cssi/SciSciGPT-SciSciNet huggingface dataset:
Body mass index and pulmonary complications in critically ill black patients

Background: Obesity predisposes patients to pulmonary complication: however, the association in critically ill Black populations is poorly understood. Objectives: To determine the association of body mass index (BMI) on pulmonary complications in Black patients in the ICU. Methods: A retrospective chart review of adult patients (n=605) aged 18 years and older with a medical ICU stay of greater than 24 hours during 2012 was performed. Patients were categorized based on BMI as under weight (BMI≤18.4kg/m2), normal weight (18.5-24.9kg/m2), overweight (25-29.9kg/m2), class I (30-34.99kg/m2), class II (35-39.99kg/m2) or, class III obesity (≥40kg/m2). Primary outcomes were need for and duration of mechanical ventilation and rate of ARDS. Secondary outcomes included ICU and hospital length of stay (LOS) and ICU mortality. Results: The overall rate of obesity was 35%. Patients with obesity (BMI≥30kg/m2) were more likely to be female (p Conclusion: Obesity was neither associated with increased pulmonary complications or mortality in critically ill Black patients. However patients with class II and III obesity require longer ICU and hospital stay.
The seismic pulse in materials possessing solid friction, II: Lamb's problem

Abstract The study of the propagation of seismic waves through a medium having attenuation factors varying as the first power of the frequency has been extended to the geometry used by Lamb for the perfectly elastic case. The results show three pulse groups corresponding to P, S , and R events. For high Q , all three pulses are very sharp; these pulses broaden at rates proportional to the product of the distance and 1/ Q . For symmetric pulse input and high Q , the R pulse is noticeably asymmetric, the P pulse only weakly so.
Minimization of the Thiolactomycin Biosynthetic Pathway Reveals that the Cytochrome P450 Enzyme TlmF Is Required for Five-Membered Thiolactone Ring Formation

Thiolactomycin (TLM) belongs to a class of rare and unique thiotetronate antibiotics that inhibit bacterial fatty acid synthesis. Although this group of natural product antibiotics was first discovered over 30 years ago, the study of TLM biosynthesis remains in its infancy. We recently discovered the biosynthetic gene cluster (BGC) for TLM from the marine bacterium Salinispora pacifica CNS-863. Here, we report the investigation of TLM biosynthetic logic through mutagenesis and comparative metabolic analyses. Our results revealed that only four genes (tlmF, tlmG, tlmH, and tlmI) are required for the construction of the characteristic γ-thiolactone skeleton of this class of antibiotics. We further showed that the cytochrome P450 TlmF does not directly participate in sulfur insertion and C-S bond formation chemistry but rather in the construction of the five-membered thiolactone ring as, upon its deletion, we observed the alternative production of the six-membered δ-thiolactomycin. Our findings pave the way for future biochemical investigation of the biosynthesis of this structurally unique group of thiotetronic acid natural products.
Scenarios to decarbonize residential water heating in California

This paper presents the first detailed long-term stock turnover model to investigate scenarios to decarbonize the residential water heating sector in California, which is currently dominated by natural gas. We model a mix of water heating (WH) technologies including conventional and on-demand (tank-less) natural gas heating, electric resistance, existing electric heat pumps, advanced heat pumps with low global warming refrigerants and solar thermal water heaters. Technically feasible policy scenarios are developed by considering combinations of WH technologies with efficiency gains within each technology, lowering global warming potential of refrigerants and decreasing grid carbon intensity. We then evaluate energy demand, emissions and equipment replacement costs of the pathways. We develop multiple scenarios by which the annual greenhouse gas emissions from residential water heaters in California can be reduced by over 80% from 1990 levels resulting in an annual savings of over 10 Million Metric Tons by 2050. The overall cost of transition will depend on future cost reductions in heat pump and solar thermal water heating equipment, energy costs, and hot water consumption.
Error free sense amplifier circuit design for STT-MRAM nonvolatile memory

The spin transfer torque magnetic random access (STT-MRAM) is suitable for embedded memories and also for the second level cache memory in the mobile CPU's. The most capable NVM component is STT-MRAM, which enhances the performance by 3.3 nS access time. It has strong radiation hardness, higher integrity and maximum endurance compared to SRAM. The power consumption of STT-MRAM is decreased by an order of magnitude by reducing the writing current. In this article, a new error free sense amplifier circuit is proposed. The detail analysis of the sense amplifier circuit is provided here. Finally, the performance of the proposed the sense amplifier is compared with existing sense amplifiers.
Demonstration of Constant 8 W/mm Power Density at 10, 30, and 94 GHz in State-of-the-Art Millimeter-Wave N-Polar GaN MISHEMTs

