cssi/SciSciGPT-SciSciNet huggingface dataset:
Prescription Opioid Use is Associated with Virologic Failure in People Living with HIV.

Prescription opioid misuse is a rising epidemic in the U.S., and people living with HIV are at increased risk. We assessed the association between prescription opioid use and virologic failure in HIV+ patients in the South Texas HIV Cohort. We found prescription opioid use was significantly associated with virologic failure, after adjustment for age, race, gender, insurance status, years living with HIV, reported HIV risk factor, chronic hepatitis C virus infection, current substance abuse, and care engagement. These findings suggest that opioid analgesic use may have negative consequences beyond misuse in people living with HIV.
Chapter 8 - Opioid Analgesics and Narcotic Antagonists

The Side Effects of Drugs Annuals forms a series of volumes in which the adverse effects of drugs and adverse reactions to them are surveyed. This series supplements the contents of Meyler's Side Effects of Drugs: the International Encyclopedia of Adverse Drug Reactions and Interactions. This review of December 2014 to July 2015 publications on adverse reactions to opioid analgesics and narcotic antagonists covers alfentanil, codeine, dextrometrophan, diamorphine (heroin), dihydrocodeine, fentanyl, hydrocodone, methadone, morphine, oxycodone, papaverine, pethidine, remifentanyl, tramadol, buprenorphine, methylnaltrexone, naloxone, and naltrexone. This edition also features emerging evidence of ketamine as an adjunct for analgesia.
Asymmetric nanowire SQUID: Linear current-phase relation, stochastic switching, and symmetries

We study nanostructures based on two ultrathin superconducting nanowires connected in parallel to form a superconducting quantum interference device (SQUID). The measured function of the critical current versus magnetic field, ${I}_{C}(B)$, is multivalued, asymmetric, and its maxima and minima are shifted from the usual integer and half integer flux quantum points. We also propose a low-temperature-limit model which generates accurate fits to the ${I}_{C}(B)$ functions and provides verifiable predictions. The key assumption of our model is that each wire is characterized by a sample-specific critical phase ${\ensuremath{\phi}}_{C}$ defined as the phase difference at which the supercurrent in the wire is the maximum. For our nanowires ${\ensuremath{\phi}}_{C}$ is much greater than the usual $\ensuremath{\pi}/2$, which makes a qualitative difference in the behavior of the SQUID. The nanowire current-phase relation is assumed linear, since the wires are much longer than the coherence length. The model explains single-valuedness regions where only one vorticity value ${n}_{v}$ is stable. Also, it predicts regions where multiple vorticity values are stable because the Little-Parks (LP) diamonds, which describe the region of stability for each winding number ${n}_{v}$ in the current-field diagram, can overlap. We also observe and explain regions in which the standard deviation of the switching current is independent of the magnetic field. We develop a technique that allows a reliable detection of hidden phase slips and use it to determine the boundaries of the LP diamonds even at low currents where ${I}_{C}(B)$ is not directly measurable.
Madness, Modernism, and Interpretation: A Conversation with Louis Sass

In this conversation, Louis Sass discusses phenomenological and hermeneutic themes as they have applied to his work with psychopathology, specifically schizophrenia. Sass has consistently argued for a phenomenological approach to the study of self, subjectivity, and mental disorder. He asserts that these phenomenological approaches to psychopathology can be explanatory as well as descriptive.
Coordinated Scheduling for a Multi-server Network in Outpatient Pre-operative Care

Many parts of the healthcare system remain fragmented and outpatient surgical care is no exception. In this paper, we develop a coordinated pre-operative scheduling approach between Anesthesiology and Internal Medicine to optimize patients’ medical conditions prior to surgery. Coordinating these two services has conceptual appeal because any health issues discovered by the anesthesiologist can often be addressed by a general internist. We design a patient-centered approach that allows the patient to see both providers, if necessary, on a single visit. This problem is modeled as a two-station stochastic network, where each station (or clinic) may be staffed by multiple parallel providers and patients see the first available provider. To solve the scheduling problem, we formulate an optimization model to maximize the net benefit of scheduling patients. The objective balances benefits against patient waiting time and clinic overtime costs. We develop a scheduling method with a booking limit to create a balanced network schedule. Due to the complexity of this problem, the solution approach is myopic. In addition, we develop a hybrid method that combines analytical calculation and simulation-based optimization. We demonstrate our approach on a healthcare network at The University of Texas Health Sciences Center in San Antonio. We compare our method against other policies and show that it yields high quality and robust results. Based on the level of generality of our model and results, the insights gained are not limited to the particular application, but can be applied to other patient-centered models where scheduling coordination can be used. This article is protected by copyright. All rights reserved.
Predictive value of oxygenation index for outcomes in left-sided congenital diaphragmatic hernia.

