cssi/SciSciGPT-SciSciNet huggingface dataset:
Outcomes in women age 40 years and older with cytologically benign endometrial cells

Objective We sought to estimate cytologically benign endometrial cell (CBEC)-associated endometrial hyperplasia and cancer rates, and describe clinical and histologic outcomes. Study Design Medical records of women age >40 years with CBEC in 2005 through 2010 were reviewed for clinical characteristics; assessment with endometrial biopsy, ultrasound, or hysteroscopy; and consequent outcomes. Results Of 658 women, 281 (42.7%) were assessed: 39.4% of 330 premenopausal, and 46.0% of 328 postmenopausal women. Among these, cancer rate was 3.6% and differed between premenopausal (0.8%) and postmenopausal (6.0%) women ( P = .019). Hyperplasia rate was similar in premenopausal (3.9%) and postmenopausal (3.3%) women. Of 20 assessed women with endometrial pathology, 4 (1 premenopausal) women with cancer and 4 (2 premenopausal) women with hyperplasia had no abnormal bleeding. Conclusion Cancer was more common in postmenopausal women with assessed CBEC while hyperplasia was comparably distributed between premenopausal and postmenopausal women. Findings support CBEC assessment regardless of menopausal status or abnormal bleeding.
Assessing Computational Steps for CLIP-Seq Data Analysis

RNA-binding protein (RBP) is a key player in regulating gene expression at the posttranscriptional level. CLIP-Seq, with the ability to provide a genome-wide map of protein-RNA interactions, has been increasingly used to decipher RBP-mediated posttranscriptional regulation. Generating highly reliable binding sites from CLIP-Seq requires not only stringent library preparation but also considerable computational efforts. Here we presented a first systematic evaluation of major computational steps for identifying RBP binding sites from CLIP-Seq data, including preprocessing, the choice of control samples, peak normalization, and motif discovery. We found that avoiding PCR amplification artifacts, normalizing to input RNA or mRNAseq, and defining the background model from control samples can reduce the bias introduced by RNA abundance and improve the quality of detected binding sites. Our findings can serve as a general guideline for CLIP experiments design and the comprehensive analysis of CLIP-Seq data.
Addition reaction of multifunctional epoxides with silk fibroin

The reaction of di- and tri-functional epoxides with silk fibroin was investigated in the presence of various salts in different solvents at 45–75°C. The reaction rates depend on the nature of the salts and the solvents used. Large weight gains (to 28%) were obtained in the reactions with ethyleneglycol diglycidyl ether, glycerol triglycidyl ether, and vinylcyclohexene dioxide catalyzed by thiosulfate, thiocyanate, cyanide, or chloride ions in such solvents as carbon tetrachloride, toluene, ethanol, and isopropanol. The weight gains in the silk/epoxide reaction were obtained mainly by the reaction of epoxide with the phenolic hydroxyl groups of the tyrosine residues, although lysine, histidine, arginine, and serine residues were found to react. The silk fabrics reacted with the epoxides were imparted with low solubilities in aqueous NaOH and HCl solutions without an appreciable decrease of moisture regain and flexibility of the fabric, and had much improved creaseproof properties. Die Reaktion von di- und trifunktionellen Epoxiden mit Seidenfibroin wurde in Gegenwart verschiedener Salze in mehreren Losungsmitteln bei 45 bis 75°C untersucht. Die Reaktionsgeschwindigkeiten hangen von der Art der verwendeten Salze und Losungsmittel ab. Grose Gewichtszunahmen (bis zu 28%) wurden bei der Reaktion mit Athylenglykol-diglycidather, Glycerin-triglycidather und Vinylcyclohexan-dioxid in Losungsmitteln wie Tetrachlorkohlenstoff, Toluol, Athanol und Isopropanol erhalten, wenn mit Thiosulfat-, Rhodanid-, Cyanid- oder Chlorionen katalysiert wurde. Die Gewichtszunahmen bei der Seide/Epoxid-Reaktion wurden hauptsachlich durch Reaktion des Epoxids mit der phenolischen Hydroxylgruppe der Tyrosinreste erhalten, wobei auch Lysin-, Histidin-, Arginin- und Serinreste reagieren. Die Seide besas nach der Reaktion mit den Epoxiden geringe Loslichkeit in wasriger NaOH und HCl ohne Abnahme der Feuchtigkeitsaufnahme und Biegsamkeit und hatte stark verbesserte Knitterfestigkeit.
Impact of obesity on women's health.

