cssi/SciSciGPT-SciSciNet huggingface dataset:
Pathology in the Medical Profession?: Taking the Pulse of Physician Wellness and Burnout

Context.—In the past decades, physician wellness has diminished in every aspect of professional life. Burnout symptoms in the United States affect 30% to 68% of physicians overall—exceeding the levels of any other professional group. The ramifications of burnout present an underrecognized crisis in the health care system that carries the consequences of personal, professional, institutional, and societal costs. Objective.—To bring to light the elements of current medical practice that contribute to physician professional fulfillment and burnout. Intervention measures, steps toward burnout prevention, and the present limitations thereof are also addressed. Data Sources.—This narrative literature review was performed by using studies in PubMed (National Center for Biotechnology Information) and large online physician surveys, published through December 2015. Because of geographic differences, the review is primarily concentrated on physicians across specialties in the United States. Small studies and those ...
High Ms Fe16N2 thin film with Ag under layer on GaAs substrate

(001) textured Fe16N2 thin film with Ag under layer is successfully grown on GaAs substrate using a facing target sputtering (FTS) system. After post annealing, chemically ordered Fe16N2 phase is formed and detected by X-ray diffraction (XRD). High saturation magnetization (Ms) is measured by a vibrating sample magnetometer (VSM). In comparison with Fe16N2 with Ag under layer on MgO substrate and Fe16N2 with Fe under layer on GaAs substrate, the current layer structure shows a higher Ms value, with a magnetically softer feature in contrast to the above cases. In addition, X-ray photoelectron spectroscopy (XPS) is performed to characterize the binding energy of N atoms. To verify the role of strain that the FeN layer experiences in the above three structures, Grazing Incidence X-ray Diffraction (GIXRD) is conducted to reveal a large in-plane lattice constant due to the in-plane biaxial tensile strain.
Enhanced Dopamine Release by Dopamine Transport Inhibitors Described by a Restricted Diffusion Model and Fast-Scan Cyclic Voltammetry.

Fast-scan cyclic voltammetry (FSCV) using carbon fiber electrodes is widely used to rapidly monitor changes in dopamine (DA) levels in vitro and in vivo. Current analytical approaches utilize parameters such as peak oxidation current amplitude and decay times to estimate release and uptake processes, respectively. However, peak amplitude changes are often observed with uptake inhibitors, thereby confounding the interpretation of these parameters. To overcome this limitation, we demonstrate that a simple five-parameter, two-compartment model mathematically describes DA signals as a balance of release (r/ke) and uptake (ku), summed with adsorption (kads and kdes) of DA to the carbon electrode surface. Using nonlinear regression, we demonstrate that our model precisely describes measured DA signals obtained in brain slice recordings. The parameters extracted from these curves were then validated using pharmacological manipulations that selectively alter vesicular release or DA transporter (DAT)-mediated upta...
Creep in corundum refractories containing a glass phase

Using a model of the creep process it is possible to determine the structural factors of a refractory material which determine the magnitude and rate of the deformation process at various stages of creep. On the basis of the hypotheses developed in this paper we can make an attempt, by deliberately changing the structure of the refractory, to obtain the required value of deformation in different periods of the creep process.
Locating mines in SAR imagery using change detection methods

In this paper we present several methods for change detection in a pair of multi-look synthetic aperture radar (SAR) images of the same scene. We implement and compare several techniques which vary in complexity. Among the simple methods that are implemented are differencing, Euclidean distance, and image ratioing. These methods require minimal processing time, with little computational complexity, and incorporate no statistical information. We also implemented methods which incorporate second order statistic calculations in making a change decision in efforts to mitigate false alarms arising from the speckle noise, misregistration errors, and nonlinear variations in SAR images. These methods include a Wiener prediction-based method, Mahalanobis distance measure and subspace projection method. We compare the performance of these methods using multilook SAR images containing several targets (mines). We present results in the form of receiver operating characteristics (ROC) curves.
Development and Validation of an Assessment of Regional Anesthesia Ultrasound Interpretation Skills.

Background Interpretation of ultrasound images and knowledge of anatomy are essential skills for ultrasound-guided peripheral nerve blocks. Competency-based educational models promoted by the Accreditation Council for Graduate Medical Education require the development of assessment tools for the achievement of different competency milestones to demonstrate the longitudinal development of skills that occur during training. Methods A rigorous study guided by psychometric principles was undertaken to identify and validate the domains and items in an assessment of ultrasound interpretation skills for regional anesthesia. A survey of residents, academic faculty, and community anesthesiologists, as well as video recordings of experts teaching ultrasound-guided peripheral nerve blocks, was used to develop short video clips with accompanying multiple choice–style questions. Four rounds of pilot testing produced a 50-question assessment that was subsequently administered online to residents, fellows, and faculty from multiple institutions. Results Test results from 90 participants were analyzed with Item Response Theory model fitting indicating that a 47-item subset of the test fits the model well (P = 0.11). There was a significant linear relation between expected and predicted item difficulty (P Conclusions This study provides evidence for the reliability, content validity, and construct validity of a 47-item multiple choice–style online test of ultrasound interpretation skills for regional anesthesia, which can be used as an assessment of competency milestone achievement in anesthesiology training.
Intervention: Reality TV, Whiteness, and Narratives of Addiction

