cssi/SciSciGPT-SciSciNet huggingface dataset:
Meningitis and encephalitis in children: An update

Over the course of the past decade, much has changed on the landscape of meningitis and encephalitis in children. West Nile virus has emerged in the United States as a new etiologic pathogen causing encephalitis. Human herpesvirus-6 has been identified as a cause of encephalitis and febrile seizures. Lymphocytic choriomeningitis virus has been identified as an underrecognized neuroteratogen. The emergence of penicillin-resistant Streptococcus pneumoniae has complicated the treatment of bacterial meningitis, whereas the Haemophilus influenzae vaccine has fundamentally altered the disease's epidemiology. The recognition that much of the neuropathologic change induced by bacterial meningitis is inflammation mediated has paved the way to the demonstration that dexamethasone can substantially improve the outcome of bacterial meningitis in children. Although much progress has been made toward understanding, treating, and preventing these important infections, much remains to be learned.
Measurements of extinct fission products in nuclear bomb debris: Determination of the yield of the Trinity nuclear test 70 y later

This paper describes an approach to measuring extinct fission products that would allow for the characterization of a nuclear test at any time. The isotopic composition of molybdenum in five samples of glassy debris from the 1945 Trinity nuclear test has been measured. Nonnatural molybdenum isotopic compositions were observed, reflecting an input from the decay of the short-lived fission products 95Zr and 97Zr. By measuring both the perturbation of the 95Mo/96Mo and 97Mo/96Mo isotopic ratios and the total amount of molybdenum in the Trinity nuclear debris samples, it is possible to calculate the original concentrations of the 95Zr and 97Zr isotopes formed in the nuclear detonation. Together with a determination of the amount of plutonium in the debris, these measurements of extinct fission products allow for new estimates of the efficiency and yield of the historic Trinity test.
On composing a resilient tree in a network with intermittent links based on stress centrality

This paper discusses a composition problem of a resilient tree on a graph modeling a communication network whose links are intermittent. The resiliency of a tree is defined exploiting the binary relation on two kinds of edge weights: availability and commonality. Availability represents a probabilistic stability of a communication link corresponding to an edge, and commonality indicates the influence of an edge based on relative locations of edges on a tree. Our simulation analyzes that the trees satisfying the proposed ordering property on the binary relation provide more stable connections among communication nodes.
Hierarchical sulfur electrodes as a testing platform for understanding the high-loading capability of Li-S batteries

Abstract Lithium-sulfur (Li-S) batteries are considered as an attractive electrochemical energy storage system due to the high theoretical capacity of sulfur (1,675 mA h g −1 ). However, high-loading sulfur cathodes would need to be employed for the Li-S cells to be practical, but the resulting poor cell cyclability and severe electrode degradation hamper their development. Here, we present a hierarchical sulfur cathode as a testing platform for understanding the high-loading capability of Li-S batteries. The hierarchical cathode presents good electrochemical utilization of above 70%, stable cyclability for 500–1,000 cycles, and high sulfur loadings of 4.2–10.0 mg cm −2 . The exploration of the activation and the polysulfide-retention processes of the high-loading cathodes illustrates that the electrochemical stability mainly results from the stabilization of dissolved polysulfides within the cathode region as the electrochemically active catholyte. Therefore, the utilization of stabilized polysulfide migration might be a meaningful opportunity for designing high-loading cathodes and further improving their electrochemical stability and long-term cyclability.
Advances and practical use of the molecular markers for thyroid cancer

Background : Thyroid nodules are very common; however, only 5–15% of nodules are malignant. Although most of the malignant thyroid cancers can be identified pre-operatively by cytological analysis, approximately 20–30% of these nodules are classified indeterminate. Subsequently, repeated Fine Needle Aspiration (FNA) or thyroid surgery may be required for a more definitive diagnosis. In the United States, the incidence of thyroid cancer has tripled from 1975 with an incidence rate of 14.3 per 100,000 individuals, primarily due to an increased diagnosis of papillary thyroid cancer which increased by 9.1 per 100,000 (RR 3.7, 95% CI (3.4–4.0)); however, mortality has remained stable. Many patients with cytologically indeterminate nodules undergo unnecessary diagnostic surgeries, placing them at risk of potential surgical complications and need for lifelong levothyroxine replacement. The advent of molecular gene testing has drawn significant attention toward improved stratification of these indeterminate lesions into benign or malignant. Detection of any pertinant molecular mutations in the indeterminate categories- atypia of undetermined significance (AUS)/ follicular lesion of undetermined significance (FLUS), follicular neoplasm (FN)/suspicious for a follicular neoplasm (SFN), and suspicious for malignant cells (SMC) has been shown to confer the risk of histologic malignancy of 88, 87 and 95% respectively, while a negative test for the mutation was reassuring with a very high negative predictive value over 95%. Purpose : The purpose of this article is to review the current recommendations to implement molecular genetic testing for thyroid nodules. We review the most common gene mutations harbored in the various thyroid cancers, including BRAF, RAS, and RET/PTC. We will also review the more recently discovered gene mutations for thyroid cancer, including TERT mutations. Finally, we will discuss the practice guidelines to implement molecular gene testing for the indeterminate cytology of thyroid nodules as well as the new category of non-invasive follicular thyroid neoplasm with papillary-like nuclear features as an intermediate pathology which will not require aggressive therapy after diagnostic lobectomy. (Published: 13 December 2016) Citation: Advances in Cellular and Molecular Otolaryngology 2016, 4: 33948 - http://dx.doi.org/10.3402/acmo.v4.33948
Algorithms for time-dependent chromatographic peak areas: 1. Algorithms evaluated for fully resolved peaks