Objective To review the impacts of obesity on women's reproductive health and fertility. Design Literature review. Setting Academic medical center. Patient(s) Forty articles are referenced. The number of patients evaluated in each of the studies varies from 33 to 213,208. Intervention(s) Articles were identified from an Ovid/Medline search using the search terms obesity, dysfunctional uterine bleeding, contraception, miscarriage, infertility, and weight loss. Main Outcome Measure(s) The impacts of obesity on reproductive health and fertility. Result(s) Obesity is associated with early puberty, aberrant menstrual patterns, decreased contraceptive efficacy, ovulatory disorders, an increased miscarriage rate, and worse assisted reproductive technology outcomes. Losing weight can ameliorate many of these problems. Conclusion(s) Obesity is one of the most significant causes of morbidity and mortality in the U.S. Providers must educate patients about the impacts of obesity on reproductive health and fertility.
Use of new technology to improve utilization and adherence to immunotherapy

Technology and social media have dramatically altered the landscape in which we practice medicine. Clinicians have increasingly turned to technology and the internet to enhance patient care. Allergists have used these modalities to improve utilization and adherence to immunotherapy. Electronic medical records (EMRs) are being widely adopted by allergy practices and some offer allergy/immunology specific modules that aid in daily workflow. The development of specialized devices that reduce pain associated with immunotherapy administration may improve compliance with immunotherapy. Social media and other forms of electronic communication such as e-mail, Facebook, Twitter, short message service (SMS), and YouTube give clinicians multiple avenues to disseminate information and reach their patients, possibly improving patient adherence to therapy. Finally, tablet computers, online networks, and electronic surveys provide additional ways to connect patients and physicians.
More daytime sleeping predicts less functional recovery among older people undergoing inpatient post-acute rehabilitation.

Study Objectives: To study the association between sleep/wake patterns among older adults during inpatient post-acute rehabilitation and their immediate and long-term functional recovery
Case report: comparative response of fever to corticosteroids in tuberculosis and in connective tissue disease.

Abstract A young woman with fever and pleural effusion eventually was found to have both primary tuberculosis and systemic lupus erythematosus. Before either diagnosis was confirmed, the patient had a dramatic defervescence in response to prednisone; her condition had not improved initially after anti-tuberculous therapy. Uncertainty regarding the clinical significance of this remarkable temperature response led us to review our experience with febrile tuberculous patients who had received corticosteroids. Of 14 such patients, nine had rapid declines of body temperature to below 36.5C. In a comparable group of 14 patients with a variety of connective tissue diseases, 12 showed an equally dramatic defervescence after corticosteroid administration. The data suggest that a prompt temperature decline following corticosteroid therapy is a nonspecific response that cannot be used to differentiate between fever of infectious or noninfectious origin.
Comparative Courtship Behavior and Karyology in Monodontomerus (Hymenoptera: Torymidae)

The sexual behavior and chromosome complement of 4 species of Monodontomerus Westwood are described. Courtship involves approach, display (precopulatory behavior), and copulation. Male display consists of a repetitive series of sterotyped movements which increase in amplitude and frequency of occurrrence until a highly ritualized and species-characteristic climax act is performed. Although the basic courtship pattern in Monodontomerus is similar to that of other chalcidoids, several unique elements of male climax display are present. These include swiveling of the head about the neck in males of M. saltuosus Grissell and appression of the scapes against the female antennae in males of M. montivagus Ashmead and M. dementi Grissell. Haploid karyotypes of 4 metacentric (M. obscurus Westwood), 5 metacentric (saltuosus), and 5 metacentric + 1 small acrocentric chromosome (montivagus and dementi) are reported. A framework of systematic relationships within the genus is constructed based on ethological and karyological data. A chromosome number of n=5 and a prolonged dorsal display consisting of antennation, wing flicking, and mouthpart movements are postulated as ancestral for the genus.
The retention of 45 Ca by the chorio-allantoic sac of the chicken embryo.

Abstract The chorio-allantoic sacs of 10 and 11-day chicken embryos were injected with 45 Ca in order to assay their permeability to calcium. The retention of radioactive calcium by the sacs was found to be almost complete, since less than one-fourth of the administered dose escaped to the embryos during one week of incubation. This slow turnover of 45 Ca suggests that the endoderm of the chorio-allantoic membrane isolates the calcium of the allantoic fluid.
The deafness of Beethoven: an audiologic and medical overview

The hearing loss of Ludwig von Beethoven has fascinated physicians, audiologists, and musicologists for almost 200 years. In this review of the literature, the features, treatment, and differential diagnosis of the composer's malady are discussed. An original series of hypothetical audiograms and actual photomicrographs depicting cochlear otosclerosis and Paget's disease are also provided. The author concludes with the majority of otologists that cochlear otosclerosis is the most likely diagnosis for the hearing loss. In addition, a summary of Beethoven's complicated medical history and results of the autopsy that confirmed chronic liver disease are included.
Diaspora and Nation in the Indian Ocean: Transnational Histories of Race and Urban Space in Tanzania

Ned Bertz. Honolulu: University of Hawai'i Press, 2015. ix and 275 pp., notes, bibliography, index. $59.00 cloth (ISBN 978-0-8248-5155-2).Diaspora and Nation in the Indian Ocean from historian Ned ...
Refractory anastomotic bile leaks after orthotopic liver transplantation are associated with hepatic artery disease