This paper reports on state-of-the-art millimeter-wave power performance of N-polar GaN-based metal–insulator–semiconductor high-electron-mobility transistors at 30 and 94 GHz. The performance is enabled by our N-polar deep recess structure, whereby a GaN cap layer is added in the access regions of the transistor to simultaneously enhance the access region conductivity while mitigating dc-to-RF dispersion. The impact of lateral scaling of the drain access region length is examined using the tradeoff between breakdown voltage and small-signal gain. Load-pull measurements are presented at 94 GHz, corresponding to the target device operating frequency in W-band, where the device demonstrated a peak power-added efficiency (PAE) of 28.8% at 16 V and record-high maximum output power density of 8 W/mm at 20 V. Additional load-pull measurements at 30 and 10 GHz demonstrate the viability of this device across a wide frequency range where the peak power remained constant at 8 W/mm and with peak PAEs of 56% and 58%, respectively.
Bariatric Surgery for Weight Loss

Approximately 5% of the American population currently suffers from extreme obesity, defined as a body mass index (BMI) >40 kg/m 2 . Extreme obesity is associated with increased risk of morbidity and mortality as well as untoward psychosocial issues, including body image dissatisfaction. Bariatric surgery is the most effective treatment for extreme obesity. It is associated with significant improvements in morbidity and mortality. Psychosocial status typically improves as patients lose substantial amounts of weight within the first few years of surgery. However, preoperative psychosocial functioning may be associated with changes in psychosocial status postoperatively. Furthermore, a minority of patients appear to experience a number of significant psychological issues postoperatively.
Constitutive Relationships for Sheet Molding Materials

Constitutive relationships (or “Combining Rules”) are described to predict the Young’s moduli (E1, E2, E3), shear moduli (G12, G13, G23), Poisson’s ratios (ν 12, ν13, ν23) and coefficients of thermal expansion (α 1, α 2, α 3) for two-component (fiber/resin) and three-component (fiber/filler/resin) sheet molding materials. Two important features of these relationships are the incorporation of (i) a quantitative orientation parameter to characterize states of fiber orientation intermediate between random and collimated and (ii) an effective aspect ratio to account for the affect of filament aggregation and “swirling.” The model predictions are shown to agree, within experimental error, with characterizations for SMC-65 (47%, by volume, E-glass fiber; 53% Polyester resin); SMC-25 (18%, by volume, E-glass; fiber, 32% Calcium Carbonate filler; 50% Polyester resin) and SMC-R50 (35%, by volume, E-glass fiber; 11% Calcium Carbonate filler; 54% Polyester resin).
Association of high circulating neuregulin-1 with clinical benefit in EGFR wild-type NSCLC patients treated with rilotumumab and erlotinib.

e20647Background: We previously reported a 59% disease control rate among EGFR wild-type (WT) patients in a phase II trial of the combination of rilotumumab (an HGF neutralizing antibody) and erlot...
Estimated Clinical and Economic Impact through Use of a Novel Blood Collection Device To Reduce Blood Culture Contamination in the Emergency Department: a Cost-Benefit Analysis

ABSTRACT Blood culture contamination results in increased hospital costs and exposure to antimicrobials. We evaluated the potential clinical and economic benefits of an initial specimen diversion device (ISDD) when routinely utilized for blood culture collection in the emergency department (ED) of a quaternary care medical center. A decision analysis model was created to identify the cost benefit of the use of the ISDD device in the ED. Probabilistic costs were determined from the published literature and the direct observation of pharmacy/microbiology staff. The primary outcome was the expected per-patient cost savings (microbiology, pharmacy, and indirect hospital costs) with the routine use of an ISDD from a hospital perspective. The indirect costs included those related to an increased hospital length of stay, additional procedures, adverse drug reactions, and hospital-acquired infections. Models were created to represent hospitals that routinely or do not routinely use rapid diagnostic tests (RDT) on positive blood cultures. The routine implementation of ISDD for blood culture collection in the ED was cost beneficial compared to conventional blood culture collection methods. When implemented in a hospital utilizing RDT with a baseline contamination rate of 6%, ISDD use was associated with a cost savings of $272 (3%) per blood culture in terms of overall hospital costs and $28 (5.4%) in direct-only costs. The main drivers of cost were baseline contamination rates and the duration of antibiotics given to patients with negative blood cultures. These findings support the routine use of ISDD during blood culture collection in the ED as a cost-beneficial strategy to reduce the clinical and economic impact of blood culture contamination in terms of microbiology, pharmacy, and wider indirect hospital impacts.
Impact of Precise Control over Microstructure in Thiophene–Selenophene Copolymers

Controlling the sequence of repeat units in a synthetic polymer has been a long-standing topic of interest in chemistry. As methods to regulate sequence become more sophisticated, it is critical to consider how controlling the arrangement of repeat units along the polymer backbone impacts properties. In this work, thiophene–selenophene copolymers (statistical and periodic) were compared to elucidate the impact of periodicity on electronic properties and structural organization in conjugated macromolecules. Polymers were synthesized using catalyst-transfer polycondensation (CTP) enabling control over molecular weight and dispersity. The study revealed that optical bandgaps and redox potentials of periodic and statistical copolymers varied with composition in a predictable manner, regardless of monomer ordering along the chain. While the bandgaps of the two types of copolymers were indistinguishable, X-ray scattering revealed differences in solid-state packing. Both types of copolymers exhibited well-define...
Imputation of race/ethnicity to enable measurement of HEDIS performance by race/ethnicity

