cssi/SciSciGPT-SciSciNet huggingface dataset:
Melanomas detected with the aid of total cutaneous photography.

Summary Background Early detection of melanoma results in excision of thinner melanomas, which are associated with better prognosis. Total cutaneous photography provides a temporal comparison of lesions, which allows clinicians and patients to recognize new and subtly changing lesions. Objectives We examined the utility of total cutaneous photography in detecting melanoma, identified the reason for biopsy of suspicious lesions and determined who detected new melanomas, the physician on follow-up examination or the patient on self-examination. Patients/methods The charts of the 576 patients in the total cutaneous photography database were reviewed. Twelve patients were identified who had melanoma diagnosed with photographic assistance. Baseline and prebiopsy photographs, dermatology clinic notes (115 patient visits) and pathology reports for each biopsied lesion were reviewed. Histological diagnosis, cause for biopsy, and whether the lesion was detected by the patient or physician, was recorded for each of the biopsied lesions. Also noted were all the lesions that concerned patients, the cause for concern, and whether these lesions were biopsied. Results A total of 93 lesions were biopsied in these patients. Twenty-seven (35%) of 77 melanocytic lesions were histologically diagnosed as melanoma. The thickest melanoma found measured 1·1 mm, indicating a favourable prognosis in our patients. Seventy-four per cent of the melanomas were biopsied due to changes from baseline and 19% were biopsied because they were new lesions. The changes noted were subtle and the lesions that proved to be melanoma did not satisfy the classical clinical criteria for melanoma. Eight (30%) of the melanomas were identified by patients on skin self-examination. Twenty-six per cent of the lesions that concerned patients were not biopsied after evaluation by a physician. Conclusions We found that photographically assisted follow-up helped detect new and subtly changing melanomas, which did not satisfy the classical clinical features of melanoma. In addition, photographically assisted follow-up helped detect nonmelanoma skin cancers. Patient skin self-examination proved to be valuable, in that it complemented physician follow-up examination in detecting melanomas. Photographic follow-up was also valuable in avoiding unnecessary biopsy in suspicious, but stable lesions. Total cutaneous photography therefore may be an effective way to increase the sensitivity and specificity for detecting melanoma.
Analysis of charge pump phase locked loop in the presence of loop delay and deterministic noise

Rigorous math is provided in this paper to obtain the transfer function of a charge pump phase locked loop (CPLL). The math clearly explains when and how the impulse invariant transform based method works and corrects its errors in some cases. The loop transfer function is then used for loop stability evaluation and jitter calculation. It is shown that the loop stability can be improved by increasing loop gain and loop delay, revealing a counterintuitive application of loop delay, i.e., a loop delay can be used to speed up phase locking process. As for the jitter calculation, a closed form expression is derived to predict the output jitter due to deterministic input noise.
Prognostic indicators of hepatic injury following jejunoileal bypass performed for refractory obesity: a prospective study.

To evaluate factors predisposing to liver injury following jejunoileal bypass, 27 patients underwent clinical evaluation and liver biopsy prior to bypass and at 3, 6, 12, 18, and 24 months and yearly thereafter. Nineteen patients developed increased fatty infiltration of the liver, 1 developed cryptogenic cirrhosis, and 7 developed steatonecrosis, central hyaline sclerosis, or cirrhosis indistinguishable from alcoholic liver disease during the period of rapid weight loss. Two of these 7 patients developed clinical liver failure; inactive cirrhosis evolved after parenteral alimentation and reanastomosis in one, and after oral nutritional supplementation in the other. Four of 5 asymptomatic patients resolved to inactive cirrhosis as weight loss diminished. Each of the 7 patients had pericentral fibrosis on pre-bypass liver biopsies, suggesting a previous hepatic injury. These patients were older (p < 0.02) and, 3 months following bypass, had greater cumulative per cent weight loss (p < 0.05), higher levels of serum aspartate aminotransferase (p < 0.005), and greater 45-min bromosulfophthalein retention (p < 0.02). Histologic evidence of pericentral fibrosis identified patients at risk to develop steatonecrosis and cirrhosis; these lesions occurred in older patients who had greater weight loss following jejunoileal bypass.
The influence of Prosopis canopies on understorey vegetation: Effects of landscape position

Abstract The influence of canopy trees and shrubs on understorey plants is complex and context-dependent. Canopy plants can exert positive, negative or neutral effects on production, composition and diversity of understorey plant communities, depending on local environmental conditions and position in the landscape. We studied the influence of Prosopis velutina (mesquite) on soil moisture and nitrogen availability, and understorey vegetation along a topographic gradient in the Sonoran Desert. We found significant increases in both soil moisture and N along the gradient from desert to riparian zone. In addition, P. velutina canopies had positive effects, relative to open areas, on soil moisture in the desert, and soil N in both desert and intermediate terrace. Biomass of understorey vegetation was highest and species richness was lowest in the riparian zone. Canopies had a positive effect on biomass in both desert and terrace, and a negative effect on species richness in the terrace. The effect of the cano...
Robust approach to channel estimation and detection for OFDM systems