Abstract Background & objectives Congenital Diaphragmatic Hernia (CDH) is associated with significant morbidity and mortality. This study compares the efficacy of the highest oxygenation index in the first 48 h (HiOI) versus current prenatal indices to predict survival and morbidity. Methods Medical records of 50 prenatally diagnosed, isolated, left-sided CDH patients treated from January 2011 to April 2016 were reviewed. Data abstracted included HiOI, lung to head ratio (LHR), observed to expected total fetal lung volume (O/E TFLV), percent liver herniation (%LH), 6 month survival, respiratory support at discharge, ventilator days and length of stay. Data were analyzed using parametric and nonparametric tests and regression analyses as appropriate. Results HiOI was associated with significantly increased LOS ( p p p =0.001) and higher odds of death ( p =0.004) with risk of death increasing by 5% for every one-unit increase in OI. HiOI was statistically a better predictor of LOS than O/E TFLV ( p =0.007) and %LH ( p =0.02). Conclusions In isolated, left-sided CDH patients, HiOI is associated with higher mortality, greater length of stay, more ventilator days and increased respiratory support at discharge. HiOI is a better predictor of length of stay than O/E TFLV and %LH. Type of study Retrospective Study Level of evidence II
Postdates induction with an unfavorable cervix and risk of cesarean.

Objective: To determine the risk of cesarean delivery associated with postdates induction (≥41 weeks) compared to term induction (37–40w6d) among women with an unfavorable cervix, and to examine th...
Techniques of Impella removal while preserving arterial access.

Abstract Preservation of the arterial access site after removal of large caliber mechanical circulatory devices (MCD) can be challenging. In this paper, we describe two novel techniques and review the current literature focusing on the maintenance of arterial access after Impella removal.
Reactivation of Simian Varicella Virus in Rhesus Macaques After CD4 T Cell Depletion

Rhesus macaques intrabronchially inoculated with simian varicella virus (SVV), the counterpart of human varicella-zoster virus (VZV), developed primary infection with viremia and rash, which resolved upon clearance of viremia, followed by the establishment of latency. To assess the role of CD4 T cell immunity in reactivation, monkeys were treated with a single 50-mg/kg dose of a humanized monoclonal anti-CD4 antibody; within 1 week, circulating CD4 T cells were reduced from 40 to 60% to 5 to 30% of the total T cell population and remained low for 2 months. Very low viremia was seen only in some of the treated monkeys. Zoster rash developed after 7 days in the monkey with the most extensive CD4 T cell depletion (5%) and in all other monkeys at 10 to 49 days posttreatment, with recurrent zoster in one treated monkey. SVV DNA was detected in the lung from two of five monkeys, in bronchial lymph nodes from one of the five monkeys, and in ganglia from at least two dermatomes in three of five monkeys. Immunofluorescence analysis of skin rash, lungs, lymph nodes, and ganglia revealed SVV ORF63 protein at the following sites: sweat glands in skin; type II cells in lung alveoli, macrophages, and dendritic cells in lymph nodes; and the neuronal cytoplasm of ganglia. Detection of SVV antigen in multiple tissues upon CD4 T cell depletion and virus reactivation suggests a critical role for CD4 T cell immunity in controlling varicella virus latency.IMPORTANCE Reactivation of latent VZV in humans can result in serious neurological complications. VZV-specific cell-mediated immunity is critical for the maintenance of latency. Similar to VZV in humans, SVV causes varicella in monkeys, establishes latency in ganglia, and reactivates to produce shingles. Here, we show that depletion of CD4 T cells in rhesus macaques results in SVV reactivation, with virus antigens found in zoster rash and SVV DNA and antigens found in lungs, lymph nodes, and ganglia. These results suggest the critical role of CD4 T cell immunity in controlling varicella virus latency.
A Photoelastic Technique for Ground Shock Investigation

Abstract Stress wave propagation in solids due to surface pressure waves has been investigated in dynamic photoelastic studies involving a high speed framing camera. An aerodynamic shock tube provided the dynamic loading for a low elastic modulus model approximating a two-dimensional half-space configuration. Photographic results indicate both steady-state and transient effects correlating with theoretical analysis of the half-space problem. The method of testing developed in this investigation promises to be of use in determining dynamic states of stress in various geometries of interest subjected to ground shock loading.
The Role of Lipid Rafts in Mediating the Anticancer Effects of γ-Tocotrienol

