these optimal control synthesis ideas, together with some examples of engineering applications and computational techniques. The chapter shows how Neustadt's method can be implemented to compute optimal controls and describes two convergence acceleration methods. It should be understood that there are many other ways to carry out the maximization and in particular instances some of these may prove to be simpler or quicker, or just more appealing to the individual's taste.
Unsuccessful Lumbar Puncture: Blame It on the Patient, Not the Operator (P1.317)

OBJECTIVE: The objective of this study is to identify predictors of a successful lumbar puncture (LP) performance by neurology residents in an outpatient clinic. BACKGROUND: Little research has been done evaluating patient or operator characteristics that determine successful LP performance by neurology residents. Identification of such factors could aid in the design of compensatory interventions to improve success. DESIGN/METHODS: We performed a retrospective analysis of all consecutive patients who underwent elective LP in the Neurology Outpatient Clinic at the University of Iowa between the years 2009-2012. We recorded demographic, anthropometric and clinical information, and the level of the training of the resident performing the procedure. Outcomes of the LP were dichotomized as success (traumatic or non-traumatic) and failure. This study was previously approved by the University of Iowa IRB. RESULTS: A total of 328 patients (59% women) were included. Men were significantly older that women, and the indication of the procedure was different by sex. Evaluation of headache or multiple sclerosis were more common indications in women than in men. Nineteen percent of the LPs were unsuccessful. We found a very strong correlation between patient BMI and unsuccessful outcome (p<0.0001). Headache as indication for the LP also correlated with lower rate of success, although this was explained by the higher BMI in this group. Level of training of the operator did not influence outcome. CONCLUSIONS: Patient BMI is the key factor that determines lack of success in LP by neurology residents in an outpatient setting. The predicted high failure rate in patients with high BMIs suggests that in patients with BMI>35, implementing interventions such as the use of ultrasound guidance might be cost-effective. Unexpectedly, our data does not support more successful performance by more senior residents. Study Supported by: Disclosure: Dr. Edwards has nothing to disclose. Dr. Leira has nothing to disclose. Dr. Gonzalez-Alegre has received personal compensation for activities with Lundbeck.
Antenatal prediction of graduated risk of hyaline membrane disease by amniotic fluid foam test for surfactant.

Abstract We measured amniotic fluid surfactant by the semiquantitative foam stability test within 24 hours before delivery of 410 infants, 64 of whom developed HMD diagnosed by standard criteria. When surfactant titers Were ranked in eight categories, they predicted graded risks of HMD. On this basis we defined five “risk groups” with significantly different incidences of HMD (I = 0.5%; II = 10%; III = 25%; IV =41%; V = 79%). Infants in Groups I and II were heavier and more mature than those in Groups III to V. However, among infants of equivalent GA or birth weight, the incidence of HMD still correlated significantly with the foam test results. Within each risk group the incidence of HMD was equal among infants delivered by vagina and by cesarean section, slightly greater among males than females, and inversely proportional to GA. In Group V the incidence of HMD was 100% among infants at less than 33 weeks' GA. We used this relationship to devise a system that improved prediction of HMD by combining the foam test results with GA.
Dear Doctor: A tool to facilitate patient‐centered communication

BACKGROUND Patient-centered care has been identified as 1 of the 6 aims for the 21st century healthcare system. The notepad is a simple tool for reminders and personal interactions. We introduced Dear Doctor (DD) notes, a bedside notepad designed to prompt patient questions and improve patient satisfaction. OBJECTIVE To provide DD notes as a bedside tool to facilitate patient communication and improve patient encounters with physicians in the hospital. DESIGN This is a single-center, cross-sectional survey. METHODS Over a 3-month period (July 2009–September 2009), all hospitalized patients in the intervention group (1 general medicine and 1 cardiology unit) at a large academic medical center received a DD notepad, a pen, and instructions on its use. We surveyed patients who received the DD notes on the intervention group (n = 440) and compared their responses to those from a matched control group (1 general medicine and 1 cardiology unit, n = 224). RESULTS Of the 440 patients surveyed in the intervention group, 78% (n = 343) received the notepads in their rooms and 47% (n = 207) used them. Of the 343 patients who received the DD notepads, 65% (n = 223) reported that they took notes related to their hospital stay compared to only 22% of 224 patients (n = 50) in the control group (P < 0.001). The 207 patients using the DD notes had their questions more often answered by their physicians as measured on a 5-point Likert scale, compared to the control group (4.63 vs 4.45; P < 0.001). However, overall rating of communication did not differ between intervention and control groups in an intention-to-treat analysis (4.55 vs 4.55, P = 0.89). All patients who used the DD notepads responded on the survey that communication with their physicians was enhanced to at least some degree. CONCLUSIONS Utilizing a bedside notepad improved patients' satisfaction with physician communication. A simple, low-cost, patient-centered tool such as the DD notes may enhance a patient's overall experience with their providers and the hospital. Journal of Hospital Medicine 2013;8:553–558. © 2013 Society of Hospital Medicine
Assessing barriers to change in drinking behavior: results of an online employee screening program.