Purpose – Reality TV shows that feature embodied “transformations” are popular, including Intervention, a program that depicts therapeutic recovery from addiction to “health.” The purpose of this chapter is to address the ways whiteness constitutes narratives of addiction on Intervention. Methodology – This analysis uses a mixed methodology. I conducted a systematic analysis of nine (9) seasons of one hundred and forty-seven (147) episodes featuring one hundred and fifty-seven individual “addicts” (157) and logged details, including race and gender. For the qualitative analysis, I watched each episode more than once (some, I watched several times) and took extensive notes on each episode. Findings – The majority of characters (87%) are white, and the audience is invited to gaze through a white lens that tells a particular kind of story about addiction. The therapeutic model valorized by Intervention rests on neoliberal regimes of self-sufficient citizenship that compel us all toward “health” and becoming “productive” citizens. Such regimes presume whiteness. Failure to comply with an intervention becomes a “tragedy” of wasted whiteness. When talk of racism erupts, producers work to re-frame it in ways that erase systemic racism. Social implications – The whiteness embedded in Intervention serves to justify and reinforce the punitive regimes of controlling African American and Latina/o drug users through the criminal justice system while controlling white drug users through self-disciplining therapeutic regimes of rehab. Originality – Systematic studies of media content consistently find a connection between media representations of addiction and narratives about race, yet whiteness has rarely been the critical focus of addiction.
Design Philosophy of Man Powered Aircraft

In 1961 I assisted Mr. G. M. Lilley in writing a survey of the design and performance of man powered aircraft. Our conclusions were that man powered flight is just possible if the aircraft is carefully designed to give excellent aerodynamic characteristics, with a stiff, light structure and flown by a pilot whose power output is comparable with that of a National Amateur Cycling Champion. Such a machine would not fly more than fifteen to twenty feet above the ground and could operate only in still air conditions. The type of aircraft which emerged from the calculations was similar in general principles to those being developed currently at Hatfield and Southampton. In this lecture I propose to investigate some of the basic relationships which are involved in the hope that possible ways of obtaining further improvements may emerge. Since the conclusion of our survey was that flight was marginally possible, slight improvements might well go a long way towards making man powered flight possible.
Foreign body aspiration in children and role of flexible bronchoscopy: A 3 year experience

Abstract Background Flexible airway bronchoscopy is an accepted and frequently performed procedure in the evaluation of children with known or suspected airway and lung parenchymal disorders. Methods Between 2012 and 2015, retrospective analysis of 134 flexible bronchoscopies was done in Children’s Hospital, Cairo University, as regards demographic profile, clinical and radiological presentation and diagnostic indication. The results were analyzed on the basis of bronchoscopy inspection, conclusion and future recommendations. Results Patients indicated for flexible bronchoscopy presented clinically with unilateral diminished breath sounds in 24.6%, unilateral bronchial breathing in 17.9%, recurrent lower respiratory tract infection in 11.2%, persistent cough in 4.5% and stridor in 9.7%, others showed radiological findings in the form of unilateral hyperinflation in 9%, bronchiectasis in 3.7% and unilateral wheezes in 1.5%. Out of 134 patients undergoing bronchoscopy, 38% had foreign body (FB) in the airways although only 7.5% of patients had recalled a previous history of FB aspiration (15.6% in the trachea, 52% in the right side and 31.3% in the left side, among those patients 60.8% were males while 39.2% were females), 14.1% had tracheal abnormality, 26.8% had post inflammatory changes, 56.7% had right bronchus abnormality, 55.2% had left bronchus abnormality, bronchoalveolar lavage (BAL) was done in 30.6% of patients, FB was successfully removed in 15.6% of patients and further cardiothoracic intervention was needed in 29.8% of patients. Conclusion The combination of history, physical examination, and chest X-ray findings are crucial when investigating a child with suspected foreign body aspiration. Flexible bronchoscopy is effective for diagnostic and sometimes therapeutic purpose of problems in the upper and lower respiratory airways in children, with a high success rate as it significantly reduces the rate of negative rigid bronchoscopies and ultimately saves the child from undergoing an unnecessary procedure.
Intrinsic and Extrinsic Science: A Dialectic of Scientific Fame.

