cssi/SciSciGPT-SciSciNet huggingface dataset:
Numerical Investigation of 3D Effects on a 2D Dominated Flow

The interface between gases of two densities will become unstable when accelerated continuously in the direction of the density gradient, resulting in the Rayleigh–Taylor instability [1, 2], or accelerated impulsively in any direction, resulting in the Richtmyer–Meshkov instability (RMI) [3, 4]. These instabilities are governed by the vorticity transport equation, $$ \frac{D\omega}{D t}=\left(\omega \cdot \nabla \right) U-\omega \left(\nabla \cdot U\right)+\nu {\nabla}^2\omega +\frac{1}{\rho^2}\left(\nabla \rho \times \nabla p\right), $$ (1) where the non-zero cross product of the density and pressure gradients in the final term will lead to the production of vorticity. The first term on the right of Eq. (1) is the vortex stretching term, where a velocity gradient in the direction of the vorticity vector can lead to an amplification of vorticity and a reduction of its length scale. Eventually this effect can allow the third term on the right of Eq. (1) to dissipate the energy through viscous effects. Vortex stretching is fundamentally a three-dimensional effect and is responsible for the cascade of length scales in turbulent flows [5]. Therefore dissipation and scalar mixing can be expected to increase in three-dimensional flows when compared with two-dimensional flows. Often the RMI and RTI are studied by imposing a well-defined, 2D, single mode perturbation. In experiments, higher mode, 3D perturbations are unavoidable and can eventually grow to break the two-dimensional nature of the interface.
Transcriptional control of amino acid homeostasis is disrupted in Huntington’s disease

Disturbances in amino acid metabolism, which have been observed in Huntington's disease (HD), may account for the profound inanition of HD patients. HD is triggered by an expansion of polyglutamine repeats in the protein huntingtin (Htt), impacting diverse cellular processes, ranging from transcriptional regulation to cognitive and motor functions. We show here that the master regulator of amino acid homeostasis, activating transcription factor 4 (ATF4), is dysfunctional in HD because of oxidative stress contributed by aberrant cysteine biosynthesis and transport. Consistent with these observations, antioxidant supplementation reverses the disordered ATF4 response to nutrient stress. Our findings establish a molecular link between amino acid disposition and oxidative stress leading to cytotoxicity. This signaling cascade may be relevant to other diseases involving redox imbalance and deficits in amino acid metabolism.
Contextual Control Of New Equivalence Classes

This study describes a method which allows for the unambiguous measurement of contextual control of equivalence class membership. Two equivalence classes, Ai-Bi-Ci and Aj-Bj-Cj, were formed by training Ai-Bi, Bi-Ci, Aj-Bj, and Bj-Cj in the presence of a short line denoted by X. In a subsequent test, all relations were displayed in the presence of a long line denoted by Y, to see if performances would indicate the emergence of the alternative classes Ai-Bj-Cj and Aj-Bi-Ci. If they did not emerge, Ai-Bj, Bj-Cj, Aj-Bi, and Bi-Ci were trained in the presence of Y, and the emergent relations test performances indicated the development of the alternative classes. This three-stage cycle was repeated with new sets of stimuli until the alternative classes emerged during the initial tests conducted in the presence of Y for two consecutive sets of new stimuli. This occurred after training with 4, 6, and 12 new classes for three of the five subjects. These outcomes could not be accounted for in terms of compound or multielement stimulus control because the contextual stimuli influenced membership in new equivalence classes. These results, then, provided an unequivocal demonstration of contextual control over the membership of stimuli in new equivalence classes. Finally, performances occasioned by primary generalization tests showed that contextual control extended to many lines that were similar in length to those used as the X and Y stimuli. These contingency-based performances have the formal appearance of rule-governed behavior.
A Framework for Evaluating and Optimizing FPGA-Based SoCs for Aerospace Computing

On-board processing systems are often deployed in harsh aerospace environments and must therefore adhere to stringent constraints such as low power, small size, and high dependability in the presence of faults. Field-programmable gate arrays (FPGAs) are often an attractive option for designers seeking low-power, high-performance devices. However, unlike nonreconfigurable devices, radiation effects can alter an FPGA’s functionality instead of just the device’s data, requiring designers to consider fault-tolerant strategies to mitigate these effects. In this article, we present a framework to ease these system design challenges and aid designers in considering a broad range of devices and fault-tolerant strategies for on-board processing, highlighting the most promising options and tradeoffs early in the design process. This article focuses on the power, dependability, and lifetime evaluation metrics, which our framework calculates and leverages to evaluate the effectiveness of varying system-on-chip (SoC) designs. Finally, we use our framework to evaluate SoC designs for a case study on a hyperspectral-imaging (HSI) mission to demonstrate our framework’s ability to identify efficient and effective SoC designs.
Siderophore vaccine conjugates protect against uropathogenic Escherichia coli urinary tract infection