Objective To improve an existing method, Medicare Bayesian Improved Surname Geocoding (MBISG) 1.0 that augments the Centers for Medicare & Medicaid Services' (CMS) administrative measure of race/ethnicity with surname and geographic data to estimate race/ethnicity. Data sources/study setting Data from 284 627 respondents to the 2014 Medicare CAHPS survey. Study design We compared performance (cross-validated Pearson correlation of estimates and self-reported race/ethnicity) for several alternative models predicting self-reported race/ethnicity in cross-sectional observational data to assess accuracy of estimates, resulting in MBISG 2.0. MBISG 2.0 adds to MBISG 1.0 first name, demographic, and coverage predictors of race/ethnicity and uses a more flexible data aggregation framework. Data collection/extraction methods We linked survey-reported race/ethnicity to CMS administrative and US census data. Principal findings MBISG 2.0 removed 25-39 percent of the remaining MBISG 1.0 error for Hispanics, Whites, and Asian/Pacific Islanders (API), and 9 percent for Blacks, resulting in correlations of 0.88 to 0.95 with self-reported race/ethnicity for these groups. Conclusions MBISG 2.0 represents a substantial improvement over MBISG 1.0 and the use of CMS administrative data on race/ethnicity alone. MBISG 2.0 is used in CMS' public reporting of Medicare Advantage contract HEDIS measures stratified by race/ethnicity for Hispanics, Whites, API, and Blacks.
NOT SO FAST … A CASE OF LEPTOMENINGEAL CARCINOMATOSIS MASQUERADING AS TACHY-BRADY SYNDROME

Tachy-Brady syndrome, a form of sick sinus syndrome occurs due to sinoatrial node dysfunction. Rarely, it can be mimicked by autonomic dysfunction. A 54 year old female with history significant for triple negative metastatic breast cancer presented complaining of elevated BPs following a physical
Robust Neural Networks are More Interpretable for Genomics

Abstract Deep neural networks (DNNs) have been applied to a variety of regulatory genomics tasks. For interpretability, attribution methods are employed to provide importance scores for each nucleotide in a given sequence. However, even with state-of-the-art DNNs, there is no guarantee that these methods can recover interpretable, biological representations. Here we perform systematic experiments on synthetic genomic data to raise awareness of this issue. We find that deeper networks have better generalization performance, but attribution methods recover less interpretable representations. Then, we show training methods promoting robustness – including regularization, injecting random noise into the data, and adversarial training – significantly improve interpretability of DNNs, especially for smaller datasets.
Divided we stand, united we worry: Predictors of worry in anticipation of a political election

Across two studies, we examined predictors of voters’ worry about the outcome of a political election, thus testing the application of the uncertainty navigation model to political waiting periods. Using a theoretically-grounded set of predictors, we assessed voters who preferred either the Democrats or Republicans to control the House of Representatives following the 2018 U.S. midterm election (N = 376) and Trump and Clinton voters leading up to the 2016 U.S. presidential election (N = 669). Findings generally supported the predictions of the model, such that people worried more as Election Day approached, as did people who saw the election outcome as more important, who believed it was more likely their preferred candidate would lose (Study 2), and who had a set of worry-exacerbating traits. Taken together, the findings provide considerable insight into the dynamics of worry during stressful waiting periods and support the generalizability of the uncertainty navigation model to political contexts.
Organizational support versus supervisor support: The impact on hospitality managers’ psychological contract and work engagement

Abstract Considering perceived organizational support (POS) and perceived supervisor support (PSS) at the same time and understanding which one is more critical receives little attention. A scenario-based experimental design was conducted to examine the influences of high PSS & low POS and low PSS & high POS on hospitality employees’ psychological contract (PC) and work engagement. The results show that managers experience both psychological contract breach (PCB) and lower work engagement under these two imperfect situations. Furthermore, managers have relatively higher PCB and lower work engagement under the situation of receiving lower PSS than receiving lower POS. Finally, it was found that PCB has a more negative influence on managers’ work engagement when receiving lower PSS. Theoretical and practical implications based on the results are discussed.
Co-Occurring Alcohol Use Disorder and Anxiety: Bridging Psychiatric, Psychological, and Neurobiological Perspectives

