cssi/SciSciGPT-SciSciNet huggingface dataset:
Integrated water resource and flood risk management: comparing the US and the EU

Floods are the most important natural hazard in the EU and US, causing 700 deaths and at least €25 billion in insured economic losses in Europe since 1998, and causing nearly $10 billion annual average flood losses in the US. Flood control is commonly viewed as a matter of building dykes, dams, and other structures, but effective flood management within the perspective of Integrated Water Resource Management (IWRM) must address multiple components of the flood risk management cycle (Figure 1). We systematically reviewed governance structures, guidance documents, and mapping products in both the EU and US, drawing particular examples from California and Spain, to determine how the US and the EU approach the flood risk management within different IWRM initiatives, which strategies and agencies are involved in the different phases –characterization (flood hazard and risk assessment and mapping), mitigation (prevention and protection), emergency (preparation and response), and (short and long term) recovery-, and how these agencies relate to each other. The regions have strong similarities in economy and environmental values, but have evolved very different approaches to cope with floods. The US and EU have similar organizational structures, but very different legislative frameworks. In the US overarching policy and large scale infrastructure funding have traditionally resided at the federal level with state and local agencies exercising strong land use control. EU member states have arguably advanced ahead of the US in some significant ways since adoption of the EU Floods Directive in 2007, a more top-down approach. Among the Directive’s many components, one important requirement is submission of flood risk management plans (by the end of 2015), which, for first time, take into account all phases of flood management. This umbrella strategy to cope with floods is creating a more consistent and integrated flood risk management approach in Europe. In 2008, the State of California, with over 2500 km of levees, enacted a comprehensive package of flood management legislation and state bond financing that far exceeds federal and other state’s actions. This program known as FloodSafe California provided funding for projects within Integrated Regional Water Management Plans, an attempt to implement IWRM at regional scale. Although the efforts of FloodSafe California represent as a major change in direction in US flood risk management, the actions still do not fully implement the integrated flood risk approach promoted by the EU.
Automatic detailed localization of facial features

We propose a complete framework for automatic detailed facial feature localization. Feature points and contours of the eyes, the nose, the mouth and the chin are of interest. Face detection is performed followed by the region detection that locates a rough bounding box of each facial component, and detailed features are then extracted within each bounding box. Since the feature points lie on the shape contours, we start from shape contour extraction, and then detect the feature points from the extracted contours. Experimental results show the robustness and accuracy of our methods. The main application of our work is automatic diagnosis based on facial features.
Supporting Mothers with Mental Illness: Postpartum Mental Health Service Linkage as a Matter of Public Health and Child Welfare Policy

Through our work in youth advocacy as, respectively, legal and public health professionals, we are all too aware of the high levels of health care fragmentation experienced during pregnancy and postpartum by poor, young mothers of color. Meredith Matone's research highlights the heightened risk of fragmentation for girls with histories of child welfare involvement. For example, she found that 66.7% of young mothers who had resided in out-of-home placements and who had taken antipsychotic medication prior to becoming pregnant failed to fill prescriptions for antipsychotics in their first postpartum year. Put another way, two-thirds of these vulnerable young mothers--a far higher proportion than young mothers without histories of child welfare involvement--were not getting the treatment that they needed to care for themselves and their children. The very real consequences of this phenomenon can be seen in the experiences of Jesse Krohn's clients, several of whom have their stories told here. Treatment discontinuity, particularly during the transition to parenthood, places mothers at risk for poor health outcomes and maladaptive parenting approaches; threatens the health and safety of infants; and triggers child welfare involvement. This article explores the negative consequences and root causes of treatment discontinuity, as well as particularized population vulnerabilities for treatment discontinuity including, as noted, involvement with child welfare. It will also provide public health and child welfare policy solutions for reducing treatment discontinuity and improving mental and physical health outcomes for new mothers and infants. The population of mothers at highest risk for postpartum treatment gaps is not small: more than 40% of Medicaid-financed births to young women aged 15 to 24 occurred in mothers who had a childhood relationship to the child welfare system. It is unacceptable to be aware of the pervasiveness of this problem, particularly among intersectionally vulnerable women, and not deploy a targeted and evidence-based preventative and remedial response.
Molecular Expression Analysis of Restrictive Receptor for Interleukin 13, a Brain Tumor-associated Cancer/Testis Antigen