This paper describes a preliminary study of an alternative method to fit chromatographic data. Peak-shaped responses are integrated to obtain unidirectional data for area versus time and an empirical model is used to fit the data. Results are reported for two similar models, each of which characterizes the total sigmoid function for each component in terms of the leading and trailing segments of two separate sigmoids. The use of leading and trailing segments of two sigmoids makes it possible to fit area chromatograms with large degrees of asymmetry. Performance of the models was evaluated by fitting them to data for single-component experimental and simulated data with degrees of asymmetry at 10% of peak height between 0.37 (fronting) and 7.33 (tailing). Results obtained using the area-based models are compared with results obtained by fitting a commercially available model for an exponentially modified Gaussian (EMG) to the peak data from which the area data were obtained. Areas computed using the two area-based models vary linearly with barbiturate concentrations over 100- to 200-fold concentration ranges and are more rugged to changes in peak shapes and asymmetry than the EMG model. Both area-based models give substantially smaller errors in peak area and smaller root-mean-squared fitting errors than the EMG model for peaks with moderate to high degrees of asymmetry.
The effects of variable practice on locomotor adaptation to a novel asymmetric gait

Very little is known about the effects of specific practice on motor learning of predictive balance control during novel bipedal gait. This information could provide an insight into how the direction and magnitude of predictive errors during acquisition of a novel gait task influence transfer of balance control, as well as yield a practice protocol for the restoration of balance for those with locomotor impairments. This study examined the effect of a variable practice paradigm on transfer of a novel asymmetric gait pattern in able-bodied individuals. Using a split-belt treadmill, one limb was driven at a constant velocity (constant limb) and the other underwent specific changes in velocity (variable limb) during practice according to one of three prescribed practice paradigms: serial, where the variable limb velocity increased linearly; random blocked, where variable limb underwent random belt velocity changes every 20 strides; and random practice, where the variable limb underwent random step-to-step changes in velocity. Random practice showed the highest balance control variability during acquisition compared to serial and random blocked practice which demonstrated the best transfer of balance control on one transfer test. Both random and random blocked practices showed significantly less balance control variability during a second transfer test compared to serial practice. These results indicate that random blocked practice may be best for generalizability of balance control while learning a novel gait, perhaps, indicating that individuals who underwent this practice paradigm were able to find the most optimal balance control solution during practice.
Triple Quadrupole Mass Spectrometry

The use of triple quadrupole mass spectrometers for bioanalytical applications is introduced. The influence of collision energy and pressure on low-energy collisional activation spectra is described and the interpretation of a product ion spectrum for the structure determination of a peptide is illustrated.
Replication checkpoint-mediated symmetric DNA synthesis: beginning to understand mechanism.

Beginning in the 1950's, Arthur Kornberg's research on DNA polymerases, followed by the efforts of many others, provided a seminal understanding of catalytic DNA synthesis [1], a fundamental proces...
Imaging analysis of biological soil crusts to understand surface heating properties in the Mojave Desert of California.

Abstract Biological soil crusts (biocrusts) are composed of a combination of cyanobacteria, green algae, lichens, and mosses that can protect arid soil surfaces from erosive forces. The presence of biocrusts in desert regions is influenced by a complex interaction of climatic, edaphic, and topographic variables, but their distribution and coverage densities in southern California deserts are not precisely mapped. Visible satellite bands (red-green-blue; RGB) and infra-red image resolution are generally too coarse to distinguish between biocrusts and their interstitial sand substrates, limiting most remote sensing analysis of these soil biotic assemblages. The purpose of this study was to better understand the relationships between biocrust cover, surface coloration and roughness, and the thermal infra-red (TIR) emission properties of biocrusts to determine if new types of imaging of desert surfaces could be used to more accurately detect biocrust presence. Based on the results from megapixel digital photos and TIR imaging for nearly 130 different, well-developed biocrust surfaces in the Mojave and Lower Colorado Deserts of California, we designed laboratory heating experiments to test the effect of biocrust cover on the heating properties of sandy wash habitats. Biocrust samples collected from the field were subjected to artificial heating and cooling to simulate the Mojave Desert diurnal cycle. We used image segmentation algorithms to separate true-color biocrust images from their sandy substrates, and to map the heating and cooling patterns of these surfaces with different levels of biocrust coloration and roughness. The major findings of this study showed that biocrust patch images in the field had Red texture mean values between digital numbers of 95 and 131 with moderate positive tail shewness levels, indicative of a highly rugose surface of the biocrust cover. Such patches were also well-compacted overall, with moderate skewness toward negative tails. In controlled laboratory temperature experiments to simulate the desert diurnal cycle, surface wetting with a fine mist of water resulted in significantly lower peak surface temperatures of biocrust samples compared to dry biocrust heating results of the same crust and sand samples. The findings of this study can improve future mapping for lichen-dominated biocrust surfaces in the Mojave Desert.
Trapped-Hole Diffusion in Photoexcited CdSe Nanorods

