cssi/SciSciGPT-SciSciNet huggingface dataset:
The effect of low body mass index on outcome in critically ill surgical patients.

BACKGROUND Body mass index (BMI) has been correlated with complications and outcome in surgical patients at the two extremes of the nutrition spectrum. OBJECTIVE To study the relationship between BMI, outcome, hospital length of stay, and complications in patients admitted to the surgical intensive care unit (SICU). DESIGN Review of prospectively acquired data in SICU patients. Data acquired included weight, height, age, gender, Acute Physiology and Chronic Health Evaluation (APACHE) II-III scores, Simplified Acute Physiology II (SAPS II) scores, and morbidity and mortality. Patients who stayed in the unit <24 hours were excluded. RESULTS Of 793 patients, 706 had a normal BMI (NBMI; mean 22.12 kg/m²) and 87 were underweight (UBMI; mean 16.81 kg/m²). There was no statistically significant difference in APACHE II-III and SAPS scores. The NBMI group had more infections, and the UBMI group had more pulmonary complications (χ(2), P < .0087). There was no significant difference in acute respiratory distress syndrome, atrial fibrillation, myocardial infarction, septicemia, or ventilator- associated pneumonia (Fisher exact test, P = 0.38; χ(2), P = .41). The ICU length of stay between the 2 groups was not significantly different (6.7 vs 5.8 days; P = .64). Overall, there was 11.1% (88/793) SICU mortality; 74 of 706 (10.5%) patients expired in the NBMI group, and 14 of 87 (16.1%) patients expired in the UBMI group. CONCLUSIONS Low BMI is associated with increased mortality in SICU patients. A BMI <18.5 kg/m² is an independent factor affecting outcome in surgical critical care patients.
On Ensuring Multilayer Wirability by Stretching Layouts

Every knock-knee layout is four-layer wirable. However, there are knock-knee layouts that cannot be wired in less than four layers. While it is easy to determine whether a knock-knee layout is one-layer wirable or two-layer wirable, the problem of determining three-layer wirability of knock-knee layouts is NP-complete. A knock-knee layout may be stretched vertically (horizontally) by introducing empty rows (columns) so that it can be wired in fewer than four layers. In this paper we discuss two different types of stretching schemes. It is known that under these two stretching schemes, any knock-knee layout is three-layer wirable by stretching it up to (4/3) of the knock-knee layout area (upper bound). We show that there are knock-knee layouts that when stretched and wired in three layers under scheme I (II) require at least 1.2 (1.07563) of the original layout area. Our lower bound for the area increase factor can be used to guide the search for effective stretching-based dynamic programming three-layer wiring algorithms similar to the one presented in [8].
Surface Characterization of Replicate Wood Surfaces for Cleaning Studies

A need exists to develop realistic surfaces, with differing degrees of surface roughness, to standardize methods for sampling and cleaning of environmental contaminants. This study reports on development and characterization of a novel means to create reproducible wood surfaces that are approximately 7 × 10 cm2 and have differing degree of surface roughness. Three unique specimens were prepared by creating 3-dimensional digital-scans of actual wood surfaces found in three St. Louis homes. These surfaces had distinct depressions that likely arose from tool marks. A reverse image die of each specimen was made from high density plastic. Replicates of the three specimens were created by placing a die and wood veneer section into a rolling-press leaving the original topographies gathered from the homes. These specimens were used in a separate study to evaluate cleaning leaded dust using wipe or vacuuming treatments. The separate cleaning studies found no difference in cleaning due to the effects of the different surfaces. An in-depth examination of the three specimens was held to determine if differences in surface roughness of the specimens explained removal of lead from its surface. A method using optical, 3-D laser profilometry was used to determine if there were statistical differences between the surface roughness of the three specimens and within the specimens themselves. Area-scale analyses were made to calculate relative areas as a function of scale as a way of characterizing the roughness. Statistical differences were found for surface roughness between each of three surface specimens at a scale where small particles, deposited in the cleaning studies may adhere to the wood. However, within the specimens, surface roughness, at the scale where fine particles may lodge, were not consistent inside or outside tool marks. Therefore, differences in surface roughness were found within and between surfaces but they may not be large enough or different enough for detection using simple cleaning methods. Specimens with larger differences in surface roughness may be needed to simulate differences in cleaning effectiveness. This work should be continued to understand the scales for the different interactions of particle deposition, adhesion, and removal toward development of standard reference surfaces with well-characterized textures.
Wink on Pink: Interpreting Japanese Cute as It Grabs the Global Headlines