Background and Aims Anastomotic bile leaks are common after orthotopic liver transplant (OLT), and standard treatment consists of placement of a biliary endoprosthesis. The objectives of this study were to identify risk factors for refractory anastomotic bile leaks and to determine the morbidity associated with refractory bile leaks after OLT. Methods Consecutive adult patients who underwent ERCP for treatment of post-OLT biliary adverse events between 2009 and 2014 at a high-volume transplant center were retrospectively identified. A refractory leak was defined as a bile leak that persisted after placement of a plastic biliary endoprosthesis and required repeat endoscopic or surgical intervention. Results Forty-three subjects met study inclusion criteria. Median age was 57 years, and 36 (84%) subjects were men. Refractory bile leaks were diagnosed in 40% of subjects (17/43). Time-to-event analysis revealed an association between refractory bile leaks and the combined outcome of death, repeat transplant, or surgical biliary revision (hazard ratio, 3.78; 95% confidence interval, 1.25-11.45; P = .01). Hepatic artery disease was more common with refractory compared with treatment-responsive bile leaks (53% vs 8%, P = .001). Conclusions Refractory anastomotic bile leaks after liver transplantation are associated with decreased event-free survival. Hepatic artery disease is associated with refractory leaks. Large-scale prospective studies should be performed to define the optimal management of patients at risk for refractory bile leaks.
A matter of scale: multi-scale ethnographic research on education in the United States

In recent years, cultural anthropologists conducting educational ethnographies in the US have pursued some new methodological approaches. These new approaches can be attributed to advances in cultu...
A COMPARATIVE EVALUATION OF OFFICIAL METHODS FOR THE STANDARD PLATE COUNT OF CREAM

Three official methods to measure cream samples for Standard Plate Counts (SPC) were reviewed. A statistical analysis was made of results from 135 analysts over a 2-year period. Results demonstrated that: (a) pipetting samples is the least precise method to prepare cream samples for the SPC, (b) when compared to the SPC variance of 0.012, variation among analysts is significant for the procedure that weighs 11 g of cream, while the among-analyst variance is not significant when the 1-g weighing procedure is employed, and (c) weighing 1 g of cream is the most precise method to prepare cream samples for SPC determinations.
Organizational Policy Advocacy for a Quality Improvement Innovation in a Maternal and Child Health Network: Lessons Learned in Early Implementation

ABSTRACTThis article analyzes and reports lessons learned in early implementation of a large quality improvement innovation for a maternal and child health network working in a large Midwestern metropolitan area. It uses a case study method to focus on how internal advocacy and policy practice helped network partners accept and adapt to the initial rollout of a mandated quality improvement system that required careful data tracking for a universal screening and referral process for perinatal mood and anxiety disorders. Three key findings emerged. Network participants endorsed new outreach to the executives of network partners to confirm their support of and compliance with the new quality improvement system. Participants also strategized ways to maintain program autonomy and disperse concerns about heavy-handed implementation of the quality improvement program. Finally, they identified ways to adapt the quality improvement program in response to concerns raised.
Boron-based reactive materials with high concentrations of iodine as a biocidal additive

Abstract Metal-based iodine-bearing reactive materials are of interest as additives to energetic formulations aimed to defeat biological weapons of mass destruction. This work was aimed to develop a material including a boron-based thermite with the maximized iodine concentration. The thermite was prepared mechanochemically, and Ca(IO 3 ) 2 served as an oxidizer. First, a B·I 2 composite powder was prepared starting with 40 wt% of iodine. This composite retains up to 30% of iodine, which is released in three steps upon heating. The main iodine loss occurs at temperatures exceeding 673 K (400 °C). The binary B·I 2 powder was used as a starting material to prepare the final thermite with the total concentration of iodine of 57.6 wt%. The thermite comprises loose agglomerates with particle sizes in the range of 1–10 µm, with submicron boron-iodine particles embedded in Ca(IO 3 ) 2 . Combustion tests of the ternary composite thermite powder in an air-acetylene flame showed the flame temperatures close to 2050 K, and solid residue in the form of fine oxidized spheres with boron and calcium oxides mixed homogeneously. A correlation between particle sizes and their burn times is reported as well.
Effect of oxygen vacancies and strain on the phonon spectrum of HfO2 thin films

The effect of strain and oxygen deficiency on the Raman spectrum of monoclinic HfO2 is investigated theoretically using first-principles calculations. 1% in-plane compressive strain applied to a and c axes is found to blue shift the phonon frequencies, while 1% tensile strain does the opposite. The simulations are compared, and good agreement is found with the experimental results of Raman frequencies greater than 110 cm−1 for 50 nm HfO2 thin films. Several Raman modes measured below 110 cm−1 and previously assigned to HfO2 are found to be rotational modes of gases present in air ambient (nitrogen and oxygen). However, localized vibrational modes introduced by threefold-coordinated oxygen (O3) vacancies are identified at 96.4 cm−1 computationally. These results are important for a deeper understanding of vibrational modes in HfO2, which has technological applications in transistors and particularly in resistive random-access memory whose operation relies on oxygen-deficient HfOx.
The Logic of Discovery in Strategic Management Research:Taking Stock and Looking Ahead

In this paper, we argue that strategic management has strayed from its focal purpose-- efficient and effective management practice, and suggest a refocusing of strategic management research on the ...
Catheter Hydrophone Aberration Correction for Transcranial Histotripsy Treatment of Intracerebral Hemorrhage: Proof-of-Concept