γ-Tocotrienol, a natural isoform within the vitamin E family of compounds, displays potent antiproliferative and apoptotic activity against a wide range of cancers, particularly breast cancer. A large percentage of human breast cancers characteristically display aberrant receptor tyrosine kinase activity, including receptors within the HER family, c-Met, and VEGF among others. Lipid rafts are specialized microdomains within the plasma membrane that are required for receptor tyrosine kinase dimerization, activation, and signal transduction. Recent studies demonstrate that the anticancer effects of γ-tocotrienol are associated with its accumulation in the lipid raft microdomain where it appears to interfere with the receptor tyrosine kinase dimerization and activation in human breast cancer cells. Heregulin is a potent ligand that activates HER3 and HER4 receptors, and overexpression of this ligand is associated with the development of chemotherapy resistance. Exosomes released from cancer cells are small vesicles originating from the outward budding of lipid rafts that carry various mitogenic proteins that then act locally in an autocrine/paracrine manner to stimulate cancer cell growth. However, exosomes isolated from the culture media of breast cancer cells treated with γ-tocotrienol contain significantly less heregulin content and are significantly less potent in stimulating HER3/HER4 heterodimerization, activation, and mitogenic signaling, as compared to exosomes isolated from the culture media of breast cancer cells grown in control media. These findings provide strong evidence that the anticancer effects of γ-tocotrienol result, at least in part, by directly disrupting lipid raft integrity by directly interfering with HER receptor dimerization and signaling within the lipid rafts and indirectly by reducing exosome heregulin content and subsequent autocrine/paracrine mitogenic stimulation.
The effect of surface roughness orientation on PEEK (polyetheretherketone) transfer film volume in multi-directional and linear sliding

Abstract Polymer transfer films are thought to reduce friction and wear during sliding. In such cases, a continuous, uniform transfer film is thought to yield better wear performance. However, several polymers, including the thermoplastic polyetheretherketone (PEEK), do not always display this behavior. Recent works analyzing transfer film quality of PEEK resulted in no clear correlation to wear. Currently, the mechanisms for PEEK transfer film development are unknown, but there is evidence suggesting roughness orientation relative to sliding and frictional heating play key roles. In this work, the development of PEEK transfer film is explored in relation to multi-directional versus linear sliding, roughness orientation and temperature rise. Three distinct wear paths were chosen for wear tests. The transfer film of the square wear paths was analyzed using white light profilometry and imaging software to obtain the volume and area coverage by the film. The temperature rise during sliding of the bulk polymer pin was recorded with infrared camera radiometry for linear reciprocating tests. Scratch tests and chemical etching were conducted on the polymer pin surface to evaluate any directional bias or crystallinity orientation induced by sliding. It was found that wear debris and polymer chain orientation play no noticeable role in PEEK's transfer film formation. The transfer film gradient increased with frictional heating, and transfer film color changed under certain conditions. This color changed also correlated to reduced wear. This study also confirms that transfer film development is strongly dependent on roughness orientation, and its effects are examined.
The Temporal Turn in Ancient Judaism and Jewish Studies

Despite the apparent finality of Heschel’s pronouncement, in 1951, that Judaism is a ‘religion of time’, the past two decades have seen renewed scholarly interest in the relationship between time, ...
CO2 absorption from simulated flue gas in a bubble column

Carbon dioxide (CO2) absorption from power plant generated flue gas is investigated for CO2 emissions reduction. Amino acid alkaline solvents have the potential to reduce the energy required for so...
High Performance Partial Coherent X-Ray Ptychography

During the last century, X-ray science has enabled breakthrough discoveries in fields as diverse as medicine, material science or electronics, and recently, ptychography has risen as a reference imaging technique in the field. It provides resolutions of a billionth of a meter, macroscopic field of view, or the capability to retrieve chemical or magnetic contrast, among other features. The goal of ptychography is to reconstruct a 2D visualization of a sample from a collection of diffraction patterns generated from the interaction of a light source with the sample. Reconstruction involves solving a nonlinear optimization problem employing a large amount of measured data—typically two orders of magnitude bigger than the reconstructed sample—so high performance solutions are normally required. A common problem in ptychography is that the majority of the flux from the light sources is often discarded to define the coherence of an illumination. Gradient Decomposition of the Probe (GDP) is a novel method devised to address this issue. It provides the capability to significantly improve the quality of the image when partial coherence effects take place, at the expense of a three-fold increase of the memory requirements and computation. This downside, along with the fine-grained degree of parallelism of the operations involved in GDP, makes it an ideal target for GPU acceleration. In this paper we propose the first high performance implementation of GDP for partial coherence X-ray ptychography. The proposed solution exploits an efficient data layout and multi-gpu parallelism to achieve massive acceleration and efficient scaling. The experimental results demonstrate the enhanced reconstruction quality and performance of our solution, able process up to 4 million input samples per second on a single high-end workstation, and compare its performance with a reference HPC ptychography pipeline.
Doxorubicin obliterates mouse ovarian reserve through both primordial follicle atresia and overactivation