Surface charge-carrier traps are ubiquitous in colloidal semiconductor nanocrystals and fundamentally impact excited-state relaxation, making it critical to understand both their nature and their dynamics. Here, using photoluminescence upconversion and transient absorption spectroscopy, we study hole trapping and the dissociation between electrons and trapped holes in nonuniform CdSe nanorods and monitor their subsequent recombination dynamics. These recombination dynamics are described well with a diffusion–annihilation model wherein the trapped hole undergoes a random walk on the nanocrystal surface until it encounters the electron. This model fits the nonexponential excited-state decay over more than 7 orders of magnitude in time with a single adjustable parameter. The characterization of the spatial dynamics of trapped holes in CdSe nanostructures extends our fundamental understanding of excited-state dynamics in this important class of materials. The surface motion of trapped holes may have important...
A MODIFICATION OF GOEL-OKUMOTO MODEL

A stochastic model for a software failure phenomenon based on a non-homogeneous Poisson process (NHPP) was suggested by Goel and Okumoto (G-O). Later Hossain and Dahiya (H/D G-O model) modified the model. We suggest a further modification of it. Several quantitative measures for software performance are developed, ML equations are investigated and a sufficient condition for the MLE to be finite is given. The results of the model are applied to real software failure data and compared with G-O and Yamada et al models.
Cerebral Blood Flow Regulation during Cardiopulmonary Bypass: Correlation with Postoperative Neurologic and Neuropsychologic Deficits

Postoperative neuropsychologic deficits after cardiopulmonary bypass for coronary revascularization or open cardiac procedures remains a disturbing and poorly understood complication. The etiology of postoperative neuropsychologic deficits is being aggressively investigated, but remains controversial. It has been widely speculated that these complications are the results of either: 1) embolism of air or particulate matter, or 2) hypoperfusion during cardiopulmonary bypass. Since the incidence of postoperative neuropsychologic deficits (PNPD) is significantly higher after cardiac than non-cardiac surgery, events associated with cardiopulmonary bypass (CPB) must lead to these complications. The fact that many of the PNPD are transient and nonfocal lends credence to the possibility of hypoperfusion or changes in cerebral autoregulation and cerebral blood flow (CBF) as a mechanism for these injuries. Therefore, the research on neurologic and neuropsychologic outcome at The Duke Heart Center has centered around CBF and changes occurring during cardiopulmonary bypass.
Use of a comprehensive state birth data system to assess mother's satisfaction with length of stay.

Objective: To assess length of stay, home visits, and mothers' feelings after full implementation of a law requiring a 48-hour minimum stay for women with normal vaginal deliveries. Methods: The New Jersey Electronic Birth Certificate System (EBC) was used to capture demographic characteristics, and length of stay (LOS), and to select a sample of women with low risk uncomplicated vaginal deliveries. A follow-up mail survey (with a nonresponder phone component) enhanced the information available on the EBC. Results: The response rate for women included in the sample was 82.1% (1276/1555). The mean length of stay was 1.9 days. Sixty-two percent (787) of women thought their LOS after delivery was just right. Women who thought their stays were too short tended to be older, married, working outside the home, or have an LOS of less than 48 hours. The most common reasons for thinking the LOS was too short was a need for rest and concern about the baby. Discussion: The combination of an augmented electronic birth certificate system and a follow-up survey proved to be a rapid, reliable, and inexpensive method of assessment. The mothers' desires for rest, education on the care of her newborn, and reassurance that any medical complications could be handled, are paramount concerns that need to be taken into account by payers and practitioners wanting to decrease LOS.
Dyslipidemia: Relationship to Insulin Resistance, Fatty Liver, and Sub-Clinical Atherosclerosis

Insulin resistance and dyslipidemias are clinical hallmarks of cardiometabolic and fatty liver disease, however the underlying pathophysiology is not yet fully understood. Therefore, there is considerable interest in adequately defining risk factors by age, sex, and race/ethnicity in an effort to design appropriate interventions and treatments for obesity-related diseases. This chapter begins with a background on the epidemiology of obesity, type 2 diabetes, and subclinical atherosclerosis. By focusing on the distribution of body, where we will also emphasize hypothesized mechanisms behind insulin resistance, dyslipidemia and its relationship to atherosclerosis progression. Finally, we will discuss advanced imaging methods and treatments used to identify and treat these obesity-related metabolic disorders.
Computed Dental Radiography Used to Reproduce Antemortem Film Position