Uropathogenic Escherichia coli (UPEC) is the primary cause of uncomplicated urinary tract infections (UTIs). Whereas most infections are isolated cases, 1 in 40 women experience recurrent UTIs. The rise in antibiotic resistance has complicated the management of chronic UTIs and necessitates new preventative strategies. Currently, no UTI vaccines are approved for use in the United States, and the development of a highly effective vaccine remains elusive. Here, we have pursued a strategy for eliciting protective immunity by vaccinating with small molecules required for pathogenesis, rather than proteins or peptides. Small iron-chelating molecules called siderophores were selected as antigens to vaccinate against UTI for this vaccine strategy. These pathogen-associated stealth siderophores evade host immune defenses and enhance bacterial virulence. Previous animal studies revealed that vaccination with siderophore receptor proteins protects against UTI. The poor solubility of these integral outer-membrane proteins in aqueous solutions limits their practical utility. Because their cognate siderophores are water soluble, we hypothesized that these bacterial-derived small molecules are prime vaccine candidates. To test this hypothesis, we immunized mice with siderophores conjugated to an immunogenic carrier protein. The siderophore–protein conjugates elicited an adaptive immune response that targeted bacterial stealth siderophores and protected against UTI. Our study has identified additional antigens suitable for a multicomponent UTI vaccine and highlights the potential use of bacterial-derived small molecules as antigens in vaccine therapies.
Aortic root surgery with circulatory arrest: Predictors of prolonged postoperative hospital stay

Abstract Objective Little is known about the outcomes of aortic root operations that involve inducing hypothermic circulatory arrest for relatively extensive proximal aortic surgery. We attempted to identify predictors of postoperative hospital length of stay (LOS) and factors that affect postoperative recovery. Methods During 2006-2014, 247 of 265 patients (93.2%) with disease extending into the aortic arch survived aortic root operations (206 elective, 41 urgent/emergent) in which hypothermic circulatory arrest with moderate hypothermia was used. Stepwise multivariate regression analysis was performed to identify predictors of LOS (as a continuous variable) and prolonged LOS (defined as LOS >9 days, the median for the cohort). By this definition, 111 patients (45%) had prolonged LOS and 136 (55%) did not. Results Preoperative factors that independently predicted longer LOS in the entire cohort included age ( P = .0014), redo sternotomy ( P = .0047), and intraoperative packed red blood cell (PRBC) transfusion ( P = .0007). Redo sternotomy and intraoperative PRBC transfusion also predicted longer LOS in 3 subgroup analyses: one of elective cases, one from which total arch replacement procedures were excluded, and one limited to patients who were discharged home. Age predicted longer LOS in the non-total arch (hemiarch) replacement patients. Ventilator support >48 hours ( P P = .028). Conclusions In patients undergoing aortic root surgery with hypothermic circulatory arrest for disease extending into the aortic arch, reducing intraoperative PRBC transfusion except when absolutely necessary may reduce postoperative LOS and expedite recovery. Performing aortic valve–sparing root replacement, when feasible, may also reduce LOS.
Surgical management of children with intractable functional constipation; experience of a single tertiary children's hospital

Background Children with intractable functional constipation (FC) may eventually require surgery. However, guidelines regarding the surgical management of children with intractable FC are lacking. The aim of this study was to describe the surgical management of FC in children. Methods A retrospective chart review was performed of children with FC (according to the Rome III criteria) who underwent ileostomy, colostomy or (sub)total colectomy at a tertiary hospital. Treatment success was defined as no longer fulfilling the Rome III-FC-criteria or having a functional ostomy. In addition, a self-developed questionnaire was administered to parents by telephone to assess postsurgical satisfaction (yes-no question and rated on a scale of 1–10). Key Results Thirty-seven patients (68% female) were included; median age at first surgery was 12 years (range 1.6–17.6). The initial surgical procedure consisted of ileostomy (n=21), colostomy (n=10), sigmoid resection (n=5) and subtotal colectomy (n=1). Success criteria were fulfilled by 85% of the patients. Postsurgical satisfaction of parents was 91% with a median postoperative satisfaction score of 8 (range 2-10), and 97% would opt for the same procedure(s) if necessary. Thirty patients (81%) experienced stoma problems, with 12 patients (32%) requiring stoma-revisions. Other complications occurred in 16 patients (43%). Conclusions & Inferences Surgery can improve symptoms in children with intractable FC. Despite morbidity and complications, parental satisfaction is high. Prospective, high-quality research is necessary to develop guidelines for the diagnostic work-up and surgical management in children with intractable FC.
Complementary and integrative medicine in the management of headache

Headaches, including primary headaches such as migraine and tension-type headache, are a common clinical problem. Complementary and integrative medicine (CIM), formerly known as complementary and alternative medicine (CAM), uses evidence informed modalities to assist in the health and healing of patients. CIM commonly includes the use of nutrition, movement practices, manual therapy, traditional Chinese medicine, and mind-body strategies. This review summarizes the literature on the use of CIM for primary headache and is based on five meta-analyses, seven systematic reviews, and 34 randomized controlled trials (RCTs). The overall quality of the evidence for CIM in headache management is generally low and occasionally moderate. Available evidence suggests that traditional Chinese medicine including acupuncture, massage, yoga, biofeedback, and meditation have a positive effect on migraine and tension headaches. Spinal manipulation, chiropractic care, some supplements and botanicals, diet alteration, and hydrotherapy may also be beneficial in migraine headache. CIM has not been studied or it is not effective for cluster headache. Further research is needed to determine the most effective role for CIM in patients with headache.
Comparing electronic and traditional bullying in embarrassment and exclusion scenarios