In this article, I argue that scientific fame and impact exists on a continuum from the mundane to the transformative/revolutionary. Ideally, one achieves fame and impact in science by synthesizing two extreme career prototypes: intrinsic and extrinsic research. The former is guided by interest, curiosity, passion, gut, and intuition for important untapped topics. The latter is guided by money, grants, and/or what is being published in top-tier journals. Assessment of fame and impact in science ultimately rests on productivity (publication) and some variation of its impact (citations). In addition to those traditional measures of impact, there are some relatively new metrics (e.g., the h index and altmetrics). If psychology is to achieve consensual cumulative progress and better rates of replication, I propose that upcoming psychologists would do well to understand that success is not equal to fame and that individual career success is not necessarily the same as disciplinary success. Finally, if one is t...
Role of Improved Vascular Health in the Declining Incidence of Dementia

As people are living longer, the disease burden is shifting toward diseases of old age, including an increasing prevalence of dementia, most commonly because of Alzheimer disease (AD). The risk of developing dementia doubles every 5 years after the age of 65 years.1 There are currently 5.1 million Americans aged >65 years living with dementia, and this number is expected to reach 13.8 million by the year 2050.2 Despite an increasing prevalence of dementia, the FHS (Framingham Heart Study) recently showed that the age-specific incidence of dementia has steadily declined over the previous 3 decades (Figure).3 In other words, whereas the overall number of people affected by dementia will continue to increase because of population aging, an individual’s risk of developing dementia by a specific age has decreased by as much as 20% each decade over the past 30 years. Other studies have also pointed toward a declining incidence of dementia in the United States and Europe.4–6 The Health and Retirement Study also reported a decline in dementia prevalence in the United States from the year 2000 to 2012.7 Collectively, these studies provide hope that some cases of dementia can be prevented or delayed. Figure. Trends in ( A ) dementia incidence and ( B ) education and vascular risk factors over four nonoverlapping epochs in the Framingham Heart Study. The baseline examination period was from 1977 to 1983 for the first epoch, 1986 to 1991 for the second epoch, 1992 to 1998 for the third epoch, and 2004 to 2008 for the fourth epoch. Data are from Satizabal et al.3 BP indicates blood pressure; HDL-C, high-density lipoprotein cholesterol; high school, completion of high-school education; and Rx, treatment. The factors underlying changing temporal trends in dementia are not entirely clear. It is important to understand what …
Chronic CB1 cannabinoid receptor antagonism persistently increases dendritic spine densities in brain regions important to zebra finch vocal learning and production in an antidepressant-sensitive manner.

During typical late-postnatal CNS development, net reductions in dendritic spine densities are associated with activity-dependent learning. Prior results showed agonist exposure in young animals increased spine densities in a subset of song regions while adult exposures did not, suggesting endocannabinoid signaling regulates dendritic spine dynamics important to vocal development. Here we addressed this question using the CB1 receptor-selective antagonist SR141716A (SR) to disrupt endocannabinoid signaling both during and after vocal learning. We hypothesized antagonist exposure during vocal development, but not adulthood, would alter spine densities. Following 25 days of exposure and a 25 day maturation period, 3D reconstructions of Golgi-Cox stained neurons were used to measure spine densities. We found antagonist treatments during both age periods increased densities within Area X (basal ganglia) and following adult treatments within HVC (premotor cortical-like). Results suggest both inappropriate cannabinoid receptor stimulation and inhibition are capable of similar disregulatory effects during establishment of circuits important to vocal learning, with antagonism extending these effects through adulthood. Given clinical evidence of depressant effects of SR, we tested the ability of the antidepressant monoamine oxidase inhibitor (MAOI) phenelzine to mitigate SR-induced spine density increases. This was confirmed implicating interaction between monoamine and endocannabinoid systems. Finally, we evaluated acute effects of these drugs to alter ability of novel song exposure to increase spine densities in auditory NCM and other regions, finding when combined, SR and phenelzine increased densities within Area X. These results contribute to understanding relevance of dendritic spine dynamics in neuronal development, drug abuse, and depression.
Effects of pair bonding on parental behavior and dopamine activity in the nucleus accumbens in male prairie voles

Male parental care is a vital behavior for the development as well as the physical and mental well-being of the young. However, little is known about the neurochemical regulation of male parental behavior, mainly due to the lack of appropriate animal models. In this study, we used the socially monogamous male prairie vole (Microtus ochrogaster) to investigate the effect of pair-bonding experience on paternal behavior and dopamine (DA) signaling in the nucleus accumbens (NAcc) in the brain. We compared sexually naive males with males that were pair bonded with a female for two weeks. Our data showed that pair-bonded males displayed enhanced paternal behavior, particularly in pup licking/grooming, associated with increased DA type-1 receptor (D1R) protein expression in the NAcc, compared to sexually naive males. Site-specific brain microdialysis revealed a significant, but transient, increase in DA release in the NAcc associated with pup exposure in both groups of the males. Further, pharmacological blockade of D1R in the NAcc decreased pup licking/grooming in the pair-bonded males. Together, our data demonstrate that pair-bonding experience with a female facilitated male parental behavior via NAcc D1R mediation in male prairie voles.
Diaphragm — Deltoid synkinesis with myelographic demonstration of the cause