A robust channel estimation and detection scheme has been developed that explicitly accounts for channel estimation error by optimising the worst-case performance over a properly selected bounded uncertainty set. Numerical results show improved performance using the proposed robust approach over the one that ignores the prior estimation errors.
Drama as literacy: perceptions of an interactive pedagogy

When I look back on my early years as a teacher, I think I went into survival mode without even realising it. I was trained as an actor. Theatre in all its forms was and is part of who I am, and I ...
Biology of the brachyuran crab Pinnixa chaetopterana Stimpson (Decapoda: Pinnotheridae) symbiotic with tubicolous polychaetes along the Atlantic coast of the United States, with additional notes on other polychaete associations

ABSTRACT The pinnotherid crab Pinnixa chaetopterana inhabits marine polychaete tubes (e.g., Amphitrite ornata and Chaetopterus variopedatus) along the Atlantic and Gulf of Mexico coasts of the United States. This crab occurred in 58.5% of Amphitrite tubes in New Jersey. The polychaete Lepidametria commensalis was found in 64.6% of Amphitrite tubes, often (41.7%) with the crab. In North Carolina, the occurrences of P. chaetopterana and the porcellanid crab Polyonyx gibbesi in Chaetopterus tubes were 69.1% and 30.9%, respectively. In addition, juveniles of the pinnotherid Tumidotheres maculatus occurred with 13.6% of these worms, nearly all (95.1%) of which were in tubes with P. chaetopterana. In Florida, 82.6% of Chaetopterus tubes harbored crabs, but P. gibbesi was dominant with a prevalence of 79.7% versus 2.9% for P. chaetopterana. The tubes of other species of polychaetes and bivalve burrows, however, were used as habitats by the pinnixid. The pinnixid crabs living with Amphitrite were significantly sm...
Impact of Grazing and Desertification in the Chihuahuan Desert: Plant Communities, Granivores and Granivory

Abstract Livestock effects on plant communities through overgrazing (desertification) should affect the structure and functioning of semarid rangeland communities. We measured plant, granivorous ant and rodent communities and rates of seed removal by rodents and ants in grazed (by livestock) and ungrazed desert grasslands as well as mesquite and creosotebush shrublands to test hypotheses on the effects of grazing and desertification on ecosystem structure and functioning. In desert grasslands grazing reduced the cover of perennial grasses, particularly the dominant Bouteloua eriopoda, but the cover of forbs and shrubs did not differ between treatments. One species of perennial grass, Dasyochloa pulchellum, increased in grazed grasslands compared with grassland exclosures. Detrended correspondence analysis showed that grazing caused desert grasslands to shift in community structure towards the shrublands. There were more seed harvesting ant and rodent species in the creosotebush shrublands than in the gras...
Definitive airway management in emergency department patients with a King laryngeal tube™ in place: a simple and safe approach.

To the Editor, We thank Dr. Dodd et al. for their interest in our manuscript and sharing their experience. They describe an alternate, equally safe, controlled technique using a video laryngoscope-guided exchange with excellent results. We agree that a video laryngoscope-guided technique has the advantage of familiarity and simplicity. During the time of our study, however, video laryngoscopy was still being introduced into clinical practice. In our report, we also described a safe technique for exchanging the King LT(S)D laryngeal tube (King LT) for a standard endotracheal tube utilizing an Arndt exchange catheter. The circumstances surrounding King LT use (e.g., suboptimal conditions encountered in the field, venous and lymphatic compression resulting from the oropharyngeal cuff, duration of use) contribute to airway edema. Given our patient’s demographics and location, considerable time may have elapsed during transport prior to definitive airway management, possibly resulting in a greater degree of airway edema influencing the final technique. No one technique has been shown to be superior in making this exchange. Given patientand case-specific variables, available equipment and experience, and comfort and experience of the bedside clinicians, it is prudent to have multiple techniques and options available when exchanging a King LT, two of which are described in this commentary.
Fiber type as compared to wavelength may contribute more to improving postoperative recovery following endovenous laser ablation

Objective To define the relative importance of fiber type as compared to laser wavelength on tissue injury depth, postoperative pain, and bruising during endovenous laser ablation. Methods This study included 213 limbs that were treated with an 810-, 980-, or 1470-nm laser, with bare-tip (BT) or jacket-tip (JT) fibers. Pain scores (10-point scale) and bruising scores (5-point scale) were recorded. Tissue thermal injury depth (mm) was evaluated in vitro for the 810- and 1470-nm wavelengths with BT and JT fibers. Results The JT fibers had lower pain scores as compared to the BT fibers at 810 nm (1.69 ± 1.77 vs 3.70 ± 1.34; P P P P P P = .015), and with JT fibers, a similar result trended toward significance (1.14 ± 1.06 vs 1.69 ± 1.77; P = .057). The 980-nm JT fiber showed less bruising as compared to the 810-nm JT fiber (0.89 ± 1.06 vs 1.42 ± 1.19; P = .019). Similarly, the 1470-nm JT fiber showed less bruising as compared to the 810-nm JT fiber (0.94 ± 1.02 vs 1.42 ± 1.19; P = .038). The in vitro study showed thermal injury depths that were less for 1470 nm as compared to 810 nm, with JT fibers (0.20 ± 0.16 mm vs 0.36 ± 0.26 mm; P = .013) or with BT fibers (0.71 ± 0.31 mm vs 1.05 ± 0.34 mm; P =.001). All mean differences between JT and BT fibers were greater than between differing wavelengths. The multivariate analysis for the in vitro study showed a mean difference between 1470 nm and 810 nm of 0.26 mm, P P Conclusions The use of a JT fiber appeared to be more significant in reducing pain and bruising as compared to a longer wavelength. Moreover, the results appeared additive, and the cohort using 1470 nm with a JT fiber produced the best treatment outcomes. Additional study is required to confirm the efficacy and durability of the various iterations evaluated; however, these data should be taken into consideration when undertaking treatment with endovenous laser ablation.
Furocuomarin Photosensitized Reactions With Fatty Acids

