cssi/SciSciGPT-SciSciNet huggingface dataset:
Gist-based conceptual processing of pictures remains intact in patients with amnestic mild cognitive impairment.

Objective: The picture superiority effect, better memory for pictures compared to words, has been found in young adults, healthy older adults, and, most recently, in patients with Alzheimer’s disease and mild cognitive impairment. Although the picture superiority effect is widely found, there is still debate over what drives this effect. One main question is whether it is enhanced perceptual or conceptual information that leads to the advantage for pictures over words. In this experiment, we examined the picture superiority effect in healthy older adults and patients with amnestic mild cognitive impairment (MCI) to better understand the role of gist-based conceptual processing. Method: We had participants study three exemplars of categories as either words or pictures. In the test phase, participants were again shown pictures or words and were asked to determine whether the item was in the same category as something they had studied earlier or whether it was from a new category. Results: We found that all participants demonstrated a robust picture superiority effect, better performance for pictures than for words. Conclusions: These results suggest that the gist-based conceptual processing of pictures is preserved in patients with MCI. While in healthy older adults preserved recollection for pictures could lead to the picture superiority effect, in patients with MCI it is most likely that the picture superiority effect is a result of spared conceptually based familiarity for pictures, perhaps combined with their intact ability to extract and use gist information.
Association Between Hospital Process Composite Performance and Patient Outcomes After In-Hospital Cardiac Arrest Care.

Importance Survival rates after in-hospital cardiac arrest (IHCA) vary significantly among US centers; whether this variation is owing to differences in IHCA care quality is unknown. Objective To evaluate hospital-level variation to determine whether hospital process composite performance measures of IHCA care quality are associated with patient outcomes. Design, Setting, and Participants Using data from the American Heart Association’s Get With the Guidelines–Resuscitation (GWTG-R) program, we analyzed 35 283 patients 18 years or older with IHCA treated at 261 US hospitals from January 1, 2010, through December 31, 2012. We calculated the hospital process composite performance score for IHCA using 5 guideline-recommended process measures. Opportunity-based scores were calculated for all patients, aggregated at the hospital level, divided into quartiles, and then associated with risk-standardized survival and neurologic status by a test for trend. The scores were then evaluated through hierarchical logistic regression and reported as odds ratios per 10% increment in hospital process composite performance. Interventions Acute care treatments for IHCA. Main Outcomes and Measures The primary outcome was survival to discharge measured as risk standard survival rates, and the secondary outcome was favorable neurologic status at hospital discharge. Results Of the 35 283 adults included in this study, the median age was 67 years (interquartile range [IQR] 56-78 years), and 57.9% were male. The median IHCA hospital process composite performance was 89.7% (interquartile range, 85.4%-93.1%) and varied among hospital quartiles from 82.6% (lowest) to 94.8% (highest). The IHCA hospital process composite performance was linearly associated with risk-standardized hospital survival to discharge rates: 21.1%, 21.4%, 22.8%, and 23.4% from lowest to highest performance quartiles, respectively (P Conclusions and Relevance The quality of guideline-based care for IHCA varies significantly among US hospitals and is associated with patient survival and neurologic outcomes.
Hypotheses on Religion in the Military

Recent U.S. military engagements in the Middle East have drawn public attention to the thorny issue of religion in the armed forces but the scholarship on religion in the military lags far behind these developments. Scholars have not developed a coherent research program around the challenges that religion faces in the armed forces or the religious issues that soldiers, commanders and military institutions grapple with on a daily basis. This papers seeks to initiate a scholarly conversations about the roles and effects of religion in the armed forces. I propose exploratory hypotheses that touch on some key themes that such a research program might cover, at three levels of analysis. At the institutional level, scholars should interrogate the relationship between religious norms and constitutional challenges in society and in the military. At the unit level, research should explore the impact that chaplains and group rituals have on unit morale. At the individual level, this research program should initiate a comprehensive investigation of the effects of individual religious practices on the mental health of soldiers and, in turn, the impact that participation in combat has on soldiers' religiosity. These illustrative hypotheses are far from exhaustive and should be regarded as invitations for future exploration.
Electrocatalytic properties of La 0.9 Sr 0.1 MnO 3 -based electrodes for oxygen reduction

Electrochemical reduction of oxygen at the interface between a La0.9Sr0.1MnO3 (LSM)-based electrode and an electrolyte, either yttria-stabilized-zirconia (YSZ) or La0.8Sr0.2Ga0.9Mg0.1O3 (LSGM), has been investigated using DC polarization, impedance spectroscopy, and potential step methods at temperatures from 1053 to 1173 K. Results show that the mechanism of oxygen reduction at an LSM/electrolyte interface changes with the type of electrolyte. At an LSM/YSZ interface, the apparent cathodic charge transfer coefficient is about 1 at high temperatures, implying that the rate-determining step (r.d.s.) is the diffusion of partially reduced oxygen species, while at an LSM/LSGM interface the cathodic charge transfer coefficient is about 0.5, implying that the r.d.s. is the donation of electrons to atomic oxygen. The relaxation behavior of the LSM/electrolyte interfaces displays an even more dramatic dependence on the type of electrolyte. Under cathodic polarization, the current passing through an LSM/YSZ interface increases with time whereas that through an LSM/LSGM interface decreases with time, further confirming that it is the triple phase boundaries (TPBs), rather than the surface of the LSM or the LSM/gas interface, that dominate the electrode kinetics when LSM is used as an electrode.
Entomological Correlates of Babesia microti Prevalence in an Area Where Ixodes scapularis (Acari: Ixodidae) Is Endemic