Histotripsy is a minimally invasive ultrasound therapy that has shown rapid liquefaction of blood clots through human skullcaps in an in vitro intracerebral hemorrhage model. However, the efficiency of these treatments can be compromised if the skull-induced aberrations are uncorrected. We have developed a catheter hydrophone which can perform aberration correction (AC) and drain the liquefied clot following histotripsy treatment. Histotripsy pulses were delivered through an excised human skullcap using a 256-element, 500-kHz hemisphere array transducer with a 15-cm focal distance. A custom hydrophone was fabricated using a $0.5\times 0.5\times0.3$ mm PZT-5h crystal interfaced to a coaxial cable and integrated into a drainage catheter. An AC algorithm was developed to correct the aberrations introduced between histotripsy pulses from each array element. An increase in focal pressure of up to 60% was achieved at the geometric focus and 27%–62% across a range of electronic steering locations. The sagittal and axial −6-dB beam widths decreased from 4.6 to 2.2 mm in the sagittal direction and 8 to 4.4 mm in the axial direction, compared to 1.5 and 3 mm in the absence of aberration. After performing AC, lesions with diameters ranging from 0.24 to 1.35 mm were generated using electronic steering over a $10 \times 10$ mm grid in a tissue-mimicking phantom. An average volume of 4.07 ± 0.91 mL was liquefied and drained after using electronic steering to treat a 4.2-mL spherical volume in in vitro bovine clots through the skullcap.
Achieving the gauge potential in a synthetic space using coherent Raman sideband generation

We study nontrivial topological effect in the Raman sideband generation process, where probe field shows features of one-way transport and Landau levels. Our proposal provides a unique connection between topological photonics and nonlinear optics.
The Evaluation of an Approach for Automatic Generated Documentation

Two studies are conducted to evaluate an approach to automatically generate natural language documentation summaries for C++ methods. The documentation approach relies on a method's stereotype information. First, each method is automatically assigned a stereotype(s) based on static analysis and a set of heuristics. Then, the approach uses the stereotype information, static analysis, and predefined templates to generate a natural-language summary/documentation for each method. This documentation is automatically added to the code base as a comment for each method. The result of the first study reveals that the generated documentation is accurate, does not include unnecessary information, and does a reasonable job describing what the method does. Based on statistical analysis of the second study, the most important part of the documentation is the short description as it describes the intended behavior of a method.
Vibronic Ground-State Degeneracies and the Berry Phase: A Continuous Symmetry Perspective.

We develop a geometric construction to prove the inevitability of the electronic ground-state (adiabatic) Berry phase for a class of Jahn–Teller (JT) models with maximal continuous symmetries and N > 2 intersecting electronic states. Given that vibronic ground-state degeneracy in JT models may be seen as a consequence of the electronic Berry phase and that any JT problem may be obtained from the subset that we investigate in this Letter by symmetry-breaking, our arguments reveal the fundamental origin of the vibronic ground-state degeneracy of JT models.
Assembly and Purification of Prototype Foamy Virus Intasomes

A defining feature and necessary step of the retrovirus life cycle is the integration of the viral genome into the host genome. All retroviruses encode an integrase (IN) enzyme that catalyzes the covalent joining of viral to host DNA, which is known as strand transfer. Integration may be modeled in vitro with recombinant retroviral IN and DNA oligomers mimicking the ends of the viral genome. In order to more closely recapitulate the integration reaction that occurs in vivo, integration complexes are assembled from recombinant IN and synthetic oligomers by dialysis in a reduced salt concentration buffer. The integration complex, called an intasome, may be purified by size exclusion chromatography. In the case of prototype foamy virus (PFV), the intasome is a tetramer of IN and two DNA oligomers and is readily separated from monomeric IN and free oligomer DNA. The integration efficiency of PFV intasomes may be assayed under a variety of experimental conditions to better understand the dynamics and mechanics of retroviral integration.
Flip the switch: BTG2–PRMT1 protein complexes antagonize pre-B-cell proliferation to promote B-cell development

Flip the switch: BTG2–PRMT1 protein complexes antagonize pre-B-cell proliferation to promote B-cell development
Intervento rivolto a crisi in corso di malattie mentali: Determinare i requisiti di sicurezza

Nel mondo degli interventi sulla crisi, un’area che non puo essere ignorata e quella della salute mentale: quando la si mette a confronto con tutte le altre malattie — come fatto nello Studio sul Peso Globale delle Malattie (1996), condotto dall’Organizzazione Mondiale della Sanita, la Banca Mondiale e l’Universita di Harvard — la malattia mentale si trova in cima alla lista come una delle cause principali di invalidita (contando gli anni di vita sana persi) (Murray e Lopez, 1996). Nei paesi sviluppati, le dieci cause principali della perdita di anni di vita sani tra i 15 e i 44 anni sono: 1. grave disturbo depressivo; 2. uso di alcol; 3. incidenti stradali; 4. schizofrenia; 5. autolesionismo; 6. disturbo bipolare; 7. uso di droghe; 8. disturbo ossessivo compulsivo; 9. osteoartrite; 10. violenza.
Craniomaxillofacial Bone Healing, Biomechanics, and Rigid Internal Fixation