Visual comparison of conventional antemortem and postmortem dental radiographs is often included in forensic identification. Ten forensic cases employing dry mandibular and maxillary bones and a dry study skull were exposed using the CDR digital dental X-ray system developed by Schick Technologies, Inc. Exposures of 0.08s at 10 mA and 70 kVp were taken with an INTREX intraoral dental X-ray unit. Digital radiography has the ability to produce an image instantaneously, allowing an operator to retake an incorrectly aligned radiograph almost immediately. It gives the forensic scientist a simplified method for reproducing antemortem radiographic position more efficiently and often with greater accuracy than conventional radiography.
From Traffic to Chocolate Chip Cookies with the Poisson Distribution

Imagine that you are sitting at a pleasant cafe near a quiet country road, sipping cappuccino and enjoying the scenic countryside. After a while, you notice how little traffic there is on the road. The waiter nods sadly, he says only about five vehicles pass per hour during the afternoon—he wishes the traffic were heavier so business would improve. What is the probability that at least one vehicle will pass in the next 15 minutes?
Targeting Tertiary Lymphoid Structures for Tumor Immunotherapy

Tumor microenvironments (TME) are usually immunosuppressive and prevent lymphocyte priming. Recent clinical trials have shown that cancer immunotherapy such as immune checkpoint inhibitors can induce unprecedented durable responses in patients with a variety of cancers. Tertiary lymphoid structures (TLS) can form inside or adjacent to tumor tissues due to persistent inflammation. The formation of TLS facilitates lymphocyte trafficking and infiltration into tumor tissues. It can also support effective antigen presentation and lymphocyte activation. Thus, TLS have become an intriguing target to manipulate antitumor immunity. Several therapeutics targeting TLS have been developed and shown promising antitumor effects in various mouse models. In this chapter, we describe the general approach to establish transplantable mouse tumor models for the study of immunotherapy. We introduce the strategies for therapy through systemic or local treatment targeting TLS. We also present approaches to evaluate the antitumor immune responses provoked by the therapies.
Conservation of Crop Wild Relatives in the USA

Crop wild relatives (CWR) are found throughout the USA, with a high concentration in the eastern part of the country. These wild plants include the ancestors of crops domesticated within the borders of the country, such as sunflower, pecan, blueberry, cranberry, and squash, as well as the relatives of crops domesticated elsewhere. This chapter presents an overview of some of the CWR found in the USA and the status and potential for improved conservation through both ex situ and in situ approaches. The largest collection of CWR germplasm from the USA is the National Plant Germplasm System, managed by the US Department of Agriculture, Agricultural Research Service (USDA-ARS). Other germplasm conservation networks, including the Bureau of Land Management-led Seeds of Success, the Center for Plant Conservation’s Collection of Endangered Plants, and the American Public Gardens Association/US National Arboretum-coordinated Plant Collections Network, support collection and conservation of plants that include CWR. Active sampling of CWR for ex situ conservation is ongoing, especially for certain crop groups, such as potato, sunflower, and small fruits. In situ conservation of CWR is mostly passive, involving protected areas that were established for other objectives. Ample opportunities exist to fill gaps in ex situ collections and to more deliberately conserve CWR on public lands, particularly by making better use of available sources of information, harnessing existing frameworks, and developing new partnerships.
Convergent energies and anharmonic vibrational spectra of Ca2H2 and Ca2H4 constitutional isomers.

Three constitutional isomers of both Ca2H2 and Ca2H4 have been characterized with molecular electronic structure theory. Correlation methods as complete as CCSDT(Q) and basis sets as large as cc-pwCV5Z have been used to converge the relative energies within chemical accuracy (≤1 kcal mol−1). Anharmonic vibrational frequencies were computed using second-order vibrational perturbation theory employing CCSD(T)/cc-pwCVTZ cubic and quartic force-fields and a CCSD(T)/cc-pwCVQZ quadratic force field. The monobridged [Ca(μ2-H)CaH] and dibridged [Ca(μ2-H)2Ca] isomers of Ca2H2 were predicted to lie 6.5 and 12.9 kcal mol−1 below the energy of the classical HCaCaH linear isomer, respectively. Despite the energetic favorability of the bridged Ca2H2 isomers, we conclude (surprisingly) that only the higher energy linear structure has been observed in the laboratory. At 0 K, the tribridged [Ca(μ2-H)3CaH] isomer of Ca2H4 is predicted to be enthalpically favored by 0.9 kcal mol−1 in comparison to the enthalpy of the dibridged [HCa(μ2-H)2CaH] structure. Comparison of experiment with our computed frequencies suggests that the observed vibrational features arise from both the dibridged and the tribridged Ca2H4 structures.
Digital health technologies: opportunities and challenges in rheumatology.