This man had an automobile accident with undefined cervical injury 30 years prior to examination. He has a normal C4 nerve function on the left, a moderately reduced C5 motor function on the left, but spontaneous undirectional synkinetic contraction of the anterior head of the left deltoid muscle during active diaphragm contraction. An epiarachnoidal course within the vertebral canal between the C4 and C5 roots was demonstrated myelographically, and probably represents the course of the innervating fibers producing this synkinesis. — Synkinesis refers to the simultaneous contraction of muscles which do not normally act together. This phenomenon usually occurs after nerve injury, and is the result of misdirection of the regenerating nerve fibers. In this case report, the etiology was traumatic and the site of the lesion was demonstrated by Pantopaque myelgraphy.
Transcoding: A new strategy for relay channels

The relay channel is a traditional information-theoretic problem which has important applications in the Internet of Things (IoT) and other future communication networks. In this work, we focus on the simplest possible relaying model: the so-called separated (or two-hop) relay channel where there is no direct link between the source and the destination. Previous work has shown that for this channel, the decode-and-forward (DF) relaying strategy is capacity-achieving under the assumption of asymptotic block lengths. In this paper, however, we are interested in the finite-delay regime where simpler sub-optimal techniques like amplify-and-forward (AF) can be used to avoid the need for buffering at the relay. We present a new strategy called transcoding which presents a tradeoff between the low-latency advantages of amplify-and-forward and the high-rate, high-latency decode-and-forward scheme. Our results indicate that our simple, intuitive transcoding schemes outperform traditional relaying schemes in the finite-delay regime.
Intrapersonal Factors of Male and Female Adolescent Fruit and Vegetable Intake.

OBJECTIVES In this study, we examined the role of socio-demographic (race/ethnicity, sex, grade, nativity, literacy, body mass index) and individual-level (normative beliefs, knowledge, perceived barriers, food preference, self-efficacy) factors on US adolescent fruit and vegetable consumption. METHODS We conducted hierarchical multiple regression analysis to determine the influence of factors on adolescent fruit and vegetable consumption in a nationally represen- tative sample of 795 adolescents from the National Cancer Institute's 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study. RESULTS Socio-demographic variables explained little variance (1.7%) whereas individual-level factors explained approximately 29% of the variance in adolescent fruit and vegetable consumption. Statistically significant (p < .001) predictors of adolescent fruit and vegetable consumption were food preference (β = .253), self-efficacy (β = .184), perceived barriers (β = -.139), and normative beliefs (β = .134). After controlling for sex, food preference and normative beliefs were stronger predictors of male, and perceived barriers was a stronger predictor of female, adolescent fruit and vegetable consumption. CONCLUSIONS Understanding the predictive strength and sex-specific differences of intrapersonal variables on male and female adolescent fruit and vegetable consumption informs health promotion efforts to increase intake to recommended amounts.
Analysis of risk factors associated with unilateral hearing loss in children who initially passed newborn hearing screening

Abstract Objective To analyze 2007 Joint Committee on Infant Hearing (JCIH) risk factors in children with confirmed unilateral hearing loss (UHL) who initially passed newborn hearing screening. Methods Retrospective record review of 16,108 infants who passed newborn hearing screening but had one or more JCIH risk factors prompting subsequent follow-up through the universal newborn hearing screening (UNHS) program in Virginia from 2010 to 2012. The study was reviewed and qualified as exempt by the Virginia Commonwealth University Institutional Review Board (IRB) and the Virginia Department of Health. Results Over the 2-year study period, 14896 (4.9% of total births) children passed UNHS but had the presence of one or more JCIH risk factor. Ultimately, we identified 121 babies from this group with confirmed hearing loss (0.7%), with 48 babies (0.2%) showing UHL. The most common risk factors associated with the development of confirmed UHL after passing the initial screen were neonatal indicators, craniofacial anomalies, family history, and stigmata of syndrome associated with hearing loss. Conclusion Neonatal indicators and craniofacial anomalies were the categories most often found in children with confirmed unilateral hearing loss who initially passed their newborn hearing screen. While neonatal indicators were also the most common associated risk factor in all hearing loss, craniofacial abnormalities are relatively more common in children with UHL who initially passed newborn hearing screening. Further studies assessing the etiology underlying the hearing loss and risk factor associations are warranted.
Impact of Superdisintegrants and Film Thickness on Disintegration Time of Strip Films Loaded With Poorly Water-Soluble Drug Microparticles