stand two young women in various shades of pink from head to toe: shocking pink hair adorned with multiple pink barrettes, fuzzy pink kitten earmuffs, pink baby doll dresses, mismatched pink knee-high socks, and pink laced shoes. Around one woman's neck hangs that icon of cute: Sanrio Company's flagship character since 1974, Hello Kitty. Among the barrettes in the other woman's hair is, again, Kitty. Standing at the entrance to Harajuku?the commercial mecca of street youth culture in Japan?they pose, leaning into each other, hands clenched, kitten-paw-style, at their cheeks. In the insouciant style of these Tokyo women, the look is not passively sweet, but assertively in-your-face kawaii (cute). This is cute with a wink, gesturing to the cameras that await them. The women pose for multiple gazes, knowing that what they donned that morning might be seen thousands of miles away, captured by foreign and Japanese photogra phers and posted on Web sites or eventually published in magazines and glossy coffee table books. The interaction between viewer and viewed defines and reifies the spectacle of kawaii, or what I call "Japanese cute." Nestled within the interaction, tucked among the frills of this Tokyo "cute overload" rests that mouthless icon of Japanese girl culture, Hello Kitty. Another gaze upon Japanese cute and, specifically, Hello Kitty comes from multiple news wire sources in August 2007. The headline declares, "To Punish Thai Police, a Hello Kitty Armband." Reported widely from the Associated Press to CNN International to Al Jazeera, the story revolves around a new strat egy devised by Bangkok police to discipline not the general public, but their own male patrol force. Any delinquent officer would be shamed into compliance by being forced to wear a bright pink Hello Kitty armband. Hello Kitty?that ulti mate symbol of cute femininity in Asia and elsewhere?presumably provided a sufficient threat to the police officers' masculinity. As of the news item's
An Empirically Derived Typology of Families: I. Relationships with Adult Health

In this report we describe the development and partial validation of an empirically derived typology of families based on 11 family variable composites derived from the California Family Health Project. Our goal was to use the typology to condense and integrate the findings from previous analyses of a large group of family variables and to account for differences in the self-reported health of adult family members. Exploratory and confirmatory cluster analyses conducted separately by gender classified 97% of the sample into four parallel types for husbands and wives: Balanced, Traditional, Disconnected, and Emotionally Strained. A 1-way MANOVA indicated that all 11 family variable composites significantly differentiated the four family types for husbands and wives. Significant differences among the four family types were also found on 10 demographic and other family variables, using ANOVA. Using MANOVA, we compared the four family types on 12 self-reported health and well-being variables by gender. Both husbands and wives from Balanced and Traditional families reported higher health scores than spouses from Disconnected and Emotionally Strained families, but no single profile of health scores was unique to a particular family type. The four family types provide an integrated and comprehensive framework for describing the family in health research.
Medicaid Access, Rate Setting and Payment Suits: How the Obama Administration is Undermining Its Own Health Reform Goals

Medicaid is a critical part of ensuring health care access for vulnerable populations, which is why it was expanded as part of the Affordable Care Act passed in 2010. But many are cautiously optimistic about this expansion. Health care access for Medicaid beneficiaries depends on providers willing to treat them, yet many providers are severely restricting the number of Medicaid patients they see or are dropping out of the Medicaid program altogether. This threat to Medicaid access can be traced to state payment cuts, freezes, or changes in rate-setting methodology that dramatically reduce provider reimbursement. Congress gave states significant flexibility in rate setting in order to encourage them to experiment with health delivery and financing models that would reduce cost and deliver care more efficiently. Nonetheless, there are constraints on this flexibility. Rates must be adequate to ensure timely and equal access to quality care. There are also procedural requirements - states must get federal regulatory approval of rate changes and give the public adequate notice and opportunity to comment on such changes. Since Medicaid’s enactment, however, providers and beneficiaries have brought payment suits challenging state rate cuts and rate-setting methodology as violating these requirements. In some cases, states ignore clear procedural requirements, making cuts without any consideration of access and quality factors. In other instances, the claim is that a state’s process is inadequate because it does not consider the information necessary to ensure equal access. But the fate of Medicaid payment suits as a tool for protecting health care access and quality is uncertain for a number of reasons. First, the Supreme Court in Douglas v. Independent Living Center has taken up (and just recently remanded to the Ninth Circuit) a case that considers providers’ and beneficiaries’ right to challenge state rate cuts in federal court, as well as the level of review courts must apply to cuts approved by the federal government. Second, the recent Medicaid expansion means that more people will be eligible for Medicaid and will need providers, further exacerbating access concerns. Finally, despite the Obama Administration’s renewed focus on Medicaid access generally, it is sending conflicting signals about its commitment to enforce existing federal access and quality protections. This Article explores the efficacy of payment suits as a tool for Medicaid access enforcement, and it considers the implications of the current regulatory and jurisprudential uncertainty for this important enforcement tool.
Health System Consolidation and Diabetes Care Performance at Ambulatory Clinics.