The past decade in rheumatology has seen tremendous innovation in digital health technologies, including the electronic health record, virtual visits, mobile health, wearable technology, digital therapeutics, artificial intelligence and machine learning. The increased availability of these technologies offers opportunities for improving important aspects of rheumatology, including access, outcomes, adherence and research. However, despite its growth in some areas, particularly with non-health-care consumers, digital health technology has not substantially changed the delivery of rheumatology care. This Review discusses key barriers and opportunities to improve application of digital health technologies in rheumatology. Key topics include smart design, voice enablement and the integration of electronic patient-reported outcomes. Smart design involves active engagement with the end users of the technologies, including patients and clinicians through focus groups, user testing sessions and prototype review. Voice enablement using voice assistants could be critical for enabling patients with hand arthritis to effectively use smartphone apps and might facilitate patient engagement with many technologies. Tracking many rheumatic diseases requires frequent monitoring of patient-reported outcomes. Current practice only collects this information sporadically, and rarely between visits. Digital health technology could enable patient-reported outcomes to inform appropriate timing of face-to-face visits and enable improved application of treat-to-target strategies. However, best practice standards for digital health technologies do not yet exist. To achieve the potential of digital health technology in rheumatology, rheumatology professionals will need to be more engaged upstream in the technology design process and provide leadership to effectively incorporate the new tools into clinical care. Digital health technologies (DHTs) have a variety of interesting current and possible future applications in rheumatology. In this article, the authors describe some of the key barriers that prevent DHT integration into rheumatology care and discuss ways in which these barriers could be addressed.
Structural Allograft Versus Synthetic Interbody Cage for Anterior Cervical Discectomy and Fusion: A Comparison of 1-Year Outcomes From a National Database:

Study Design:Observational cohort study.Objective:To compare 1-year perioperative complications between structural allograft (SA) and synthetic cage (SC) for anterior cervical discectomy and fusion...
A Spatial Model of Housing Returns and Neighborhood Substitutability

This paper provides a method for estimating housing indicesat the local level. It develops a "distance-weightedrepeat-sale" procedure to exploit the factor structure ofthe error-covariance matrix in the repeat-sales model. Adistance function defined in characteristic andgeographical space provides weights for the generalizedleast-squares model, and allows the use all of the repeated-sales in a metropolitan area to measure returns for thespecific neighborhood of interest. We use distance-weightedrepeat-sales to estimate return indices for all zip codes inthe San Francisco Bay area over the period 1980 through1994. When distance is defined in terms of socio-economiccharacteristics, we find that median household income is thesalient variable explaining covariance of neighborhoodhousing returns. Racial composition and educationalattainment, while significant, are much less influential.Zip-code level indices often deviate dramatically from thecity-wide index, depending upon income levels. This hasimplications for investors and lenders. Our resultsindicate that rates of return may vary considerably within ametropolitan area. Thus, simply using broad metropolitanarea indices as a proxy for capital appreciation within aspecific neighborhood may not be justified.
Systematic review and meta-analysis: real-world data rates of deep remission with anti-TNFα in inflammatory bowel disease.

Background Deep remission (DR) is a treatment target in IBD associated with reduced hospitalization and improved outcome. Randomized control trial (RCT) data demonstrates efficacy of anti-TNFα agents in achieving DR; however, real-world data (RWD) can provide information complementary to RCTs, specifically regarding treatment duration. In this systematic review with meta-analysis, we use real-world data (RWD) to determine rates of DR in IBD treated with anti-TNFα. Methods We completed a systematic search of MEDLINE and EMBASE on July 8, 2019 with review of major gastrointestinal conference abstracts from 2012 to 2019. Studies utilizing RWD (data not from phase I-III RCTs) of adult IBD patients treated with anti-TNFα agents were included. DR was defined by clinical and endoscopic remission at minimum. DR was assessed at 8 weeks, 6 months, 1 year, and 2 years. Risk of bias was assessed with the Newcastle Ottawa Scale. Results 29,033 publications were identified. Fifteen publications, nine manuscripts and six conference abstracts, were included encompassing 1212 patients (769 Crohn's disease-CD, 443 ulcerative colitis-UC), and analyzed using Comprehensive Meta-Analysis. Rate of DR was 36.4% (95% CI 12.6-69.4%) at 8 weeks, 39.1% (95% CI 10.4-78%) at 6 months, 44.4% (95% CI 34.6-54.6%) at 1 year, and 36% (95% CI 18.7-58%) at 2 years. DR in CD at 1 year was 48.6% (95% CI 32.8-64.7%) and in UC was 43.6% (95% CI 32.8-55.1%). Conclusions The rate of DR was highest after 1 year of therapy, in nearly 45% of IBD patients treated with anti-TNFα. Similar rates were achieved between patients with UC and CD. The findings highlight the efficacy of anti-TNFα in real-world setting. Future studies using RWD can determine efficacy of newer IBD therapeutics in routine clinical practice.
Microbial Metabolites as Pesticides

Beneficial microbes used for the control of crop pests have one or more modes of action against their target arthropods, nematodes, pathogens, or weeds. Metabolites, enzymes, volatile compounds, and other bioactive materials help them to antagonize and suppress target pests. The pesticidal activity of several microbial metabolites has been extensively studied, but only a few have commercial potential. While microbes themselves, rather than their metabolites, are primarily used for plant disease control, metabolites such as anisomycin, avermectins, bialophos, and spinosad are some examples of successful commercialization for insect, mite, nematode, and weed control. Biopesticides based on fermentation solids and solubles, without live microbes, are also available in the market. Pesticides based on Burkholderia rinojensis and Chromobacterium subtsugae for insect and mite control and Myrothecium verrucaria for nematode control are some of such examples that do not have viable microbes. Microbial biopesticides play a critical role in integrated pest management and maintaining crop productivity. This chapter focuses on microbial metabolites and metabolite-producing microbes that are commercialized and briefly discusses the potential of others.
Hospital Guardianship: A Quality Needs Assessment of "Unbefriended" Patients Who Lack Decisional Capacity.