The basic orthopedic principles of bone healing and fixation biomechanics are applicable to craniomaxillofacial reconstructive surgery. In general, however, the emphasis is less on providing mechanical stability to resist high levels of applied physiological forces than on establishing rigid immobilization both to obtain proper, stable anatomic configuration and to promote rapid healing.1 For each particular surgical application, there exists a variety of fixation techniques to achieve these goals. This chapter discusses fixation methods in general, as well as their biomechanical aspects as they influence bone healing, and relates these principles to several bone-specific clinical applications.
Lysosomal Metabolism of Proteins

The lysosome is a major site of mammalian protein degradation and is calculated to be capable of degrading as much protein as the digestive tract (Barrett and Kirschke, 1981). Detailed characteristics are known for several of the enzymes involved in lysosomal proteolysis, although recent data suggest that the current catalog of enzymes involved in protein degradation is by no means complete. Although the enzymes are the necessary tools for hydrolysis, they are only effective in the right environment. In this chapter the relationship between the different enzymes and their environment is discussed, including mechanisms by which lysosomal proteolysis is controlled. Delivery of substrates to the lysosome, the pH in the lysosome, and removal of products from the lysosome are discussed in depth elsewhere in this volume (Chapters 3, 4, 5, 10, and 11), so discussion of these topics will be restricted to how they relate specifically to protein turnover. This chapter focuses on how the proteases function to hydrolyze proteins in the lysosome (for information on the pathological roles and the chemistry of the lysosomal proteases, see Lee and Marzella, 1994, and Mason and Wilcox, 1993).
Economic Analysis of Fast Spectrum Reactors

Economics always plays a pivotal role in the decision process associated with the construction of any project. Accordingly, we shall endeavor in this chapter to outline the key factors that influence the cost of building a nuclear power plant—with special emphasis regarding fast spectrum reactors. It is very difficult at the present time, however, to provide firm cost estimates for fast spectrum systems because very few reactors of this type have been built in recent years and none of these could be considered fully commercial. Hence, we shall focus our discussion on comparative evaluations, i.e. citing the differences between fast spectrum systems and the current generation of light water reactors (LWRs). Specific mathematical techniques for determining actual costs, once key input numbers are known, are contained in Appendix D. Specific techniques for defining such items as the time value of money, levelized costs, etc. are detailed in this Appendix.
SPDP: An Automatically Synthesized Lossless Compression Algorithm for Floating-Point Data

Scientific computing produces, transfers, and stores massive amounts of single- and double-precision floating-point data, making this a domain that can greatly benefit from data compression. To gain insight into what makes an effective lossless compression algorithm for such data, we generated over nine million algorithms and selected the one that yields the highest compression ratio on 26 datasets. The resulting algorithm, called SPDP, comprises four data transformations that operate exclusively at word or byte granularity. Nevertheless, SPDP delivers the highest compression ratio on eleven datasets and, on average, outperforms all but one of the seven compared compressors. An analysis of SPDP's internals reveals how to build effective compression algorithms for scientific data.
Box diagrams to assess students systems thinking about the rock, water and carbon cycles

Box-diagrams of reservoirs and processes that describe the rock, water and carbon cycles were used in a general education course as instructional and assessment tools. Students overall success at constructing correct box-diagram models of the water cycle demonstrates that they have three critical abilities: 1) to identify substances, locations of substances and processes that move and change substances in a system, 2) to organize the substances and processes within different frameworks and 3) to understand the generally cyclic nature of a system. Many students lack a fourth critical ability, to recognize parts of a system that are not readily apparent or visible. Students who lack this fourth ability are not able to construct diagrams with appropriate ions, molecules and/or chemical reactions. This lack of appropriate mental models is the major source of error in students' attempts to describe movement and change of matter with rock and carbon cycle box diagrams. Students have greater success with box-diagram models of the water cycle because chemical reactions were not included in the water cycle. Phase change is important in understanding the water cycle and students show evidence of poor understanding of condensation.
High-Frequency Absorption-FIFO Pipelining for Stratix 10 HyperFlex

FPGAs often have significantly lower clock frequencies than microprocessors and GPUs, due largely to propagation delays incurred by the reconfigurable interconnect. The Stratix 10 HyperFlex architecture reduces this problem by embedding numerous registers throughout the routing resources. However, such Hyper-Registers do not support back-pressure (i.e., pipeline stalls) that is commonly used in FPGA pipelines. In this paper, we present and evaluate pipeline transformations using absorption FIFOs, which avoid back-pressure limitations to enable numerous pipelines to benefit from HyperFlex, while also eliminating potentially expensive stall penalties incurred by existing techniques. We demonstrate that these transformations not only enable significant clock improvements on Stratix 10, but also for devices without HyperFlex, potentially making absorption FIFOs a better high-frequency strategy for any FPGA.
Litigation and Public Health Policymaking: The Case of Tobacco Control

