cssi/SciSciGPT-SciSciNet huggingface dataset:
Evaluation of the end-of-life nursing education consortium project in the USA.

Care of patients at the end of life is contingent on adequate preparation of health care providers. Nursing, as the predominant caring profession in end-of-life (EOL) care, must achieve competence in physical and psychosocial care of patients and families facing terminal illness. Previous research has demonstrated that nursing education has not prepared nurses to provide optimum EOL care. To date, there has not been a unified or organized effort to broadly address the preparation of nurses in EOL care. This article describes one national project, the End-of-Life Nursing Education Consortium (ELNEC), which was developed as a comprehensive effort to improve EOL care by nurses in the United States. The ELNEC project consists of EOL education for various nursing audiences: the undergraduate faculty; continuing education providers; pediatrics; oncology; and the graduate faculty. This organized effort is a major step towards strengthening nursing knowledge in EOL care to improve care of the dying.
Predictors of Oxygen Desaturation During Submaximal Exercise in 8,000 Patients

Study objectives: To determine predictors of oxygen desaturation during submaximal exercise in patients with various lung diseases. Design and setting: This retrospective case series used pulmonary function laboratory results from all patients referred to a major tertiary-care center. Patients and measurements: All patients > 35 years old who underwent spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), lung volumes, and pulse oximetry during 3-min submaximal step-test exercise during 1996 were included (4,545 men and 3,472 women). Logistic regression models, correcting for gender, age, and weight, determined the odds ratios (ORs) for oxygen desaturation of > 4% during exercise for each category of lung function abnormality (compared to those with entirely normal lung function). Results: Approximately 74% of the patients had airways obstruction, while only 5.6% had restriction of lung volumes. One third of those with obstruction had a low DLCO, compared to 56% with restriction, while 2.7% had a low DLCO without obstruction or restriction. The risk of oxygen desaturation during submaximal exercise was very high (OR, 34) in patients with restriction and low DLCO (as in interstitial lung disease) and in patients with obstruction and low DLCO (as in COPD; OR, 18), intermediate (OR, 9) in patients with only a low DLCO, and lowest in those with a normal DLCO (OR, 4 if restricted; OR, 2 if obstructed). A cut point of DLCO < 62% predicted resulted in 75% sensitivity and specificity for exercise desaturation. No untoward cardiac events occurred in any patients during or following the submaximal exercise tests. Conclusions: The risk of oxygen desaturation during submaximal exercise is very high in patients with a low DLCO. Submaximal exercise tests are safe, even in elderly patients with heart and lung diseases. (CHEST 2001; 120:88 ‐92)
Fluphenazine plasma level monitoring for patients receiving fluphenazine decanoate

Abstract Background: Finding a dose of an antipsychotic for maintenance therapy that is both safe and effective can be difficult because clinicians are unable to titrate dose against clinical response in patients who are already stable. Therapeutic monitoring of antipsychotic plasma levels has the potential for helping clinicians in dosage selection. With this in mind, we evaluated the usefulness of monitoring fluphenazine plasma levels for patients with schizophrenia who were receiving maintenance treatment with fluphenazine decanoate. Method: Thirty-one patients with schizophrenia were randomly assigned to low, medium, or high (0.1–0.3, 0.3–0.6, 0.6–1.0 ng/ml) plasma levels of fluphenazine. The dose of fluphenazine decanoate was adjusted in order to maintain patients in their assigned range. Side effects, psychopathology, and psychotic exacerbations were measured during the year following randomization. Results: All of the psychotic exacerbations occurred during the first eight weeks following randomization, before patients had adequate time to reach their plasma level assignments. We did not find a relationship between plasma levels of fluphenazine and clinical outcomes or side effects. Conclusion: Our results do not provide support for the usefulness of monitoring fluphenazine plasma levels for patients receiving fluphenazine decanoate.
Preparation and in vivo characterization of a cocaine hydrolase engineered from human butyrylcholinesterase for metabolizing cocaine.

Cocaine is a widely abused drug without an FDA (Food and Drug Administration)-approved medication. It has been recognized that an ideal anti-cocaine medication would accelerate cocaine metabolism producing biologically inactive metabolites via a route similar to the primary cocaine-metabolizing pathway, i.e. human BChE (butyrylcholinesterase)-catalysed hydrolysis. However, the native human BChE has a low catalytic activity against cocaine. We recently designed and discovered a BChE mutant (A199S/F227A/S287G/A328W/Y332G) with a high catalytic activity (kcat=5700 min-1, Km=3.1 μM) specifically for cocaine, and the mutant was proven effective in protecting mice from acute cocaine toxicity of a lethal dose of cocaine (180 mg/kg of body weight, LD100). Further characterization in animal models requires establishment of a high-efficiency stable cell line for the BChE mutant production at a relatively larger scale. It has been extremely challenging to develop a high-efficiency stable cell line expressing BChE or its mutant. In the present study, we successfully developed a stable cell line efficiently expressing the BChE mutant by using a lentivirus-based repeated-transduction method. The scaled-up protein production enabled us to determine for the first time the in vivo catalytic activity and the biological half-life of this high-activity mutant of human BChE in accelerating cocaine clearance. In particular, it has been demonstrated that the BChE mutant (administered to mice 1 min prior to cocaine) can quickly metabolize cocaine and completely eliminate cocaine-induced hyperactivity in rodents, implying that the BChE mutant may be developed as a promising therapeutic agent for cocaine abuse treatment.
Simultaneous percutaneous transcatheter aortic valve replacement and endovascular abdominal aortic aneurysm repair in a high risk patient with hostile aortic neck, a case report