Objective We addressed two questions regarding health system consolidation through the acquisition of ambulatory clinics: (1) Was increasing health system size associated with improved diabetes care performance and (2) Did the diabetes care performance of acquired clinics improve postacquisition? Data Sources/Study Setting Six hundred sixty-one ambulatory clinics in Minnesota and bordering states that reported performance data from 2007 to 2013. Study Design We employed fixed effects regression to determine if increased health system size and being acquired improved clinics' performance. Using our regression results, we estimated the average effect of consolidation on the performance of clinics that were acquired during our study. Data Collection/Extraction Methods Publicly reported performance data obtained from Minnesota Community Measurement. Principal Findings Acquired clinics experienced performance improvements starting in their third year postacquisition. By their fifth year postacquisition, acquired clinics had 3.6 percentage points (95 percent confidence interval: 2.0, 5.1) higher performance than if they had never been acquired. Increasing health system size was associated with slight performance improvements at the end of the study. Conclusions Health systems modestly improved the diabetes care performance of their acquired clinics; however, we found little evidence that systems experienced large, system-wide performance gains by increasing their size.
How Accountants Can Fight Activist Investors

The case of the socially disruptive breakup of the century-old Timken provides an example of how accountants could have exercised creative leadership to push back against self-interested constituencies who manipulated accounting data. Accountants can exercise creativity in educating decision makers about the uncertainty inherent in accounting estimates. Accountants can present information in a nuanced manner that will pierce the illusion that there is a single rational choice. By presenting information in a creative and nuanced manner, accountants can empower decision makers to make courageous, reasonable choices that balance financial realities with the public interest.
Pyrolysis of Kraft Lignin with Additives

The pyrolysis of softwood (SW) kraft lignin in the presence of NiCl2 and ZSM-5 zeolite as an additive was examined at 700 °C. Gel permeation chromatography (GPC), quantitative 13C and 31P NMR were used to characterize the pyrolysis oil. Based on the results of 13C and 31P NMR for the pyrolysis oils, the use of zeolite during pyrolysis caused the near complete loss of aliphatic hydroxyl and carboxyl groups in the bio-oil and about 80% of methoxyl groups were also eliminated. The zeolite was shown to improve the decomposition of aliphatic hydroxyl groups, carboxyl, methoxyl groups, and ether bonds in the lignin during pyrolysis. In addition, as determined by 13C NMR, the oxygen content in the bio-oil decreased after the use of zeolite. The results of GPC analysis indicated that the addition of H-ZSM-5 zeolite with lignin provided a bio-oil that had ∼10% lower average molecular weight than the pyrolysis product acquired without the additive.
A Novel ImageJ Macro for Automated Cell Death Quantitation in the Retina.

In recent years, research of degenerative retinal diseases has been focused on understanding cell death and ways of interfering with it. Several experimental animal models of diabetic retinopathy, retinitis pigmentosa, retinal detachment, and glaucoma, have revealed that cell death in the retina can occur through different modalities, including apoptosis and necroptosis among others, and encompasses multiple inducers and pathways and displays different morphologic characteristics.1–5 From the many tools used to characterize and quantify cell death, the terminal deoxynucleotidyl transferase (dUTP) nick end labeling (TUNEL) assay is likely the most widespread method. This assay detects fragmented or nicked DNA by means of a terminal deoxynucleotidyl transferase enzyme, which incorporates fluorescent-labeled dUTPs in damaged nucleic acid regions. First described by Gavrieli et al.,6 this assay has been a sensitive method for detecting apoptosis.7 However, as TUNEL assay detects DNA fragments regardless of the induced cell death pathway, it cannot distinguish between apoptotic or other forms of programmed cell death.3,8–10 Despite its limitations, TUNEL assay remains the most widespread method used to screen for any form of programmed cell death, to date. In order to quantitate TUNEL assay results in tissue sections, manual counting of TUNEL-positive (TUNEL+) cells, ideally by two masked observers is performed.11 Observers count TUNEL+ cells and measure the respective retinal area, and results are expressed as either TUNEL+ cells/area or TUNEL+ cells/total cells. However, this process is time consuming, prone to measurement errors, and not entirely reproducible. Therefore, an automated approach is of interest to address these difficulties. To the best of our knowledge, there is no automated cell death quantitation method available, capable of segmenting retinal layers and counting individual TUNEL+ cells in the retina without performance variability. The purpose of this study was to introduce a novel ImageJ macro for the automated detection of cell death in retinal cross-sections. In addition, we studied differences in grading between an experienced and an inexperienced observer. Because the introduction of a new measurement method requires that it be parallel with the gold standard, or commonly accepted method, we validated this macro by comparing its performance relative to that of two observers. We found that the ImageJ macro can achieve a fast and accurate retinal cell death quantitation.
Office-Based Treatment and Management of the Frontal Sinus

With changes in the health care system imminent, office-based procedures offer multiple benefits, including a decrease in health care costs to the patient and the healthcare system. Office procedures can provide successful results with high patient satisfaction ratings. This chapter discusses patient and disease selection in managing different frontal sinus problems in the office including sinusitis, nasal polyposis, mucoceles, and stenosis. The principles and technique for anesthesia and different office technologies including the microdebrider and balloon dilation are discussed. Surveillance and post-surgical medical management of frontal sinus disease is also reviewed. This chapter is meant for all otolaryngologists who want to understand the principles for office-based management of the frontal sinus. It is also meant for novice or seasoned physicians who wish to improve their office-based skills in frontal sinus procedures.
The kielin/chordin-like protein KCP attenuates nonalcoholic fatty liver disease in mice

The kielin/chordin-like protein (KCP) attenuates transforming growth factor-β (TGF-β) signaling in development and disease. Loss of KCP promotes liver pathology in aging mice, similar to hepatostea...
Automatic Fitting of Binary Interaction Parameters for Multi-fluid Helmholtz-Energy-Explicit Mixture Models