Zoonotic prevalence of Babesia microti Franca piroplasms infecting white-footed mice, Peromyscus leucopus Rafinesque, was determined at 34 sites in Rhode Island where nymphal blacklegged tick, Ixodes scapularis Say, densities ranged from low to hyperabundant (1.7-525.3 nymphs per hour of flagging). Babesia was only detected at sites where tick abundance was moderate to high (> 20 nymphs per hour of flagging) and appeared to exhibit a clumped distribution. Where B. microti was detected, the mean number of nymphal ticks collected per hour of flagging was 229.2 compared with a mean of 40.1 at sites where Babesia was not detected. By combining the spatial occurrence of Babesia with a tick density database in a geographic information system, it may be possible to predict the pattern of zoonotic and human infection with B. microti.
A survey of quadratic programming applications to business and economics

One of the shortcomings of linear programming lies in its linearity assumption, primarily in the objective function. This compels us to work with a constant marginal rate of substitution and constant return to scale. However, this assumption is at variance with the economists' preference postulates. This paper presents a survey of quadratic programming practices in corporate and economic planning formulations. It examines a variety of applications of quadratic programming—portfolio selection, monopolists' profit maximization, inequality constrained least-squares estimation, spatial equilibrium analysis, goal programming with quadratic preferences, and optimal decision rules.
Methodologies for weight estimation of fixed and flapping wing micro air vehicles

One of the important steps in the sizing process of fixed and flapping wing micro air vehicles (MAVs) is weight estimation of the electrical and structural components. In order to enhance the flight performance and endurance of MAVs, it is required to carefully estimate their weight with a minimum error. In this study, methodologies to estimate the weight of fixed and flapping wing MAVs are proposed. After dividing the total weight of the MAV into weights of structural and electrical components, these two weights are separately identified. The weight of the MAV electrical components is estimated by using engineering design techniques and the weight of the structure is identified by using statistical and computational methods. The proposed methodology for structural weight estimation is based on calculating the percentage of the used material in the construction of different parts of MAVs and then presenting the weight of each part in terms of the wing surface. The proposed computational method gives the exact estimation for the weight of each structure component, such as wing, tail, fuselage, and etc. Based on the offered method for weight estimation of MAVs, the weight estimation of a fixed wing MAV with inverse Zimmerman planform and a flapping wing MAV named “Thunder I” are experimentally shown. This developed methodology gives guidelines for weight estimation and determination of the structural weight percentages in order to design and fabricate efficient fixed and flapping wing MAVs.
Herbal Use and Medical Pluralism Among Latinos in Southern California

Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet few patients disclose CAM use to medical doctors. Our objectives were to (1) assess Latino herbal use, (2) explore the most commonly used herbs for common ailments, and (3) examine patients’ disclosure of herb use to their physicians. Self-administered questionnaires were collected from 318 Latino patients seeking treatment at community health centers. Descriptive statistical analysis was conducted to determine the frequency of stated objectives among the participants. Fisher’s exact test was used to compare differences among CAM users and non-users. Most respondents (90%) reported using herbs. Less than a third (31%) of those herb users felt comfortable speaking English to their physician. A majority (74.8%) of the respondents utilizing herbs reported never disclosing their herbal use to their healthcare providers, and of those that did, majority (63%) were under the age of 36 years. Of those that disclosed their herbal use, only 31% perceived receiving a positive reaction about herbal use from their providers. Chamomile, cinnamon, Aloe vera, spearmint, and key lime were the top used herbs in this population. Herbal use disclosure reflects a greater sense of trust and communication between patient and provider. Therefore, a need exists to increase provider competency for patients using herbs in order to improve consistency of care and facilitate healthy patients and communities, especially among Spanish-speaking Latinos in Southern California.
Millimeter-wave power amplifiers & transmitters

This review paper covers the basic principles, architectures, and representative results related to millimeter-wave silicon power amplifiers and transmitters. Effects of technology on the performance metrics of linear and switching power amplifiers as the frequency increases to the mm-wave regime are demonstrated. Methods that can enhance the output power, namely various power combining schemes as well as transistor stacking, along with practical considerations at mm-wave frequencies are covered. Finally, mm-wave transmitter architectures and associated design tradeoffs are discussed.
Direct Sodium Channel Regulation by Calmodulin