Abstract Although strip films are a promising platform for delivery of poorly water-soluble drug particles via slurry casting, the effect of critical material attributes, for example, superdisintegrants (SDIs) on critical quality attributes, including film disintegration time (DT), remains underexplored. A 2-level factorial design is considered to examine the impact of the SDI type (sodium starch glycolate and croscarmellose sodium), their amount, and film thickness. SDIs were used with hydroxypropyl methylcellulose (E15LV) and glycerin solutions along with viscosity matching. Fenofibrate, a model poorly water-soluble drug, was micronized and surface modified via fluid energy milling. Significant decreases in film DT, measured using 3 different methods, were observed due to the addition of SDIs. Percentage reduction in DT was a strong function of SDI amount, and thinner films disintegrated faster. Films with either higher SDI concentrations (>9%) or films under 80 μm, exhibited fast DT ( 80% in 10 min). All films achieved good content uniformity, except for those with the lowest amount of SDI, attributed to insufficient viscosity and thickness nonuniformity due to the SDI. Finally, all films achieved adequate mechanical properties, notwithstanding minor negative impact of SDIs.
Interdependent Independence: The Meanings of Autonomy Among Chinese American and Filipino American Adolescents

A growing body of research suggests important ethnic differences in parenting styles and parent-adolescent relationship quality. Most of that work examines ethnic group differences in widely accepted survey measures of parenting, including parental monitoring and autonomy-granting. Less is known about the cultural meanings held by young people (and parents) with regard to these commonly understood concepts of parenting. We conducted eight focus group interviews with a total of 40 Chinese American and Filipino American adolescents, asking them to describe autonomy in relation to their parents. They provided typical definitions of adolescent independence, but followed up with in-depth discussions of the interdependent nature of independence. These youth defined independence in reference to their relationships with parents, and in relational and contingent terms. For girls, independence is interdependent due to mutually understood family role obligations: parents know what is best for their daughters, and daughters express autonomy by making choices consistent with their parent’s preferences. For Chinese American girls, parents’ role pertained to choices about college, and parents’ lower levels of acculturation were discussed as explanations for parental perspectives on independence. Some parents of Filipino American girls wanted them to be autonomous; girls distinguished between decisions about life goals versus day-to-day decisions, about which their parents allowed more independence. For boys, autonomy was continent on parental approval, or was negotiated with parents. Being independent meant to live on your own, but further discussion revealed the degree to which this independence was negotiated with parents and expressed with sensitivity to parental concerns.
Use of emergency medicaid by undocumented immigrants.

An exploration of the types of emergency medical care most used by undocumented immigrants in one study area and the preventive interventions that the study results suggest. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.
Motives and Metaphors in Considerations of Animal Nature

“What proof is there that brutes are other than a superior race of marionettes, which eat without pleasure, cry without pain, desire nothing, know nothing, and only simulate intelligence as a bee simulates a mathematician?” (Huxley, 1893; quoted in Boden, 1972, p. 281). If we could persuade ourselves that animals are really inanimate, we should have little if any reason to think that there are ethical issues raised by their use in research in the neural and behavioral sciences. Although some people get emotionally attached to objects such as cars, or houses, or paintings, they usually stop short of claiming rights for them. We do, of course, value such things; and pleas for the preservation of historic buildings, works of art, natural habitats, and so forth, usually include appeal to a sense of responsibility or some such moral consideration. Yet what is usually argued in these cases is that people would be the poorer for loss of whatever is in jeopardy; unless one is an animist, the things themselves are not credited with existing to themselves in some way that entitles them to be considered as having interests, points of view, rights, which should be taken into account when there is a question about how they are to be treated. By and large, whether we regard a thing or a creature as having a claim on ethical consideration will depend upon the extent to which it appears to be sentient in the ways in which we are—possessed of sensations, feelings, emotions, motives, intentions, and so forth.
Antithrombotic therapy in abdominal aortic aneurysm: beneficial or detrimental?

Abdominal aortic aneurysm (AAA) is a degenerative vascular pathology resulting in significant morbidity and mortality in older adults due to rupture and sudden death. Despite 150 000 new cases and nearly 15 000 deaths annually, the only approved treatment of AAA is surgical or endovascular intervention when the risk for aortic rupture is increased. The goal of the scientific community is to develop novel pharmaceutical treatment strategies to reduce the need for surgical intervention. Because most clinically relevant AAAs contain a complex structure of fibrin, inflammatory cells, platelets, and red blood cells in the aneurysmal sac known as an intraluminal thrombus (ILT), antithrombotic therapies have emerged as potential pharmaceutical agents for the treatment of AAA progression. However, the efficacy of these treatments has not been shown, and the effects of shrinking the ILT may be as detrimental as they are beneficial. This review discusses the prospect of anticoagulant and antiplatelet (termed collectively as antithrombotic) therapies in AAA. Herein, we discuss the role of the coagulation cascade and platelet activation in human and animal models of AAA, the composition of ILT in AAA, a possible role of the ILT in aneurysm stabilization, and the implications of antithrombotic drugs in AAA treatment.
How Clinician–Family Interactions Potentially Impact Clinicians’ Conceptualization and Discussions Regarding Prognostic Uncertainties:

Objectives:Little is known about how clinicians perceive prognostic uncertainty. Our study objective was to identify factors that influence how prognostic uncertainty is viewed by physicians, as it...
Environmental pH and peptide signaling control virulence of Streptococcus pyogenes via a quorum-sensing pathway