Many tobacco control advocates believe that legislators and regulators have failed to enact and implement sufficiently stringent tobacco control laws and thus have supported litigation as a means of achieving public health policy goals. In this article, we examine the relationship between litigation and public health policy formulation in the context of the debate over tobacco control policy. The fundamental questions are how social policy should be made regarding the use of tobacco products, and which institutions should be responsible for controlling tobacco use: the market, the political system (i.e., the legislative and regulatory branches of government), or the courts. On balance we conclude that litigation is a second-best solution. We see a distinct role for litigation as a complement to a broader, comprehensive approach to tobacco control policymaking, rather than as an alternative to the traditional political apparatus of formulating and implementing public health policy. Our analysis suggests that, in general, public health goals are more directly achievable through the political process than through litigation, though situations such as those concerning tobacco control blur the bounds between litigation and the politics of public health. Litigation has stimulated a national debate over the role of smoking in society and may well move the policy agenda. But we conclude that a sustained legislative and regulatory presence ought to be the bulwark of meaningful policy changes.
Patients' and Providers' Views on Causes and Consequences of Healthcare Fragmentation in the Ambulatory Setting: a Qualitative Study.

Patients with chronic conditions routinely see multiple outpatient providers, who may or may not communicate with each other. Gaps in information across providers caring for the same patient can lead to harm for patients. However, the exact causes and consequences of healthcare fragmentation are not understood well enough to design interventions to address them. We sought to elicit patients’ and providers’ views on the causes and consequences of healthcare fragmentation. We conducted a qualitative study with focus groups of patients and, separately, of providers (attending physicians and nurse practitioners) at an academic hospital-based primary care practice in New York City in June–August 2017. Patient participants were English-speaking adults with ≥ 2 chronic conditions. Each focus group lasted 1 h and asked the same two questions: “Why do you think some patients receive care from many different providers and others do not?” and “What do you think happens as a result of patients receiving care from many different providers?” Data collection continued until a point of data saturation was reached. Thematic analysis was used to identify themes and subthemes. We conducted 6 focus groups with a total of 46 participants (25 patients and 21 providers). Study participants identified 41 unique causes of fragmentation, which originate from 4 different levels of the healthcare system (patient, provider, healthcare organization, and healthcare environment); most causes were not related to medical need. Participants also identified 24 unique consequences of fragmentation, of which 3 were desirable and 21 were undesirable. The results of this study offer a granular roadmap for how to decrease healthcare fragmentation. The large number and severity of negative consequences (including medical errors, misdiagnosis, increased cost, and provider burnout) underscore the urgent need for interventions to address this problem directly.
Efficacy of antibiotic prophylaxis in intraoral bone grafting procedures: a systematic review and meta-analysis

The purpose of this systematic review was to investigate the efficacy of antibiotic prophylaxis (AP) in intraoral bone grafting procedures for the prevention of postoperative infection (POI). Electronic and manual searches were conducted to identify randomized controlled trials (RCTs). The primary outcome assessed was receptor site POI; secondary outcomes assessed included donor site POI, wound dehiscence, pain, graft failure, need for re-grafting, adverse events, patient satisfaction, and quality of life. A random-effects meta-analysis was conducted to obtain risk ratios of dichotomous data. Four RCTs were selected: one examined AP versus placebo and concluded that there was an increased risk of POI without AP; three examined comparative antibiotic regimens and found no statistically significant difference between them. A meta-analysis of prophylactic regimens, including data from the two RCTs that compared preoperative AP to perioperative AP, indicated no statistically significant difference in POI outcomes (P= 0.94, risk ratio 0.94). It was not possible to conduct further meta-analyses for POIs or for any secondary outcomes due to insufficient published data. The risk of bias assessment indicated an overall unclear risk of bias. On the basis of the present review, there is insufficient evidence to support or refute AP for the prevention of POIs in intraoral bone graft placement procedures.
Hypermetallic polar molecules for precision measurements

Laser cooling is a powerful method to control molecules for applications in precision measurement, as well as quantum information, many-body physics, and fundamental chemistry. However, many optically active metal centers in valence states which are promising for these applications, especially precision measurement, are difficult to laser cool. In order to extend the control afforded by laser cooling to a wider array of promising atoms, we consider the use of small, hypermetallic molecules that contain multiple metal centers. We provide a detailed analysis of YbCCCa and YbCCAl as prototypical examples with different spin multiplicities and consider their feasibility for precision measurements making use of the heavy Yb atom. We find that these molecules are linear and feature metal-centered valence electrons and study the complex hybridization and spin structures that are relevant to photon cycling and laser cooling. Our findings suggest that this hypermetallic approach may be a versatile tool for experimental control of metal species that do not otherwise efficiently cycle photons and could present a relevant platform for state-of-the-art precision measurements.
Vision-Guided Robot for Planetary Habitat Assembly