We have found that furocoumarins illuminated with near ultraviolet light form covalent adducts with unsaturated fatty acids. Typically 4mM 4,5′,8-trimethylpsoralen (tmPso) and 20mM oleic acid methyl ester (OAME) were mixed in ethanol and illuminated at a distance of 2 cm in a 1 cm pathlength glass test tube with a bank of four General Electric F1578 BLB fluorescent lamps having a light flux of 25 Jm−2s−1 and maximum emission at 360 nm. Aliquots of the reaction mixture were injected into a C-18 reverse phase HPLC column and eluted with Acetonitrile/ Water (90:10 v/v). The absorbance of the eluent was monitored with a Hewlett-Packard diode array detector. Four product peaks with HPLC retention times longer than the parent fatty ester were detected for the irradiated mixture. The exact masses of 524.3512 and 524.3510, observed by mass spectrometry for the two photoproducts formed in highest yield, are in excellent agreement with 524.3502 calculated for C32H48O5, the sum of the empirical formulas of TMP and OAME.
Differences in GH secretion from individual somatotropes in rats genetically selected for fast and slow growth

A reverse hemolytic plaque assay was used to examine effects of selection for fast (F) and slow (S) growth on growth hormone (GH) secretion by individual somatotropes. Anterior pituitaries (AP) from 32 male Charles River CD strain rats selected for F and S growth for 20 generations were used. Four rats per line were used at 4, 6, 8, or 10 wk of age. Body weight (P < 0.0001) of F rats was greater compared with S rats. AP (P < 0.05) were heavier at 8 and 10 wk of age in F compared with S line rats. Percentages of GH-secreting cells were unaffected by age (range = 32.7-35.5%) and line [F = 33.1 +/- 1.2% (SE) vs. S = 34.5 +/- 1.2%] or by human GH-releasing factor (hGRF). At 8 and 10 wk, mean plaque-forming area was greater (P < 0.0001) in F compared with S rats under both nonstimulated (2,704 +/- 202 vs. 1,648 +/- 202 microns2) and hGRF-stimulated secretion (4,503 +/- 202 vs. 2,682 +/- 202 microns2). Results indicate that differences in growth observed in the two lines may be due to a greater secretory capacity of individual somatotropes rather than to a greater percentage of somatotropes or sensitivity of somatotropes to secretagogue.
Quantitative DC and High Frequency AC Seismoelectric Measurement on Berea Sandstone

Summary In brinesaturated rock, the existence of mobile charge within a thin layer along the fluidsolid interface, which is known as electric double layer (abbreviated as EDL) leads to electrokinetic phenomena. DC streaming potential is the electric potential induced by the fluid flow under constant pressure across a fluid filled porous rock. The alternating electric field induced by an acoustic wave propagating through the porous rock is the so called seismoelectric signal. In this paper, we present quantitative AC seismoelectic measurement at high frequencies (10 kHz to 120 kHz) on Berea sandstone 500 (BS500) rock samples. In a solution tank, we measure the seismoelectric signals induced by acoustic waves at 10kHz to 120 kHz on BS500 plate saturated with 0.01S/m to 0.4S/m NaCl brines. We use single sine pulse as the acoustic source wavelets. Received acoustic and electric signals are analyzed in both time domain and frequency domain. DC streaming potential is also measured on BS500 cylinders with the same brine saturations as in AC experiments. Given the BS500 rock 3CT image and experiment measurements, we can quantify the porosity, permeability, tortuosity and Λ parameter. The frequency dependence of the coupling coefficient with respect to its DC limit is calculated theorectically using Pride's model. The majority of the measured AC seismoelectric voltage coupling coefficient follows the trend predicted by Pride's model. The high frequency, high pressure transient and wavelet techniques presented in this work extend our ability to conduct quantitative SE measurements at acoustic borehole logging frequencies applied in the field and laboratory.
Rapid production of reconstruction drawings from serial sections.