Many aspects of the sophisticated mechanism of sodium channel regulation by Ca2+ and calmodulin remain unresolved and controversial. In this issue of Structure, Johnson et al. (2018) provide compelling structural and functional evidence clarifying considerably how calmodulin engages the inactivation gate of the sodium channel and the consequences for regulation.
Promotion of Cognitive Health Through Prevention: The Case of Sports Concussion

Sports-related concussions are frequent injuries occurring in most contact and collision sports across all ages and all levels of play. Once thought of as a comical injury that was “part of the game,” it is now understood that concussions are brain injuries that can have permanent and at times devastating neurocognitive consequences if not evaluated and managed appropriately. This chapter reviews the definition of concussion, mechanism of injury, the pathophysiology underlying the injury, epidemiology, and the clinical management of players who have sustained a concussion. The focus then turns to prevention of the injury and, more importantly, the prevention of deleterious consequences from improper management. Various prevention strategies are discussed ranging from education to legislative reform.
Chemical methods for determining the electron storage capacity of black carbon.

Abstract Electron storage capacity (ESC) is a new and important property that determines the capacity of a black carbon to mediate abiotic and microbial electron transfer reactions in natural and engineered systems. It is necessary to develop accurate and reproducible methods to measure black carbon's ESC in order to understand its redox behavior and to predict its capacity to support redox transformation of contaminants in subsurface environments. In this study, we developed chemical methods that employed combinations of reductants and oxidants of different redox potentials – Ti(III) citrate or dithionite as reductant, and ferricyanide or dissolved O2 as oxidant – to measure the ESC of a wood-derived biochar. Pore diffusion within biochar particles was rate-limiting and controlled the timescale for redox equilibrium and ESC measurements. • The new methods can handle sample mass on the order of a gram • Sample pretreatment (e.g., oxidation via aeration) is necessary to produce consistent results • For a given reductant-oxidant pair, colorimetric (or potentiometric) measurements gave constant and reproducible ESC
Information Subspace-Based Fusion for Vehicle Classification

Union of Subspaces (UoS) is a new paradigm for signal modeling and processing, which is capable of identifying more complex trends in data sets than simple linear models. Relying on a bi-sparsity pursuit framework and advanced nonsmooth optimization techniques, the Robust Subspace Recovery (RoSuRe) algorithm was introduced in the recent literature as a reliable and numerically efficient algorithm to unfold unions of subspaces. In this study, we apply RoSuRe to prospect the structure of a data type (e.g. sensed data on vehicle through passive audio and magnetic observations). Applying RoSuRe to the observation data set, we obtain a new representation of the time series, respecting an underlying UoS model. We subsequently employ Spectral Clustering on the new representations of the data set. The classification performance on the dataset shows a considerable improvement compared to direct application of other unsupervised clustering methods.
Managing Teamwork: A Key Leadership Practice

How leaders manage teamwork impacts team performance and well-being. After a brief review of some relevant literature, a practice oriented framework for managing teamwork is offered and the value of engaging in this process is noted. A proven practical coaching approach and real world application example with an executive are provided to help further operationalize the framework. This approach is offered to help enhance a managerial leader’s effectiveness when managing team dynamics and teamwork in workplace settings. Some challenges such as optimizing team behavioral diversity, managing geographically distributed teams, and applying recent developments in neuroscience are considered.
A Faster DiSH: Hardware Implementation of a Discrete Cell Signaling Simulator

Development of fast methods to conduct in silico experiments using computational models of cellular signaling is a promising approach toward advances in personalized medicine. However, software-based cellular network simulation has runtimes plagued by wasted CPU cycles and unnecessary processes. Hardware emulation affords substantial speedup, but prior attempts at hardware implementation of biological simulators have been limited in scope and have suffered from inaccuracies due to poor random number generation. In this work, we propose several simulation schemes utilizing novel random update index generation techniques for step-based and round-based stochastic simulations of cellular networks. Our results show improved runtimes while maintaining simulation accuracy compared to software implementations.
Unique bipiperidinyl impurities produced from the “One-Pot” synthesis of fentanyl

Abstract The synthetic opioid fentanyl has consistently been on the illicit drug market within the United States for more than five years. One of the many challenges to law enforcement is determining the manner in which the fentanyl is being synthesized. Knowing the synthetic route being utilized in illicit production could allow law enforcement intelligence to track and control essential fentanyl precursors. Identifying the synthetic route during the analyses of illicit fentanyl requires knowledge of any and all possible synthetic impurities that may be formed. In 2005, researchers from India published a modified version of the Siegfried route that could reportedly be completed in one reaction vessel. The “one-pot” method was investigated, and three new synthetic impurities were subsequently identified and characterized. The formation of these synthetic impurities and their analytical characterization are discussed.
Medication Adherence Barriers: Development and Retrospective Pilot Test of an Evidence-Based Screening Instrument.