Background Abdominal aortic aneurysm (AAA) can be a potential life threatening condition if left untreated. Total endovascular techniques to approach aortic aneurysms have extended management options and enabled patients who are unfit for open surgery to undergo repair. Transcatheter aortic valve replacement is increasingly used to treat patients with severe symptomatic aortic stenosis, who once were considered high risk for traditional open aortic valve replacement.
Light-Driven and Phonon-Assisted Dynamics in Organic and Semiconductor Nanostructures

Semiconductor Nanostructures Svetlana Kilina,† Dmitri Kilin,‡ and Sergei Tretiak* †Chemistry and Biochemistry Department, North Dakota State University, Fargo, North Dakota 5810, United States ‡Department of Chemistry, University of South Dakota, Vermillion, South Dakota 57069, United States Theoretical Division, Center for Nonlinear Studies (CNLS) and Center for Integrated Nanotechnologies (CINT), Los Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
Phenoloxidase activity in the infraorder Isoptera: unraveling life-history correlates of immune investment

Within the area of ecological immunology, the quantification of phenoloxidase (PO) activity has been used as a proxy for estimating immune investment. Because termites have unique life-history traits and significant inter-specific differences exist regarding their nesting and foraging habits, comparative studies on PO activity can shed light on the general principles influencing immune investment against the backdrop of sociality, reproductive potential, and gender. We quantified PO activity across four termite species ranging from the phylogenetically basal to the most derived, each with their particular nesting/foraging strategies. Our data indicate that PO activity varies across species, with soil-dwelling termites exhibiting significantly higher PO levels than the above-ground wood nester species which in turn have higher PO levels than arboreal species. Moreover, our comparative approach suggests that pathogenic risks can override reproductive potential as a more important driver of immune investment. No gender-based differences in PO activities were recorded. Although termite PO activity levels vary in accordance with a priori predictions made from life-history theory, our data indicate that nesting and foraging strategies (and their resulting pathogenic pressures) can supersede reproductive potential and other life-history traits in influencing investment in PO. Termites, within the eusocial insects, provide a unique perspective for inferring how different ecological pressures may have influenced immune function in general and their levels of PO activity, in particular.
The Gaiasphere and the limits of knowledge

Joss Bland-HawthornAnglo-Australian Observatory, 167 Vimiera Road, Eastwood, NSW2122, Australia; jbh@aao.gov.auAbstract. At the heart of a successful theory of galaxy formation mustbe a detailed physical understanding of the dissipational processes whichform spiral galaxies. To what extent can we unravel the events thatproduced the Galaxy as we see it today? Could some of the residualinhomogeneities from prehistory have escaped the dissipative process atan early stage? To make a comprehensive inventory of surviving inhomo-geneities would require a vast catalog of stellar properties that is presentlyout of reach. The Gaia space astrometry mission, set to launch at theend of the decade, will acquire detailed phase space coordinates for aboutone billion stars, within a sphere of diameter 20 kpc – the Gaiasphere.Here we look forward to a time when all stars within the Gaiasphere havecomplete chemical abundance measurements (including α, s and r pro-cess elements). Even with such a vast increase in information, there mayexist fundamental − but unproven − limits to unravelling the observedcomplexity.1. IntroductionEddington once remarked that ‘the contemplation in natural science of a widerdomain than the actual leads to a far better understanding of the actual.’ Ourintuition is that any dynamical phase early on in the history of the Galaxy whichis dominated by relaxation or dissipation probably removes more informationthan it retains. This remains largely true for controlled experiments withinterrestrial laboratories for the reason that it is exceedingly diﬃcult to track ﬂuidparticles, for example, in order to unravel the process under study. However,at least in principle, the situation may be more tractable in astrophysics inthat individual stars carry information about the birth site at the time of theirformation. Nature oﬀers us a vast untapped reservoir of information in thedetailed chemical abundances stored within stellar atmospheres.The fossil evidence of galaxy formation is not restricted to chemical abun-dances alone. In our review, “The New Galaxy – Signatures of its Formation,”we stress the importance of new observations across a wide range of parameterspace (Freeman & Bland-Hawthorn 2002). We are coming into a new era ofgalactic investigation, in which one can study the fossil remnants of the early1
High-pressure elasticity of alumina studied by first principles