A substantial number of people who have problems with alcohol also experience strong anxiety and mood problems. This article provides an overview of the evolving perspectives of this association in the context of three related disciplines-psychiatry, psychology, and neuroscience. Psychiatric and epidemiological studies show that having either an anxiety- or alcohol-related diagnosis elevates the prospective risk for developing the other disorder. From the psychological perspective, behavioral research demonstrates that drinking to cope with negative affect is a potent marker for current and future problems with alcohol. Neuroscientific research implicates overlapping neurobiological systems and psychological processes in promoting the rise of negative affect and alcohol misuse. The psychiatric perspective that alcohol misuse and co-occurring anxiety represent neurobiologically distinct diagnostic conditions has dominated the field for many decades. However, recent research provides increasing support for the neuroscientific perspective that these conditions share underlying, mutually exacerbating, neurobiological processes.
Preparing for the Implementation of an Agnis Enabled Data Reporting System and Comprehensive Research Level Data Repository for All Cellular Therapy Patients

Background Dana-Farber Cancer Institute (DFCI) includes both a pediatric and adult transplant program. Though there are many shared resources each program is accredited individually, and they are separate CIBMTR reporting centers. With consistent growth and increasingly demanding reporting requirements, it was determined that one comprehensive internal database that filled the needs of both programs was necessary. Aim/Goals Establish a comprehensive internal database that streamlined multiple unmet needs within two large cellular therapy programs including: • Pre and post therapy case management data • Ability to fulfill all CIBMTR regulatory reporting requirements • A comprehensive research level data repository for all cellular therapy patients Methods • Workgroups were formed to map out the current and future state workflow • Gaps in the workflow and areas of vulnerability and data entry duplication were identified • Testing scripts were developed and data entry into the test environment began • During the testing period end user job aids were created and modified • Entry into historical data systems halted prior to go-live • Electronic and manual data conversion began • Data management staff validated the historical data converted to the new system • End users were trained in preparation of software "go-live" • Full production database was successfully launched • Throughout this process meetings were held between the pediatric and adult joint working group to share best practices and pinpoint opportunities for collaboration. Conclusions • "You don't know what you don't know" • The amount of time dedicated to rolling out the new system and the magnitude of change that accompanied this was far larger than anyone could anticipate • The time commitment required of team members placed significant constraints on completion of their day-to-day responsibilities • Adapting to the new system with confidence and ease took much longer than originally projected • Data managers shifted pre-transplant data entry to real time, allowing case coordinators and clinical staff to access data during the patient's work-up period • A better understanding of the correlation between the pre and post transplant data was realized Next steps • Continue progress on the work flow mapping project to solidify job roles • Maintain system stability by implementing change control policies • Preserve data integrity with newly developed audit and validation guidelines
Semiquinone radical-bridged M2 (M = Fe, Co, Ni) complexes with strong magnetic exchange giving rise to slow magnetic relaxation

The use of radical bridging ligands to facilitate strong magnetic exchange between paramagnetic metal centers represents a key step toward the realization of single-molecule magnets with high operating temperatures. Moreover, bridging ligands that allow the incorporation of high-anisotropy metal ions are particularly advantageous. Toward these ends, we report the synthesis and detailed characterization of the dinuclear hydroquinone-bridged complexes [(Me6tren)2MII2(C6H4O22−)]2+ (Me6tren = tris(2-dimethylaminoethyl)amine; M = Fe, Co, Ni) and their one-electron-oxidized, semiquinone-bridged analogues [(Me6tren)2MII2(C6H4O2−˙)]3+. Single-crystal X-ray diffraction shows that the Me6tren ligand restrains the metal centers in a trigonal bipyramidal geometry, and coordination of the bridging hydro- or semiquinone ligand results in a parallel alignment of the three-fold axes. We quantify the p-benzosemiquinone–transition metal magnetic exchange coupling for the first time and find that the nickel(II) complex exhibits a substantial J < −600 cm−1, resulting in a well-isolated S = 3/2 ground state even as high as 300 K. The iron and cobalt complexes feature metal–semiquinone exchange constants of J = −144(1) and −252(2) cm−1, respectively, which are substantially larger in magnitude than those reported for related bis(bidentate) semiquinoid complexes. Finally, the semiquinone-bridged cobalt and nickel complexes exhibit field-induced slow magnetic relaxation, with relaxation barriers of Ueff = 22 and 46 cm−1, respectively. Remarkably, the Orbach relaxation observed for the Ni complex is in stark contrast to the fast processes that dominate relaxation in related mononuclear NiII complexes, thus demonstrating that strong magnetic coupling can engender slow magnetic relaxation.
Problems of a Money Economy

Money is a social institution that brings great benefits to people by permitting efficient exchanges of goods and services. But when money is mishandled by the powers that be, it is a source of inflation and unemployment. It would be good to have a monetary system that generates only benefits; but that is probably not possible. Why this is so will be an important part of the story told in this book. Before we proceed with that story, however, we must spend some time discussing the functions of money and, particularly, the benefits that accrue to society from its use.
Localization - guaranteed navigation in GPS-denied environment via multi-UAV closed-loop coordination