The focus of this research is to develop a vision guided autonomous system for simulated structure assembly on distant planets/moons. This concept supports NASA’s Space Technology Mission Directorate (STMD) by enabling autonomous structure or habitat assembly. To accomplish this, simulated building materials shaped as bricks are used to assemble structures in a similar fashion as on earth. The bricks would be produced via additive manufacturing from the in-situ environment, which is not the focus of this research. This is an alternative methodology to many of the NASA 3D Printed Habitat Centennial Challenge concepts; it is accomplished by mounting a robot arm atop a mecanum drive robotic platform. The mecanum base enables the system to traverse omni-directionally over the terrain while the robot arm provides material manipulation abilities. To counter the changing work conditions, a vision system provides flexible peripheral input. The system would travel to the approximate build location then the vision system would provide guided input for the automated assembly. Each subsystem provides flexibility to simulate a scenario of being deployed on a distant planet/moon while the appropriately sized construction blocks allowed the rover to build a structure piece by piece.
Fungal Cardiac Infections

Abstract Fungal infections of the heart occur significantly less frequently than bacterial infections, but they carry an excessively high mortality rate. Fungal endocarditis has an estimate mortality rate of ~50% while bacterial causes result in an ~18% in-hospital mortality (Murdoch et al., 2009). This article covers the cardiac involvement, particularly endocarditis and myocarditis, of common invasive fungi pathogens.
Global thermodynamic, transport-property and dynamic characteristics of the Venus lower atmosphere below the cloud layer

Abstract This study investigates the global characteristics of the Venus lower atmosphere below the cloud layer. Starting from available data regarding species composition, temperature and pressure, the general thermodynamic and transport properties of the Venus lower atmosphere are first computed at altitudes below the cloud layer. The thermodynamic and transport properties are validated with known data. A thermodynamic stability analysis for a variety of potentially existing mixtures is conducted to highlight the sensitivity of the thermodynamic regime to the variation of the species molar fractions. The limits of thermodynamic stability are represented in the thermodynamic phase diagram of the mixture, and thus regions of phase stability and instability are determined. It is found that the Venus lower-atmosphere thermodynamic regime is located in the stable, single-phase regime, with supercritical conditions occurring in the lower few kilometers, thereby validating ad-hoc expectations which have never envisaged the existence of a two-phase regime at those altitudes. Using thermodynamic and transport-property information thus computed, several non-dimensional numbers are calculated. The Prandtl number is first evaluated. Then, the characteristic Reynolds number is estimated for different assumed length scales, showing that, independent of the length scale, the entire lower atmosphere below the cloud deck is in a fully-turbulent flow regime. Finally, the speed of sound and the Mach number are computed as function of altitude. The information obtained from all these calculations fills a scientific void, and may be crucial for the design of landers on the Venus surface.
Transition preparation activities among families of youth on the autism spectrum: Preliminary study using repeated assessments across a school year

Much is still unknown about the transition to adulthood for youth with autism spectrum disorder (ASD), including what preparation activities best support positive adult outcomes. Parents play a crucial role in the transition planning and preparation process, yet the existing literature lacks detailed information about parent perceptions about transition preparation activities. To examine family transition preparation activities, we conducted a ten-month study of the transition preparation process of 15 families of youth with ASD across an academic year. Youth were ages 14-17 and 93% male. We collected data on transition preparation activity time spent and parent satisfaction over twenty data collection points. We used multi-level modeling to determine longitudinal trajectories of parent-reported preparation for the transition to adulthood based on endorsed transition preparation activities. Findings from this preliminary study revealed that discussions about the future were the most commonly endorsed activities, while social activities were most associated with increased parental perception of transition preparation over time. This study expands understanding of various transition preparation activities engaged in by families of youth with ASD during high school, though research with a larger and more diverse sample is needed to extend findings.
The U.S. Student Loan Debt Crisis: State Crime or State-Produced Harm?:

The unprecedented US$1.64 trillion level of student loan debt in the United States can be linked to the neoliberal process of privatization of higher education. But is the U.S. student loan debt cr...
Intake of Nuts or Nut Products Does Not Lead to Weight Gain, Independent of Dietary Substitution Instructions: A Systematic Review and Meta-Analysis of Randomized Trials.

Several clinical interventions report that consuming nuts will not cause weight gain. However, it is unclear if the type of instructions provided for how to incorporate nuts into the diet impacts weight outcomes. We performed a systematic review and meta-analysis of published nut-feeding trials with and without dietary substitution instructions to determine if there are changes in body weight (BW) or composition. PubMed and Web of Science were searched through 31 December 2019 for clinical trials involving the daily consumption of nuts or nut-based snacks/meals by adults (≥18 y) for >3 wk that reported BW, BMI, waist circumference (WC), or total body fat percentage (BF%). Each study was categorized by whether or not it contained dietary substitution instructions. Within these 2 categories, an aggregated mean effect size and 95% CI was produced using a fixed-effects model. Quality of studies was assessed through the Cochrane risk-of-bias tool. Fifty-five studies were included in the meta-analysis. In studies without dietary substitution instructions, there was no change in BW [standardized mean difference (SMD): 0.01 kg; 95% CI: -0.07, 0.08; I2 = 0%] or BF% (SMD: -0.05%; 95% CI: -0.19, 0.09; I2 = 0%). In studies with dietary substitution instructions, there was no change in BW (SMD: -0.01 kg; 95% CI: -0.11, 0.09; I2 = 0%); however, there was a significant decrease in BF% (SMD: -0.32%; 95% CI: -0.61%, -0.03%; I2 = 35.4%; P < 0.05). There was no change in BMI or WC for either category of studies. Nut-enriched diet interventions did not result in changes in BW, BMI, or WC in studies either with or without substitution instructions. Slight decreases in BF% may occur if substitution instructions are used, but more research is needed. Limitations included varying methodologies between included studies and the frequency of unreported outcome variables in excluded studies.
A musician-centered approach to management of performance-related upper musculoskeletal injuries.