BACKGROUND: The vast majority of patients with high-grade gliomas (HGG) over-express interleukin 4 (IL4)-independent binding sites for IL13 in situ. In addition, mutated IL13-based cytotoxins directed specifically toward glioma-associated sites are arguably the most active anti-glioma agents. Two IL13 receptor (R) proteins were identified: (1) IL13R alpha', a component of the signaling, heterodimeric high-affinity receptor for IL13 that is shared with IL4, and (2) IL13R alpha, a monomeric, IL4-independent receptor. MATERIALS AND METHODS: We analyzed gene expression of IL13R alpha, IL13R alpha' and that of IL4Rbeta, which is the other subunit of the shared IL13/4 receptor. The study was conducted with 40 human normal adult tissues, 20 discrete regions of the central nervous system (CNS), 7 fetal tissues, several cultured cell lines, and surgical CNS specimens. RESULTS: The most striking feature of the IL13R alpha gene expression was the virtual lack of its transcripts within the CNS. Furthermore, only the testes exhibited a prominent presence of the mRNA for IL13R alpha among peripheral organs. In contrast, the components of the shared IL13/4 receptor were readily detected both in the CNS and in vital organs, such as liver, heart, lungs, and gastrointestinal tract. CONCLUSIONS: The results strongly support a need to redirect IL13 towards its more restrictive, IL4-independent, receptor for glioma diagnosis and therapies. Moreover, the gene for IL13R alpha resides on chromosome X. Since IL13R alpha is (1) a cancer-associated protein, (2) virtually restricted to testes among normal tissues, and (3) its gene is on chromosome X, IL13R alpha is unexpectedly categorized as a cancer/testis antigen. Our findings make IL13R alpha even more attractive as a target for variety of approaches in glioma molecular management.
The utility of serum 25-Hydroxyvitamin-D and body mass index in the work-up of patients presenting to a bone health clinic

Background : 25-hydroxyvitamin-D (25[OH]D) and Dual-energy x-ray absorptiometry (DEXA) are routinely evaluated in bone health clinics, but existing literature is conflicting with regard to whether these factors predict fragility fractures. We hypothesized that both serum 25(OH)D levels and bone density are lower in patients who have sustained fragility fracture(s) prior to initial presentation compared to those patients who have not. Methods : We reviewed the charts of 102 consecutive patients presenting to a single-center Bone Health Clinic, comprising 11 males and 91 females with a mean age of 68 and range of 50 to 92. Demographic data, serum 25(OH)D levels, fracture history, and DEXA scans were obtained at the initial visit. Results : 64 patients had previously sustained a fragility fracture, and 38 patients had not. 25(OH)D levels were similar in the fracture and non-fracture groups (37.12±17.02 ng/mL versus 38.55±16.42, p=0.676). DEXA T-scores were similar between fracture and non-fracture groups (-2.28±1.33 versus -1.82±1.1, p=0.075). Patients with rheumatoid arthritis (RA) (n=7) had lower 25(OH)D levels upon presentation (mean 22.57±8.46 versus 38.77±16.67, p=0.001). BMI was inversely correlated with 25(OH)D level (Pearson correlation [R] =-0.211, p=0.033). Age was inversely correlated with DEXA T-score (R=-0.269, p-0.009), whereas BMI was positively correlated with DEXA T-score (R=0.259, p=0.013). The other demographic variables and risk factors studied were not significantly associated with either 25(OH)D levels or DEXA T-scores. Within the fracture group, DEXA T-scores were lower for patients who had sustained a hip fracture (n=15) compared to those who had sustained a fragility fracture elsewhere (-3.12±1.02 versus -2.03±1.32, p=0.004), but their 25(OH)D levels did not differ (34.33±25.49 versus 37.98±13.69, p=0.602). Conclusions : In this cohort of patients referred to a Bone Health Clinic, serum 25(OH)D levels and DEXA T-scores did not differ between those patients who had sustained a fragility fracture from those who had not.
A 62-Year-Old Woman With Wheezing, Respiratory Failure, and an Abnormal CT Scan

Case presentation A previously healthy 62-year-old woman was transferred to the ICU from the medical ward with acute bronchospastic respiratory failure requiring intubation and mechanical ventilation. Four weeks before, the patient was vacationing in Arizona and acquired a mildly productive cough as well as mild dyspnea. She presented to an urgent care facility and was diagnosed with community-acquired pneumonia. She received a 5-day course of azithromycin, with partial improvement of her symptoms. The patient returned home 1 week prior to admission, reporting worsening dyspnea, chest pressure, cough, and fever. The patient was admitted to the medical ward, and treatment for unresolved pneumonia was begun with levofloxacin, an inhaled short-acting beta agonist, and oral prednisone. Despite this treatment, the patient experienced severe respiratory distress with audible wheezing as well as increased work of breathing. She was intubated for acute hypoxemic respiratory failure and transferred to the ICU.
Feet kinematics upon slipping discriminate between recoveries and three types of slip-induced falls

This study investigated the relationship between feet kinematics upon slipping while walking and the outcome of the slip. Seventy-one slips (induced by walking over an unexpectedly slippery surface...
The action of climbing fibers on Purkinje cell responsiveness to mossy fiber inputs

Publisher Summary This chapter discusses studies that have provided evidence that the effect of climbing fiber activity is not limited to a modification in the discharge frequency of the simple spikes. By using an autocorrelation technique designed for nonstationary stochastic processes, it was demonstrated for many Purkinje cells that the simple spike activity following the climbing fiber input possessed a specific temporal pattern. This pattern consisted of a strong positive correlation occurring after the inactivation response, which decayed gradually to baseline over periods ranging from 50 to 200 msec. This finding was coupled with the observation that Purkinje cells possessing long-duration positive correlation were more likely to respond to natural cutaneous or proprioceptive inputs than neurons for which a shorter correlation was observed. Therefore, it was hypothesized that the climbing fiber event is involved in controlling the responsiveness of a Purkinje cell to mossy fiber inputs. The chapter also discusses the combined effect of a climbing fiber input on both the reduction and increase in impulse activity of a Purkinje cell.
Bone graft materials for posterolateral fusion made simple: a systematic review