A method of preparing reconstruction drawings from serial histologic sections is described. Areas to be reconstructed are projected and the tissue components of interest traced. The tracings are transferred laterally onto grid lines which represent the plane of each section. The completed image is made by connecting the components of structures on adjacent lines. The procedure requires but little special equipment and is rapid, versatile and easily learned.
Shape-Controlled Metal-Metal and Metal-Polymer Janus Structures by Thermoplastic Embossing.

We report the fabrication of metal–metal and metal–polymer Janus structures by embossing of thermoplastic metallic glasses and polymers. Hybrid structures with controllable shapes and interfaces are synthesized by template-assisted embossing. Different manufacturing strategies such as co-embossing and additive embossing are demonstrated for joining the materials with diverse compositions and functionalities. Structures with distinct combinations of properties such as hydrophobic-hydrophilic, opaque-transparent, insulator-conductor, and nonmagnetic-ferromagnetic are produced using this approach. These anisotropic properties are further utilized for selective functionalization of Janus structures.
The Origins of American Land-Grant Railroad Rates

The pragmatic origins of government policy toward business are well illustrated in this study of the reduced-rate provisions granted to certain American railroads during the 19th century.
Optimal Operation for Community-Based Multi-Party Microgrid in Grid-Connected and Islanded Modes

Microgrid is regarded as the future power system configuration, which can be operated by connecting to the bulk power grid, as well as in stand-alone mode for serving microgrid loads during failures of upstream grid. This paper proposes a business model for operating the community-based multi-party microgrid, which involves critical loads and generators of multiple owners. Different from most operational microgrids with single owner of critical loads and on-site generators, the community-based multi-party microgrid discussed in this paper presents different structure and thus unique operating goals. An iterative bi-level model is proposed to simulate the interaction between the community microgrid operator (named as mini-ISO) and multiple parties for deriving good enough market clearing results during the microgrid’s normal operation status. On the other hand, a centralized energy management model is proposed to simulate the microgrid operation during major disruption events with limited generation resources and competing needs from multiple owners’ critical loads. Numerical simulations evaluate the effectiveness of the proposed operation framework for the community-based multi-party microgrid.
Detection of influenza-like illness in Nanshan District of Shenzhen City from 2010 to 2013

Objective To analyze the variation of influenza virus in Nanshan District of Shenzhen City from 2010 to2013.Methods The throat swab of influenza like illness(ILI) patients were collected in Nanshan Hospital weekly, theInfluenza virus were isolated and identified using Madin-Darby canine kidney(MDCK) continuous cell line. The cell culturemedium were collected for hemagglutination test, and the positive samples were subsequently detected by hemagglutinationinhibition test(HI test) for pathogen identification. Results A total of 246 Influenza virus strains were isolated from 1 028 ILIcases from 2010 to 2013 and the positive rate was 23.9%. In 2010, the positive rate was 22.3%(59/264) including 9 H1N1virus strains, 35 new H1N1 strains, 5 H3N2 strqains and 10 BV strains. In 2011, the positive rate was 23.3%(57/245)including 20 new H1N1 strains, 35 BV strains and 2 BY strains.In 2012, the separating positive rate was 20%(52/260), whichconstituted of 35 H3N2, 1 new H1N1, 13 BV, and 3 BY strains; In 2013, the positive rate was 30.1%(78/259) including 27H3N2 strains,33 new H1N1 strains, and 18 BY strains showing significant statistically difference among years(χ2=8.0725,P0.05). Conclusions The positive rate of influenza virus in 2013 was higher than the average detection rate in 2010-2012.The dominant strains responsible for influenza epidemic were new H1N1, H3N2 and B strains. Influenza B virus hadtransformed from B Victoria to B Yamagata mainly prevalent at the end of winter and the beginning of spring, as well as the endof summer and the beginning of autumn.
Intravascular clotting after endotoxin in rabbits with impaired intrinsic clotting produced by a factor VIII antibody.

A rabbit model in which intrinsic clotting was selectively impaired by injection of a human factor VIII antibody was used to evaluate the mechanism of endotoxin-induced intravascular clotting in cortisone-treated rabbits. Three groups of animals were studied: a control group given factor VIII antibody followed by saline; a second control group given an inert material followed by endotoxin; and an experimental group given factor VIII antibody followed by endotoxin. The following parameters were measured: 125 I-fibrinogen kinetics, fibrinogen levels, factor VIII, factor VII, factor V, WBC, platelets, and hematocrit. The kidneys were examined for deposition of fibrin. Mean values for factor VIII at the time of injection of the second test material and mean values for fibrinogen consumed in the 6 hr after the second injection were as follows: antibody-saline group, 8.5% and 11.0 mg/kg; control material-endotoxin group, 90% and 29.6 mg/kg; and antibody endotoxin group, 7.0% and 32.7 mg/kg. Factor V, factor VII, granulocytes, and platelets fell in both groups of animals given endotoxin. One animal in each group given endotoxin developed gross renal cortical necrosis. These data establish that selective impairment of the intrinsic clotting reactions does not reduce the amount of clotting induced by a single injection of endotoxin in the cortisone-treated rabbit.
Spatial and temporal patterns of drought in the Continental U.S. during the past century