We investigate by first principles the elastic behavior of Al 2O3-alumina under pressure (up to 300 GPa) in the corundum and Rh2O3 (II) phase. The results are in excellent agreement with available low pressure (<1 GPa) experimental data. The anisotropy in elasticity for corundum decreases up to 50 GPa and then increases slowly with pressure whereas for the Rh 2O3 (II) phase the anisotropy increases monotonically with compression. Strong shear wave anisotropy in the Rh 2O3 (II) phase is found to be associated with the relatively small c55 modulus, and its softening at high pressures. Unlike corundum, the directions of the fastest and slowest wave propagation, and the maximum polarization anisotropy of Rh 2O3 (II) phase remain unchanged with pressure. At the corundum to Rh2O3 (II) phase transition pressure (78 GPa at 0 K), the anisotropy increases by more than 100% but the density and wave velocities increase only by 2%. The calculated (0 K) densities and wave velocities at lower mantle pressures are slightly larger (by 5%) than the corresponding seismic profiles. Our results suggest that the presence of free Al 2O3 in small amounts in the lower mantle may not be detected in seismic density and velocity profile. However, its anisotropy may produce a detectable signal, particularly, at pressure conditions typical of the D'' region.
Combinación de mediciones de la práctica y el desempeño docente: consideraciones técnicas y conceptuales para la evaluación docente

Reform efforts in education systems in the United States and other countries place increasing emphasis on the promise of teacher evaluation systems to help complement traditional school-level accountability in improving classroom instruction and student learning. This paper offers a review of the key conceptual and methodological issues faced in measuring a construct as complex and multidimensional as teacher quality or effectiveness in the context of high-stakes accountability policies. The common methods of assessing teacher practice and performance are reviewed, along with approaches for using these different indicators in combination for formative and summative evaluation purposes. The focus here is on the validity of the inferences about teacher effectiveness that can be derived from these information sources, and the implications and potential consequences for education policy and the practice of implementing these systems in the field.
Coarse-Grained Models for Aqueous Polyethylene Glycol Solutions

A new coarse-grained force field is developed for polyethylene glycol (PEG) in water. The force field is based on the MARTINI model but with the big multipole water (BMW) model for the solvent. The polymer force field is reparameterized using the MARTINI protocol. The new force field removes the ring-like conformations seen in simulations of short chains with the MARTINI force field; these conformations are not observed in atomistic simulations. We also investigate the effect of using parameters for the end-group that are different from those for the repeat units, with the MARTINI and BMW/MARTINI models. We find that the new BMW/MARTINI force field removes the ring-like conformations seen in the MARTINI models and has more accurate predictions for the density of neat PEG. However, solvent-separated-pairs between chain ends and slow dynamics of the PEG reflect its own artifacts. We also carry out fine-grained simulations of PEG with bundled water clusters and show that the water bundling can lead to ring-like conformations of the polymer molecules. The simulations emphasize the pitfalls of coarse-graining several molecules into one site and suggest that polymer-solvent systems might be a stringent test for coarse-grained force fields.
Secondary or Compensatory Hypoglycemia.

In contrast with true hypoglycemia, of which insulin hypoglycemia is an example, we suggest the term secondary or compensatory hypoglycemia for those conditions in which an initial rise in blood sugar is followed by a fall below normal. McGuigan and Ross1 state that many investigators have reported a hyperglycemia, while others working with the same substance have demonstrated a hypoglycemia. Santos2 finds that secretin exerts a hypoglycemic action in man, dog and rabbit. Lambert and Hermann,3 however, show that injection of secretin causes transient hyperglycemia, followed by hypoglycemia. Such differences in observation may be due to the quantity of reserve glycogen in the animal, or to the time of withdrawal of the blood for analysis, after injection of the biologic mixture or compound under investigation.We postulate that any biologic condition or chemical substance giving rise to persistent hyperglycemia may eventually produce hypoglycemia. Josephs4 has demonstrated that the hyperglycemia developed d...
Tumor Growth Kinetics and Oncologic Outcomes of Patients Undergoing Active Surveillance for Residual Renal Tumor following Percutaneous Thermal Ablation.

Abstract Purpose To evaluate growth kinetics and oncologic outcomes of patients with renal tumors undergoing active surveillance (AS) for residual viable tumor following percutaneous ablation. Materials and Methods Following percutaneous thermal ablation, residual tumor was detected in 21/133 (16%) patients on initial follow-up imaging, and AS was undertaken in 17/21 (81%) patients. Initial tumor volumes and volumes after ablation were assessed from cross-sectional imaging to calculate volumetric growth rate (VGR) and volume doubling time (VDT) of residual tumor. The rate of metastasis, overall survival, and renal cell carcinoma (RCC)–specific survival were compared between patients in the AS group and in the routine follow up group of patients who did not have residual tumor. Results Median tumor volume prior to ablation, after first ablation, and at final follow-up were 25 cm 3 , 6 cm 3 , and 6 cm 3 , respectively, in patients with residual tumor. Stable, mild, and moderate VGR occurred in 8/17 (47%), 4/17 (24%), and 5/17 (29%) cases, respectively. The 4 cases with fastest VDT underwent delayed intervention with ablation (n = 1) and nephrectomy (n = 3) without subsequent residual, recurrence, or metastasis. There was no significant difference in the rates of RCC metastasis, overall survival, or RCC-specific survival between AS and routine follow-up groups. Metastatic RCC and subsequent death occurred in 1 patient in the AS group, after the patient had refused offers for retreatment for local progression over 60.7 months of follow-up. Conclusions In cases when patients are not amenable to further intervention, AS of residual tumor may be an acceptable alternative and allows for successful delayed intervention when needed.
Effect of post-deposition heat treatment on electrodeposited NiCoCrAlY coatings