Iliac crest has long been the gold standard for lumbar fusion, but concerns over donor site morbidity have led to a wide variety of bone graft substitutes. Despite prolific research, a general consensus is yet to be reached on bone graft materials that lead to optimal fusion. The purpose of this review is to evaluate the current literature for bone graft material options that maximize fusion rate in posterolateral lumbar fusion surgery. Systematic Review. A PRISMA—compliant systematic review of PubMed, EMBASE, and the Web of Science was conducted. Included studies were published from January 2000 to July 2015, were clinical human research studies involving available autograft, allograft, or synthetic bone graft options in posterolateral lumbar spine fusion, and reported radiographic fusion rate as a primary end outcome. This research had no funding source and the authors have no conflicts to declare. 81 articles underwent full-text review, and 48 were included in this study. 18 studies assessed fusion rate by plain radiographs alone (37.5%), while 6 used CT scan (12.5%), and 24 used both (50.0%). 45 studies looked at ICBG in conjunction with LAG (29), BCP(1), APC (2), BMPs (6), or DBM (1). Aggregate mean fusion rates among these ranged from 68.0 to 91.5%. 22 studies evaluated fusion rates of LAG, either isolated (3) or combined with ceramic extenders (8), DBM (4), BMP (1), BMA (4), APC (1), or ICBG(1). Aggregate mean fusion rate ranged from 75 to 95.5%. With the exception of studies involving allograft (mean fusion rate 40.0%), the mean fusion rate for all other graft combinations exceeded 70.0%. While our results find that LAG+BMA provided highest fusion rate, most material options analyzed in this study provide comparable fusion outcomes. The ideal graft option must incorporate a combination of materials with osteoconductive, osteoinductive, and osteogenic properties. Our results represent the robust and dynamic nature of the current state of lumbar graft technology. These slides can be retrieved under Electronic Supplementary Material.
Clinical and histopathologic findings in dogs with the ultrasonographic appearance of gastric muscularis unorganized hyperechoic striations

Ultrasonographic appearance of unorganized hyperechoic striations (UHS) has been observed in the canine gastric muscularis layer. The purpose of the study was to determine the prevalence, sonographic and postmortem histologic features, and to determine the clinical significance of canine gastric muscularis UHS. In the prospective study, 72 dogs were included. The presence of gastric muscularis UHS were reviewed to determine its distribution and location. In the retrospective study, 167 dogs that had both abdominal ultrasonography and necropsy were included. The prevalence of gastric muscularis UHS in dogs was 37.5% in the prospective and 5.4% in the retrospective studies respectively. The higher prevalence in prospective study was due to greater anticipation by the radiologists in search for gastric muscularis UHS. In the ventral gastric wall, the muscularis UHS were better defined when the gastric lumen was empty or non-distended, and were mostly parallel with the serosa when the gastric wall was distended (with gas or fluid). Visualization of the dorsal gastric wall was often obscured by gas shadowing from luminal gas. Histopathology was performed on eight dogs with gastric muscularis UHS, three of which had fibrous tissue observed with Masson’s trichrome stain. Presence of gastric muscularis UHS in dogs may have been attributable to presence of incomplete interfaces between the inner oblique, middle circular and outer longitudinal layers of the gastric tunica muscularis or due to presence of fibrous tissue within the gastric muscularis layer. The clinical significance of canine gastric muscularis UHS is uncertain.
Subfoveal Lucency after Treatment of Vitreomacular Traction without Macular Hole in the Phase 3 Trials of Ocriplasmin Vitreolysis.

Purpose To describe the clinical impact of subfoveal lucency (SFL) seen on OCT before and after treatment of vitreomacular traction (VMT) or symptomatic vitreomacular adhesion (VMA) without macular hole (MH) in the prospective phase 3 trials of ocriplasmin vitreolysis. Design Randomized double-blind placebo-controlled multicenter study. Participants Four hundred ninety-nine eyes with VMT or VMA without MH. Methods Eyes were randomized to either a single intravitreal injection of ocriplasmin or placebo treatment and were followed up for 6 months. Main Outcome Measures Eyes were analyzed for presence, dimensions, and course of SFL on OCT, release of VMT, and their effect on visual acuity (VA). Results Among eyes without baseline SFL, new SFL was more frequent after ocriplasmin than placebo at week 1 (23.1% vs. 6.54%; P = 0.0002) and week 2 (19.7% vs. 3.85%; P = 0.0001), but was similar in frequency by week 4 (8.37% vs. 7.69%; P = 0.83). Six-month VA for eyes demonstrating SFL after ocriplasmin during the first 2 weeks was comparable with those without SFL at any point in the study (P = 0.12). In placebo-treated eyes but not ocriplasmin-treated eyes, SFL was associated with worse VA at all visits. The increase in SFL width from baseline to week 2 was significantly greater with ocriplasmin than placebo (P = 0.029). Among ocriplasmin-treated eyes at month 6, those with SFL and VMT release had better VA than those with SFL and persistent adhesion (P = 0.037) and similar VA to those with persistent adhesion without SFL (P = 0.17). In the placebo group, those with baseline SFL showed low rates of spontaneous VMT release at month 6 compared with those without baseline SFL (3/21 eyes vs. 33/99 eyes; P = 0.045). Conclusions Compared with placebo, SFL occurred more frequently only in the initial weeks after treatment with ocriplasmin. When SFL developed after ocriplasmin administration, VA was not impacted at the 6-month visit. Persistent SFL in ocriplasmin-treated eyes at month 6 was associated with poorer vision if VMT had not released. Eyes with SFL at baseline had low rates of spontaneous VMT release and may need treatment.
THE ROLE OF FILAMENTOUS MICROORGANISMS IN ACTIVATED SLUDGE SETTLING