Background The “unbefriended” patient does not demonstrate capacity to make their own medical decisions, does not have an advance directive, and lacks a surrogate decision maker. For these patients without a designated health care proxy, hospitals may need to petition for public guardianship, a notoriously arduous process with undefined impact on hospital resources. Objective The objective of this study was to describe the characteristics, system needs, and financial impact of unrepresented inpatients in an academic, tertiary care, urban medical center. Methods The Northwestern Memorial Hospital Quality and Patient Safety Committee approved a systematic needs assessment. Retrospective chart review was conducted for patients admitted from September 1, 2013 to August 31, 2019 for whom the hospital petitioned for a public guardian. Results From fiscal years 2014 to 2019, 156 patients were petitioned for public guardianship. The number of cases rose sequentially from 8 in 2014 to 44 in 2019. The 2 most common conditions that impaired capacity were neurocognitive disorders (56.4%) and psychotic disorders (17.9%). The psychiatry consultation service consulted 71.2% of cases vs 71.1%. There were 2347 medically unnecessary hospital days related to the pursuit of guardianship, and the associated costs to the health system were estimated to be more than $5.8 million. Conclusions The number of unbefriended patients who lacked decisional capacity necessitating public guardianship dramatically escalated over 5 years. These patients had high rates of homelessness and psychiatric illness, consistent with previous research. Further investigation is needed to understand and address the needs of this vulnerable population.
University Health Class: Keep or Cut? Implications for the Future

As health and fitness continue to decline and metabolic risk factors reciprocate with increasing incidence in younger and larger cohorts, the importance of conceptually based university health clas...
Mapping factors associated with deaths in immigration detention in the United States, 2011-2018: A thematic analysis

Abstract Background Climate change, poverty, and violence increasingly drive migration to the United States. United States Immigration and Customs Enforcement (ICE) detain some individuals while awaiting determination of immigration status or potential deportation. Over the last two decades, more than 200 individuals died in ICE detention. In this study, we aim to identify systemic issues related to deaths of individuals in ICE detention to potentially mitigate further harm. Methods The ICE Office of Detention Oversight conducts investigations after each death in detention, producing a report called a “Detainee Death Review”. To identify systemic issues in these deaths, we used thematic analysis to review 55 Detainee Death Reviews available between 2011 and 2018. Findings We identified 3 major themes of pervasive issues—Detainee Not Patient, System Over Patient, and Grossly Substandard Care— and 11 subthemes. Subthemes of culture of shortcuts, delays in care, and poor care delivered were present in the vast majority of cases. Subthemes bias and discrimination, language injustice, falsification of and inconsistencies between records and reports, willful indifference, security over health, communication breakdown, inadequate resources, failure of protective mechanisms, missing/ignoring red flags, and failure of emergency response were also prominent. Interpretation This study identified underlying systems issues within the medical care provided in ICE detention. While there are issues with language services, discrimination, and inadequate response to medical emergencies, the greatest issue is the lack of independent, external review. Greater transparency is required, so that adherence to basic standards of care for individuals in ICE detention can be better evaluated. Funding Haas Jr. Fund and the University of Southern California’s Equity Research Institute.
Exploring the intersection of the microbiome and the developing brain: Impacts on schizophrenia risk.

Abstract Recent findings show that the perinatal maternal and infant microbiomes have profound potential to impact long term health outcomes. Of particular interest are the ways in which the microbiome influences the developing brain during one of its most critical windows. Schizophrenia and psychosis risk are strongly connected to disruptions in perinatal neurodevelopment. In this review we present an overview of critical aspects in development of both the microbiome and brain, discuss their overlap, and consider what role the microbiome plays in schizophrenia risk during the perinatal window. Considering this, we discuss ways in which expecting and new mothers may reduce offspring schizophrenia risk.
The anode supported internal cathode tubular solid oxide fuel cell: Novel production of a cell geometry for combined heat and power applications

Abstract An effective strategy for generating combined heat and power (CHP) systems is to use the combustion of hydrocarbons to provide fuel reforming and heat production for solid oxide fuel cell (SOFC) operation. Though tubular SOFCs (tSOFCs) are well suited to the thermal cycling associated with combustion systems, they have a geometric limitation which requires significant alteration to the combustion chamber. These alterations can be eliminated by producing an anode supported internal cathode-tSOFC (IC-tSOFC) which can be directly integrated into the chamber with minimal alterations. Novel methods used to produce IC-tSOFCs are discussed in this work. Scanning electron microscopy (SEM) and performance characterization are used to analyze fabricated cells. With a peak power density of 369 mW∙cm−2, and an open circuit voltage (OCV) of 0.98 V, it is confirmed that novel production methods for IC-tSOFCs have been successful.
CMOL: possible hybrid semiconductor/nanodevice circuits