Abstract Electronic bullying continues to increase yet remains under-researched (e.g., Waasdorp & Bradshaw, 2015). This is especially true for college populations, a group that often uses online technology (Duggan & Brenner, 2014). A paucity of experimentally designed studies have examined and compared behavioral and emotional responses to bullying situations in both electronic and traditional formats. This study seeks to elucidate differences and similarities between the two bullying formats specifically examining cognitive, strategic, and emotional responses. We utilized an experimental design with hypothetical scenarios to investigate college students' social-cognitive responses to two forms of relational bullying: embarrassment and exclusion, presented in traditional and electronic formats. Participants were 124 college-age students at a mid-size Northeastern university. Results demonstrated different emotional responses and behavioral responses depending on the medium (electronic versus traditional). Specifically, in terms of emotions, participants felt higher embarrassment in traditional bullying scenarios and higher anger in electronic bullying scenarios. In terms of behavioral responses participants were more likely to seek help in traditional bullying scenarios compared to using the avoidance strategies of joking when bullying occurred online. Additionally, qualitative responses regarding the impact of bullying medium were analyzed and significant differences were found regarding reasons for the bullying severity and impact depending on medium. This study demonstrates several important differences between electronic and traditional bullying in terms of emotional and behavioral responses as well as qualitative reports of severity.
Sediment Zn-release during post-drought re-flooding: Assessing environmental risk to Hyalella azteca and Daphnia magna.

Abstract Hydrologic variability exacerbated by climate change affects biogeochemical cycling in sediments through changes in pH, redox, and microbial activity. These alterations affect the lability and speciation of metals, such that toxicity may be observed in otherwise non-toxic sediments. In this study, we investigate the effects of drought and reflooding on metal bioavailability in sediments with low to moderate concentrations of Zn (18–270 mg kg −1 ). Sediments were collected from coastal wetlands in Michigan, dried (36-days) and re-inundated in lab microcosms. We investigated the relationships between key parameters, for surface/porewater (dissolved and particulate metals, dissolved oxygen, redox (Eh), reduced iron, and temperature) and sediment (simultaneously extracted metals (SEM), acid volatile sulfide (AVS), Fe/Mn-oxyhydroxide, organic carbon, water content analyses, and diffusive gradient in thin films (DGTs) metal concentrations). Porewater Zn increased with inundation of dried sediments for all sediment types, exceeding United States Environmental Protection Agency (U.S. EPA) chronic criteria for freshwater organisms, and decreased as sediments became reduced. Effects on Hyalella azteca (7-day exposure) and Daphnia magna (10-day exposure) were quantified. Results show decreased growth of H. azteca for sites with elevated Zn and increased Zn-body concentration (BC Zn ) in the most contaminated sediment type. Further, BC Zn was negatively correlated with H. azteca growth. D. magna survival, growth, and reproduction were not affected. DGT metal concentrations were more reflective of porewater than organism bioaccumulation. Outcomes of predictive toxicology methods are compared to toxicity test results and suggestions are provided for model improvements. This study demonstrates that post-drought re-flooding of sediments affects Zn biogeochemical cycling with potentially adverse effects on benthic organisms, even in sediments with only moderately elevated concentrations (>150 mg kg −1 ).
Janet Taylor Spence: A Model Role Model

The article summarizes and reflects on the contributions of Janet Taylor Spence in the areas of editing, service to her institutions, and service to her profession. It is based on both the objective record and on the personal experience and observations of the author, a long-time colleague. It reviews the many editorial positions Janet Taylor Spence held, including being editor of the Annual Review of Psychology and Contemporary Psychology, and the award she received from the National Academy of Sciences. It also sketches many of the leadership positions she held, including being president of the American Psychological Association and the first elected president of the Association for Psychological Science. It emphasizes both her outstanding professional and personal qualities.
Myristoylated methionine sulfoxide reductase A is a late endosomal protein

Methionine residues in proteins provide antioxidant defense by reacting with oxidizing species, which oxidize methionine to methionine sulfoxide. Reduction of the sulfoxide back to methionine is catalyzed by methionine sulfoxide reductases, essential for protection against oxidative stress. The nonmyristoylated form of methionine sulfoxide reductase A (MSRA) is present in mitochondria, whereas the myristoylated form has been previously reported to be cytosolic. Despite the importance of MSRA in antioxidant defense, its in vivo binding partners and substrates have not been identified. Starting with a protein array, and followed by immunoprecipitation experiments, colocalization studies, and subcellular fractionation, we identified the late endosomal protein, StAR-related lipid transfer domain–containing 3 (STARD3), as a binding partner of myristoylated MSRA, but not of nonmyristoylated MSRA. STARD3 is known to have both membrane-binding and cytosolic domains that are important in STARD3-mediated transport of cholesterol from the endoplasmic reticulum to the endosome. We found that the STARD3 cytosolic domain localizes MSRA to the late endosome. We propose that the previous conclusion that myristoylated MSRA is strictly a cytosolic protein is artifactual and likely due to vigorous overexpression of MSRA. We conclude that myristoylated MSRA is a late endosomal protein that may play a role in lipid metabolism or may protect endosomal proteins from oxidative damage.
Art and architecture: Effectively communicating models of systems