Bacteria control gene expression in concert with their population density by a process called quorum sensing, which is modulated by bacterial chemical signals and environmental factors. In the human pathogen Streptococcus pyogenes, production of secreted virulence factor SpeB is controlled by a quorum-sensing pathway and environmental pH. The quorum-sensing pathway consists of a secreted leaderless peptide signal (SIP), and its cognate receptor RopB. Here, we report that the SIP quorum-sensing pathway has a pH-sensing mechanism operative through a pH-sensitive histidine switch located at the base of the SIP-binding pocket of RopB. Environmental acidification induces protonation of His144 and reorganization of hydrogen bonding networks in RopB, which facilitates SIP recognition. The convergence of two disparate signals in the SIP signaling pathway results in induction of SpeB production and increased bacterial virulence. Our findings provide a model for investigating analogous crosstalk in other microorganisms. The mechanism by which environmental pH controls the virulence of the pathogen Streptococcus pyogenes is unclear. Here, Do et al. show that changes in pH affect the activity of the virulence regulator RopB via its interaction with a quorum-sensing peptide signal.
What Is of Recent Interest in Echocardiography?: Insights From the JACC Family of Journals.

![Figure][1] We continue our periodic series summarizing our favorite original research papers from various JACC journals in multiple imaging specialties. The aim remains to highlight what papers saw active interest among investigators and readers and what these papers contributed towards
AN ANALYSIS OF PATIENTS HOSPITALIZED WITH CARDIAC AMYLOIDOSIS AND HEART FAILURE IN THE UNITED STATES: INSIGHT FROM THE NATIONAL INPATIENT SAMPLE

Heart failure (HF) is a common cause of hospitalization in the United States. Cardiac amyloidosis (CA) has become a more widely accepted cause of HF hospitalizations in the US, however there remains limited data about this patient population largely due to its under-recognition. This study aimed to
Analysis of the survey result of the coal-burning endemic fluorosis in Hongya County of Sichuan Province in 2006

Objective To investigate the current status of coal-burning endemic fluorosis and the fluoride content in foods and drinking water in Hongya County,Sichuan Province.Methods Dental fluorosis and urinary fluoride were suveyed in children of 8～12 years old in two schools which repectively located in Gaomiao and Wawushan Town.The adults above 20 years old underwent clinical examination.At the same time,fifty adults above 20 years old in Garden Village were chosen to take forearm and calf X-ray films to find out the evidence of skeletal fluorosis.The content of fluoride in food such as bacon,corn,dry capsicum in Sanxing Village in Gaomiao Town and Futian Village in Wawushan Town as well as drinking water in five families in Sanxing Village were determined.Results The dental fluorosis rate of children was 40.76%(161/395),the dental fluorosis index was 0.86 in Gaomiao Town.The dental fluorosis rate of children was 14.36%(82/571),the dental fluorosis index was 0.31 in Wawushan Town.The medium value of the urine fluoride was 0.81 mg/L.ranged 0.16～3.89 mg/L.The positive rate oi the clinical examination of skeletal fluorosis was 5.27%(27/512),the X-rays detective rate was 4.00%(2/50).The medium value in bacon,corn,dry capsicum were 6.00,0.64,1.49 mg/kg.The averaged content of the fluoride in drinking water(0.14±0.06)mg/L of local household was within the eligible limitation.Conclusions It is currently a mild endemic disease in Hongya Country,its incidence is reduced apparently,pathogenetic environmental fluoride content is reduced.The main source of fluoride is from the preserved ham contaminated with fluoride,which is epidemiologically significant in endemic area of Hongya County.Defluoriding countermeasures should be taken in the endemic areas. Key words: Fluoride poisoning; Fluorosis,dental; X-rays; Environmental pollution
Mechanical ear and "blue book" in 1973.

Abstract Cochlear implant has progressively become an essential treatment for profound hearing loss. The aim of this historical note is to briefly review the very beginnings of this technique, in 1973, with the production of a painting entitled “Mechanical ear” and the first international congress on cochlear implants. In a way, these two events marked the beginning of an antagonism that played a very important role in the development and especially the acceptance of cochlear implants in the multicultural society of the late twentieth century.
Optical erosion

A review is presented of some of the facts and ideas related to the possible erosive action of light on condensed matter. Various mechanisms are described which would be expected to lead to erosion. These include « bond-breaking », auto-ionization, indirect, phonon-assisted processes, local heating phenomena, etc. Some special cases are mentioned in which photo-disintegration has been observed, although these examples are not true erosion in the sense intended here. Areas of possible importance of this effect are mentioned, large ignorance of its efficiency is exposed, and pertinent experiments are suggested.
In A Younger Voice: Doing Child-Centered Qualitative Research