Consider a scenario where multiple Unmanned Aerial Vehicles (UAVs) autonomously collaborate with each other to explore an unknown environment where GPS is not available. A visual fiducial marker with known geometry is fixed on each UAV to provide relative localization between any pair of UAVs. Nevertheless, the UAV s need to plan their motion to ensure that the marker always appears in camera's field-of-view so that they can be localized. Such requirement limits the trajectory space of UAVs when they are exploring the environment. To solve this issue, our first technical contribution is an innovative multi-UAV spatial closed-loop coordination mechanism, which provides guaranteed relative localization wherever they are in the unknown and texture-less environment. The coordination, however, requires that the environment satisfy line-of-sight (LOS) constraints, and therefore necessities the division of the global environment into different subareas such that LOS constraints are met within each subarea. Our second contribution is a novel temporal-spatial pose graph to register different subareas into one global environment accurately. Finally, we present an iterative strategy to simultaneously maximize the volume of exploration space and minimize the localization error under the line-of-sight (LOS) constraints. Comparison with STOA visual localization techniques in simulated unknown environment demonstrates that our method is robust, accurate and independent of the environment.
Patient Demographics and Anthropometric Measurements Predict Tibial and Femoral Component Sizing in Total Knee Arthroplasty.

Background Accurate sizing is critical for the overall success of a total knee arthroplasty (TKA). This study's primary purpose was to investigate the ability to predict the tibial and femoral component size in a single implant system from patient demographics and anthropometric data. A secondary goal was to compare the predicted tibial and femoral component sizes from our statistical model with a previously validated electronic application used to predict the implant size. Methods A consecutive series of 484 patients undergoing a primary TKA at a single institution was reviewed. Data on height, weight, body mass index, sex, age, and component size were collected. A proportional odds model was developed to predict tibial and femoral component sizes. The relationship between the proportional odds model predictions was also compared with the component sizes determined by the Arthroplasty Size Predictor electronic application. Results Weight, height, and sex predicted the implanted component size with an accuracy of 54.0% (n = 247/484) for the tibia and 51.1% (n = 231/484) for the femur. The accuracy improved to 94.4% (n = 457/484) for the tibia and 93.4% (n = 452/484) for the femur within ±1 component size. Our data are highly correlated to the Arthroplasty Size Predictor for the predicted tibial component size (ρ = 0.91, P < .001) and femoral component size (ρ = 0.89, P < .001). Conclusions Our novel templating model may improve operative efficiency for a single TKA system. Our findings have a high concordance with a widely available electronic application used to predict implant sizes for a variety of TKA systems.
Purely Faith-Based vs. Rationally-Informed Theological Bioethics.

McCarthy, Homan, and Rozier (2020) offer a compelling case for re-opening dialogue between theological and secular bioethics and I wholeheartedly support their overall project. As Lisa Cahill (2005...
Increasing silicone mold longevity: a review of surface modification techniques for PDMS-PDMS double casting.

Polydimethylsiloxane (PDMS) has been used extensively for microfluidic devices due to its chemical properties allowing for rapid molding and versatile biological application. Soft lithography-based...
AutoKG: Constructing Virtual Knowledge Graphs from Unstructured Documents for Question Answering

Knowledge graphs (KGs) have the advantage of providing fine-grained detail for question-answering systems. Unfortunately, building a reliable KG is time-consuming and expensive as it requires human intervention. To overcome this issue, we propose a novel framework to automatically construct a KG from unstructured documents that does not require external alignment. We first extract surface-form knowledge tuples from unstructured documents and encode them with contextual information. Entities with similar context semantics are then linked through internal alignment to form a graph structure. This allows us to extract the desired information from multiple documents by traversing the generated KG without a manual process. We examine its performance in retrieval based QA systems by reformulating the WikiMovies and MetaQA datasets into a tuple-level retrieval task. The experimental results show that our method outperforms traditional retrieval methods by a large margin.
Discovering critical KPI factors from natural language in maintenance work orders