Systems architecting has been considered for a long time both an art and a science. The systems architect uses heuristics, stories, and models to communicate complex architectural concepts to stakeholders. As adoption of model­based systems engineering grows, and digital models of system architecture increase in use, there is a danger that the communications gap between system architects and the stakeholders they are working for will grow. Previous work created a competency model exploring the link between art, systems thinking, and systems architecture. A further conference panel entitled "If architectures are so useful, why are they so seldom used?" inspired a discussion of the growing communications gap between the system architect as modeler and the system architect as communicator. Decision makers cannot read and interpret formal system models. However, principles and practices of systems architecture are exhibited in the creation of film scores, fine arts, and building architecture. Reflecting on the authors' experience as practitioners and educators of systems thinking and systems architecting, this paper discusses the need for formal education in the arts as a way to bridge the communication problems that technical architects have with their stakeholders.
Abstract Minkowski Spaces As Fibre Bundles

A new definition is proposed for representation spaces of Special Relativistic physical events. These spaces - called here Minkowski Spaces - are given a structure of a fibre bundle over a four dimensional manifold. The Lorentz group appears as the structure group of this fibre bundle. It is shown that there is a unique torsion-free connection in this bundle which induces the usual pseudo-Riemannian structure on the base manifold.
Zwitterionic and neutral binuclear complexes formed from copper(II) hexafluoroacetylacetonate and an amino alcohol

Reaction of anhydrous Cu(hfac)2 (hfacH = 1,1,1,5,5,5-hexafluoro-2,4-pentanedione) with 2-(diisopropylamino)ethanol yields two different binuclear copper(II) complexes. Compound 1, [Cu(hfac)2(μ-OCH2CH2NH(i-Pr)2)]2, Cu2C36H42O10N2F24, consists of centrosymmetric dimers containing two cis-Cu(hfac)2 moieties that are bridged by two zwitterionic 2-(diisopropylammonio)ethoxide ions. Cell parameters are a = 11.6516(13); b = 14.0117(17); c = 15.3258(17) A β = 105.75(9)° in space group P21/n. The copper ions exhibit tetragonally distorted octahedral coordination, with two of the Cu—O(hfac) distances showing characteristic elongation (2.2858(16) and 2.3192(17) A). Compound 2, [Cu(hfac)((i-Pr)2NCH2CH2O)]2, Cu2C26H38O6N2F12, also contains centrosymmetric dimers; these are formed by two square-pyramidal moieties joined at their bases. Cell parameters are a = 7.7353(5); b = 13.6166(17); c = 15.683(2) A β = 98.23(1)° in space group P21/n. In this structure the apical Cu—O(hfac) distance is elongated (2.254(4) A), and the O atoms of the 2-(diisopropylamino)ethoxide ions are bridging.
Why Rural African-American Women who use Cocaine Mistrust Women: The Insider Perspective

Little is known about the social networks of rural African-American women who use drugs, although the social networks of their urban counterparts have been characterized as small, mixed gendered, and distrustful of other women. The purpose of this study was to gain insight into the characteristics of the social networks of rural African-American women, both users and non-users of drugs. Thirty rural women who used cocaine participated in in-depth qualitative interviews. Rural women who used drugs gave several reasons for their mistrust of other women and tended to have small social networks, which included family members and men to the exclusion of non-familial women. The findings of this study have implications for both research and practice.
Immunotherapy in Prostate Cancer: Teaching an Old Dog New Tricks

Immunotherapy is rapidly transforming cancer care across a range of tumor types. Although Sipuleucel-T represented the first successful vaccine for the treatment of established cancer, other immunotherapeutic approaches for prostate cancer such as checkpoint inhibitors have been relatively disappointing to date. However, significant promise is on the horizon as there is a wide array trials evaluating immunotherapy in prostate cancer patients. These include both immune checkpoint inhibitors and antigen-specific approaches including vaccines, antibody-drug conjugates, and antitumor antibodies. Furthermore, a better understanding of the key mechanisms that promote the immunosuppressive microenvironment of prostate cancer is emerging. These insights may eventually make it possible to determine which patients will benefit from immunotherapy. This review will discuss the successes and failures of immunotherapy in prostate cancer. We will also present key lessons learned from completed trials and highlight important ongoing studies.
Critiquing the Concept of BCI Illiteracy.