In the highest-accuracy mixture models available today, these being the multi-fluid Helmholtz-energy-explicit formulations, there are a number of binary interaction parameters that must be obtained through correlation or estimation schemes. These binary interaction parameters are used to shape the thermodynamic surface and yield higher-fidelity predictions of various thermodynamic properties including vapor-liquid equilibria and homogeneous p-v-T data, among others. In this work, we have used a novel and entirely automatic evolutionary optimization algorithm written in the python programming language to fit the two most important interaction parameters for more than 1100 binary mixtures. This fitting algorithm can be run on multiple processors in parallel, resulting in a reasonable total running time for this large set of binary mixtures. For more than 830 of the binary pairs, the median absolute relative error in bubble-point pressure is less than 5%. The source code for the fitter is provided as supplem...
The QT interval as a Noninvasive Marker of Atrial Refractoriness

Background Atrial refractoriness may be an important determinant of atrial fibrillation (AF) risk, but its measurement is not clinically accessible. Because the QT interval predicts incident AF and the atrium and ventricle share repolarizing ion currents, we investigated the association between an individual's QT interval and atrial effective refractory period (AERP). Methods In paroxysmal AF patients presenting for catheter ablation, the QT interval was measured from the surface 12-lead electrocardiogram. The AERP was defined as the longest S1–S2 coupling interval without atrial capture using a 600-ms drive cycle length. Results In 28 patients, there was a positive correlation between QTc and mean AERP. After multivariate adjustment, a 1-ms increase in QTc predicted a 0.70-ms increase in AERP. Conclusions The QTc interval reflects the AERP, suggesting that the QTc interval may be used as a marker of atrial refractoriness relevant to assessing AF risk and mechanism-specific therapeutic strategies.
Traumatic Aneurysm of Perforating Peroneal Artery

1. Anomalous arterial circulation at the ankle is present in 3 per cent of the population, and predisposes to arterial injury by severe inversion, plantar flexion of the ankle. 2. Arterial bleeding should be considered in the differential diagnosis of severe pain following inversion, plantar flexion, ankle sprains. 3. A case is presented with a post-traumatic false aneurysm of the perforating peroneal artery. This was associated with rupture of the anterior fibulotalar ligament, the anterior portion of the talocalcaneal ligament, and anterolateral ankle joint capsule. The patient had a satisfactory functional result following resection of the aneurysm and repair of the artery and damaged ligaments.
Engaging Undergraduates in Soil Sustainability Decision-Making through an InTeGrate Module.

ABSTRACT Continued agricultural productivity hinges on understanding how to manage soil resources. A 2-week undergraduate introductory-level module: A Growing Concern: Sustaining Soil Resources Through Local Decision Making was collaboratively developed through the InTeGrate Project. InTeGrate modules and courses engage students in grand challenges of sustainability (e.g., agriculture, water, and climate) using active learning strategies. In A Growing Concern, students examine physical and chemical distinctions between intensively managed agricultural landscapes (e.g., conventional tillage) and natural vegetative types. They analyze geospatial and soil profile data to identify how intensive land management threatens soil sustainability. After exploring land practice and climate impacts on soil, they create extension-style fact sheets that provide recommended practices to reduce soil erosion. To maximize accessibility, we piloted the module in three settings: (1) an interdisciplinary Ecological Agriculture...
Abstract WMP45: Targeted Inhibition of the Alternative Complement Pathway Enhances Rehabilitation-Induced Cognitive and Motor Recovery in a Murine Model of Chronic Stroke

Introduction: Activation of inflammatory cascades after stroke exacerbate acute injury and limit response to rehabilitation (rehab). The complement (C) system is a prominent component of inflammato...
The Status of Structural and Functional MRI in Adolescents with Attention-Deficit/Hyperactivity Disorder

Neuroimaging has been widely used to evaluate the structural and functional integrity of the brain in persons with attention-deficit/hyperactivity disorder (ADHD) across the lifespan. Despite the wealth of research in ADHD, there is a dearth of research that has focused on the important developmental phase of adolescence, with most studies having combined children and adolescents within their sample. Online databases were searched for structural and functional magnetic resonance imaging (MRI) studies of ADHD where the sample included only or largely adolescents (age range 10–19 years). Forty-four publications met inclusion criteria, of which 10 were structural MRI and 34 were functional MRI. Considerable variability was seen across studies in terms of methodology (e.g., diagnostic criteria, imaging analyses, functional MRI tasks), rendering it difficult to arrive at any firm conclusions. With that caveat, adolescents with ADHD have been commonly observed to have alterations in frontal-striatal regions, as well as other brain areas such as the thalamus, parietal lobes, and white matter pathways. Together, the evidence suggests a lag in brain maturation in adolescents with the disorder, though some degrees of normalization of brain abnormalities may be seen at least in a subset of this population. Further structural and functional MRI research focused on adolescents with ADHD will be important to elucidate the etiology and treatment of the disorder during this phase of development.
Autologous Fat Transfer to the Cheeks and Chin