Background Adherence to a prescribed medication regimen is often critical to successful comorbid disease management and decreased risk for adverse outcomes. The barriers that result in nonadherence are often multilayered and complex, making them difficult to address in an outpatient clinic setting. Objectives The primary objective of this project was to develop an evidence-based observational screening instrument and determine its potential to identify barriers to medication adherence. Methods Medication adherence barriers were divided into five categories. These barriers provided the foundation for the screening instrument. To pilot test the instrument, a retrospective, quasiexperimental, observational comparison study was designed. The pilot study evaluated retrospective data of the Oncology Care Model (OCM). Findings Of 250 OCM patient records, 184 (74%) revealed potential medication adherence barriers for patients with uncontrolled comorbid illness or events.
Chapter 87 – Application of Transgenic Mice to Problems of Skeletal Biology

Publisher Summary This chapter focuses on the application of transgenic mice to address various problems of skeletal biology such as the effects of protein structure and gene regulation on bone structure or bone cell differentiation. Transgenic mice provide an excellent setting for studying complex regulatory systems that cannot be modeled or fully appreciated in isolated experimental systems in vitro or in cellulo. This potential is particularly important in the analysis of the cells that synthesize the extracellular matrix, as their response to regulatory signals from the external environment is dependent on their state of cellular differentiation. Type I collagen is the major structural protein of bone, while type II is the primary collagen of cartilage. Mutations affecting the structural integrity of these two molecules result in osteogenesis imperfecta (OI) and chondrodysplasias, respectively. While molecular genetic studies of humans affected with these disorders have illustrated that the spectrum of disease severity can be correlated to specific mutations, a clearer understanding of how these mutations affect protein function can be obtained from a transgenic mice. Comprehension of disease severity based on mutation analysis requires an understanding of how the molecule is assembled, secreted, and incorporated into the extracellular matrix. While these steps may be defined in in vitro systems, the functional significance requires a transgenic approach. The Mov-13 mouse was discovered as an embryonic lethal in homozygous mice derived from a heterozygous breeding pair containing an experimentally introduced retroviral insertion. The cells derived from homozygous Mov-13 mice are valuable tools to study in vitro interactions of transfected collagen genes with endogenous macromolecules.
EXPRES. I. HD 3651 as an Ideal RV Benchmark

The next generation of exoplanet-hunting spectrographs should deliver up to an order of magnitude improvement in radial velocity (RV) precision over the standard 1 state-of-the-art spectrographs. This advance is critical for enabling the detection of Earth-mass planets around Sun-like stars. New calibration techniques such as laser frequency combs and stabilized etalons ensure that the instrumental stability is well characterized. However, additional sources of error include stellar noise, undetected short-period planets, and telluric contamination. To understand and ultimately mitigate error sources, the contributing terms in the error budget must be isolated to the greatest extent possible. Here, we introduce a new high-cadence RV program, the Extreme Precision Spectrograph (EXPRES) 100 Earths Survey, which aims to identify rocky planets around bright, nearby G and K dwarfs. We also present a benchmark case: the 62 day orbit of a Saturn-mass planet orbiting the chromospherically quiet star, HD 3651. The combination of high eccentricity (0.6) and a moderately long orbital period ensures significant dynamical clearing of any inner planets. Our Keplerian model for this planetary orbit has a residual rms of 58 cm s−1 over a ~6 month time baseline. By eliminating significant contributors to the RV error budget, HD 3651 serves as a standard for evaluating the long-term precision of extreme precision RV programs.
Seasonal effects on the stoichiometry of microbes, primary production, and nutrient cycling

We develop a compartment model inspired by producer–herbivore–microbe soil food webs and determine how the naturally occurring seasonal variation in producer and detrital quality affects microbial nutrient cycling and the feedback to primary production. We show that seasonal changes in the stoichiometric quality of the producer coupled with the efficiency of herbivore grazing could induce a switch in the stoichiometric signature and therefore the functioning of the microbial community. Microbial decomposers are responsible for the flux of essential nutrients through an ecosystem. Our model enables one to quantitatively understand the tipping points between bacterially or fungally dominated decomposer communities, and more generally, the complex relationships between microbial decomposers, primary production, and nutrient cycling.
Mitochondrial Phenotypes Distinguish Pathogenic MFN2 Mutations by Pooled Functional Genomics Screen

Most human genetic variation is classified as VUS - variants of uncertain significance. While advances in genome editing have allowed innovation in pooled screening platforms, many screens deal with relatively simple readouts (viability, fluorescence) and cannot identify the complex cellular phenotypes that underlie most human diseases. In this paper, we present a generalizable functional genomics platform that combines high-content imaging, machine learning, and microraft isolation in a new method termed "Raft-Seq". We highlight the efficacy of our platform by showing its ability to distinguish pathogenic point mutations of the mitochondrial regulator MFN2, even when the cellular phenotype is subtle. We also show that our platform achieves its efficacy using multiple cellular features, which can be configured on-the-fly. Raft-Seq enables a new way to perform pooled screening on sets of mutations in biologically relevant cells, with the ability to physically capture any cell with a perturbed phenotype and expand it clonally, directly from the primary screen. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=122 SRC="FIGDIR/small/434746v1_ufig1.gif" ALT="Figure 1"> View larger version (46K): org.highwire.dtl.DTLVardef@1d1a431org.highwire.dtl.DTLVardef@72aba5org.highwire.dtl.DTLVardef@62feb1org.highwire.dtl.DTLVardef@13f2b2d_HPS_FORMAT_FIGEXP M_FIG Graphical Abstract Here, we address the need to evaluate the impact of a multitude of genetic variants. This manuscript depicts the methods of using machine learning on a biologically relevant phenotype to predict specific point mutations, followed by physically capturing those mutated cells. C_FIG
Topological clustering of multilayer networks