ABSTRACT In this study, activated sludges from two laboratory units and twelve sewage treatment plants were examined to develop a relationhip between the quantity of filamentous microorganisms and settling characteristics. Using 14-cm diameter, 69-cm liquid depth settling columns, activated sludge characteristics, evaluated by reflocculation time, zone settling velocity, and 60-min compact volume height were related to the quantity of filamentous microorganisms represented by total filament length. Increases in reflocculation time and 60-min compact volume height were observed when filament length concentration was over about 107 μm/ml at five levels of suspended solids. No effect of filaments was observed when they were below 107 μm/ml. A mechanism for the influence of filaments on zone settling velocity was postulated for varying levels of filaments and suspended solids.
The Nature of Personality

While there are many definitions of personality existing, little will be lost if, for the present, we limit ourselves to its most general and abstract meaning: Personality is an hypothetical construct referring to an organized system of reaction tendencies that mediates relations between the person and his/her environment, rendering the person’s behavior distinctive and more or less uniquely identifying. The term derives from the Greek persona, or mask, the “face” the individual displays to the world, although in modern usage there is no suggestion of drama, or intent, or even necessarily of conscious awareness. The construct is a complex one in that it refers not only to “surface” behavior but also to its purported underlying causes, its “dynamics” so to speak, whether or not these may be accessible to the consciousness of the individual concerned.
Atelectasis and mucus plugging in spinal cord injury: case report and therapeutic approaches.

Introduction: The leading causes ofmorbidity and mortality in the spinal cord injury (SCI) population are airway mucus plugging and atelectasis.Objective: To illustrate the risks of pulmonary disea...
Howell-Jolly Body–Like Inclusions in Neutrophils of Patients With Myelodysplastic Syndrome: A Novel Correlation

Context.— Howell-Jolly body–like inclusions have been previously associated with patients who are human immunodeficiency virus (HIV) infected, taking antiviral medications, and immunosuppressed. These inclusions appear in neutrophils and resemble Howell-Jolly bodies of normoblasts in abnormal erythropoiesis. In granulocytes, they are thought to represent detached nuclear fragments produced from dysplastic granulopoiesis. To the best of our knowledge, no association of Howell-Jolly body–like inclusions and myelodysplastic syndrome (MDS) has been reported previously. Objective.— To establish an unprecedented correlation of Howell-Jolly body–like inclusions in patients with MDS. Design.— Eleven bone marrow cases from patients diagnosed with MDS and 20 bone marrow cases with no significant pathologic alterations were retrospectively reviewed. Detailed medical record review was performed to ensure none of the patients had a history of HIV, or was taking immunosuppressants and/or antiviral medications. Results....
Repeatability of EMG activity during exoskeleton assisted walking in children with cerebral palsy: implications for real time adaptable control

Effective solutions for gait rehabilitation in children with cerebral palsy (CP) remain elusive. Wearable robotic exoskeletons offer the potential to greatly increase the dosage and intensity of gait training in this population, which may improve outcomes. We recently reported that a robotic exoskeleton significantly improved knee extension in children with crouch gait from CP. Longitudinal studies are necessary to fully understand long term biomechanical effects of exoskeleton gait training. Given that children's gait can change both as they develop and throughout their therapy, advanced control strategies which can adapt assistance over time may be beneficial. But, stride-to-stride variability makes it difficult to ascertain the effects of exoskeleton assistance and therefore complicates implementation of adaptable control algorithms. Here, we examine the use of the variance ratio (VR), a previously published measure, to assess the effect of exoskeleton assistance on knee extensor and flexor EMG variability in children with CP. Our results show that VR was significantly increased ($p<0.001)$ compared to baseline during walking with exoskeleton assistance. After five practice sessions, we found that VR was reduced though still greater than baseline levels. Given its sensitivity to exoskeleton assistance and ease of computation, VR may be a useful measure in the future for evaluating stride-to-stride variability in real time to inform algorithmic decision making for autonomous adaptable control.
Contesting the international order by integrating it: the case of China’s Belt and Road initiative