The author reviews the recent work on devices and architectures for possible hybrid semiconductor/nanodevice integrated circuits of "CMOL" variety. Such circuit would combine an advanced CMOS subsystem fabricated by the usual lithographic patterning with a two-layer nanowire crossbar (formed, e.g., by nanoimprinting) with the wires connected, at each crosspoint, by two-terminal nanodevices. The CMOL concept enables a combination of the advantages of its components (e.g., reliability of MOSFET transistors and minuscule footprint of nanodevices), as well as those of patterning techniques: the flexibility of the optical lithography and the potentially low cost of nanoimprinting and nanodevice formation (e.g., the chemically-directed molecular self-assembly). This powerful combination may allow CMOL circuits to reach an unparalleled device density (up to 10/sup 12/ functions per cm/sup 2/) and ultrahigh information processing performance (up to 10/sup 20/ operations per second per cm/sup 2/), at acceptable power dissipation (below 100 W/cm/sup 2/) in several digital and mixed-signal systems including terabit-scale memories, reconfigurable FPGA-like logic circuits, and neuromorphic networks. The main challenges on the way toward practical CMOL systems is the fabrication of highly reproducible nanodevices and the improvement of CMOL circuit architectures.
The effect of remote substituents upon the course and reactivity of homoallylic systems

Abstract Several C19 substituted cholesteryl p-toluenesulphonate esters have been synthesized for the purpose of studying the effects of the C19 substituent upon the course and rate of solvolylic reactions in this system. The rates of acetolysis were determined for the C19 hydroxy, methoxy, acetoxy, aldehydo and thioacetal cholesteryl p-toluenesulphonates. Kinetic evidence is presented for trans-annular stabilization of the transition state for ionization possibly via C6C19 bridged structures. The relative magnitudes of the rate variations are discussed in terms of inductive effects, ring strain effects incurred in the bridged structures and entropy factors. Solvolysis of Δ5-cholestene-3β, 19-diol 3-p-toluenesulphonate (IX) does not yield 3α, 5-cyclo-6β, 19-oxidocholestane (XIII), the product corresponding to intramolecular neutralization of the ion. The fact that the predominant product is 3α, 5-cyclocholestane-6β, 19-diol (XII), indicates that in spite of a kinetically demonstrable interaction between C6C19, the stereochemistry of attack of solvent at C6 is not influenced by such an effect. Similarly, hydrolysis of Δ5-cholestene-3β-ol-19-al 3-p-toluenesulphonate (VIII) yielded mainly 3α, 5-cyclocholestane-6β-ol-19-al (XIV). The mechanistic implications of these results discussed along with the general question of the possible modes of interaction of remote polar groups with developing cationic centres in solvolytic reactions.
The Accuracy of Galileo's Observations and the Early Search for Stellar Parallax

The question of annual stellar parallax is usually viewed as having been a "win-win situation" for seventeenth-century astronomers who subscribed to the Copernican view of universe in which the Earth orbits the Sun and the Sun is one of many suns (the fixed stars) scattered throughout space. Detecting parallax would be solid evidence for the Earth's motion, but failure to detect parallax could be explained by the stars lying at great distances. Recent work pertaining to Galileo's observations of double stars illustrates Galileo's skill as an observer. It also indicates that, given the knowledge of optics of the time, Galileo could expect his measurements to be accurate enough that they would have revealed stellar parallax had it existed. Thus parallax was not a "win-win situation" after all. It could be solid evidence against the Earth's motion, evidence which fortunately did not dissuade Galileo from the Copernican view.
The effect of screw head design on rod derotation in the correction of thoracolumbar spinal deformity: laboratory investigation.

Object The use of fixed-axis pedicle screws for correction of thoracolumbar deformity in adult surgery is demanding because of the challenge of assembling the bent rod to the screw in order to achieve curve correction. Polyaxial screw designs, providing increased degrees of freedom at the screw-rod interface, were reported to be insufficient in achieving correction of thoracic deformity in the axial plane. Using a multisegment bovine calf spine model, this study investigated the ability of a new uniplanar screw design to achieve derotation correction of the vertebrae and maintain a degree of correction comparable to that of fixed-axis and polyaxial screw designs. Methods Eighteen calf thoracolumbar spine segments from T-6 to L-1 (n = 6 per screw design) underwent bilateral facetectomies at the T9–11 levels and were instrumented bilaterally with pedicle screws and rods. To assess the efficacy of each screw design in imparting rotational correction, each instrumented level was tested under applied torsional...
Embodiment in Human Communication