Multilayer networks continue to gain significant attention in many areas of study, particularly due to their high utility in modeling interdependent systems such as critical infrastructures, human brain connectome, and socioenvironmental ecosystems. However, clustering of multilayer networks, especially using the information on higher-order interactions of the system entities, still remains in its infancy. In turn, higher-order connectivity is often the key in such multilayer network applications as developing optimal partitioning of critical infrastructures in order to isolate unhealthy system components under cyber-physical threats and simultaneous identification of multiple brain regions affected by trauma or mental illness. In this paper, we introduce the concepts of topological data analysis to studies of complex multilayer networks and propose a topological approach for network clustering. The key rationale is to group nodes based not on pairwise connectivity patterns or relationships between observations recorded at two individual nodes but based on how similar in shape their local neighborhoods are at various resolution scales. Since shapes of local node neighborhoods are quantified using a topological summary in terms of persistence diagrams, we refer to the approach as clustering using persistence diagrams (CPD). CPD systematically accounts for the important heterogeneous higher-order properties of node interactions within and in-between network layers and integrates information from the node neighbors. We illustrate the utility of CPD by applying it to an emerging problem of societal importance: vulnerability zoning of residential properties to weather- and climate-induced risks in the context of house insurance claim dynamics.
Outcomes of "Real-World" Insulin Strategies in the Management of Hospital Hyperglycemia.

Context Guidelines recommend scheduled long-acting basal and short-acting bolus insulin several times daily to manage inpatient hyperglycemia. In the "real world," insulin therapy is complicated, with limited data on the comparative effectiveness of different insulin strategies. Objective This work aimed to evaluate the association of different insulin strategies with glucose control and hospital outcomes after adjustment for patient and physician factors that influence choice of therapy. Methods This retrospective, observational study took place at an academic hospital. Participants included noncritically ill hospitalized medical/surgical patients (n = 4558) receiving subcutaneous insulin for 75% or longer during admission. Insulin therapy was grouped into 3 strategies within the first 48 hours: basal bolus (BB: scheduled long and short/rapid n = 2358), sliding scale (SS: short/rapid acting n = 1855), or basal only (BO: long only: n = 345). Main outcome measures included glucose control: hypoglycemic days, hyperglycemic days, euglycemic days, mean glucose; and hospitalization: in-hospital mortality, length of stay (LOS), and readmissions. Results Initial therapy with BB was associated with more hypoglycemic (2.40; CI, 2.04 to 2.82) (P < .001) and fewer euglycemic days (0.90; CI, 0.85 to 0.97) (P = .003) than SS, whereas BO was associated with fewer hyperglycemic days (0.70; CI, 0.62 to 0.79) (P < .001), lower mean glucose (-18.03; CI, -22.46 to -12.61) (P < .001), and more euglycemic days (1.22; CI, 1.09 to 1.37) (P < .001) compared to SS. No difference in mortality, LOS, and readmissions was found. However, decreased LOS was observed in the BB subgroup with a medical diagnostic related group (0.93; CI, 0.89 to 0.97) (P < .001). Conclusion BO had a more favorable hyperglycemia profile than SS. BB, on the other hand, showed worse glycemic control as compared to SS. In the real-world hospital, BO may be a simpler and more effective insulin strategy.
Mantle temperature and density anomalies: The influence of thermodynamic formulation, melt, and anelasticity

Abstract Deriving a quantitative geodynamical interpretation from tomography models is a difficult task. It is also a timely task, particularly given the many high-resolution tomography models published in recent years. It is important to assess mantle structure in terms of density and temperature anomalies. Here, we provide a new estimation of the conversion factors between seismic velocity anomalies and density anomalies, Rρ/v, and between seismic velocity anomalies and temperature anomalies, RT/v. These conversion factors are found by considering the constraints provided by thermodynamics, the influence of melt, and anelasticity. To determine the elastic component, we performed thermodynamic simulations by considering several compositions representative of normal or plume-enriched mantle. We also explore the effects of the presence of melt on seismic velocity and consider a radial attenuation profile to account for anelasticity. We provide an envelope of acceptable models, by combining the range of possible solutions combining the elastic, anelastic, and melt relationships used in deriving the conversion factors. Several of the frequently used velocity-density scaling relationships are encompassed in this envelope. We assess the validity of our result by calculating temperature anomalies from the tomographic models using our scaling relationships—these anomalies lie within the range constrained by melting temperatures registered in volcanic rocks (±300 K). Further, we show that the geoid model computed through our velocity-density scaling from the S40RTS tomography provides a good fit to the observed geoid.
A General Method for Synthesis of Isomaleimide Derivatives

A mild and efficient method for the synthesis of isoimide by a simple reaction of 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC) with various kinds of maleimicacid, succimicacid, pthaleimicacid in dichloromethane at room temperature is described.
Exposure to air pollutant mixture and gestational diabetes mellitus in Southern California: Results from electronic health record data of a large pregnancy cohort.