Brain–computer interfaces (BCIs) are a form of technology that read a user’s neural signals to perform a task, often with the aim of inferring user intention. They demonstrate potential in a wide range of clinical, commercial, and personal applications. But BCIs are not always simple to operate, and even with training some BCI users do not operate their systems as intended. Many researchers have described this phenomenon as “BCI illiteracy,” and a body of research has emerged aiming to characterize, predict, and solve this perceived problem. However, BCI illiteracy is an inadequate concept for explaining difficulty that users face in operating BCI systems. BCI illiteracy is a methodologically weak concept; furthermore, it relies on the flawed assumption that BCI users possess physiological or functional traits that prevent proficient performance during BCI use. Alternative concepts to BCI illiteracy may offer better outcomes for prospective users and may avoid the conceptual pitfalls that BCI illiteracy brings to the BCI research process.
Adaptation of the Roseman 6-Point Mastery Learning Model to the College of Medicine Program:

Medical education has evolved over time toward a model which integrates clinical medicine with the basic sciences. More recently, medical education has put an emphasis on outcome-based education. Other areas of health care education have had a similar emphasis which can provide models to inform a new model for medical education. The Roseman University of Health Sciences has developed and implemented a model based on underlying tenets of mastery learning since 1999. The model has been implemented in pharmacy, nursing, and dental education. It was conceived as an integration of 6 key points which reinforce each other and interrelate to support learning. The model has been modified for application to medical education in support of medical education's outcome-based emphasis and to address the educational demands of the changing environment of the practice of medicine.
Integrating Minuchin's Boundary Continuum And Bowen's Differentiation Scale: A Curvilinear Representation

The purpose of this article is to discuss an integration of Minuchin's boundary continuum and Bowen's differentiation scale. Minuchin's boundary continuum provides a framework for understanding proximity and distance within relationships. It graphically depicts health in relationships as being a dynamic middle ground between the extremes of enmeshment and disengagement. Bowen's differentiation scale illustrates differences in emotional health, such as the ability to distinguish between thoughts and feelings, associated with varying levels of differentiation. A curvilinear integration of Minuchin's continuum and Bowen's scale retains the advantages of each and also expands their understanding.
Supporting QOS Controlled Handoff in Mobiware

Currently, the ATM Forum’s Wireless ATM (WATM) working group is in the process of developing a set of new specifications for ATM mobility. The work encompasses the definition of a new 25 Mbps air-interface, suitable location management and a fast handoff scheme. To date, most of the working group contributions have focussed on extensions to existing signalling specifications with little regard for the type of Quality of Service (QOS) which could be achieved during handoff. The working group considers WATM to be a direct extension to the standard ATM specification with uniformity of end-to-end QOS. In this paper we advocate an alternative approach. We argue that large-scale mobility requirements, limited radio resources, and fluctuation network conditions make the delivery of hard QOS guarantees in the wireless domain very difficult. To address this challenge, we are implementing a QOS-aware middleware platform called “mobiware” which operates between the application and radio ATM link layers. At the heart of the mobiware platform lies a QOS controlled handoff algorithm which exploits the inherent scalability of audio and video flows. Implicit in the term “QOS controlled” is the notion that audio and video flows can be represented as multi-layer scalable flows and adapted during handoff to meet fluctuating network conditions based on a user-supplied QOS adaptation policy. Novel aspects of the mobiware QOS controlled handoff signalling algorithm include the use of mobile-soft-state to represent mobile flows, aggregation techniques for bundling and transporting mobile flows to and from mobile devices, and re-routing and QOS re-negotiation anchor points which limit the impact of small scale mobility on the wireline network.
Tapping into Love

As I prepare to walk into work, I glance out the window and see rain has settled in. Most of my summer field season is spent mucking around in some form of aquatic habitat including lakes, rivers, bogs, fens, and marshes. It isn’t too much of a stretch to say that almost every day of my summer I am wet, so a little rain on my walk shouldn’t deter me. I grab my wide brimmed hat, pull the collar of my coat up, and ready myself for the trip. Exiting the house, I am met with both tiny droplets and a little breeze that drives the rain into my face. There always seems to be some form of wind here in northwest Ohio, so that bit isn’t unusual. I lower my head slightly to provide my face with some protection from the rain and start my daily commute.
Providing Incentive for Emergency Physician X-Waiver Training: An Evaluation of Program Success and Postintervention Buprenorphine Prescribing.