An electrolytic process was utilised to fabricate NiCoCrAlY coatings, involving deposition of a composite coating consisting of the (Ni,Co) matrix and CrAlY particles, followed by a diffusion heat treatment to convert the composite coating to the desired NiCoCrAlY microstructure. This study focused on the effects of the post-deposition heat-treating conditions (temperature and atmosphere) on the final coating microstructure and composition. The (Ni,Co)–CrAlY composite coatings were heat-treated for 2 h at 1000, 1100 and 1200°C in vacuum and Ar, respectively. Phase constituents and concentrations of the major elements in the coating after heat treatment were examined. Vacuum heat treatment at temperatures ≥1100°C resulted in a significant decrease in Cr content at the coating surface due to Cr evaporation. Heat treatment at 1200°C also caused outward diffusion of Ti from the substrate alloy to the coating layer.
Reaching the Goal: Expanding Health Insurance Coverage in New England

As the number and percentage of people without health insurance continues to climb, the goal of expanding such coverage is even more pressing. Traditional strategies have had only limited success. And with little movement at the federal level, states have chosen to enact their own bold initiatives. Four New England states - Maine, Massachusetts, Rhode Island, and Vermont - have recently passed or implemented programs to expand health insurance coverage, some with the goal of achieving near-universal coverage. By combining different strategies from across the political spectrum, the new initiatives represent a unique amalgam approach to expanding health care coverage. This paper examines existing strategies that have taken a more incremental approach to expanding coverage and also explores the new initiatives in New England, comparing and contrasting their designs and strategies. Over the past decade or so, states have had varying degrees of success in pursuing a number of traditional strategies, often in combination, to achieve incremental reductions in the rate of uninsured. Policies targeting the low-income population, such as Medicaid and SCHIP expansions, have been modestly successful in expanding coverage at a fairly low cost. Yet efforts to address the high-risk population and policies to expand coverage in the individual and small group markets have had limited success. In contrast to previous efforts to expand coverage, the new insurance initiatives in New England emphasize "shared responsibility," placing the onus for coverage on government, employers, and individuals alike. Several of the plans provide public subsidies to ensure affordability for low-income residents. Two states also impose financial penalties on employers that do not offer health insurance coverage. To encourage individual participation, most of the plans offer fairly comprehensive coverage, with relatively limited cost sharing. Massachusetts has gone further, mandating that individuals purchase coverage, either from the state, through their employer, or in the private market. Yet, the New England states face various pitfalls as they expand coverage. For example, in setting subsidies for individual premiums, policymakers must balance the need to make coverage affordable with the desire to minimize the potential for disruption in the group insurance market. Another challenge is to maintain minimum benefits standards while negotiating premium discounts with insurers, a task that may prove difficult in the future if the new programs are unable to attract a sufficiently large share of the market. Finally, many of the new programs rely on cooperation between states and insurers, which can be difficult to sustain over time, especially in states with few players in the private market.
The compositional and physical properties of localized lunar pyroclastic deposits

Abstract Lunar localized pyroclastic deposits are low albedo deposits with areas 2 . These deposits were difficult to study before the turn of the millennium because of the lack of available high spatial-resolution data. With the launch of the Lunar Reconnaissance Orbiter, Kaguya, and Chaandrayan-1, new sets of diverse high spatial-resolution data are now available. Using several of these data sets, we conducted a study of 34 localized pyroclastic deposits globally. For each localized pyroclastic deposit, we examined topography to estimate pyroclastic volume and juvenile proportions, S-band radar backscatter, thermal-infrared-derived measures of surficial rock abundance and regolith density, and mineral abundances. Our goals are to (1) quantitatively characterize the physical and mineralogical properties of each localized pyroclastic deposit, (2) investigate the physical and mineralogical variations among localized pyroclastic deposits, (3) compare these properties of localized ( 2 ) to regional pyroclastic deposits (> 2500 km 2 ), and (4) provide useful parameters for future volcanological modeling. From this study, we find that: (1) localized pyroclastic deposits exhibit low relief structures, (2) the surface rock abundance and circular polarization ratio of localized pyroclastic deposits display a wide range of values (0.2–0.5% and 0.3–0.6, respectively), (3) the glass abundance of localized pyroclastic deposits vary between ∼0 and ∼80 wt.%, (4) there are four types of localized pyroclastic deposits based upon the surface rock abundance and glass abundance parameters, (5) pyroclastic deposits within the same floor-fractured crater tend to have similar properties, and (6) localized pyroclastic deposits are diverse with respect to regional pyroclastic deposits, but a subset of localized pyroclastic deposits have similar physical and mineralogical properties to regional pyroclastic deposits.
Disassociation between primary motor cortical activity and movement kinematics during adaptation to reach perturbations