This article defines the present moment in the anthropology of embodied human communication as a moment of possible fusion between (a) the new conception of the living human body emerging in biology, cognitive science and neuroscience, and sociology and anthropology and (b) the advanced methodology and research on social interaction in the “interactionist” tradition, which is reinterpreted here as a study of socialized practices for interacting in, and inhabiting, the world with others. A growing number of studies of interaction are now focused on “multimodal” communication in complex material settings. The convergence of research programs is illustrated here by sociological research on dance and sports, by a practice-based approach to gesture, and by a selective overview of recent studies of multimodality. Particular attention is given to two influential theoretical programs, one by E. Hutchins and the other by C. Goodwin.
The Changing Swedish Electorate Class Voting, Contextual Effects, and Voter Volatility

This article attempts to assess the contribution of long-term changes in Swedish social structure to three recent developments in Swedish electoral behavior: the decline of the Social Democrats, the decline in class voting, and the increase in the volatility of party preference. The author argues that the decline of the Social Democrats cannot be attributed to long-term structural changes in the electorate but rather is a product of the policies and electoral strategies pursued by the parties. The decline in class voting is found to be partly attributable to long-term structural change. Original secondary analysis of survey data is then presented to show that the socioeconomic composition of individuals' places of residence affects their voting behavior independent of individual-level characteristics. The author then argues that the parties' policies and electoral strategies have reinforced the tendency toward decreasing class voting. Finally, both long-term structural changes and the decline in class vot...
Late-Onset Hearing Loss: Strategies for Effective Counseling.

Late-onset hearing loss is one of the major chronic conditions experienced by older individuals. The term presbycusis is typically used when describing this condition. Presbycusis refers to many degenerative changes that affect older people's hearing. This article provides practical suggestions for working with persons with this condition.
Polar Wander and Surface Convergence of Europa's Ice Shell: Evidence from a Survey of Strike-Slip Displacement

Two global issues regarding Europa are addressed by a survey of strike-slip faults. First, a common type of terrain that appears to represent convergent sites of surface removal, which may help compensate for substantial widespread dilation along tectonic bands elsewhere, thus helping resolve the problem of conserving global surface area, is identified. Second, evidence for polar wander may provide the first confirmation of that theoretically predicted phenomenon. These results, among others, come from an extensive survey of strike-slip faults over the portion of the surface where Galileo images at 200-m/pixel resolution were obtained for regional mapping purposes. The images cover two broad swaths that run from the far north to the far south, one in the leading hemisphere and the other in the trailing hemisphere. Among the faults that have been mapped are a fault 170 km long with a strike-slip offset of 83 km, the greatest yet identified on Europa, and a quasi-circular strike-slip fault that surrounds a 500-km-wide plate, which has undergone rotation as a rigid unit. Reconstruction of specific examples of strike slip reveals sites of lateral convergence. Because Europa is unique in many ways, these sites are not similar to compression features on other bodies, which may explain why they had previously been difficult to identify. The distribution of strike slip in both hemispheres, when compared with predictions of the theory of tidal walking, provides evidence for polar wander: The crust of Europa appears to have slid as a single unit relative to the spin axis, such that the site on the crust that was previously at the north rotational pole has wandered, probably during the last few million years, to a location currently in the leading hemisphere, about 30° away from the spin axis. Such polar wander probably also explains symmetry patterns in the distribution of chaotic terrain, pits, and uplift features.
Calculated inversion barrier of AsF3

Abstract The inversion barrier of AsF 3 has been calculated using SCF theory with a moderately large basis set of Slater type orbitals, including polarization functions on the central atom. The calculated barrier is ≈ 112 kcal mole . The highest occupied molecular orbital in planar AsF 3 is shown to have A' 1 symmetry, rather than A″ 2 symmetry typical for molecules of this type.
Self‐Avoiding Walks on the Tetrahedral Lattice

Self‐avoiding walks on the tetrahedral lattice were studied. By extending the excluded‐volume condition to incorporate first nonbonded nearest neighbors one obtains a value of the polymer index γ to be 1.255. This is in agreement with the direct enumeration studies of Mazur and Joseph and is interpreted in terms of the intrinsic excluded volume and excess excluded volume. It is suggested that all real systems may have to be studied in their own right to obtain their molecular‐weight configurational dependence.
Emission FTIR analyses of thin microscopic patches of jet fuel residues deposited on heated metal surfaces

The relationship of fuel stability to fuel composition and the development of mechanisms for deposit formation were investigated. Fuel deposits reduce heat transfer efficiency and increase resistance to fuel flow and are highly detrimental to aircraft performance. Infrared emission Fourier transform spectroscopy was chosen as the primary method of analysis because it was sensitive enough to be used in-situ on tiny patches of monolayers or of only a few molecular layers of deposits which generally proved completely insoluble in any nondestructive solvents. Deposits of four base fuels were compared; dodecane, a dodecane/tetralin blend, commercial Jet A fuel, and a broadened-properties jet fuel particularly rich in polynuclear aromatics. Every fuel in turn was provided with and without small additions of such additives as thiophene, furan, pyrrole, and copper and iron naphthenates.