Optimizing maintenance practices is a continuous process that must take into account the evolving state of the equipment, resources, workers, and more. To help streamline this process, facilities need a concise procedure for identifying critical tasks and assets that have major impact on the performance of maintenance activities. This work provides a process for making data investigations more effective by discovering influential equipment, actions, and other environmental factors from tacit knowledge within maintenance documents and reports. Traditional application of text analysis focuses on prediction and modeling of system state directly. Variation in domain data, quality, and managerial expectations prevent the creation of a generic method to do this with real industrial data. Instead, text analysis techniques can be applied to discover key factors within a system, which function as indicators for further, in-depth analysis. These factors can point investigators where to find good or bad behaviors, but do not explicitly perform any anomaly detection. This paper details an adaptable procedure tailored to maintenance and industrial settings for determining important named entities within natural language documents. The procedure in this paper utilizes natural language processing techniques to extract these terms or concepts from maintenance work orders and measure their influence on Key Performance Indicators (KPIs) as defined by managers and decision makers. We present a case study to demonstrate the developed workflow (algorithmic procedure) to identify terms associated with concepts or systems which have strong relationships with a selected KPI, such as time or cost. This proof of concept uses the length of time a Maintenance Work Order (MWO) remains open from creation to completion as the relevant performance indicator. By identifying tasks, assets, and environments that have significant relevance to KPIs, planners and decision makers can more easily direct investigations to identify problem areas within a facility, better allocate resources, and guide more effective analysis for both monitoring and improving a facility. The output of the analysis workflow presented in this paper is not intended as a direct indicator of good or bad practices and assets, but instead is intended to be used to help direct and improve the effectiveness of investigations determining those. This workflow provides a preparatory investigation that both conditions the data, helps guide investigators into more productive and effective investigations of the latent information contained in human generated work logs, specifically the natural language recorded in MWOs. When this information preparing and gathering procedure is used in conjunction with other tacit knowledge or analysis tools it gives a more full picture of the efficiency and effectiveness of maintenance strategies. When properly applied, this methodology can identify pain points, highlight anomalous patterns, or verify expected outcomes of a facility’s maintenance strategy.
An American Perspective of the Dental and Public Health Initiatives in Cuba

Aim:To compare following the Cuban Revolution, Cuba?s economy and civil society was transformed by the initiation of a program of nationalization and political consolidation. The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the healthcare of its citizens. Other industrialized nations continue to surpass the US in health-related outcomes indicating areas of improvement in its healthcare system. Assessing the successes and failures as well as the advantages and disadvantages of other countries? healthcare systems may be instrumental in the development of modifications to the organization and delivery system of healthcare in the US. This paper aims to report the information attained from previous literature as well as from first-hand observations from a public health trip to Cuba in order to compare the healthcare systems in Cuba and the United States.Materials and Methods:A group of New York University College of Dentistry faculty and students traveled to Cuba in April 2019 for professional research and professional meetings (CFR 515.564). While in Cuba, the researchers took written notes of the lecture-based material and conversations. Upon return to the United States, published literature was searched for the collection of any additional data and all qualitative data and quantitative data was compiled and organized. Since 1959, Cuba has made continuous adjustments and improvements to its universal, free and accessible healthcare system.Results:There have been notable improvements to the country?s public health status, such as the implementation of an immunization program and subsequent eradication of communicable diseases, such as polio and rubella. Additionally, the implementation of the National Program on Dentistry guarantees dental care to all Cuban children under the age of 19. Today, the Cuban National Health System (NHS) initiatives have evolved to combat the novel coronavirus (COVID-19) pandemic.Conclusion:Recognizing the advantages as well as the disadvantages of the Cuba?s National Health System (NHS) would be useful for future policymakers in the United States. Cuban approaches to health could be tailored to the United States environment to improve healthcare effectiveness and population health status in the future.
Resilience: The Capacity for Resilience

Resilience is defined as the capacity to recover from stress or the ability to withstand the effects of stressors that are typically associated with negative outcomes. From a phenomenological viewpoint, it is described as the bodily self’s exuberant directedness toward a lifeworld of meaning possibilities. From an existential perspective, it is depicted as a form of life energy or creative vitality that enables the individual to courageously confront one’s normal and existential anxieties, which include threats to one’s being and to one’s identificatory value-laden meanings. It is this creative vitality that keeps us realistically hopeful and helps us cope constructively with the inevitable setbacks of everyday living. Maturity requires balancing vitality with vulnerability.
Highly migratory species predictive spatial modeling (PRiSM): an analytical framework for assessing the performance of spatial fisheries management

Spatial management for highly migratory species (HMS) is difficult due to many species’ mobile habits and the dynamic nature of oceanic habitats. Current static spatial management areas for fisheries in the United States have been in place for extended periods of time with limited data collection inside the areas, making any analysis of their efficacy challenging. Spatial modeling approaches can be specifically designed to integrate species data from outside of closed areas to project species distributions inside and outside closed areas relative to the fishery. We developed HMS-PRedictive Spatial Modeling (PRiSM), which uses fishery-dependent observer data of species’ presence–absence, oceanographic covariates, and gear covariates in a generalized additive model (GAM) framework to produce fishery interaction spatial models. Species fishery interaction distributions were generated monthly within the domain of two HMS longline fisheries and used to produce a series of performance metrics for HMS closed areas. PRiSM was tested on bycatch species, including shortfin mako shark (Isurus oxyrinchus), billfish (Istiophoridae), and leatherback sea turtle (Dermochelys coriacea) in a pelagic longline fishery, and sandbar shark (Carcharhinus plumbeus), dusky shark (C. obscurus), and scalloped hammerhead shark (Sphyrna lewini) in a bottom longline fishery. Model validation procedures suggest PRiSM performed well for these species. The closed area performance metrics provided an objective and flexible framework to compare distributions between closed and open areas under recent environmental conditions. Fisheries managers can use the metrics generated by PRiSM to supplement other streams of information and guide spatial management decisions to support sustainable fisheries.
An Investigation of Children's Understanding of Food and Nutrition.