The relationship between movement kinematics and motor cortical activity was studied in monkeys performing a center-out reaching task during their adaptation to force perturbations applied to the wrist. The main feature of adaptive changes in movement kinematics was anticipatory deviation of hand paths in the direction opposite to that of the upcoming perturbation. We identified a group of neurons in the dorsal lateral portion of the primary motor cortex where a gradual buildup of spike activity immediately preceding the actual (in perturbation trials) or the "would-be" (in unperturbed/catch trials) perturbation onset was observed. These neurons were actively involved in the adaptation process, which was evident from the gradual increase in the amplitude of their movement-related modulation of spike activity from virtual zero and development of certain directional tuning pattern (DTP). However, the day-to-day dynamics of the kinematics adaptation was dramatically different from that of the neuronal activity. Hence, the adaptive modification of the motor cortical activity is more likely to reflect the development of the internal model of the perturbation dynamics, rather than motor instructions determining the adaptive behavior.
Enhanced detection of advanced malicious software

Over the last year the number of polymorphic and metamorphic malware samples seen in the wild has grown exponentially. The development of signatures for defensive purposes simply cannot keep up with the pace of these new malware attacks. New and sophisticated malware have been able to bypass network protection infrastructures to deliver attacks on the intended target. The network defense apparatus which relies on signature-based detection finds itself practically useless and unable to protect networks, platforms and data. This paper describes a novel approach to detect polymorphic and metamorphic malware. Our approach uses a unique method of leveraging multidimensional topological data with advanced clustering techniques for network detection. The results of our initial research and a discussion of future research possibilities are also presented.
Tibia/Fibula Shaft Fracture

Various common injuries in the pelvis and lower extremity are investigated in this chapter. Significant attention is paid not only to proper diagnostic examination and imaging, but also to optimal nonoperative and operative treatment options to manage these conditions.
Isolation of Foodborne Pathogens on Selective, Differential, and Enriched Medium by Streak Plating

We will introduce the selective, differential, and enriched medium for several foodborne pathogens, practice streak plating to get bacterial single colonies on various agars, and observe bacterial colony morphology.
Emerging STT-MRAM circuit and architecture co-design in 45nm technology

The spin transfer torque magnetic random access (STT-MRAM) is suitable for embedded memories and also for the second level cache memory in the mobile CPU's. The most capable Nonvolatile memory (NVM) component is STT-MRAM. There is a demand to improve efficient circuit and architecture to compete with the existing NVM technologies. Low energy consumption is achieved to write and read into MTJ. This provides the Circuit and Architecture Co-design of STT-MRAM. Our contributions are: One bit STT-MRAM circuit design and SPICE simulation, Monte Carlo simulation of access transistor, 8×8 array/architecture of STT-MRAM is implemented by the single cell.
Successful Treatment of Disseminated Nocardiosis Caused by Nocardia veterana in a Dog

A 5-year-old male castrated Lhasa Apso cross was evaluated for a 1-month history of inappetence, lethargy, gagging, and progressive right thoracic limb lameness. Synovial fluid analysis revealed nonseptic suppurative inflammation, and a diagnosis of immune-mediated polyarthritis (IMPA) was made. After 3 months of treatment with prednisone and later cyclosporine, the dog developed multiple firm cutaneous and subcutaneous masses and a focal mass within the jejunum. Cultures of blood, urine, skin lesions, and the jejunal mass identified Nocardia veterana by matrix-absorption laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) and allowed for earlier identification of the organism compared to more traditional secA1 gene sequencing. Immunosuppressive drug treatment was discontinued, and the dog was treated for 3 months by administration of trimethoprim-sulfamethoxazole (TMS). No recurrence of clinical signs was reported 1 year later. This case report highlights the clinical utility of MALDI-TOF MS, particularly for the rapid identification of slow-growing, fastidious organisms.
The US Food and Drug Administration's tentative approval process and the global fight against HIV.

Introduction In 2004, the US government began to utilize the Food and Drug Administration's (USFDA) tentative approval process (tFDA) as a basis to determine which HIV drugs are appropriate to be purchased and used in resource-constrained settings. This process permits products that are not approved for marketing in the US, including medicines with active patents or marketing restrictions in the US, to be purchased and distributed in resource-constrained settings. Although the tFDA was originally intended to support the United States' President's Emergency Plan for AIDS Relief (PEPFAR), the USFDA list has become a cornerstone of international HIV programmes that support procurement of ARVs, such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Our objective in this article is to help the global HIV policy makers and implementers of HIV programmes better understand the benefits and limitations of the tFDA by providing an in-depth review of the relevant legal and regulatory processes. Discussion USFDA's dedicated tFDA process for ARVs used by the PEPFAR programme has a wide impact globally; however, the implementation and the regulatory processes governing the programme have not been thoroughly described in the medical literature. This paper seeks to help stakeholders better understand the legal and regulatory aspects associated with review of ARVs under the tFDA by describing the following: (1) the tFDA and its importance to global ARV procurement; (2) the regulatory pathways for applications under tFDA for the PEPFAR programme, including modifications to applications, review timelines and costs; (3) the role of US patents, US marketing exclusivity rights, and the Medicines Patents Pool in tFDA; and (4) an overview of how applications for PEPFAR programme are processed through the USFDA. We also provide a case study of a new ARV, tenofovir alafenamide fumarate (TAF), not yet reviewed by USFDA for PEPFAR use. Conclusions In this paper, we describe the importance and implementation of USFDA's tentative approval process to review ARVs for resource-constrained settings. We also highlight the impact of patents and exclusivities on review of HIV drugs under tFDA and illustrate the concepts using a new HIV drug as an example.
Outcomes of a Family Based Pediatric Obesity Program - Preliminary Results.