What does the Belt and Road initiative (BRI) tell us about China’s perceptions of the international order? This paper takes an inductive approach by examining the BRI for a two-pronged purpose: fir...
The Islamic State: The Rise of Vigilante Justice

This chapter examines the Islamic State as a case study of militant Islam’s vigilante justice. Its military and ideological actions embody vigilante justice at work. The word “justice” and its surrogate terms such as revenge, irhaab (terrorism), endurance, and terror are key markers of the organization’s political and theological vocabulary. From the inaugural speech of Abu Bakr al-Baghdadi on June 29, 2014, to the hymn of its foot soldiers conquering new territories, the echo of vengeful justice rings loud. This chapter also examines the rationale and the articulation of many aspects of the organization’s vision of vigilante justice, including vengeance, gruesome violence, and the blatant rejection of political freedom. Specific elements under consideration include the organization’s brand of violence, its politics of legitimizing al-Baghdadi’s leadership, and the emphasis on the caliphate through forceful bay’a (a pledge of allegiance) instead of invoking free will in pledging allegiance to the emir.
A Plant-Inversion Based Switched Iterative Learning Control Scheme for a Special Class of Multivariable Systems

This paper presents a plant-inversion based Switched Iterative Learning Control (SILC) scheme for a special class of Multi-Input Multi-Output (MIMO) systems for which only one output channel can be accessed at any given time. While Asymptotic Stability (AS), or zero error convergence, is predominantly considered in Iterative Learning Control (ILC), AS cannot be achieved for this class of systems. A weaker condition, bounded convergence, however, can be obtained. With the SILC scheme proposed in this paper, the measurement channels are accessed one at a time in a specific order. Each time an output channel is accessed, bounded convergence of all of the channel errors is achieved by using an ILC algorithm. As the access is switched from one channel to the next, the previously achieved convergent error is brought to a new value due to the change of measurement information, which may or may not be less than the previous one, depending on the structure of the learning matrix. Using the inverse plant dynamics as a learning matrix and as the switching action continues occurring, the bounded convergence tends to zero convergence. Illustrative examples are provided to demonstrate the effectiveness of the proposed SILC scheme and its robustness to modeling uncertainty.Copyright © 2018 by ASME
Determinants and the Role of Self-Efficacy in a Sodium-Reduction Trial in Hemodialysis Patients.

Objective This study was to assess the impact of baseline dietary self-efficacy on the effect of a dietary intervention to reduce sodium intake in patients undergoing hemodialysis (HD) and to identify determinants of low dietary self-efficacy. Methods This is a post hoc analysis of the BalanceWise study, a randomized controlled trial that aimed to reduce dietary sodium intake in HD patients recruited from 17 dialysis centers in Pennsylvania. The main outcome measures include dietary self-efficacy and reported dietary sodium density. Analysis of variance with post hoc group-wise comparison was used to examine the effect of baseline dietary self-efficacy on changes in reported sodium density in the intervention and control groups at 8 and 16 weeks. Chi-square test, independent t tests, or Wilcoxon rank-sum tests were used to identify determinants of low dietary self-efficacy. Results The interaction between dietary self-efficacy and the impact of the intervention on changes in reported dietary sodium density approached significance at 8 and 16 weeks (P interaction=0.051 and 0.06, respectively). Younger age and perceived income inadequacy were significantly associated with low self-efficacy in patients undergoing HD. Conclusion The benefits of dietary interventions designed to improve self-efficacy may differ by the baseline self-efficacy status. This may be particularly important for HD patients who are younger and report inadequate income as they had lower dietary self-efficacy.
Multiple Path Infrastructure-less Networks A Cooperative Approach

For future generation networks, the development of new and novel architectures is needed if integration, expansion, and usability demands are to be met. This paper proposes a new network architecture that can be used for developing and maintaining multi-path routes through a cooperative node approach. The cooperative nodes assist in the network development and are designed to act as forwarders of messages using idle or underutilized channels. The proposed architecture shows that, even without optimization, significant improvement can be seen in latency, goodput, and channel utilization. The architecture consists of five stages named Discovery, Decision, Utilization, Data Collection, and Dynamic Adaptation. By design, the architecture is developed to be modular with individual stages capable of functioning unaided by the other stages and developed to be easily implemented in any of the network layers. Due to space constraints, optimization and challenges such as the handling of unrelated packet formats are omitted and proposed in different works.
Web Exclusive. Annals On Call - Stories in Medicine.