Study objective Emergency department (ED) initiation of buprenorphine for patients with opioid use disorder increases treatment engagement but remains an uncommon practice. One important barrier to ED-initiated buprenorphine is the additional training requirement (X waiver). Our objective is to evaluate the influence of a financial incentive program on emergency physician completion of X-waiver training. Secondary objectives are to evaluate the program’s effect on buprenorphine prescribing and to explore physician attitudes toward the incentive. Methods We conducted a prospective, observational cohort study set in 3 urban academic EDs before and after implementation of a financial incentive program providing $750 for completion of X-waiver training. We describe program participation as well as rates of buprenorphine prescribing per opioid use disorder–related encounter before and after the intervention period, using electronic health record data. We also completed a postintervention physician survey assessing attitudes about the incentive program. Results Overall, 89% of eligible emergency physicians (56/63) completed the X-waiver training during the 6-week incentive period. In the 5 months after the incentive, buprenorphine prescribing per opioid use disorder–related encounter increased from 0.5% to 16% (Δ 15%; 95% confidence interval 10.6% to 19.9%), with substantial variability across sites (range 8% to 22% of opioid use disorder–related encounters). In a postintervention survey, 67% of participating physicians indicated that they would have completed the training for a lower amount. Conclusion A financial incentive paying approximately half the clinical rate was effective in promoting emergency physician X-waiver training. The effect on ED-based buprenorphine prescribing was positive but variable across sites, and likely dependent on the availability of additional supports.
Special ambulatory gynecologic considerations in the era of coronavirus disease 2019 (COVID-19) and implications for future practice.

The coronavirus disease 2019 pandemic has altered medical practice in unprecedented ways. Although much of the emphasis in obstetrics and gynecology to date has been on the as yet uncertain effects of coronavirus disease 2019 in pregnancy and on changes to surgical management, the pandemic has broad implications for ambulatory gynecologic care. In this article, we review important ambulatory gynecologic topics such as safety and mental health, reproductive life planning, sexually transmitted infections, and routine screening for breast and cervical cancer. For each topic, we review how care may be modified during the pandemic, provide recommendations when possible on how to ensure continued access to comprehensive healthcare at this time, and discuss ways that future practice may change. Social distancing requirements may place patients at higher risk for intimate partner violence and mental health concerns, threaten continued access to contraception and abortion services, affect prepregnancy planning, interrupt routine screening for breast and cervical cancer, increase risk of sexually transmitted infection acquisition and decrease access to treatment, and exacerbate already underlying racial and minority disparities in care and health outcomes. We advocate for increased use of telemedicine services with increased screening for intimate partner violence and depression using validated questionnaires. Appointments for long-acting contraceptive insertions can be prioritized. Easier access to patient-controlled injectable contraception and pharmacist-provided hormonal contraception can be facilitated. Reproductive healthcare access can be ensured through reducing needs for ultrasonography and laboratory testing for certain eligible patients desiring abortion and conducting phone follow-up for medication abortions. Priority for in-person appointments should be given to patients with sexually transmitted infection symptoms, particularly if at risk for complications, while also offering expedited partner therapy. Although routine mammography screening and cervical cancer screening may be safely delayed, we discuss society guideline recommendations for higher-risk populations. There may be an increasing role for patient-collected human papillomavirus self-samples using new cervical cancer screening guidelines that can be expanded considering the pandemic situation. Although the pandemic has strained our healthcare system, it also affords ambulatory clinicians with opportunities to expand care to vulnerable populations in ways that were previously underutilized to improve health equity.
The 1985 October Long Outburst of U Geminorum: Revealing the Viscous Timescale in Long Orbital Period Dwarf Novae

We examine the AAVSO light curve of U Gem from 1908 to 2002, with particular focus on the 1985 October outburst. This outburst was longer than any other seen in U Gem by about a factor of 2 and appears to be unique among all dwarf nova outbursts seen in systems with orbital periods longer than 3 hr in that one can measure the decay timescale during the initial slow decay. This rate is ~26 ± 6 days mag-1. Using estimates of the rate of accretion during outburst taken from Froning et al., one can show that ~1024 g of gas was accreted onto the white dwarf during the outburst, which constrains the surface density in the outer accretion disk to be ~600 g cm-2. The observed timescale for decay is consistent with that expected in U Gem, given its orbital period and disk mass at the time the outburst began. The data are not of sufficient quality to be able to ascertain a deviation from exponentiality in the decay light curve (as in the SU UMa stars' superoutbursts). When coupled with the viscous time inferred from the (short orbital period) SU UMa stars, the U Gem viscous timescale lends support to the standard model in which the decays in dwarf novae can either be viscous or thermal, with the ratio between them being roughly h/r, where h is the vertical pressure scale height in the disk. Indeed, dwarf novae are the only systems for which one can be reasonably certain of the identification of "viscous" and "thermal" decays.
Implementation of a nonopioid protocol following robot-assisted radical cystectomy with intracorporeal urinary diversion.