Background: The impact of alcohol abuse on worker productivity is considerable and appears to be increasing over time. Although early screening and intervention may help prevent or reduce the damaging health and productivity effects of problem drinking, barriers to behavioral change may render broad-based prevention efforts ineffectual. This study examined the correlates of two potential barriers to changes in drinking behavior - underestimation of drinking and lack of knowledge of helping resources - using data from web-based employee alcohol screenings. Methods: Anonymous screening data from 1185 employees of ten companies participating in the 2003 National Alcohol Screening Day were analyzed. The AUDIT, a 10-item screening instrument developed by the World Health Organization, was used to measure drinking behavior; employees' subjective assessments of their drinking were also obtained. Results: Over 53% of participants subjectively underestimated their drinking relative to their AUDIT results, and 58% of respondents did not know whether their medical insurance included benefits for alcohol treatment. Logistic regression analysis revealed that younger and male respondents tended to have the highest AUDIT scores and also (along with married respondents) were most likely to underestimate their drinking. Younger, unmarried respondents were least likely to be aware of their alcohol treatment insurance benefits. Conclusions: Current corporate efforts to curtail problem drinking among employees may not adequately address barriers to change. Targeting at-risk employee groups for alcohol screening and dissemination of information about health insurance benefits and treatment options is recommended, as is providing personalized feedback based on screening results to raise awareness of at-risk drinking and available helping resources. Language: en
The Curtius Reaction

The decomposition of acid azides to isocyanates and nitrogen is known as the Curtius rearrangement. The reaction is a preparative method for isocyanates, ureas, amides, and amines. When coupled with a hydrolytic step, the Curtius rearrangement becomes a practical procedure for replacing a carboxyl group by an amino group. The overall process of converting an acid through its azide to an amine is commonly referred to as the Curtius reaction. Acid azides are commonly prepared by treating hydrazides in cold, aqueous solution with nitrous acid. Azides can be rearranged in inert solvents, from which isocyanates can be isolated in the presence of water or alcohol., which will react with the intermediate to form urethans or ureas. Keywords: curtius reaction; monocarboxylic acids; unsaturated acids; hydroxy acids; keto acids; amino acids; functional groups; heterocyclic systems; azides; Hofmann reaction; Schmidt reaction; related reactions; experimental procedures
k-Compatible Tessellations*

Summary. The vast majority of visualization algorithms for finite element (FE) simulations assume that linear constitutive relationships are used to interpolate values over an element, because the polynomial order of the FE basis functions used in practice has traditionally been low – linear or quadratic. However, higher order FE solvers, which become increasingly popular, pose a significant challenge to visualization systems as the assumptions of the visualization algorithms are violated by higher order solutions. This paper presents a method for adapting linear visualization algorithms to higher order data through a careful examination of a linear algorithm’s properties and the assumptions it makes. This method subdivides higher order finite elements into regions where these assumptions hold (κ-compatibility). Because it is arguably one of the most useful visualization tools, isosurfacing is used as an example to illustrate our methodology.
Methodological needs and perspectives for monitoring ambient air pollution and regional haze: Tools for understanding forest responses

Abstract Methodologies for monitoring air pollutants in remote mountain forest locations are discussed, and needs for further development and refinement of such technologies are described. Even the most reliable passive samplers for ozone (O 3 ) need improvements that would help to account for the effects of wind, temperature, and relative humidity. Passive samplers for monitoring nitrogenous (N) air pollutants have not been widely used, and many new methods are still being developed. These new samplers need to be tested and calibrated against active air pollution monitoring systems before implemented on a larger scale. Portable, real-time air pollution monitors for O 3 have become available and are important for better understanding of the phytotoxic effects of pollutants. Reliable monitoring of particulate matter at the landscape level creates the greatest challenge, and special attention should be given to this issue. Although various optical methodologies are available for monitoring impairment of visibility (i.e., regional haze), methods that would allow for landscape-level evaluation of the chemical composition of particulate matter are lacking. This information is needed for estimates of fluxes of pollutants, especially N species, to forests. The existing and newly developed methodologies make it possible to monitor air pollutants across forest landscapes and develop pollution distribution models. These models and additional biological data will enable the development of biological response models, such as landscape level evaluation of foliar injury, O 3 uptake, or growth changes in pines and changes in other sensitive species. An ultimate goal for the Sierra Nevada is to develop risk assessment models that describe the sensitivity of forests to O 3 and other stressors and the risks associated with air pollution to inhabitants and visitors to the Sierra Nevada. These models are needed for well-informed decision-making regarding management and development needs in the Sierra Nevada.
Abstract 12792: Relationship Between Depression and Brain Injury in Heart Failure

Introduction: Depression is common in heart failure (HF), and is an independent predictor of mortality and morbidity. MRI detected brain injury in many regions, including those associated with depressive symptoms (hippocampus, insular lobes). However, the association between depressive symptoms and documented brain injury has not been reported in HF. Methods: Using a 3.0-Tesla MRI scanner, we assessed brain tissue injury (DTI-based mean diffusivity [MD] procedures [damage indicated by increased diffusion/MD value]) and depressive symptoms (Beck Depression Inventory-II [BDI]; BDI scores >17 indicate depression) in 16 HF (age 55.1 + 7.7 years; 12 males; LVEF 27.8 + 6.8) and 26 controls (age 49.7 + 10.8 years; 17 males). All HF subjects were NYHA Class I-II and were able to lie flat in an MRI scanner. Statistics consisted of Mann-Whitney U and Spearman’s Rho with significance set at p<0.05. Results: No significant differences were found between the groups for age or BMI. A significant difference in depressio...
Chemical Processes in the Interstellar Gas

The physical and chemical processes by which molecules are formed and destroyed in the gas phase in conditions characteristic of interstellar clouds are reviewed with an emphasis on recent developments. Some examples of their application to the chemistry of diffuse and dense clouds are briefly discussed.