Adults were once children, yet a generational gap can present itself when grown-ups seek to know children's lives, in research. In A Younger Voice discloses how qualitative research, tailored to be child-centered, can shrink the gap of generational unintelligibility. The volume invites and instructs researchers who want to explore children's vantage points as social actors. Its suggested tool kit draws from both academic and applied research, based on the author's lifelong career as a child-centered qualitative researcher. World round, research in knowing children has grown recently in anthropology, sociology, geography, economics, cultural psychology and a host of applied fields. This book draws widely from the trending child-centered research movement, taking stock of methods for fulfilling its aims. In A Younger Voice provides mature researchers with a kid-savvy guide to learning effectively about, from, and with children. The highlighted methods' are steadfastly child-attuned, "thinking smaller" in order to free children to participate with empowerment. From fieldwork and observation, to focus groups and depth interviews, to the use of photography, artwork, and metaphors, viable methods are discussed with an old-hand's acumen for making the procedures practical with children in the field. Whether an investigator is at the beginning of a project (designing from scratch procedures to involve and reveal the young) or at the final stages (conducting interpretations and analysis true to children's meanings) In A Younger Voice gives know-how for a challenging area of inquiry. Playfully interviewing children as young as five years old, as well as empowering teenagers to tell it like it is, are tasks revealed to be both doable and essential. For adults seeking to overcome generational-cultural myopia, these methods are invaluable.
Dynamically Generating Operationally Acceptable Route Alternatives Using Simulated Annealing

This paper presents a simulated annealing (SA) methodology for defining operationally acceptable route alternatives for flights impacted by weather. By dynamically generating route alternatives that inherently possess traits amenable to traffic managers and users, more efficient use of the airspace can be realized. This paper explores the use of SA to provide quality solutions quickly and to capture additional route alternative options, such as ground delay. For comparison, a k-shortest path approach and an ad hoc heuristic search approach have also been employed to generate reroutes and the results show that SA indeed provides competitive alternatives to the k-shortest path approach and improved alternatives over the heuristic search procedure. Furthermore, SA can potentially generate these alternatives with less computation effort than the k-shortest path approach and, therefore, represents a desirable method for generating alternate flight paths.
The impact of curriculum-based learning on environmental literacy and energy consumption with implications for policy

Abstract Policy related to energy efficiency programs implemented by utility companies should be informed by an understanding of building occupant behavior change. This case study utilized a longitudinal design and mixed methodology to assess the effect of curriculum-based experiential learning on elementary school students' environmental literacy and energy-saving behaviors. We found that the students significantly improved their environmental literacy. Normalizing kWh consumption for weather, we observed a decrease in energy consumption of more than 15% in student homes and more than 30% at the focal school.
Catecholamines and Neurocarondiogenic Syncope

Publisher Summary The combination of enhanced adrenomedullary and attenuated sympathoneural responses during slight reductions in cardiac filling antecede the syncope. The findings are consistent with the view that sudden, central resetting of baroreflex function can evoke a pattern of sympathoinhibition combined with adrenomedullary and vagal activation. The common faint is the most frequent cause of neurocardiogenic or vasodepressor syncope. Examples of other types of vasodepressor syncope are the carotid sinus syndrome, cough syncope, and micturation syncope. Studies indicate that the simultaneous occurrence of attenuated noradrenergic and exaggerated adrenomedullary activity to a mildly decreased cardiac filling (LBNP at—35 mm Hg) is characteristic for subjects who are prone to vasodepressor reactions during exposure to more severely decreased cardiac filling. It is unclear whether the increased arterial plasma epinephrine levels in the fainters, at a time when there is not yet any sign of syncope, elicits arterial vasodilation and contributes in that way to the later development of the syncope. The attained plasma epinephrine levels seem, however, not high enough to induce vasodilation, but it is possible that vasodilation by epinephrine becomes manifest when there is a simultaneous attenuation of the noradrenergic responsiveness or even sympathoinhibition.
Assessing elements of informed consent among living donors

Living organ donors – 50% of solid organ donors in the United States – represent a unique population who accept medical risk for the benefit of another. One of the main justifications for this practice has been respect for donor autonomy, as realized through informed consent. In this retrospective study of living donors, we investigate 2 key criteria of informed consent: (1) depth of understanding and (2) degree of voluntariness. In our survey of 262 living kidney donors 2 to 40 months post donation, we found that more than 90% understood the effects of living donation on recipient outcomes, the screening process, and the short-term medical risks of donation. In contrast, only 69% understood the psychological risks of donation; 52% the long-term medical risks of donation; and 32%, the financial risks of donation. Understanding the effects of living donation on recipient outcomes was the only factor that would affect donors' decision to donate again. 40% of donors reported feeling some pressure to donate. Donors who are related to the recipient were more likely to report feeling pressure to donate. We conclude that more studies of informed consent are needed to identify factors that may compromise the validity of informed consent.
Atrioventricular conduction in man: Effect of rate, exercise, isoproterenol and atropine on the P-R interval☆