In this episode of Annals On Call, Dr. Centor discusses the importance of stories in medicine with Dr. Faith Fitzgerald.
Detection of 1 zmol injection of angiotensin using capillary zone electrophoresis coupled to a Q-Exactive HF mass spectrometer with an electrokinetically pumped sheath-flow electrospray interface

Abstract An electrokinetically pumped sheath-flow nanoelectrospray interface provides an efficient means of transferring ions from a capillary electrophoresis system into a mass spectrometer. To characterize its performance, we analyzed angiotensin solutions prepared in a background of 0.25 mg/mL of a BSA tryptic digest. Calibration curves were prepared from 10 zmol (10−21 mol) to 10 fmol (10−14 mol) of angiotensin injected into the capillary. A parallel reaction monitoring approach was used; MS1 was set to m/z = 523.8 ± 2, and fragment ion signals at 263.1389 (y2+) and 784.4095 (b6+) were used to generate selected ion electropherograms. Calibration curves based on peak areas were linear (log-log slope of 0.94 for the y2+ fragment and 0.98 for the b6+ fragment). We then injected 1-zmol (600 copies) of angiotensin in the BSA background using a 10-μm ID separation capillary. Triplicate analyses consistently produced co-migrating peaks for the two fragment ions. The b6+ electropherogram showed no background signal, whereas the y2+ electropherogram showed a few noise spikes that were smaller than the peak maximum. Bienayme-Tchebycheff inequality was used to estimate detection limits of 230 ymol (140 ions) injected into the separation capillary. To the best of our knowledge, these electropherograms present the smallest number of molecules detected using mass spectrometry coupled with a separation.
Total pelvic exenterative surgery in patients with peritoneal metastases from appendiceal neoplasms. A case series of 2 patients.

Abstract Background Surgery which includes peritonectomy, visceral resections, and perioperative chemotherapy has been used extensively to treat peritoneal metastases from appendiceal mucinous adenocarcinoma. The results of treatment vary with the grade of the neoplasm, the extent of abdominal and pelvic disease and the completeness of tumor removal. Methods The clinical features, surgical procedures and outcome of two patients with mucinous appendiceal neoplasms were reviewed. The decision to move to total pelvic exenterative surgery after prior treatment failure was critically evaluated. Results Patient 1 had three extensive surgical procedures prior to total pelvic exenteration and one surgical procedure after. Patient 2 had one 16-h surgical procedure prior to total pelvic exenteration. Patient 1 had 8 years and 1 month survival from onset of disease until death. Patient 2 is free of disease at 27 years from onset of pseudomyxoma peritonei. After recovery of the patients from the extensive surgery, their quality of life was acceptable. Conclusion Total pelvic exenteration surgery is seldom used in patients with peritoneal metastases from appendiceal neoplasms. These two patients were studied in an attempt to determine the indications for this procedure with this disease.
Social Risks Among Primary Care Patients in a Large Urban Health System

Introduction Health systems are increasingly interested in addressing the social determinants of health via social risk screening. The objective of this study is to understand the variability in the number and types of social risks overall and in population subgroups among primary care patients routinely screened in a large urban health system. Methods Between April and December 2018, a total of 24,633 primary care patients completed a 10-item screener across 19 ambulatory sites within a health system in the Bronx, NY. The prevalence of any social risk and specific social risks was estimated overall and for population subgroups. Wald tests were used to determine statistically significant differences by subgroup. Data were analyzed in winter/spring 2019. Results Twenty percent of patients presented with at least 1 social risk. The most frequently reported risks included housing quality (6.5%) and food insecurity (6.1%). Middle-aged (30–59 years) respondents (24.7%, 95% CI=23.6%, 25.7%) compared with those aged 18–29 years (17.7%, 95% CI=16.4%, 19.2%, p Conclusions There are important differences in the prevalence of overall and individual social risks by subgroup. These findings should be considered to inform clinical care and social risk screening and interventions.
How to Be Helpful to Multiple People at Once.

When someone hosts a party, when governments choose an aid program, or when assistive robots decide what meal to serve to a family, decision-makers must determine how to help even when their recipients have very different preferences. Which combination of people's desires should a decision-maker serve? To provide a potential answer, we turned to psychology: What do people think is best when multiple people have different utilities over options? We developed a quantitative model of what people consider desirable behavior, characterizing participants' preferences by inferring which combination of "metrics" (maximax, maxsum, maximin, or inequality aversion [IA]) best explained participants' decisions in a drink-choosing task. We found that participants' behavior was best described by the maximin metric, describing the desire to maximize the happiness of the worst-off person, though participant behavior was also consistent with maximizing group utility (the maxsum metric) and the IA metric to a lesser extent. Participant behavior was consistent across variation in the agents involved and tended to become more maxsum-oriented when participants were told they were players in the task (Experiment 1). In later experiments, participants maintained maximin behavior across multi-step tasks rather than shortsightedly focusing on the individual steps therein (Experiment 2, Experiment 3). By repeatedly asking participants what choices they would hope for in an optimal, just decision-maker, and carefully disambiguating which quantitative metrics describe these nuanced choices, we help constrain the space of what behavior we desire in leaders, artificial intelligence systems helping decision-makers, and the assistive robots and decision-makers of the future.
Voter Purges After Shelby: Part of Special Symposium on Election Sciences

In Shelby County v. Holder (570 U.S. 529 (2013)), the U.S. Supreme Court struck down the “coverage formula” in Section 4b of the Voting Rights Act (VRA) that determined which jurisdictions had to p...
Competitive Advantage with Vendor Managed Inventory

Vendor managed inventory (VMI) has become a competitive supply chain management tool that has been used by retailers, suppliers and manufacturers to reduce inventory management cost over the last f...
Fully Automated Sample Processing and Analysis Workflow for Low-Input Proteome Profiling.