The purpose of the study was to examine the influences of age, family socio-economic status (SES), and parents’ food knowledge on preschool, kindergarten, and second grade students’ conceptual understanding of food and nutrition. Fifty-two parent–child dyads, consisting of 17 preschoolers, 17 kindergartners, and 18 second graders participated in the study. Parents completed a self-administered survey at home and the children were interviewed at school sites. We found the significant age effects on children’s conceptual understanding of food. Specifically, significant differences were found in total food knowledge between preschool and second-grade students, the food-body and food-fat knowledge scores between preschool and second grade students, and between kindergarten and second grade students. SES family background had no significant impact on children’s conceptual understanding of food. No clear correlation was found for food knowledge between children and their parents.
Equivalent Uniform Cycle Concept for Soil Dynamics

While additional studies of this nature would be appropriate, especially using direction independent tests such as cyclic simple shear, torsion shear, or shaking table, the writers feel justified in concluding that the data presented herein generally confirm the validity of the equivalent cycle or the cumulative damage method of dealing with irregular loading effects on soil. Some other aspects include a clarification of the relations between damage potential and equivalent number of uniform cycles, certain peculiarities of the cyclic triaxial test on saturated sands that may not be significant for clays, and a perspective comparison of the range of data scatter for cyclic tests on soil as compared with other materials. Thus, while the damage potential or equivalent cyclic concept may not be exactly valid for all cases, its continued use in the field of seismic stability analyses of soils seems to be a valid pragmatic approach.
Acute and Chronic Pancreatitis

The investigations, treatment, and management of acute and chronic pancreatitis are based on common principles but differ considerably in practice. Nutritional support is not only essential for recovery in these conditions, but because the pancreas is the heart of digestion and nutrient assimilation, successful feeding is extremely difficult when the pancreas fails. In both conditions, an understanding of pancreatic physiology and subsequent pathophysiology is essential in order to determine the most appropriate form of feeding. This chapter covers the pathophysiology of both conditions and selects feeding approaches based on careful physiological studies that are capable of overcoming the anatomic and metabolic derangements that result from the two conditions.
Chapter 30 Pharmacokinetics and Drug Design

Publisher Summary This chapter summarizes the impact of pharmacokinetics on drug design. Pharmacokinetic input in drug design recognizes the fact that, for some drugs, lack of optimum or desirable therapeutic activity is not because of an inadequacy in drug-receptor site interaction, but rather because of an inappropriate concentration and/or time-course of drug presentation to the receptor. Drugs containing the catechol and phenol functional groups present interesting examples of how absorption and metabolism can be altered through minor structural modification. Some of the β-adrenergic receptor blocking drugs (ARBD) show considerable first-pass metabolism. The antiarrhythmic drug lidocaine is also subjected to extensive first-pass metabolism. Its metabolites, monoethylglycinexylidide, and glycinexylidide are pharmacologically active. Modification of drug absorption rate can also lead to improvement of therapeutic efficacy. This is usually accomplished by altering the dissolution characteristics of the drug via formulation techniques other than through structural modification. Improvement of drug solubility may also be necessary because an injectable form of the drug is desired. Absorption kinetics is an important consideration for drugs that produce toxicity at the absorption site. The extent of distribution of a drug to extravascular areas can be represented pharmacokinetically either by the measurement of tissue drug concentrations in laboratory animals, or by the calculation of the apparent volume of distribution. In addition to the possibility of improving therapeutic effects, structural modifications utilizing pharmacokinetic analysis of drug distribution can explain and potentially avoid toxicities by selective distribution away from specific tissues. Drug enantiomers may differ pharmacokinetically as well as pharmacologically. Thus, choice of a particular enantiomer for clinical use may be based on pharmacokinetic as well as pharmacologic grounds.
Factors Influencing Agnotobiotic Cultures of the Rumen Ciliate, Entodinium simplex

The nutrition of Entodinium simplex was studied, with foliage of bluegrass (Poa pratense), perennial ryegrass (Lolium perenne), and grains of wheat (Triticum vulgare) as substrates in agnotobiotic cultures. Entodinium grew poorly when the substrates were autoclaved; better growth was obtained when the substrates were sterilized with ethylene oxide vapor. The concentration of ethylene oxide and the amount of moisture influenced the sterility and nutritional adequacy of the treated substrate. Autolysates and hydrolysates of mixed rumen protozoa stimulated growth. Protozoal extracts did not replace factors destroyed by autoclaving. Clarified rumen fluid assisted the cultivation of entodinia from small inocula but was detrimental to established cultures. Success of cultures was influenced by the medium used to grow the inoculum as well as by the medium inoculated. The results indicated that the composition of the bacterial population influences the growth of E. simplex.
Real and Perceived Terrorist Threats: Effects of September 11, 2001 Events on the U.S. Motorcoach-Based Tourism Industry