BACKGROUND Epidemiological findings are inconsistent regarding the associations between air pollution exposure during pregnancy and gestational diabetes mellitus (GDM). Several limitations exist in previous studies, including potential outcome and exposure misclassification, unassessed confounding, and lack of simultaneous consideration of air pollution mixtures and particulate matter (PM) constituents. OBJECTIVES To assess the association between GDM and maternal residential exposure to air pollution, and the joint effect of the mixture of air pollutants and PM constituents. METHODS Detailed clinical data were obtained for 395,927 pregnancies in southern California (2008-2018) from Kaiser Permanente Southern California (KPSC) electronic health records. GDM diagnosis was based on KPSC laboratory tests. Monthly average concentrations of fine particulate matter < 2.5 μm (PM2.5), <10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) were estimated using kriging interpolation of Environmental Protection Agency's routine monitoring station data, while PM2.5 constituents (i.e., sulfate, nitrate, ammonium, organic matter and black carbon) were estimated using a fine-resolution geoscience-derived model. A multilevel logistic regression was used to fit single-pollutant models; quantile g-computation approach was applied to estimate the joint effect of air pollution and PM component mixtures. Main analyses adjusted for maternal age, race/ethnicity, education, median family household income, pre-pregnancy BMI, smoking during pregnancy, insurance type, season of conception and year of delivery. RESULTS The incidence of GDM was 10.9% in the study population. In single-pollutant models, we observed an increased odds for GDM associated with exposures to PM2.5, PM10, NO2 and PM2.5 constituents. The association was strongest for NO2 [adjusted odds ratio (OR) per interquartile range: 1.176, 95% confidence interval (CI): 1.147-1.205)]. In multi-pollutant models, increased ORs for GDM in association with one quartile increase in air pollution mixtures were found for both kriging-based regional air pollutants (NO2, PM2.5, and PM10, OR = 1.095, 95% CI: 1.082-1.108) and PM2.5 constituents (i.e., sulfate, nitrate, ammonium, organic matter and black carbon, OR = 1.258, 95% CI: 1.206-1.314); NO2 (78%) and black carbon (48%) contributed the most to the overall mixture effects among all krigged air pollutants and all PM2.5 constituents, respectively. The risk of GDM associated with air pollution exposure were significantly higher among Hispanic mothers, and overweight/obese mothers. CONCLUSION This study found that exposure to a mixture of ambient PM2.5, PM10, NO2, and PM2.5 chemical constituents was associated with an increased risk of GDM. NO2 and black carbon PM2.5 contributed most to GDM risk.
Deriving Rights to Liberty

The rights to liberty championed by classical liberal and libertarian theorists may be supported as products of practical reason. The foundations for these rights rest initially on the idea that the separateness of persons is embedded in the circumstances of life that make justice a meaningful concept. We can discover the duties justice imposes on us through a procedure for identifying principles of justice based on the concept of reasonableness that supports a method for testing proposed principles for human interaction. This procedure, which I present as a contractualist method of ethical justification, vindicates principles that establish duties to others that also constitute rights to liberty and rule out some kinds of purported rights that cannot be justified through the proffered contractualist method.
Is it Time to Step Up to Stepped Care with our Cognitive-Behavioral Insomnia Therapies?

WORLDWIDE, CHRONIC INSOMNIA IS A HIGHLY PREVALENT AND OFTEN DEBILITATING CONDITION THAT REDUCES QUALITY OF LIFE, INCREASES RISKS FOR serious psychiatric and medical disorders, and enhances healthcare costs for affected individuals and society at large. A number of currently available pharmacotherapies have proven effective for the management of insomnia and some of these have demonstrated continued efficacy for extended periods of continuous treatment.1 However, there are no data demonstrating the sustained benefit of such therapies long after active treatment is discontinued. In contrast, cognitive-behavioral insomnia therapy (CBT) is a well-tested and well-proven alternative therapy that teaches patients sufficient insomnia management skills such that they appreciate continued sleep benefits long after completing active therapy.2–4 Furthermore, many patients prefer this form of treatment over pharmacotherapy when given the choice between these two forms of intervention.5 As such, CBT should have a prominent place at the “insomnia treatment table― whenever and wherever insomnia patients present for treatment.
Cognitive Task Analysis: An Approach to Knowledge Acquisition for Intelligent System Design