This study investigates the spatial and temporal patterns of multiple drought characteristics (duration, severity, and intensity) under different return periods during 1900–2012 in the Continental U.S. (CONUS). We find two significant patterns: Pattern I shows persistent droughts in western and eastern U.S. and the Great Plains, which experienced large variations in the drought characteristics over long time; Pattern II shows transient droughts in the interior of CONUS, which experienced short-term variations in drought characteristics. Trend analysis shows that duration, severity, and intensity of droughts under the various return periods are increasing in most of the Pattern I regions. Moreover, spatial distributions of duration, severity, and intensity of more frequent and less severe drought events are found to be different from those of less frequent and more severe droughts in the same time period; trends in these drought characteristics at long and short return periods are different at some locations, showing the different trends of extreme and mild droughts.
Oxytocin-mediated recruitment of slowly cycling cross bridges and isometric force in rat myometrium

The relationship between cross-bridge cycling rate and isometric stress was investigated in rat myometrium. Stress production by myometrial strips was measured under resting, K+ depolarization, and...
Boron and Methionine Status of the Rat Affects the Plasma and Bone Mineral Response to High Dietary Aluminum

Aluminum toxicity in humans with chronic renal failure has been associated with dialysis osteomalacia syndrome. Recent findings from our laboratory suggest that boron affects calcium metabolism and bone mineralization. Two experiments were done simultaneously to ascertain whether dietary boron or magnesium affects the response of rats to high dietary aluminum, and whether the response is influenced by methionine status.
A TWO-PHASE NETWORK DESIGN HEURISTIC FOR MINIMUM COST WATER DISTRIBUTION SYSTEMS UNDER A RELIABILITY CONSTRAINT

This paper presents a two-phase design and optimization procedure for constructing a pipe network water distribution system having a built-in degree of reliability. The first phase is comprised of an algorithm called TREESEARCH which iteratively constructs a tree pipe network. Starting with a shortest-path based tree, the procedure employs a linear programming subproblem to systematically modify this tree by adding and deleting one link at a time, with the aim of reducing the cost of the network while satisfying the flow continuity, energy balance, and pressure head requirement constraints. The second phase of the algorithm, called REDUNDANCY, is concerned with the issue of reliability. In this phase, the tree network constructed by the algorithm TREESEARCH is augmented through the addition of links so that there are at least two arc-disjoint paths from each source node to every demand node it serves. This augmentation is performed through the use of a set covering problem which recommends the links to be...
Addressing Health Disparities via Coordination of Care and Interprofessional Education: Lesbian, Gay, Bisexual, and Transgender Health and Oral Health Care

Lesbian, gay, bisexual, and transgender (LGBT) persons are a diverse group, but they share a common need for competent, accessible health care, dispensed without intolerance and with an understanding of their unique health needs. Dental practitioners need to understanding that LGBT persons have distinctive health (and oral health) needs. This article reviews the literature on oral and overall health of LGBT persons in the United States, and discusses ways in which dentists can improve the health care they provide to this vulnerable population, including how interprofessional education and collaborative practice may help to reduce oral health disparities within this group.
Flipping Other Areas

This chapter contains case studies from nontraditional content areas. Three case studies showcasing a flipped approach in three vastly different subject areas all emphasize a collaborative approach to problem solving. Like several of the case studies previously mentioned, these cases operate in a constructivist, student-centered environment. In-class activities replicate the workings of real-world settings and instructors use Gagne’s nine events of instruction theory to design and develop collaborative out of and in-class activities. Each case study opens with the instructional context and a rationale for flipping the classroom. The case-study authors also describe the structure of the course, as well as descriptions about how they prepared their students for flipping, and an evaluation of the flipping experience from both the instructor and student perspectives.
Advancing the Sociology of Empathy: A Proposal

Empathy is an increasingly popular term in the public sphere and in academia. Although the common belief is that empathy is a “psychological” topic, sociologists have made important contributions to this conversation. The goal of this article is to provide a theoretical effort in advancing the sociology of empathy. In the first part of the paper, I review classical and contemporary statements on empathy. I identify Charles H. Cooley as an important precursor of the sociology of empathy, and discuss how contemporary interactionists have further developed this notion. Based on these previous insights, I next propose a preliminary framework for the study of the social construction of empathy. This framework is presented in two steps. First, I introduce a vocabulary based on interpretivist concepts: empathy frames, empathy rules, and empathy performances. Next, I coin the idea of empathy paths. I theorize three ideal-typical empathy paths: self-transcendent, therapeutic, and instrumental. Throughout this presentation, I use empirical cases to illustrate the applicability of this framework. In the conclusion, I show how sociologists can inform public understandings of the meaning of empathy.
Energy-Transducing Components in Mitochondrial Respiration1

Publisher Summary This chapter discusses the energy-transducing components in mitochondrial respiration. The chapter discusses the application of the thermodynamic approach to the energy transduction processes and the design of experimental procedures that can be used to identify energy-transducing components. The experimental technique developed by Dutton and co-workers can be used to measure the half-reduction potentials of components in a “potential clamped” system not only in the “low energy” state (uncoupled) mitochondria, but also in coupled mitochondria in the “high energy” state (under the influence of a high phosphate potential). In mitochondria in state 4, the estimated oxidation-reduction potentials of each of the components in a group is very close to that for all other members of the group and thus, the components may be regarded as being essentially in equilibrium. The respiratory chain may be thought of as a series of iso-potential groups of components with energy conservation associated with electron transfer between these groups
Ventilator-Associated Pneumonia: The Role of Emerging Diagnostic Technologies.