Cheeks and chin provide three key “pillars” that define and aesthetically enhance the face. Patients blessed with strong cheeks and chin are often considered more photogenic and attractive. In many patients, loss of volume from the cheeks and chin is an early sign of aging. Aging is impacted by gravity but also equally adversely affected by atrophy. By adding volume with autologous fat to the cheeks and chin, the lost volume is restored and sagging tissues are expanded and lifted. In this chapter anatomy and techniques are discussed and possible complications are described. Volumetric rejuvenation of cheeks, tear troughs, and chin is ideally achieved with autologous fat.
Modeling Economic-Demographic Linkages: A Study of National and Regional Models

This paper discusses the evolution of linked economic-demographic models. The benefits of linking models are explored and illustrated using the major national and regional econometric models in the U.S. and Canada. The current status of linked models is evaluated and future directions of development are suggested.
Surgical interventions and anesthesia in the 1st year of life for lower urinary tract obstruction.

Abstract Background Patients with a prenatal diagnosis of lower urinary tract obstruction (LUTO) may undergo prenatal interventions, such as vesicoamniotic shunt (VAS) placement, as a temporary solution for relieving urinary tract obstruction. A recent FDA communication has raised awareness of the potential neurocognitive adverse effects of anesthesia in children. We hypothesized as to whether a prenatal LUTO staging system was predictive of the number of anesthesia events for prenatally diagnosed LUTO patients. Methods We retrospectively reviewed the prenatal and postnatal clinical records for patients with prenatally diagnosed LUTO from 2012 to 2015. Patients were stratified by prenatal VAS status and by LUTO disease severity according to Ruano et al. (Ultrasound Obstet Gynecol. 2016). Results 31 patients were identified with a prenatal LUTO diagnosis, and postnatal records were available for 21 patients (seven patients in each stage). When combining prenatal and postnatal anesthesia, there was a significant difference in the number of anesthesia encounters by stage (1.6, 3.7, and 6.7 for Stage I, II, and III respectively, p = .034). Upon univariate analysis, higher gestational age (GA) at birth was associated with a decreased number of anesthesia events in the first year (p = .031). Conclusions The majority of infants with prenatally diagnosed LUTO will undergo postnatal procedures with general anesthesia exposure in the first year of life. Patients with higher prenatal LUTO severity experienced a higher number of both prenatal and postnatal anesthesia encounters. In addition, higher GA at birth was associated with fewer anesthesia encounters in the first year. Level of evidence This is a prognostic study with Level IV evidence.
Distributed Estimation and Target Localization

In this chapter, distributed parameter estimation problems are discussed with special emphasis on target localization in WSNs. Following the structure outlined in Chap. 2 and followed in Chap. 3, fundamental limits of distributed estimation with Byzantines are first presented. After characterizing these limits, several countermeasures are discussed, among which some are specific to the estimation framework as they leverage the structure of the parameter space. Specifically, recently developed error-correcting codes-based mitigation scheme is discussed.
A Data-Driven Basis Function Approach in Nonparametric Nonlinear System Identification

In this chapter, a data-driven orthogonal basis function approach is proposed for nonparametric FIR nonlinear system identification. The basis functions are not fixed a priori and match the structure of the unknown system automatically. This eliminates the problem of blindly choosing the basis functions without a priori structural information. Further, based on the proposed basis functions, approaches are proposed for model order determination and regressor selection along with their theoretical justifications. Both random inputs and deterministic inputs are considered.
Synthesis of Some Fluorinated Phenylmethylsiloxane Polymers and Characterization of Their Surface Properties

Conditions have been established for the preparation of three fluorinated phenylmethylsiloxane polymers via syntheses of the appropriate monomers, controlled hydrolyses of these monomers, and polymerization of the resulting oligomers. The polymers thus prepared, in increasing order of fluorine content, were poly(4-fluorophenylmethylsiloxane), poly(3,5-difluorophenylmethylsiloxane), and poly[3,5-bis(trifluoromethyl)phenylmethylsiloxane]. The surface energies of the first two polymers were measured and found to be very similar to those of typical fluorosubstituted polymers that are aliphatic rather than aromatic. This similarity indicates that the bulky phenyl groups do not significantly interfere with migration of the fluorine atoms to the surfaces of these fluorinated phenylmethylsiloxane polymers.
Gap Filling and the Determinants of Long-Term Corporate Debt Issuances

Investment grade corporations issue debt across a wide spectrum of maturities. A significant proportion of the debt issued by these firms has maturities greater than 20 years. In this paper we argue that an important determinant of these long-term debt issues is gap filling behavior, in which high grade issuers fill gaps in the supply of long-term government bonds. Using a large sample of individual corporate loans and bond issues by U.S. companies between 1987 and 2009, we find evidence of gap filling behavior only in the very long end of the maturity spectrum where the required risk capital makes it difficult for arbitrageurs to smooth out supply shocks.
Ultrasound Guidance for Central Venous Access: Current Evidence and Clinical Recommendations:

Ultrasound-guided central line placement has been shown to decrease the number of needle puncture attempts, complication, and failure rates. In order to obtain successful central access, it is important to have adequate cognitive knowledge, workflow understanding, and manual dexterity to safely execute this invasive procedure. The operator should also be familiar with the anatomical variations, equipment operations, and potential complications and their prevention. In this article, we present a detailed review of ultrasound-guided central venous access. It includes a description of anatomy, operative technique, equipment operation, and techniques for specific situations. We describe the use of ultrasound guidance to avoid and identify various complications associated with this procedure. We have also reviewed recent recommendations and guidelines for the use of ultrasound for central venous access and the current evidence pertaining to the recommendations for the expected level of training, methodology, and metrics for establishing competency.
Does play constitute the good life? Suits and Aristotle on autotelicity and living well

Bernard Suits’ account of play as an autotelic activity has been greatly influential in the philosophy of sport. Suits borrows the notion of ‘autotelicity’ from Aristotle’s ethics, formulating diff...
Adult learners, remote learning, and the COVID pandemic: Restructuring educational doctorate courses in crisis

This essay serves as the narrative of an early career Assistant Professor as they recall their struggles, vulnerabilities, and insecurities while navigating the need to shift their educational leadership doctoral students to emergency remote learning amid a global pandemic. Using the foundations of transformational experiences for adult learners, the need to sustain the students’ communities of practice, and positive school leadership, the author develops and executes their action plan to meet the needs of their adult learners and support them in the online environment during the COVID-19 crisis. By applying this framework as practicing EdD scholars, we serve as a model for future directions in the teaching spaces of the Education Doctorate by bridging the gap between theory and practice in our higher education teaching spaces.
Prevalence of SARS-CoV-2 Antibodies in New York City Adults, June-October 2020: A Population-Based Survey.

BACKGROUND: Serosurveys help to ascertain burden of infection. Prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurveys in New York City (NYC) used nonrandom samples. During June-October 2020, the NYC Health Department conducted a population-based survey estimating SARS-CoV-2 antibody prevalence in NYC adults. METHODS: Participants were recruited from the NYC 2020 Community Health Survey. We estimated citywide and stratified antibody prevalence using a hybrid design: serum tested with the DiaSorin LIAISON SARS-CoV-2 S1/S2 IgG assay and self-reported antibody test results were used together. We estimated univariate frequencies and 95% confidence intervals (CI), accounting for complex survey design. Two-sided P valuesâ ≤â .05 were statistically significant. RESULTS: There were 1074 respondents; 497 provided blood and 577 provided only a self-reported antibody test result. Weighted prevalence was 24.3% overall (95% CI, 20.7%-28.3%). Latino (30.7%; 95% CI, 24.1%-38.2%; Pâ <â .01) and black (30.7%; 95% CI, 21.9%-41.2%; Pâ =â .02) respondents had a higher weighted prevalence compared with white respondents (17.4%; 95% CI, 12.5%-23.7%). CONCLUSIONS: By October 2020, nearly 1 in 3 black and 1 in 3 Latino NYC adults had SARS-CoV-2 antibodies, highlighting unequal impacts of the coronavirus disease 2019 (COVID-19) pandemic on black and Latino NYC adults.
Completion of lung cancer screening after a baseline order for LDCT at five diverse health systems.

10506Background: In 2014 and 2015, the Affordable Care Act required coverage of, and CMS began reimbursing for lung cancer screening (LCS). Previous studies have shown that when new screening tests...
Radiographic outcomes of femur fractures following SIGN Fin nailing in low- and middle-income countries.

Objective To measure the effectiveness of the Surgical Implant Generation Network (SIGN) Fin nail for achieving satisfactory postoperative radiographic alignment following femoral shaft fractures. Methods Femoral shaft fractures stabilized with the SIGN Fin nail were identified using the SIGN Online Surgical Database. A random number generator was used to identify 500 femur fractures fixed within 6 weeks of injury for which postoperative radiographs were available. Fractures were classified using OTA/AO and Winquist-Hansen classification systems. Deviation from anatomic alignment was measured on anterior-posterior and lateral radiographs using an on-screen protractor tool. Other clinical variables recorded in the SIGN Online Surgical Database were also analyzed. Simple logistic regression was used to assess for associations between subject and surgical characteristics and misalignment status. Intra- and inter-rater agreement was assessed with intraclass correlation coefficient (ICC). Results The overall rate of malalignment >5° was 9.4%. Factors associated with increased incidence of malalignment include older age, increased time to surgery, distal diaphyseal location, closed (vs open) reduction, degree of comminution, and fracture classification. Intra-rater ICC was 0.70 (0.52, 0.82) in the coronal plane and 0.55 (0.32, 0.72) in the sagittal plane. Inter-rater ICC was 0.37 (0.08, 0.60) and 0.32 (0.05, 0.54), respectively. Conclusion The SIGN Fin nail is an effective implant for fixation of femoral shaft fractures in resource-limited regions, achieving rates of satisfactory postoperative alignment comparable to that of the standard SIGN nail as well as femoral shaft fractures treated in North American Trauma Centers. Further research is required to investigate rotational alignment and long-term clinical outcomes for the SIGN Fin nail. Level of evidence IV.
Detection, evaluation, and treatment of pituitary microadenomas in patients with galactorrhea and amenorrhea