Abstract Purpose The implementation of robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) for management of patients with muscle-invasive or high-risk noninvasive bladder cancer has increased in utilization over the last decade. Here, we seek to describe institutional opioid prescription and utilization patterns following implementation of a nonopioid (NOP) perioperative pain management protocol in patients who received RARC with ICUD. Materials and methods The records of all patients who underwent RARC that utilized a NOP perioperative pain management protocol at a single academic institution from 2016 to 2020 were retrospectively reviewed. Descriptive statistical analyses were performed. For comparison, we included 74 consecutive patients who received the same NOP protocol with extracorporeal urinary diversion (ECUD). Results A total of 116 patients who received ICUD were included in our analysis. The median operation time for the ICUD group was 305 minutes (interquartile range [IQR]: 262–352). 12.1% (n = 14) of patients who underwent ICUD required narcotics during inpatient hospitalization. For these patients, the median morphine milligram equivalent requirement was 52.0 (IQR: 7.62–157). Additionally, only 12.1% (n = 14) of patients were prescribed opioids postoperatively at discharge. We identified that within 6 months of surgery only 5 (4.3%) patients required a second narcotic prescription. Furthermore, of patients who did not use mu-opioid blockers, a minority experienced postoperative ileus (15.7%, n = 16). 30- and 90-day all Clavien complication rates for patients were 44.8% (n = 52) and 49.1% (n = 57), respectively. Nineteen (16.4%) patients were readmitted within 30 days of discharge, of which none were pain related. When compared to ECUD, patients who received ICUD experienced similar complication and readmission rates. Conclusions The implementation of a NOP protocol for patients undergoing RARC with ICUD allows for both decreased postoperative narcotic use and reduced need for narcotic prescriptions at discharge with acceptable complication and readmission rates.
Reply: Microcystic macular degeneration from optic neuropathy: not inflammatory, not trans-synaptic degeneration.

ARTICLE Sir, we read the letter by Barboni et al. (2013) with great interest. They report microcystic changes in the inner nuclear layer on optical coherence tomography in 10 of ‘several hundred’ patients with hereditary, ‘non-inflammatory’ optic neuropathies [Leber’s hereditary optic neuropathy (LHON) and dominant optic atrophy]. More clinical information about these cases would certainly be helpful in analysing why some of these patients demonstrated microcystic changes in the inner …
Response to first dose of inhaled albuterol in mechanically ventilated preterm infants.

BACKGROUND Bronchodilator responses among preterm infants are heterogeneous. Bedside measurements may identify responders. STUDY DESIGN Respiratory measurements (Resistance, Compliance, FiO2) and pulse oximetry (SpO2) patterns were downloaded from infants <30 weeks gestational age during the first 2 months of life. Mechanically ventilated infants who received albuterol were included (n = 33). Measurements were compared before and after first albuterol. Secondary analyses assessed subsequent doses. RESULTS Median gestation and birthweight were 25 3/7 weeks and 730 g, respectively. Mean Resistance decreased post-albuterol (p = 0.007). Sixty-eight percent of infants were responders based on decreased Resistance. Compliance and FiO2 did not significantly differ. Percent time in hypoxemia (SpO2 < 85%) decreased post albuterol (p < 0.02). In responders, Resistance changes diminished with subsequent administration (all p = 0.01). CONCLUSIONS Ventilator resistance decreased in two-thirds of preterm infants, consistent with studies that utilized formal pulmonary function testing. Albuterol had a variable effect on delivered FiO2; however, hypoxemia may be useful in evaluating albuterol response.
Spotlight on ocular Kaposi’s sarcoma: an update on the presentation, diagnosis, and management options

Kaposi’s sarcoma (KS) is a multifocal low-grade vascular neoplasm that can affect the skin, mucus membranes, visceral organs, and lymph nodes. KS can also affect the ocular surface and adnexa and c...
Neighborhood Socioeconomic Deprivation in Young Adulthood and Future Respiratory Health: The CARDIA Lung Study.

Abstract Purpose There are limited data on the relationship between neighborhood level factors and their association with lung health independent of individual socioeconomic status. We sought to determine whether baseline neighborhood level socioeconomic deprivation in young adults is associated with greater 20-year decline in lung function and higher risk of future lung disease, independent of baseline individual income, education, and smoking status. Methods This multicenter population-based cohort study included 2689 participants in Coronary Artery Risk Development in Young Adults (CARDIA) for whom neighborhood deprivation was determined at year 10 (baseline for study) and who had complete lung function measurements at years 10 and 30. Baseline neighborhood deprivation was defined using 1990 Census blocks as a combination of 4 factors involving median household income, poverty level, and educational achievement. The outcomes were decline in lung function over 20 years (year 10 to 30) and odds of emphysema (year 25). Results In multivariable regression models, greater baseline neighborhood deprivation was associated with greater decline in lung function (−2.34 mL/year excess annual decline in forced expiratory volume in 1 second (FEV1) in the highest versus lowest deprivation quartile (P = .014)). Furthermore, baseline neighborhood deprivation was independently associated with greater odds of emphysema (odds ratio [OR] 2.99, 95% confidence interval [CI] 1.42-6.30). Conclusions Residence in neighborhoods with greater socioeconomic deprivation in young adulthood, independent of individual income and smoking, is associated with greater 20-year decline in forced expiratory volume in 1 second and higher risk of future emphysema.
Where there's a will, there's a way? Strategies to reduce or abstain from alcohol use developed by Northern Plains American Indian women participating in a brief, alcohol-exposed pregnancy preconceptual intervention.