Publisher Summary This chapter discusses some of the common pitfalls that arise in building intelligent support systems and describe a pragmatic knowledge acquisition approach for defining and building effective intelligent support systems. The cognitive task analysis provides an umbrella structure of domain semantics that organizes and makes explicit what particular pieces of knowledge mean about problem-solving in the domain. Acquiring and using such a domain semantics is essential (l) to specify what kinds of cognitive support functions are needed, (2) to specify what kinds of computational mechanisms are capable of providing such functions, (3) to clearly delineate machine performance boundaries, and (4) to build less brittle machine problem-solvers, for example, through features that enable the human problem-solver to extend and adapt the capability of the system to handle unanticipated situations. This is in contrast to technology-driven approaches where knowledge acquisition focuses on describing domain knowledge in terms of the syntax of particular computational mechanisms. In other words, the language of implementation is used as a substitute for a cognitive language of description. The cognitive task analysis approach redefines the knowledge acquisition problem: knowledge acquisition, first, is about deciding what kinds of intelligent systems would make a difference and, second, about what domain specific knowledge is needed to fuel those systems.
SOD2 polymorphisms: unmasking the effect of polymorphism on splicing

Background The SOD2 gene encodes an antioxidant enzyme, mitochondrial superoxide dismutase. SOD2 polymorphisms are of interest because of their potential roles in the modulation of free radical-mediated macromolecular damage during aging.
Percentage of sarcomatoid component as a prognostic indicator for survival in renal cell carcinoma with sarcomatoid dedifferentiation

Abstract Objective Renal cell carcinoma with sarcomatoid dedifferentiation (sRCC) is associated with higher stage of presentation and worse survival. The objective of this study was to examine the clinicopathologic characteristics associated with overall survival (OS), specifically examining the percentage of sarcomatoid component (PSC). Methods We reviewed clinicopathologic data for all nephrectomized patients with confirmed sRCC. Histologic slides were rereviewed by dedicated genitourinary pathologists to ascertain PSC. Patient characteristics were tabulated overall and by disease stage. Cutpoints in the PSC providing a meaningful difference in OS were identified by recursive partitioning analysis (RPA). Factors selected included age group, gender, race, clinical stage, tumor histology, presurgical systemic therapy, lymphovascular invasion, and tumor size. The Kaplan-Meier method and log-rank test were used to assess differences in OS. Results Among 186 patients with sRCC, 64 (34%) had localized, and 122 (66%) had metastatic disease at presentation. Patients had primarily clear cell histology (73%). Median follow-up was 12.1 months (range: 0.1−242.2 mo). Median OS was 12.6 months (95% CI: 10.7−14.9 mo). Univariate RPA identified a PSC cutpoint of 10% as prognostically significant. Patients with PSC>10% were at higher risk of death when compared with patients with PSC≤10% (45% vs. 61% 1-y OS; P = 0.04). Multivariate RPA revealed that tumor size, presence of metastatic disease, and PSC were significantly associated with OS. Among 4 identified groups, patients with localized disease and tumor size≤10 cm were most likely to be alive at 1 year (89%), and patients with metastatic disease and PSC>40% were least likely to be alive at 1 year (28%; P Conclusion PSC appears to be a prognostic factor in patients with sRCC, with larger percentage of involvement portending a worse survival, especially in patients with metastatic disease.
A Stochastic Theory of the Generalized Cobb-Douglas Production Function

Factor substitution relations and returns to scale found in empirical studies of production functions are modeled in a way that is fully integrated with technological change and process innovation. The model is based on the Pareto boundary of random n-tuples, which is a rectangular hyperbola, asymptotic to the axes, whose parameter depends on the amount of sampling (search) activity. Conversion from probability fractiles to natural units of measurement of the factors give the Cobb-Douglas factor substitution relations. The influence of inputs on outputs is somewhat different because an upper bound on output cannot be assumed.
Nanoparticle Formulation to Improve the Efficacy of Radiation Therapy Against Radiation-resistant Leukemia

Patients with B-precursor acute lymphoblastic leukemia (BPL) are often treated with TBI-based conditioning, followed by hematopoietic stem-cell transplantation (HSCT). However, the leukemic relapse in high-risk BPL patients remained the major cause of patient mortality (Gaynon et al., 2006, Balduzzi et al., 2014). The incidence of post-HSTC relapse correlated with the level of residual leukemia burden prior to total body irradiation (TBI), indicating the radiation-resistant population of BPL cells may have contributed to the relapse. STAT-3 signaling pathway, along with PI3-K and NFkB pathways, regulates the cell survival after exposure to radiation-induced oxidative stress (Uckun et al., 2010), therefore contributes to the radiation resistance of BPL cells. Spleen tyrosine kinase (SYK), a key regulator of STAT-3, was chosen as the main target of reducing the radiation resistance (Mocsai et al., 2010). The authors identified C61, a small-molecule chemical compound inhibitor for SYK phosphorylation, which sensitized the resistant BPL cells toward radiation.
Dendritic growth during directional solidification of hypoeutectic Fe-C-Si alloys