Abstract Over a period of two and a half years, 34 women with galactorrhea or amenorrhea, all with an abnormal sellar polytomogram, underwent transsphenoidal microsurgical exploration of the sella. Eighteen women had microadenomas (≤ 1 cm. in diameter), seven had macroadenomas (>1 cm. in diameter), and five had unidentified lesions. Only one woman had a normal pituitary gland. Three women had cryosurgery without biopsy. Preoperatively, hyperprolactinemia occurred in 24 of 25 women with adenomas and two of five with nonadenomatous lesions. There were no operative deaths. Significant morbidity occurred in only three patients, none of whom had microadenomas. Postoperatively, menses resumed in 16 of the 17 women with microadenomas and in two of the seven with macroadenomas who presented with amenorrhea. Galactorrhea disappeared in 15 of the 17 women with microadenomas and in four of the seven with macroadenomas who presented with galactorrhea. In five patients with unidentified lesions, a retum of menses occurred in two of four with previous amenorrhea, and galactorrhea abated in two of three who presented with lactation. We conclude that sellar polytomography in women with hyperprolactinemia is a useful technique for the diagnosis of pituitary adenomas, a lesion which may occur more frequently than previously realized. In addition, transsphenoidal microresection of microadenomas is safe and effective.
Transmembrane helix-helix interactions in F0 suggested by suppressor mutations to Ala24-->Asp/Asp61-->Gly mutant of ATP synthase subunit.

A mutant of ATP synthase subunit c was isolated in which the essential aspartate was exchanged from position 61 on transmembrane helix-2 to position 24 on transmembrane helix-1 (Miller, M. J., Oldenburg, M., and Fillingame, R. H. (1990) Proc. Natl. Acad. Sci. U. S. A. 87, 4900-4904). The H+ transporting ATP synthase function of the Ala24–>Asp/Asp61–>Gly mutant is not optimal, and cells grow more slowly than wild type. Twenty-three third-site suppressor mutants with optimized function were isolated in this study. Ten of the optimizing mutations were located to helix-2 of subunit c, and seven of these fell in residues Phe53, Met57, and Met65. The side chains of these three residues are proposed to form a hydrophobic surface on transmembrane helix-2, which participates in the presentation or occlusion of the essential aspartate carboxyl group during proton translocation. The other 13 optimizing mutations were located to subunit a, and 10 of these fell in residues Ala217, Ile221, and Leu224. These three residues are proposed to lie on one face of a transmembrane alpha-helix that includes the essential Arg210 residue. This helix is proposed to interact with the transmembrane bihelical unit of subunit c during protonation and deprotonation of the essential Asp24 in the mutant or Asp61 in wild type.
Does Grammar Start Where Statistics Stop

How do we acquire language? Do we identify words in a stream of speech by identifying statistical regularities or by seeking grammatical structure? A new study of adults ([PeA±a][1] et al .) suggests that language acquisition involves a mixture of both types of learning. But, as [Seidenberg][2] and colleagues discuss in their Perspective, distinguishing between these two types of learning presents significant challenges. [1]: http://www.sciencemag.org/cgi/content/short/298/5593/604 [2]: http://www.sciencemag.org/cgi/content/full/298/5593/553
Influence of film-mediated interactions on the microwave and radio frequency spectrum of spin-polarized hydrogen on helium films.

We argue that helium film-mediated hydrogen-hydrogen interactions strongly reduce the magnitude of cold collision shifts in spin-polarized hydrogen adsorbed on a helium film. With plausible assumptions about experimental parameters this can explain (i) the 2 orders of magnitude discrepancy between previous theory and recent experiments and (ii) the anomalous dependence of the cold collision frequency shifts on the film's 3 He covering. The mediated interaction is attractive, suggesting that in current experiments the gas will become unstable before reaching the Kosterlitz-Thouless transition.
Are Ballot Initiative Outcomes Influenced by the Campaigns of Independent Groups? A Precinct-Randomized Field Experiment Showing That They Are

Ballot initiatives are consequential and common, with total spending on initiative campaigns in the US rivaling that of Presidential campaigns. Past work using observational data has alternately found that initiative campaign spending cannot affect initiative outcomes, can increase the number of votes rejecting (but not approving) initiatives, or can affect outcomes in either direction. We report the first field experiment to evaluate an initiative advocacy campaign with precision. We find that campaigns can influence both rejection and approval of initiatives by changing how citizens vote, as opposed to by influencing turnout or ballot completion. Our experiment (involving around 18 % of Oregon households in 2008) studied a statewide mail program conducted by a Political Action Committee. Results further suggest that two initiatives would have passed if not for the advocacy campaign to reject them. We discuss implications for theories about direct democracy, campaign finance, and campaign effects.
Certifying large branch-width