Abstract Study Design Invited Clinical Commentary Background Performance related musculoskeletal disorders (PRMD) are common in instrumental musicians and often affect the upper extremities. These overuse injuries typically result from inadequate attention to the musculoskeletal demands required for the high-level performance of musician-students and experienced instrumentalists. 1 PRMDs often interfere with career trajectory, and in extreme cases, can be career ending. Many clinicians and healthcare practitioners treating upper extremity injuries are not familiar with the specific demands faced by instrumental musicians and how to tailor treatment and prevention strategies to the specific risks and occupational needs of each instrumental group. Purpose of the study This paper describes an evidenced-based framework for the assessment, prevention, and treatment of musculoskeletal musician injuries to provide clinicians with an instrument-specific, and musician-centered guide for practice. We synthesized available literature on instrumental ergonomics, biomechanical demands, and upper extremity injuries to highlight the risks and common upper-extremity pathologies, focusing on the specific demands of instrumental groups: piano, high strings (violin and viola), low strings (cello and bass), percussion, woodwinds, and brass. Targeted assessment, prevention, and treatment strategies are reviewed in this context to provide healthcare providers with an evidence-based framework to approach the treatment of PRMD to mitigate incidence of injury during practice and performance. Methods A comprehensive search of electronic databases was conducted including all study designs. Results This review describes risk factors for PRMD in instrumental musicians, strategies to prevent misuse and performance injury, and musician-centered interventions to allow playing while reducing risk of misuse. Conclusion The suggested assessment and treatment framework can assist clinicians with a customized patient-centered approach to prevention and treatment by addressing the gap in clinical knowledge with the goal of ultimately reducing the incidence and severity of PRMD in musicians.
Exploring Secondary Teachers’ Willingness to Differentiate Instruction for ELLs

The growing English language learner (ELL) population is expanding in the United States from concentrated, urban areas to smaller, rural school districts in which mainstream content teachers provide most instruction for these students (DelliCarpini & Alonso, 2014). Most mainstream content teachers at the secondary level, however, have had little or no training in teaching ELLs and do not currently provide the differentiated instruction necessary for ELLs to be successful (Musanti & Pence, 2010; Rubinstein-Avila & Lee, 2014). Previous research has explored teacher attitudes toward ELLs in mainstream classes and the teacher beliefs related to teacher identity, teacher responsibility, and self-efficacy which all emerge as relevant to teaching ELLs. However, there is no prior research on the association these three factors potentially have with teachers’ willingness to differentiate their instruction for ELLs in mainstream classrooms. This study explored these three factors of identity, responsibility, and self-efficacy as well as EL training, their relationship to each other, and their potential correlation with a teacher’s willingness to differentiate (WTD) instruction for ELLs in a mainstream classroom. Results indicate that identity and responsibility correlate most with a willingness to differentiate, but self-efficacy, along with several other emergent factors, are also relevant.
A HER2 Tri-Specific NK Cell Engager Mediates Efficient Targeting of Human Ovarian Cancer

Clinical studies validated antibodies directed against HER2, trastuzumab, and pertuzumab, as useful methodology to target breast cancer cases where HER2 is expressed. The hope was that HER2 targeting using these antibodies in ovarian cancer patients would prove useful as well, but clinical studies have shown lackluster results in this setting, indicating a need for a more comprehensive approach. Immunotherapy approaches stimulating the innate immune system show great promise, although enhancing natural killer (NK) function is not an established mainstream immunotherapy. This study focused on a new nanobody platform technology in which the bispecific antibody was altered to incorporate a cytokine. Herein we describe bioengineered CAM1615HER2 consisting of a camelid VHH antibody fragment recognizing CD16 and a single chain variable fragment (scFv) recognizing HER2 cross-linked by the human interleukin-15 (IL-15) cytokine. This tri-specific killer engager (TriKETM) showed in vitro prowess in its ability to kill ovarian cancer human cell lines. In addition, we demonstrated its efficacy in inducing potent anti-cancer effects in an in vivo xenograft model of human ovarian cancer engrafting both cancer cells and human NK cells. While previous approaches with trastuzumab and pertuzumab faltered in ovarian cancer, the hope is incorporating targeting and cytokine priming within the same molecule will enhance efficacy in this setting.