Children that are classified as obese (body mass index (BMI) > 95(th) percentile for age and sex, Centers for Disease Control and Prevention) have an increased risk for metabolic and cardiovascular complications. Family based programs that focus on physical activity (PA) and healthy eating are recommended for treatment of pediatric obesity. The purpose of the current study is to determine the outcomes of Building Healthy Families (BHF), a family-based pediatric weight loss treatment program composed of nutrition, physical activity and behavioral modification strategies. In addition, mediating variables that are associated with weight loss in children, in order to enhance the retention and success of this program will be identified. Twenty-two obese (>95(th) percentile BMI) children (age: 9.94 ± 1.58 yrs) volunteered to participate. Children and their parents (20 moms, 20 dads, 68% obese; BMI > 30 kg·m(-2)) participated in weekly nutrition education, family lifestyle PA, and one-on-one meetings with a behavioral psychologist. Overall, child participants lost an average of 2.3 ± 2.0 kg of body mass in 12 weeks while parents lost 6.4 ± 4.3 kg of their body mass. There was a significant inverse association between percentage of program goals met and weight loss (r = - 0.67, p < 0.05). Decreases in the child participants intake of high fat, high calorie foods significantly predicted weight change (R(2)=0.98, p<0.05). In conclusion, family based pediatric obesity programs may offer significant benefits and lead to healthier lifestyles for obese children and their parents.
Global Nuclear Energy/Materials Modeling in Support of Los Alamos Nuclear Vision Project: Long-Term Tradeoffs Between Nuclear-and Fossil-Fuel Burning

A global economics/energy/environmental (E3) model has been adapted with a nuclear energy/materials model to understand better “top-level”, long-term trade offs between civilian nuclear power, nuclear-weapons proliferation, fossil-fuel burning, and global economic welfare. Using a “business-as-usual” (BAU) point-of-departure case, economic, resource, and proliferation-risk implications of plutonium recycle in LWRS, as well as greenhouse-gas-mitigating carbon taxes and a range of nuclear-energy costs (capital and fuel), have been examined After describing the essential elements of the analysis approach being developed to support the Los Alamos Nuclear Vision Project, preliminary examples of parametric variations about the BAU base-case scenario are presented. The results described herein represent a sampling from a collection of more extensive results. The primary motivation here is: a) to compare the BAU base case with results from other studies; b) to model on a regionally resolved global basis long-term (to year ∼2100) evolution of plutonium accumulation in a variety of forms under a limited range of fuel-cycle scenarios; and c) to illustrate a preliminary connectivity between risks associated with nuclear energy and fossil-fuel burning (e.g., the relationship between nuclear proliferation and greenhouse-gas accumulations).
Careers in Academic Administration

Academic administration can be an extension of an academic career at the bench or it can run parallel to a career of discovery. To be an academic administrator at the executive level in a college or university generally requires advancement through the academic ranks to the professorial level. These positions include department chair, dean of a college, head of a center or institute, provost, senior research officer, and university or college president. Positions that can begin immediately after attaining a PhD or after a postdoctoral position include some assistant dean roles and positions in technology transfer, grants management, and laboratory management, among many others. Many of the skills developed during the pursuit of an advanced degree in the life sciences are directly applicable to these jobs. All require problem solving, critical thinking, collaboration, and the ability to communicate clearly.
Diversity and SOF: Boon or Bane?

This article argues that while SOF combat elements cannot be made more inclusive, the overall SOF enterprise can. While diversity for diversity’s sake might appear to promise certain advantages, it...
Avoiding inappropriate spine surgery in a patient with major cardiac comorbidities.