Branch-width is defined for graphs, matroids, and, more generally, arbitrary symmetric submodular functions. For a finite set V, a function f on the set of subsets 2V of V is submodular if f(X) + f(Y) ≥ f(X ∩ Y) + f(X ∪ Y), and symmetric if f(X) = f(V \ X). We discuss the computational complexity of recognizing that symmetric submodular functions have branch-width at most k for fixed k. An integer-valued symmetric submodular function f on 2V is a connectivity function if f(θ) = 0 and f({v}) ≤ 1 for all v ∈ V. We show that for each constant k, if a connectivity function f on 2V is presented by an oracle and the branch-width of f is larger than k, then there is a certificate of polynomial size (in |V|) such that a polynomial-time algorithm can verify the claim that branch-width of f is larger than k. In particular it is in coNP to recognize matroids represented over a fixed field with branch-width at most k for fixed k.
Secularisation and Islamisation in Morocco and Algeria

The conflict between the state and Islamic opposition in North Africa appears to represent a dichotomous, zero‐sum confrontation between the religious and the secular. Yet the evidence reveals ambiguity in the religious‐secular divide, and Burgat and others have suggested mutual influences resulting in an Islamisation of the state and a secularisation of religious politics. This article, based on the author's dissertation, seeks to identify the religious and the secular elements of the political‐religious competition in these two countries, and to assess the Islamising or secularising impact on the state and Islamic politics during the final decades of the twentieth century.
Discretizing a Normal Prior for Change Point Estimation in Switching Regressions

Bayes decision procedures are considered for change point estimation in the simple bilinear segmented model. A discretized normal prior density is employed as the prior distribution for the change point index. Posterior probability functions are developed for this index under a vague prior formulation on the regression parameters. The procedure is applied to an example involving mercury toxicity data.
Position-assist shared control of a force-reflecting telerobot

A shared control system has been developed and implemented which mixes teleoperator commands and autonomously generated commands to assist a teleoperator in accomplishing elemental tasks with a six-axis force-reflecting telemanipulator system operating with position to position control. The basic control structure has been developed to accommodate many tasks, but only peg-insertion type tasks are presented here. The system uses predefined position constraint configuration types which have been identified in cartesian space and maximize the effectiveness of elemental tasks. The operator selects one of these types and loads the system with corresponding parameters which define the degrees of freedom which are allowed within the position constraints. Loading can be done by teaching with teleoperation, selecting from memory, or automatically from a model of the working environment. The shared controller accepts only components of position commands from the teleoperator device which are within the position constraints. Components of force at the manipulator which lie within the allowed degrees of freedom are reflected to the teleoperator device. Perpendicular forces are generated to increase telepresence by driving the teleoperator device to a position corresponding to the autonomously controlled position of the manipulator.© (1993) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Molecular Cytogenetic Study of a Hemangiopericytoma in a Newborn

Abstract Two balanced reciprocal chromosome translocations, t(8;12)(p21;p13.1) and t(15;16)(q24;q22), characterized a rare hemangiopericytoma in a newborn. Chromosome painting with a chromosome microdissection-derived whole-chromosome 8 probe confirmed that the t(8;12) was due to a reciprocal translocation. To the best of our knowledge, these chromosome findings are unique to this unusual case of a pediatric hemangiopericytoma.
Synthesis of asperphenamate, a novel fungal metabolite

Abstract The proposed structure of asperphenamate (1), a novel fungal metabolite, was confirmed by synthesis. Esterification of N-benzoyl- L -phenylalaninol with N-carbobenzoxy- L -phenylalanine, followed by deprotection of the carbobenzoxy group and benzoylation yielded a product which was identical to the natural fungal metabolite.
Geodesics for the NUT metric and gravitational monopoles

In order to provide insight about the physical interpretation of the NUT parameter, we solve the geodesic equations for the NUT metric. We show that the properties of NUT geodesics are similar to the properties of trajectories for charged particles orbiting about a magnetic monopole. In summary, we show that (1) the orbits lie on the surface of a cone, (2) the conserved total angular momentum is the sum of the orbital angular momentum plus the angular momentum due to the “monopole” field, (3) the monopole field angular momentum is independent of the separation between the source of the gravitational field and the test particle, and (4) the geodesics are “almost” spherically symmetric. The strong similarities between the NUT geodesics and the electromagnetic monopole suggest that the NUT metric is an exact solution for a gravitational magnetic monopole. However, the subtle difference of being only almost spherically symmetric implies that the analogy is not perfect. The almost spherically symmetric nature of the NUT geodesics suggest that the energy of the “Dirac string” makes a contribution to the solution. We also construct exact solutions for special orbits, discuss a twin paradox, and speculate about the Dirac quantization condition for a gravitational magnetic monopole.
On least squares fitting for stationary spatial point processes

Summary. The K-function is a popular tool for fitting spatial point process models owing to its simplicity and wide applicability. In this work we study the properties of least squares estimators of model parameters and propose a new method of model fitting via the K-function by using subsampling. We demonstrate consistency and asymptotic normality of our estimators of model parameters and compare the efficiency of our procedure with existing procedures. This is done through asymptotic theory, simulation experiments and an application to a data set on long leaf pine-trees.