Antibiotic resistance has emerged as a key determinant of outcome in patients with serious infections along with the virulence of the underlying pathogen. Within the intensive care unit (ICU) setting, ventilator-associated pneumonia (VAP) is a common nosocomial infection that is frequently caused by multidrug-resistant bacteria. Antimicrobial resistance is a growing challenge in the care of critically ill patients. Escalating rates of antibiotic resistance add substantially to the morbidity, mortality, and cost related to infection in the ICU. Both gram-positive organisms, such as methicillin-resistant Staphylococcus aureus and vancomycin-intermediate S. aureus, and gram-negative bacteria, including Pseudomonas aeruginosa, Acinetobacter species, carbapenem-resistant Enterobacteriaceae, such as the Klebsiella pneumoniae carbapenemase–producing bacteria, and extended spectrum β-lactamase organisms, have contributed to the escalating rates of resistance seen in VAP and other nosocomial infections. The rising rates of antimicrobial resistance have led to the routine empiric administration of broad-spectrum antibiotics even when bacterial infection is not documented. Moreover, there are several new broader-spectrum antibiotics that have recently become available and others scheduled for approval in the near future. The challenge to ICU clinicians is how to most effectively utilize these agents to maximize patient benefits while minimizing further emergence of resistance. Use of rapid diagnostics may hold the key for achieving this important balance. There is an urgent need for integrating the administration of new and existing antibiotics with the emerging rapid diagnostic technologies in a way that is both cost-effective and sustainable for the long run.
Pediatric Resident Training in Prepubertal Vulvar Conditions.

Abstract Study Objective To assess pediatric resident training in diagnosing and managing prepubertal gynecologic conditions. Design Voluntary 32-question survey e-mailed to participants. Setting E-mail contact through the American Academy of Pediatrics listserv. Participants Seven thousand seventy-five US pediatrics and combined internal medicine-pediatric residents. Interventions Descriptive analysis including χ2 tests was performed on survey results. Main Outcome Measures Residents' training experiences and comfort, confidence, and knowledge in evaluating pediatric gynecologic concerns. Results In the 866 of 7075 (12%) completed surveys, a greater proportion of residents reported they were “very” or “extremely” comfortable talking to parents about general pediatric topics compared with gynecologic topics (88.5% vs 30.4%; P Conclusion Our findings suggest that pediatric residents are lacking in comfort, confidence, and knowledge of prepubertal vulvovaginal conditions, especially compared with general pediatric topics. Although this improves during training, it remains low, and more education is indicated and desired by residents.
Direct Estimation of Density Functionals Using a Polynomial Basis

A number of fundamental quantities in statistical signal processing and information theory can be expressed as integral functions of two probability density functions. Such quantities are called density functionals as they map density functions onto the real line. For example, information divergence functions measure the dissimilarity between two probability density functions and are useful in a number of applications. Typically, estimating these quantities requires complete knowledge of the underlying distribution followed by multidimensional integration. Existing methods make parametric assumptions about the data distribution or use nonparametric density estimation followed by high-dimensional integration. In this paper, we propose a new alternative. We introduce the concept of “data-driven basis functions”—functions of distributions whose value we can estimate given only samples from the underlying distributions without requiring distribution fitting or direct integration. We derive a new data-driven complete basis that is similar to the deterministic Bernstein polynomial basis and develop two methods for performing basis expansions of functionals of two distributions. We also show that the new basis set allows us to approximate functions of distributions as closely as desired. Finally, we evaluate the methodology by developing data-driven estimators for the Kullback–Leibler divergences and the Hellinger distance and by constructing empirical estimates of tight bounds on the Bayes error rate.
Examining Hookah as an Introduction to Nicotine Products among College Students.

Background: Limited data exist on what young adults report as their first-ever nicotine product; some evidence suggests that they report hookah as their first product smoked. Objectives: This study...
Description of the Tl, Pb and Bi Cuprate High-Tc Superconductors (HTSC’s) as Intercalation Compounds and Classification of all HTSC’s According to Doping Mechanism

After an initial period of rapid growth during 1987 and 1988, the number of known ceramic HTSC phases is presently increasing only slowly and may be close to having reached a stable plateau. Cataloguing these phases at this time is useful for their understanding and to find directions for further development.
λ 4097.3 N iii emission in the chromospheric spectrum

The recent tentative identification of a chromospheric emission line at λ⊙ = 4097.342 A with the Niii transition 3s2S1/2 $#x2212; 3p2P∘3/2 is discussed. It is shown that the observed intensity is inconsistent with the observed flux in the XUV resonance lines and considerably greater than the predicted intensity from the chromosphere-corona transition zone. Microphotometry of a plate shows that the ‘line’ is a short interval of continuum between absorption lines.
Games, Risk and Uncertainty