The liquid decanting technique has been used to study the morphology of dendrites in directionally solidified Fe-3.08 pct C-2.01 pct Si alloy. The experimental results indicated that the morphology of primary dendrites in the Fe-C-Si system is very similar to those obtained in some transparent metal model systems and in some other metal systems. In order to study the morphological transition between cellular and dendritic growth, directionally solidified samples were quenched in cold water at various stages of solidification and the morphology was examined on the polished and etched surface. It has been found that when the growth velocity decreased from 326.6 to 0.8 μn/s, the average dendrite tip radius increased from 1.12 to 33.1 μm. At a growth velocity of about 0.65 μm/s, a transition from dendritic to cellular growth occurred. Models for dendritic growth proposed by various investigators have been briefly reviewed and compared with the present experimental results. Significant disagreements were found for some of the available theoretical models. Possible explanations have been given for these disagreements.
Differential effects of nicotinic acid in subjects with different LDL subclass patterns

Abstract Twenty-six subjects (20 male, 6 female) at high risk for CAD events were treated with moderate doses of nicotinic acid to investigate whether there was a differential lipoprotein response in patients with different LDL subclass patterns. Subjects were selected to have either pattern A (predominance of large LDL, peak particle diameter > 262 A, n = 9) or pattern B (predominance of small LDL, peak particle diameter n = 17) as assessed by 2–16% gradient gel electrophoresis of plasma. Nicotinic acid dose was similar in pattern A (2111 ± 651 mg/day) and pattern B subjects (1875 ± 698 mg/day). Total cholesterol and LDL cholesterol decreased by similar amounts in pattern A (-41 ± 26 mg/dl and −37 ± 18 mg/dl) and pattern B (−51 ± 44 mg/dl and −44 ± 45 mg/dl) subjects. Triglycerides tended to be reduced more in pattern B subjects (−100 ± 175 mg/dl) compared to pattern A subjects (−23 ± 34 mg/dl) although this difference was not statistically significant ( P = 0.08 for triglycerides log transformed). HDL cholesterol increased significantly more in the pattern B group (11.9 ± 14.2 mg/dl) compared to pattern A subjects (0.7 ± 8.5 mg/dl), ( P P
Carbon Diffusion Between the Layers in Modern Pattern-Welded Damascus Blades

Pattern-welded Damascus steel blades are made by forge welding together pairs of steels having low- and high-carbon compositions. It is often assumed that these blades consist of hard and soft layers owing to the carbon variations of the original steels and that it is this difference in hardness that produces the etching characteristics that give the surface patterns. Theoretical arguments are presented that show that, with the modern forging techniques used to make these blades, carbon diffusion should be adequate to homogenize the C level between the layers of the blades, which predicts no hardness difference between layers. Experiments are presented on several modern blades, showing that there are no hardness differences found between layers. Arguments are presented for a theory that it is the difference in alloying elements between the layers that produces the differential etching characteristics that give rise to the visual surface patterns of most contemporary pattern-welded Damascus steels.
Using simulation to address hierarchy-related errors in medical practice.

OBJECTIVE Hierarchy, the unavoidable authority gradients that exist within and between clinical disciplines, can lead to significant patient harm in high-risk situations if not mitigated. High-fidelity simulation is a powerful means of addressing this issue in a reproducible manner, but participant psychological safety must be assured. Our institution experienced a hierarchy-related medication error that we subsequently addressed using simulation. The purpose of this article is to discuss the implementation and outcome of these simulations. METHODS Script and simulation flowcharts were developed to replicate the case. Each session included the use of faculty misdirection to precipitate the error. Care was taken to assure psychological safety via carefully conducted briefing and debriefing periods. Case outcomes were assessed using the validated Team Performance During Simulated Crises Instrument. Gap analysis was used to quantify team self-insight. Session content was analyzed via video review. RESULTS Five sessions were conducted (3 in the pediatric intensive care unit and 2 in the Pediatric Emergency Department). The team was unsuccessful at addressing the error in 4 (80%) of 5 cases. Trends toward lower communication scores (3.4/5 vs 2.3/5), as well as poor team self-assessment of communicative ability, were noted in unsuccessful sessions. Learners had a positive impression of the case. CONCLUSIONS Simulation is a useful means to replicate hierarchy error in an educational environment. This methodology was viewed positively by learner teams, suggesting that psychological safety was maintained. Teams that did not address the error successfully may have impaired self-assessment ability in the communication skill domain.
The microbiologic cross-contamination of dental prostheses.

Abstract Improved sterile techniques in handling patients' dental prostheses can substantially reduce cross-contamination that may occur from the pumice and rag wheel, thereby diminishing the patient's exposure to potentially pathogenic bacteria. Methods for decreasing or eliminating these microorganisms are not only simple and practical to initiate but also time and cost effective.
Squamotacin: An Annonaceous Acetogenin with Cytotoxic Selectivity for the Human Prostate Tumor Cell Line (PC-3)

The bark extracts of Annona squamosa yielded a new bioactive acetogenin, squamotacin (1), and the known compound, molvizarin (2), which is new to this species. Compound 1 is identical to the potent...