Abstract Atrioventricular conduction was studied in 14 patients. A bipolar electrode catheter was placed in the right atrium, and the heart rate was controlled by atrial pacing. Increases in the sinus heart rate were associated with decreases in atrioventricular conduction time. When the heart rate was increased by atrial pacing, there were progressive increases in atrioventricular conduction time. Exercise, isoproterenol and atropine shortened atrioventricular conduction time. In those cases where atrioventricular conduction block occurred during atrial pacing, there was a 1:1 atrioventricular response during exercise at the same paced heart rate. Stimuli which increase the rate of discharge of the sinus pacemaker also enhance atrioventricular conduction. It is concluded that there is a fine balance between heart rate and A-V conduction. When the heart rate is increased by neurohumoral stimuli, there is a corresponding enhancement of A-V conduction. When the heart rate is increased by artificial stimulation of the atria and neurohumoral effects are not altered, there is a progressive increase in conduction time and eventual blockage of conduction at the A-V nodal region.
Monaco: A High-Performance Flat Concurrent Logic Programming System

This paper describes Monaco, a high-performance implementation of flat committed-choice languages such as Flat Guarded Horn Clauses. The compiler produces native code for linking to a runtime system on shared-memory multiprocessors. A reduced abstract-machine instruction set facilitates decision-graph code generation and traditional optimizations based on dataflow analysis. An inexpensive system-call interface is provided to lower the overhead of memory allocation and procedure invocation. Unification has been optimized to streamline the common cases. We report initial performance measurements of our current instantiation of the system, for the Sequent Symmetry, for a suite of benchmarks.
reply: Soil warming and organic carbon content

Davidson et al. question the validity of our conclusions on the grounds that differences in disturbance, high variability among sites, and the use of a single-pool model to estimate turnover time (TT) obscured the effect of temperature on the decomposition of soil carbon.
The Roles of Networks of VLF Direction-Finding Receivers during the IMS

A simple model of the distribution of electric fields and plasma dynamics in the magnetospheric equatorial plane is first reviewed. The significance of the plasma-pause in this context is mentioned. A discussion of the power, and limitations, of the normal whistler method for studying this region of space plasma leads on to a consideration of the roles that can be played by networks of VLF direction-finding (goniometer) receivers.
Ibrutinib rash in a patient with 17p del chronic lymphocytic leukemia.

A 67-year-old man with chronic lymphocytic leukemia (CLL) and deletion of chromosome 17p presented to clinic for evaluation of leukocytosis (total white blood cell count 149,000/mm3, absolute lymphocyte count 144,000/mm3) associated with fatigue, drenching night sweats, and recurrent viral infections. He had been treated previously with a combination of rituximab, cyclophosphamide, vincristine, and prednisone as well as rituximab and bendamustine (B-R), with the most recent therapy 3 years prior to his clinic visit. He had previously declined referral for hematopoietic stem cell evaluation. He was started on ibrutinib 420 mg PO daily in combination with allopurinol 300 mg PO daily for prophylaxis against tumor lysis syndrome. Two weeks after beginning therapy, he developed a painless, non-pruritic, rash that began on his wrists and then spread to his entire body (Image 1). The rash was characterized by a diffuse distribution of bright red edematous papules, ranging from 0.5 to 1 cm in diameter, with sparing of his palms and soles. He was evaluated in the Emergency Department and both allopurinol and ibrutinib were held. His absolute eosinophil count at the time was within the normal range (100/mm3). Within several days his rash had completely resolved, and given consideration for allopurinol as the etiology of his rash, he was restarted on dose-reduced ibrutinib (140 mg PO daily) without allopurinol. After a single dose, he developed recrudescence of his full-body rash and ibrutinib was once again discontinued. The rash again resolved within several days of discontinuing ibrutinib. Image 1 Painless, non-pruritic edematous papules on the trunk of a patient who developed an ibrutinib-related rash. Lesions began on the wrists and arms and subsequently generalized to the entire body. Ibrutinib (Imbruvica, Pharmacyclics/Janssen Biotech), an oral Bruton's tyrosine kinase inhibitor, was approved in February 2014 by the Federal Drug Administration for the treatment of CLL patients who have received at least one prior therapy. Ibrutinib is generally very well-tolerated, with few Grade 3 or higher adverse events [1–3]. In published studies, rash occurs at a frequency of 15–27%, although no identifying characteristics have been reported. In this case, clinical features distinguishing the rash from a classic allopurinol-mediated rash included its presentation with edematous papules (versus the morbilliform rash commonly associated with allopurinol) and its peripheral-to-central pattern of spread.
The language of liberal constitutionalism

1. The search for sovereignty: law, language, and the beginning of modern constitutionalism 2. Consent how?: challenges to Lockean constitutionalism 3. Constitutional language and the possibility of binding commitments 4. Consent to what? Exclusivity and completeness in constitutional and legal language 5. The question of substance: morality, law, and constitutional legitimacy 6. Conclusion: the defense of constitutional language.
Raman optical lattice

We present a novel optical lattice of reduced periodicity that is based on Raman transitions. We demonstrate and characterize laser cooling in this lattice. Our observations are in agreement with theoretical results.