This chapter provides an intuitive review of game theory models. These models provide a logical foundation to solve decision problems when “what we do and what others do” depend and affect all parties—each party with its own agenda. Game theory is thus a logical expression of a more complex rationality than the one we used when we consider only one decision maker. This chapter provides and elementary overview of games and their solutions, emphasizing issues of strategic risks. Examples are used to illustrate the solution of some games.
Direct Bonding Silver to Aluminum Using Eutectic Reaction in Air

The high thermal conductivity, light weight, and low cost of aluminum (Al) make it a promising substrate material for high power electronic packaging. Recently, direct bond aluminum (DBA) substrate has received significant attention as a possible alternative to direct bond copper (DBC) substrate which seems to have thermal cycling reliability issues. A main challenge of using aluminum substrates in electronic packaging is the poor bondability. The native aluminum oxide layer prevents aluminum from forming bonding with die-attach materials or metallization layers. Thus, zincating process is required to dissolve the aluminum oxide and deposit a protective layer of zinc, which provides a basis for subsequent metallization. In this research, Ag-Al eutectic bonding has been developed as a novel bonding technique to direct bond Ag to Al substrate. The shear strength of the Ag-Al joints passes military criterion (MIL-STD-883H method 2019.8) with a large margin. SEM and TEM analyses were utilized to study the microstructures in details. The results reveal that eutectic structure of Ag2Al and (Al) phase forms at the Ag/Al bonding interface. A uniform Ag2Al compound layer was observed between the eutectic structure and Ag region, with no Ag3Al compound detected. In the Ag-Al eutectic reaction process, the aluminum oxide layer was broken into pieces and dispersed into the eutectic structure region. To investigate the fracture modes of Ag-Al eutectic joints, the fracture surfaces of Ag-Al joints were evaluated after the shear test. The fracture surfaces correspond to a typical ductile fracture with plastic deformation and drawing matrix. An application of this new technique is to bond Ag foils to Al substrates and make them bondable to die-attach materials such as solders and nano-silver paste. At a more advanced level, device chips can be bonded to the Ag foil on Al substrates at 300 °C using solid state bonding technique. This foil bonding application provides an alternative to the zincating and metallization processes on aluminum substrates. Other potential applications include making Al surfaces easier to blaze to other metals such as brass and copper.
Obesity-Hypertension Physiopathology and Treatment: A Forty-Year Retrospect

During the past 40 years of research into obesity, hypertension, and chronic kidney disease, we have gained considerable knowledge on the effects of excess weight gain to alter numerous metabolic and hormonal processes, which can ultimately result in type 2 diabetes, hypertension, cardiovascular disease, and chronic kidney failure. Over this span of time, we have witnessed the naming of these metabolic and hormonal alterations as a new condition, the Metabolic Syndrome. Additionally, we have noted that hypertension in obesity appears to have some unique differences to essential hypertension in the normal weight population, and have preferred the term Obesity-Hypertension in our description of this process. The obesity epidemic worldwide has continued to surge unabated resulting in the search for new ways to reduce body weight by dietary means, pharmaceutical means, and surgical intervention. This review will focus on an overview of this condition from insights gained over the preceding 40 plus years of research and clinical experience in this field, with an emphasis on Obesity-Hypertension and therapeutic options.
The moral fabric of linguicide: un-weaving trauma narratives and dependency relationships in Indigenous language reclamation

ABSTRACTIn Therapeutic Nations, Dian Million highlights the complicated role that neoliberal arenas like the Truth and Reconciliation Commission (TRC) and international dialogues concerning human r...
Capacity Constraints and Horizontal Merger Effects

This article examines how capacity constraints affect horizontal mergers. Binding capacity constraints for merging firms may mitigate merger price effects, but capacity constraints for nonmerging f...
Anticancer Drug Development from Cyanobacteria

More than 50 % of the marine cyanobacteria are potentially exploitable for extracting bioactive substances, which are effective in killing the cancer cells. Cyanobacterial metabolites exhibit a wide range of biological effects and some of these metabolites possess potential cytotoxic activities to different mammalian cell lines. The various cyanobacterial compounds with potential anticancer properties and their cytotoxicity are discussed in this chapter. Cyanobacteria also produce a wide range of compounds that revealed apoptotic properties. Potential cyanobacterial compounds with apoptotic properties and their use as drug delivery system with cellular targets are also discussed.
Training an Interactive Helper.