Recent advances in sample preparation and analysis have enabled direct profiling of protein expression in single mammalian cells and other trace samples. Several techniques to prepare and analyze low-input samples employ custom fluidics for nanoliter sample processing and manual sample injection onto a specialized separation column. While being effective, these highly specialized systems require significant expertise to fabricate and operate, which has greatly limited implementation in most proteomic laboratories. Here, we report a fully automated platform termed autoPOTS (automated preparation in one pot for trace samples) that uses only commercially available instrumentation for sample processing and analysis. An unmodified, low-cost commercial robotic pipetting platform was utilized for one-pot sample preparation. We used low-volume 384-well plates and periodically added water or buffer to the microwells to compensate for limited evaporation during sample incubation. Prepared samples were analyzed directly from the well plate with a commercial autosampler that was modified with a 10-port valve for compatibility with 30 μm i.d. nanoLC columns. We used autoPOTS to analyze 1-500 HeLa cells and observed only a moderate reduction in peptide coverage for 150 cells and a 24% reduction in coverage for single cells compared to our previously developed nanoPOTS platform. To evaluate clinical feasibility, we identified an average of 1095 protein groups from ∼130 sorted B or T lymphocytes. We anticipate that the straightforward implementation of autoPOTS will make it an attractive option for low-input and single-cell proteomics in many laboratories.
The Potential for Quantifying Regional Distributions of Radial and Shear Strain in the Thoracic and Abdominal Aortic Wall Using Spiral Cine DENSE Magnetic Resonance Imaging.

Aortic displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging (MRI) was recently developed to assess heterogeneities in aortic wall circumferential strain (CS). However, previous studies neglected potential radial and shear strain (RSS) distributions. Herein, we present an improved aortic DENSE MRI postprocessing method to assess the feasibility of quantifying all components of the two-dimensional (2D) strain tensor. 32 previously acquired 2D DENSE scans from three distinct aortic locations were re-analyzed. Contrasting previous studies, displacements of the inner and outer aortic wall layers were processed separately to preserve RSS. Differences in regional strain between the new and old postprocessing methods were evaluated, along with interobserver, intraobserver, and interscan repeatability for all strain components. The new postprocessing method revealed an overall mean absolute difference in regional CS of 0.01 ± 0.01 compared to the prior method, with minimal impact on CS repeatability. Mean absolute magnitudes of regional RSS increased significantly compared to changes in CS (radial 0.04 ± 0.05, p < 0.001; shear 0.04 ± 0.04, p = 0.02). Most repeatability metrics for RSS were significantly worse than for CS. The unique distributions of RSS for each axial location associated well with local periaortic structures and mean aortic displacement. The new postprocessing method captures heterogeneous distributions of nonzero RSS which may provide new information for improving clinical diagnostics and computational modeling of heterogeneous aortic wall mechanics. However, future studies are required to improve the repeatability of RSS and assess the influence of partial volume effects.
Communicating Web Vessels: Improving the Responsiveness of Mobile Web Apps with Adaptive Redistribution

In a mobile web app, a browser-based client communicates with a cloud-based server across the network. An app is statically divided into client and server functionalities, so the resulting division remains fixed at runtime. However, if such static division mismatches the current network conditions and the device’s processing capacities, app responsiveness and energy efficiency can deteriorate rapidly. To address this problem, we present Communicating Web Vessels (CWV), an adaptive redistribution framework that improves the responsiveness of full-stack JavaScript mobile apps. Unlike standard computation offloading, in which client functionalities move to run on the server, CWV’s redistribution is bidirectional. Without any preprocessing, CWV enables apps to move any functionality from the server to the client and vice versa at runtime, thus adapting to the ever-changing execution environment of the web. Having moved to the client, former server functionalities become regular local functions. By monitoring the network, CWV determines if a redistribution would improve app performance, and then analyzes, transforms, sandboxes, and moves functions and program state at runtime. An evaluation with third-party mobile web apps shows that CWV optimizes their performance for dissimilar network conditions and client devices. As compared to their original versions, CWV-powered web apps improve their performance (i.e., latency, energy consumption), particularly when executed over limited networks.
The Effect of a Nursing Hold Team on Patient Satisfaction for Admitted Patients Discharged Directly From the Emergency Department.

OBJECTIVES Emergency departments (ED) across the United States face challenges related to patient volume, available capacity, and patient throughput. Patient satisfaction is adversely affected by crowding and lengthy boarding times. This study aimed to determine whether the implementation of a dedicated nursing hold team (NHT) would improve patient satisfaction scores for admitted patients discharged directly from the ED. METHODS This was a retrospective, observational study with a pre-/post-test design. All admitted adult patients who returned a Press Ganey (PG) survey were included in the study. There were two twelve-month study periods before and after implementing an ED NHT. The primary outcome was the percentage of patients who gave top box scores for all questions in the Nursing Communication Domain. RESULTS During the pre-implementation period, 108 patients (59%) gave an overall top box rating for the Nursing Communication Domain versus the post-implementation period, where 99 patients (66%) provided a top box rating (OR 1.375, p = 0.16). There was a trend toward increased satisfaction for individual categories. However, these differences were not statistically significant. CONCLUSIONS Implementing a dedicated NHT showed an increase in the overall top box PG Nursing Communication Domain score and several of the individual domain questions. Future studies should examine other potential benefits from a dedicated NHT, such as the rate of adverse events and medication delays.
The VA Storybook Program: Humanizing Care With Nurse Stories.