Abstract Motorcoach travel is a popular and economical mode of transportation. Motorcoaches carry more passengers than airlines or commuter rail each year. The motorcoach-based tourism industry in the U.S. is an industry dominated by small family-owned businesses. In this paper we examine the effects of September 11, 2001 on the motorcoach tourism industry with data drawn from a sample of 100 motorcoach tour operators. We provide insight into the segments of the business that have been most affected, customer safety and security concerns, and resulting actions by motorcoach tour operators. Motorcoach tour operator strategies to regain and grow their businesses and their perceptions regarding the future of the industry are addressed.
Client-Centered Therapy

Client-centered therapy—also referred to as person-centered therapy and Rogerian therapy—is a major approach to counseling and psychotherapy developed by Carl R. Rogers. A fundamental clinical framework informing the humanistic psychology movement, client-centered therapy and its theoretical basis stand in stark contrast to theories and psychotherapies that reduce human beings to components. The client-centered approach maintains that human beings can only be understood as wholes, through their individual subjective experiences. Another difference between client-centered therapy and most approaches to psychotherapy is that client-centered therapy “definitely rejects the medical model which involves looking for pathology and developing a specific diagnosis, or thinking of treatment in terms of cure” (Rogers, 2007, p. 1). Client-centered therapy posits specific attributes of a “good life” beyond the relative absence of psychopathology; it was designed to provide the conditions that encourage natural human growth and development toward the realization of the individual's potentials. Throughout his lengthy career, Rogers contributed numerous theoretical constructs and propositions that marked the evolution of his perspective. However, the central concept that serves as the core of his approach is the actualizing tendency. Keywords: psychotherapy; humanistic psychology; empathy; actualization
Transcription factor centric discovery of regulatory elements in mammalian genomes using alignment-independent conservation maps

The computational identification of DNA binding sites that have high affinity for a specific transcription factor is an important problem that has only been partially addressed in prokaryotes and lower eukaryotes. Given the higher length of regulatory regions and the relative low complexity of DNA binding signature, however, methods to address this problem in higher order eukaryotes are lacking. In this paper, we propose a novel computational framework, which combines cellular network reverse engineering, integrative genomics, and comparative genomic approaches, to address this problem for a set of human transcription factors. Specifically, we study the regulatory regions of putative orthologous targets of a given transcription factor, obtained by reverse engineering methods, in several mammalian genomes. Highly conserved regions are identified by pattern discovery. Finally DNA binding sites are inferred from these regions using a standard Position Weight Matrices (PWM) discovery algorithm. By framing the identification of the PWM as an optimization problem over the two parameters of the method, we are able to discover known binding sites for several genes and to propose reasonable signatures for genes that have not been previously characterized.
Preoperative BRAF(V600E) mutation screening is unlikely to alter initial surgical treatment of patients with indeterminate thyroid nodules

BACKGROUND: Preoperative B-type Raf kinase Val600Glu mutation, or BRAF(V600E), analysis has been proposed as a tool to guide initial surgery for indeterminate thyroid nodules. This study sought to determine if cytologic markers of malignancy are associated with the BRAF(V600E) mutation and if preoperative BRAF(V600E) testing would alter the initial management of patients with indeterminate nodules. METHODS: Patients who underwent surgery for a thyroid nodule between 2003 and 2012 at a tertiary care center were prospectively enrolled. Stored nodule samples were retrospectively genotyped for the BRAF(V600E) mutation. BRAF(V600E) status, demographics, cytologic and histopathologic findings, and choice of initial surgery were examined. RESULTS: A total of 960 patients were enrolled, of which 310 (32%) had an indeterminate nodule. The BRAF(V600E) mutation was identified in 13 patients (4%), 12 of whom had either cytologic atypia or were Bethesda category V. Three percent of Bethesda category III or IV nodules that were malignant harbored the mutation compared with 42% of Bethesda category V malignancies. Nuclear grooves (P = .030), pseudoinclusions (P < .001), and oval nuclei (P = .022) were all more common among BRAF(V600E) mutants. The sensitivities of using BRAF testing alone, cytologic atypia/Bethesda category V classification, or both, were 15%, 73%, and 76%, respectively. Twelve of the 13 BRAF(V600E) mutants had total thyroidectomies initially due to worrisome cytologic features, and therefore the initial management of only one patient would have been altered if BRAF(V600E) testing had been performed preoperatively. CONCLUSIONS: Preoperative mutation screening for BRAF(V600E) does not meaningfully improve risk stratification and is unlikely to alter the initial management of patients with indeterminate nodules. Cancer 2013. © 2012 American Cancer Society.