Background Alcohol-exposed pregnancy (AEP) is an ongoing concern, especially within low-resource, high-risk areas such as rural American Indian/Alaska Native (AIAN) communities. Brief, preconceptual AEP-reduction interventions are popular in such areas but have a small impact on alcohol use. Developing a strategic alcohol change plan is a key program component; however, there is little research on strategy selection, especially within contexts that positively or negatively impact selection (e.g., cultural strengths, trauma, collective efficacy within AIAN communities). This study qualitatively analyzed strategies chosen to reduce alcohol use by AIAN women participating in a culturally tailored, brief, preconceptual AEP-reduction intervention. Methods One hundred-sixty Northern Plains AIAN women who were participating in a brief AEP-reduction program developed a plan to accomplish an alcohol reduction/abstention goal at the first and last program sessions. The plan included choosing 1 or more strategies to (1) achieve the goal, (2) mitigate barriers, and (3) use cultural strengths. Qualitative analysis of the data involved thematic open and structured coding of all 3 strategies separately. We also examined how many different themes (different individual strategies) participants reported for each strategy component. Results Most participants reported only 1 strategy (theme) for each of the 3 components. Common goal-achieving and barrier-mitigation strategies included positive social supports and avoiding negative or alcohol-involved social environments. Other strategies involved circular logic (e.g., the strategy to reduce drinking was to drink less). Both traditional and western cultural strengths were reported as important resources, although many participants had no cultural resource strategy. Conclusion Programs aimed at reducing AEPs may need to provide participants more support to develop strong strategies to reduce alcohol use when implemented within areas with high levels of trauma and contextual barriers that can impact strategy selection. Such support could include ways to improve health on both interpersonal and community levels.
Psychometric Evaluation of the Cybersecurity Concept Inventory

We present a psychometric evaluation of a revised version of the Cybersecurity Concept Inventory (CCI), completed by 354 students from 29 colleges and universities. The CCI is a conceptual test of ...
Hyperpolarized Micro-NMR Platform for Sensitive Analysis of In Vitro Metabolic Flux in Living Cells.

Metabolism represents an ensemble of cellular biochemical reactions, and thus metabolic analyses can shed light on the state of cells. Metabolic changes in response to external cues, such as drug treatment, for example, can be rapid and potentially an early indicator of therapeutic response. Unfortunately, conventional techniques to study metabolism, such as optical microscopy or mass spectrometry, have functional limitations in specificity and sensitivity. To address this technical need, we developed a sensitive analytical tool based on nuclear magnetic resonance (NMR) technology, termed hyperpolarized micro-NMR, that enables rapid quantification of multiple metabolic fluxes in a small number of cells, down to 10,000 cells, nondestructively. This analytical capability was achieved by miniaturization of an NMR detection coil along with hyperpolarization of endogenous metabolites. Using this tool, we were able to quantify pyruvate-to-lactate flux in cancer stem cells nondestructively within 2 min, which has not been possible with other techniques. With further optimization, we envision that this novel device could be a powerful analytical platform for sensitive analysis of metabolism in mass-limited samples.
What is the Situation

Environmental psychology more than other aspects of psychology takes the situation to be of fundamental interest. By situation I mean the actual physical specifications of a person in a place with other people or alone, and also the convergence of cultural, social, and economic possibilities and constraints that constitute the meaning of the situation. Bruner (1990) explicates the meaning saturated nature of situations when he argues that the subject matter of psychology concerns the narratives that make sense in a culture. This argument, however, poses challenges for the cross-cultural understanding of such narratives, as exemplified in the 20 years of collaboration and exchange among Japanese and U.S. environmental psychologists.
Crystal plasticity finite element analysis of electromigration-induced deformation behavior in lead-free solder joints

The elastic and plastic anisotropy of β-Sn has an important effect on the stress state, and hence the electromigration induced degradation in Sn-based solder joints. A crystal plasticity model is developed to capture this effect. Calibration of this model is done by using the available literature data. Future refinement of the slip parameters is needed to optimize the model. The model is implemented in a finite element framework and is used to simulate the response of single crystal β-Sn to electromigration induced strains. This work can be used as a basis for future development of coupled models of electromigration and stress induced degradation in Sn-based solders.
Finding the right fold

Using mutational analysis, three groups have compared the transition states for the folding of two pairs of homologous proteins. The results of these studies suggest that protein folding mechanisms are conserved and are defined primarily by the overall topology of the native structures, as opposed to specific details of the interactions stabilizing these structures.
Factors That Influence Asynchronous Discourse with Preservice Teachers on a Public, Web-based Forum

AbstractThis study investigated asynchronous communication factors that influence the discourse of preservice science teachers on a non-restrictive, public Web-based forum. Salient elements that promoted discourse among the participants included the level of interest in a topic, the immediate relevancy of a topic to a participant at a particular time, and interpersonal factors among participants. Limitations using asynchronous communication perceived by preservice teachers included receiving feedback too late to be of use and issues pertaining to the absence of visual cues during discourse exchanges. The linear, temporal interface of the Web-based forum appeared to be a factor that limited the depth of the discussion.Telecommunication networks are transforming higher education. Recent developments in computer telecommunications technology have emerged as a means for providing support to beginning teachers. University teacher educators can continue to provide preservice teacher training with electronic net...