Developing agents that can quickly adapt their behavior to new tasks remains a challenge. Meta-learning has been applied to this problem, but previous methods require either specifying a reward function which can be tedious or providing demonstrations which can be inefficient. In this paper, we investigate if, and how, a "helper" agent can be trained to interactively adapt their behavior to maximize the reward of another agent, whom we call the "prime" agent, without observing their reward or receiving explicit demonstrations. To this end, we propose to meta-learn a helper agent along with a prime agent, who, during training, observes the reward function and serves as a surrogate for a human prime. We introduce a distribution of multi-agent cooperative foraging tasks, in which only the prime agent knows the objects that should be collected. We demonstrate that, from the emerged physical communication, the trained helper rapidly infers and collects the correct objects.
The Role of Cardioselective versus Non-Cardioselective Beta-Adrenergic Blockade in the Acute Phase of Takotsubo Cardiomyopathy

Background Takotsubo cardiomyopathy (TC) has been associated with hyperactivation of sympathetic nervous system leading to transient left ventricular (LV) dysfunction following acute emotional or physical stress. There are no controlled studies or guidelines on how to treat TC and its therapy remains empirical. We aim to study the effects of cardioselective versus non-cardioselective beta-adrenergic blockade on LV recovery in follow-up transthoracic echocardiographic studies in patients with newly diagnosed TC. Methods We performed retrospective chart review analysis of all patients who were admitted to Bronx-Care Health System from January 1, 2007 through December 31, 2017 with the diagnosis of TC. All cases of TC who presented with acute coronary syndrome and angiogram showing apical ballooning with preserved base of the heart were included. We excluded significant coronary artery disease, prior known cardiomyopathy, suspicion of any myocarditis and recent head trauma or intracranial hemorrhage. Primary outcome variables included improvement in LV end-diastolic and end-systolic volumes, LV ejection fraction as well as degree of LV wall motion abnormalities improvement from the baseline transthoracic echocardiography with use of either cardioselective or non-cardioselective beta-adrenergic antagonists. The secondary outcomes included morbidity and mortality including all-cause and HF readmission in 30 days as well as mortality at 6 and 12 months. Results Of the 2010 patients admitted with acute coronary syndrome and underwent coronary angiogram, 60 patients (2.98%) were found to have TC. The mean age for TC patients was 62 (±16) years with more females (75%) than males. Urine drug screen was positive in 38% of our population and 6% had HIV disease. The average BMI in our study subject was 23.54 KG/M2 which was observed 19.45 KG/M2 in subjects with positive drug screen (p value= 0.0213). Beta-blocker was used in 83% of the cases with 63% were on cardioselective beta-adrenergic blockade and 27% were on non-cardioselective beta-adrenergic blockade. The relationship observed between echocardiographic parameters and type of beta-adrenergic blockade did not differ. The 30-day readmission rate and all-cause mortality were found to be similar in both groups. Positive urine drug screen was not associated with 30-day readmission and all-cause mortality in TC. (p value= 0.262) Conclusions Use of Beta-adrenergic blockers did not show any improvement in echocardiographic parameters in TC. It was not associated with improved adverse outcomes such as 30-day readmission rate and all-cause mortality in TC. The study challenges the proposed role of beta-blockers in improving outcomes in patients with TC.
Guns for the Government: Ordnance, the Military “Peacetime Establishment,” and Executive Governance in the Early Republic

During the 1810s and 1820, officials in the War Department engaged in military state building, which transcended partisanship and contributed to the development of executive autonomy. The process revealed the ability of the executive to shape national security, while also foreshadowing Progressive Era trends toward expertise-based bureaucratic autonomy. The activities of the Ordnance Department suggest that the connection between war and early American state building was forged in the efforts to bolster the armaments industry. Ordnance officers established autonomy partly through arms expertise, and they were not necessarily coalition builders like the late nineteenth-century Post Office and Department of Agriculture bureaucrats, especially because they generated more hostility. Thus, there were different routes by which autonomy was and is established, but in the first decades of the nineteenth century, this autonomy depended on national security and war preparations. This article uses War Department papers, armory records, and congressional debates to show how certain bureaucrats developed the ability to work against congressional limits to their functionality. Ordnance ultimately succeeded because its leaders executed a nonpartisan military agenda and demonstrated an ability to effectively manage the nation's security apparatus, especially in times of peace.
The origin of phagocytosis in Earth history

Phagocytosis, or 'cell eating', is a eukaryote-specific process where particulate matter is engulfed via invaginations of the plasma membrane. The origin of phagocytosis has been central to discussions on eukaryogenesis for decades-, where it is argued as being either a prerequisite for, or consequence of, the acquisition of the ancestral mitochondrion. Recently, genomic and cytological evidence has increasingly supported the view that the pre-mitochondrial host cell-a bona fide archaeon branching within the 'Asgard' archaea-was incapable of phagocytosis and used alternative mechanisms to incorporate the alphaproteobacterial ancestor of mitochondria. Indeed, the diversity and variability of proteins associated with phagosomes across the eukaryotic tree suggest that phagocytosis, as seen in a variety of extant eukaryotes, may have evolved independently several times within the eukaryotic crown-group. Since phagocytosis is critical to the functioning of modern marine food webs (without it, there would be no microbial loop or animal life), multiple late origins of phagocytosis could help explain why many of the ecological and evolutionary innovations of the Neoproterozoic Era (e.g. the advent of eukaryotic biomineralization, the 'Rise of Algae' and the origin of animals) happened when they did.