Background We as spine surgeons increasingly need to carefully screen our own patients for major medical/cardiac comorbidities to determine if they are candidates for spine surgery. Our medical/cardiac colleagues rarely understand how long anti-platelet aggregates and non-steroidal anti-inflammatories (NSAIDs) have to be stopped prior to spine operaeitons, and when it is safe for them to be reinstated. Case Study A patient over 65 years of age, presented with 6 months of increased bilateral lower extremity sciatica, and 2-block neurogenic claudication. The MR scan showed moderate to severe lumbar stenosis L2-S1 with grade I L4-L5 spondylolisthesis, and multiple bilateral synovial cysts. Nevertheless, his neurological examination was normal. Further, he had > 5 stents placed within the last five years, and had undergone cardiac surgery two years ago requiring placement of a bovine aortic valve, and resection of a left ventricular wall aneurysm. He was also still on full dose Aspirin (325 mg/day), and Clopidogrel (75 mg po bid). Notably, 3 prior spinal surgeons (neurosurgery/orthopedics) had recommended multilevel lumbar laminectomy with instrumented fusions (e.g. including multilevel transforaminal lumbar interbody fusions (TLIF)). Conclusions Despite multilevel L2-S1 stenosis, Grade I L4-L5 spondylolisthesis, and multilevel bilateral synovial cysts, the patient's normal neurological examination and multiple cardiac comorbidities (i.e. requiring continued full-dose ASA/Clopidogrel) precluded, in my opinion, offering surgical intervention. Rather, I referred the patient to neurology for conservative management. What would you have done?
Using Ethical Leadership to Improve Business-To-Business Salesperson Performance: The Mediating Roles of Trust in Manager and Ethical Ambiguity

Purpose: Given the ever-increasing pressure put on sales organizations to improve performance, behave ethically and establish long-term customer relationships, this study seeks to better comprehend...
D01.2 Among men who have sex with men, pharyngeal infection contributes more to population levels of gonorrhea transmission than urethral infection, rectal infection, or both (Against the motion)

Under the renowned transmission paradigm Ro= scD, the reproductive rate of an infection (Ro) may be ≥1.0 sufficient to sustain or raise prevalence in a defined population despite a short duration of infectivity (D), if transmission efficiency (s) or the rate of transmission events (c) is sufficiently high. s is substantial for urethral to pharyngeal transmission, and probably modest for pharynx to urethra. But is s for analingus for pharyngeal to rectal infection or rectal to pharyngeal sufficient to sustain prevalent infections at either anatomic site? Is s for kissing high enough to contribute substantially to pharyngeal gonorrhea? Overall, is s for pharyngeal gonococcal infection sufficient to account, directly or indirectly, for half or more of all gonorrhea in men who have sex with men (MSM)? This proposition flies in the face of a century of historical opinion and clinical observation, the anatomy of sex, and available data. As observed by Marcello Truzzi and famously popularized by Carl Sagan, extraordinary claims require extraordinary evidence, a standard not met by observations in a single clinic or metropolitan area or by mathematical models that may not account for confounding factors. While bidirectional transmission by fellatio is well documented and contributes to ongoing transmission in MSM, the transmission efficiency of gonorrhea by kissing, or by analingus for either rectal or pharyngeal infection (or by cunnilingus, in either direction) probably is insufficient to sustain prevalence. Indeed, if anal and vaginal sex magically disappeared as sexual practices, gonorrhea might disappear entirely in exclusively heterosexual men and women and would become uncommon in MSM, including those with high rates of partner change. Reject the proposition!
Dissidents du Maghreb: depuis les indépendances: by Khadija Mohsen-Finan and Pierrre Vermeren, Paris, Belin, 2018, 396 pp., €24 (softcover), ISBN 978-2-410-00534-9

In a quarter-century of personal acquaintance with Sihem Bensedrine, this reviewer never thought of her as a ‘dissident’ – until reading the case, which Khadija Mohsen-Finan and Pierre Vermeren mak...
Beyond Politics - Promoting Covid-19 Vaccination in the United States.

Promoting Covid-19 Vaccination in the United States Consumer research and behavioral economics suggest 12 key strategies for effective vaccine promotion. We should combine relevant strategies for v...
Autonomous Situational Awareness for Robotic Swarms in High-Risk Environments.

This paper describes a technique for the autonomous mission planning of robotic swarms in high risk environments where agent disablement is likely. Given a swarm operating in a known area, a central command system generates measurements from the swarm. If those measurements indicate changes to the mission situation such as target movement or agent loss, the swarm planning is updated to reflect the new situation and guidance updates are broadcast to the swarm. The primary algorithms featured in this work are A* pathfinding and the Generalized Labeled Multi-Bernoulli multi-object tracking method.
Improving Noise Robustness of Contrastive Speech Representation Learning with Speech Reconstruction

Noise robustness is essential for deploying automatic speech recognition (ASR) systems in real-world environments. One way to reduce the effect of noise interference is to employ a preprocessing module that conducts speech enhancement, and then feed the enhanced speech to an ASR backend. In this work, instead of suppressing background noise with a conventional cascaded pipeline, we employ a noise-robust representation learned by a refined self-supervised framework for noisy speech recognition. We propose to combine a reconstruction module with contrastive learning and perform multi-task continual pre-training on noisy data. The reconstruction module is used for auxiliary learning to improve the noise robustness of the learned representation and thus is not required during inference. Experiments demonstrate the effectiveness of our proposed method. Our model substantially reduces the word error rate (WER) for the synthesized noisy LibriSpeech test sets, and yields around 4.1/7.5% WER reduction on noisy clean/other test sets compared to data augmentation. For the real-world noisy speech from the CHiME-4 challenge (1-channel track), we have obtained the state of the art ASR performance without any denoising front-end. Moreover, we achieve comparable performance to the best supervised approach reported with only 16% of labeled data.
Settlement of the Claims of Individuals by Their Countries