The Veterans Affairs (VA) Storybook Program was developed to enhance nurse-patient relationships and satisfaction with care. Personal stories about nurses were distributed to patients on a medical/...
Historical Overview, Demographics, and Clinical Presentation of Spinal Chordoma

Chordomas are slow-growing malignancies derived from the notochord. Originally described in 1846 as an incidentally discovered small, myxoid exophytic lesion of the dorsum sella, uncertainty about its embryological origin persisted until the end of the twentieth century. At that time, a combination of clinical and laboratory evidence demonstrated that it was notochord-derived and not cartilaginous in origin, as had been previously argued. Treatment of chordomas has evolved over the 150 years since Virchow’s original description. Early descriptions of chordoma are draw from autopsy series, as surgical intervention was felt to be too high risk for the overwhelming majority of lesions. But with the advancement of surgical techniques, clinical evidence began to accumulate that supported surgical excision as the treatment of choice. Additionally, in the latter half of the twentieth century, high-dose radiation with stereotactic radiosurgery or charged particle therapy was seen as a means of improving local control in lesions where en bloc resection was infeasible. In this chapter, we review the discovery of chordomas origins and the evolution of treatment paradigms. We conclude with a description of the epidemiology of chordoma and clinical presentation.
Domestic Space in Classical Antiquity: House-form and social complexity: the transformation of Early Iron Age Greece

Bronze walls led in all directions from the doorway to the inside and the cornice around them was blue; gold doors opened into the carefully built house; silver doorposts stood over the bronze threshold, with a silver lintel above and a gold handle; on each side there were gold and silver dogs…Inside there were seats all along the walls from the doorway to the interior and on them were fine, well-made fabrics, women's handiwork…And gold boys stood on well-made bases holding bright torches in their hands, shining at night for diners in the house. Homer, Odyssey 7.86–97 The organization of the built environment and use of space is a metaphor for the organization of a culture; the former are the visible, tangible expressions of invisible, intangible culture. The amount of segmentation present in a culture structures its architecture and spatial patterns… Kent 1991, 31 INTRODUCTION: ISSUES AND APPROACHES Homeric descriptions like that of the extensive and opulent palace of King Alcinoos in the Odyssey , quoted above represent our earliest surviving descriptions of housing from the ancient Greek world. Nineteenth- and early twentieth-century archaeologists were tempted to associate these poetically imagined structures with the monumental palatial buildings being unearthed at the time at sites such as Tiryns and Mycenae. But it became clear that whereas the palaces were probably destroyed before 1200 bce , the Homeric poems did not come together in their final form until about the eighth century bce .
In situ structural analysis of microsomal UDP-glucuronyltransferases by radiation inactivation

The structure of the UDP-glucuronyltransferases in microsomes from guinea pig and rat liver was examined in situ by radiation inactivation analysis. The p-nitrophenol conjugating activity of guinea pig microsomes increased at lower doses of radiation; at higher doses (greater than or equal to 36 megarads), activity showed a first order decline yielding a target size of 71 +/- 9 kDa. Treating microsomes with Triton X-100 eliminated the activation seen at lower doses of radiation and yielded a simple exponential decrease in activity which gave a larger target size (95 +/- 18 kDa). A monoexponential decrease in activity was seen in sonicated microsomes, at greater than or equal to 36 megarads. The same response was obtained when the reaction was assayed in the reverse direction. The estrone conjugating activity of guinea pig microsomes was similarly activated at lower doses of radiation and declined at higher doses (greater than or equal to 36 megarads), with a target size of 57 +/- 11 kDa. Allosteric activation of the enzyme by UDP-N-acetylglucosamine was eliminated by lower doses of radiation. Thus, activation of the enzyme by radiation, detergent, sonication, and UDP-N-acetylglucosamine appear to be interdependent. These activations are postulated to be due to the existence of the enzyme in an oligomeric form which can be dissociated into monomers with higher activity. The same biphasic activation-inactivation curves were obtained for p-nitrophenol conjugation in rat liver microsomes. The target sizes were 54 +/- 8 kDa (p-nitrophenol in the forward direction) and 66 +/- 10 kDa (p-nitrophenol in the reverse direction). Thus, the enzyme appears to be smaller in rat liver as compared with guinea pig liver. Lithocholate glucuronidating activity in rat liver microsomes (at greater than 36 megarads) gave a target size of 74 +/- 1 kDa.
Mad, Bad, and Sad: Women and the Mind Doctors – By Lisa Appignanesi

The author of this work presents an entertaining examination of mental illness with a particular focus on the interplay between cultural perspectives and medical diagnosis and how the relationship ...