A nation can settle the claims of its citizens against a foreign government. The injury must have been an internationally wrongful act by another State and the injured citizen must have been a national of the espousing state. Generally, a claim may not be espoused unless the “local remedies” rule is satisfied.The United States has a long history of settling individual claims against foreign countries by international agreements. The Supreme Court has upheld this practice.The Peace Treaty with Japan contains a mutual waiver of claims. Yet Americans who had been forced to work as slave laborers for Japanese companies filed lawsuits. The u.s. executive branch and courts held that their claims had been settled.Certain Holocaust claims were resolved under a new format. Thus, creative approaches to resolving claims are available outside the normal legal framework.
Diagnostics and Prognostocs of Electro-Mechanical Actuators

This presentation describes the research performed at NASA Ames Research Center on diagnostics and prognostics of electro-mechanical actuators.
Dialogvs, Ivlivs Exclvsvs e Coelis

In 1506, after years of expectation and disappointment, Erasmus finally put into effect his plan to visit Italy. His sojourn in the ancient centre of culture and religion was of great significance for his development both as humanist and reformer, and is therefore an important event in the history of Christian humanism in Northern Europe 1). There he perfected his command of Greek, read through ancient manuscripts unobtainable in the North, and mingled freely with the most distinguished scholars of the Italian Renaissance. There, too, he had his first opportunity to view the papacy at close range. Rome in the first years of the sixteenth century might prove very enlightening to a spiritually-minded Christian, gifted, as was Erasmus, with the piercing vision of the born satirist. For three years he regarded the turbulent Italian scene from one point of vantage after another, but always with an interested eye on the papal comedy. The first fruit of these years of thoughtful observation was the Moriae Encomium, the second, less famous but scarcely less significant, the dialogue Iulius exclusus e coelis.
GENETIC IMPLICATIONS OF RARE DISEASES.

ELSEWHERE in this number of Pediatrics appears a splendid paper by Snyderman and others on the dietary treatment of "Maple Syrup Disease." This news of a successful treatment for so distressing a disorder will be greeted by cheers from all, but there will be also an obligato of groans from the many to whom the biochemistry and the means of measurement of amino acids and of their keto derivatives are formidable and alien. It is the lot and fate of all of us who are away from medical school for more than a few years to lose touch with some or many of the most rapidly changing aspects of the study of human biology, and because we are busy with our own work, we wish to have these advances laid out for us in comprehensive and comprehensible reviews, rather than to persist in the unequal struggle to read and to understand all the original work.
Exploring the Gender Gap in Computer Science Education in Uganda

The purpose of this study is two-fold: to investigate the nature of the gender gap in computer science education in Uganda and to understand the factors that influence gender differences in computer science education in Uganda. The findings of the study indicate that there is a gender gap in computer science education. The reasons for the gap were revealed in the interviews, surveys and focus group discussions. The study concluded that several policy measures need to be taken to address the gender gap in computer science education in Uganda.
Chaperone-mediated autophagy is impaired in the lysosomal storage disorder cystinosis (740.2)

Functional lysosomes are essential for autophagosome maturation and clearance of autophagic substrates. Accordingly, Lysosomal Storage Disorders (LSDs) have been associated with autophagy defects. Cell malfunction in the LSD Cystinosis is caused by the accumulation of the amino acid cystine in lysosomes due to genetic defects in the Ctns gene (cystinosin), a lysosomal transporter. Using EM and TIRFM microscopy, we showed that lysosomal number, size and trafficking was affected in Ctns-/- cells. Although the number of autophagosomes was strongly increased in Ctns-/- cells under resting conditions, fusion of autophagosomes with lysosomes, as well as starvation-induced degradation of the autophagosome marker LC3-II, was not affected in these cells, indicating that autophagic flux is increased but not impaired in cystinosis. Interestingly, the receptor for chaperone-mediated autophagy (CMA) LAMP2a, the rate limiting step for CMA, was downregulated and mislocalized in Ctns-/- cells and tissues. Lysosomal trans...
Application of the Likelihood Function in Phylogenetic Analysis

The likelihood of a phylogenetic tree is proportional to the probability of observing the comparative data (such as aligned DNA sequences) conditional on the tree. The likelihood function is important because it is the vehicle that carries the observations. The likelihood function can be used in two ways to infer phylogeny. First, the tree that maximizes the likelihood can be chosen as the best estimate of phylogeny; this is the method of maximum likelihood. Second, a prior probability distribution on trees can be specified and inferences based upon the posterior probability distribution of trees; this is the approach taken by Bayesians. Although maximum likelihood and Bayesian inference are similar in that the same models of DNA substitution can be used to calculate the likelihood function, they differ in their interpretation of probability. Markov chain Monte Carlo (MCMC) can be used to approximate the posterior probabilities of trees. MCMC also makes it possible to perform comparative analyses that accommodate phylogenetic uncertainty. Keywords: Bayesian inference; Markov chain Monte Carlo; maximum likelihood; phylogeny inference; poisson process