Abstract Ovarian toxicity and infertility are major side effects of cancer therapy in young female cancer patients. We and others have previously demonstrated that doxorubicin (DOX), one of the most widely used chemotherapeutic chemicals, has a dose-dependent toxicity on growing follicles. However, it is not fully understood if the primordial follicles are the direct or indirect target of DOX. Using both prepubertal and young adult female mouse models, we comprehensively investigated the effect of DOX on all developmental stages of follicles, determined the impact of DOX on primordial follicle survival, activation, and development, as well as compared the impact of age on DOX-induced ovarian toxicity. Twenty-one-day-old CD-1 female mice were intraperitoneally injected with PBS or clinically relevant dose of DOX at 10 mg/kg once. Results indicated that DOX primarily damaged granulosa cells in growing follicles and oocytes in primordial follicles and DOX-induced growing follicle apoptosis was associated with the primordial follicle overactivation. Using the 5-day-old female mice with a more uniform primordial follicle population, our data revealed that DOX also directly promoted primordial follicle death and the DNA damage-TAp63α-C-CASP3 pathway was involved in DOX-induced primordial follicle oocyte apoptosis. Compared to 21-day- and 8-week-old female mice that were treated with the same dose of DOX, the 5-day-old mice had the most severe primordial follicle loss as well as the least degree of primordial follicle overactivation. Taken together, these results demonstrate that DOX obliterates mouse ovarian reserve through both primordial follicle atresia and overactivation and the DOX-induced ovarian toxicity is age dependent.
Surface composition and ordering of binary nanoparticle mixtures in spherical confinement

We use coarse-grained Langevin dynamics simulations in shrinking spherical confinement to probe the fabrication of spherical “supraballs” via the emulsion assembly of binary nanoparticle mixtures. We examine a binary mixture of silica and synthetic melanin nanoparticles and discuss the structure and composition of the resulting supraballs particularly in the context of optical nanomaterials applications. Our results demonstrate how particle chemistry, particle size, particle mixture composition, assembly timescale, and supraball size cooperate/compete to control the spatial distribution of particles on the surface and within the supraball. We find strong enrichment of melanin particles at the supraball surface, with the degree of enrichment decreasing with increasing melanin/silica size ratio. We observe appreciable crystalline ordering only in systems where the particles are of similar size, and we note that particle size dispersity, finite assembly timescale, and curvature of the supraball surface all serve to suppress particle ordering. We also report routes toward some interesting hierarchical structures such as core–shell supraballs. These findings provide design rules for the development of optical materials for structural color applications, and they also increase our fundamental understanding of nanoparticle organization near curved surfaces and may find relevance for processes such as spray drying and porous materials fabrication.
Synchrony Drives Motor Cortex Beta Bursting, Waveform Dynamics, and Phase-Amplitude Coupling in Parkinson's Disease

Several lines of inquiry have separately identified beta oscillations, synchrony, waveform shape, and phase-amplitude coupling as important but sometimes inconsistent factors in the pathophysiology of Parkinson's disease. What has so far been lacking is a means by which these neurophysiological parameters are interrelated and how they relate to clinical symptomatology. To clarify the relationship among oscillatory power, bursting, synchrony, and phase-amplitude coupling, we recorded local field potentials/electrocorticography from hand motor and premotor cortical area in human subjects with c (N = 10) and Parkinson's disease (N = 22) during deep brain stimulator implantation surgery (14 females, 18 males). We show that motor cortical high beta oscillations in Parkinson's disease demonstrate increased burst durations relative to essential tremor patients. Notably, increased corticocortical synchrony between primary motor and premotor cortices precedes motor high beta bursts, suggesting a possible causal relationship between corticocortical synchrony and localized increases in beta power. We further show that high beta bursts are associated with significant changes in waveform shape and that beta-encoded phase-amplitude coupling is more evident during periods of high beta bursting. These findings reveal a deeper structure to the pathologic changes identified in the neurophysiology of Parkinson's disease, suggesting mechanisms by which the treatment may be enhanced using targeted network synchrony disruption approaches.SIGNIFICANCE STATEMENT Understanding Parkinson's disease pathophysiology is crucial for optimizing symptom management. Present inconsistencies in the literature may be explained by temporal transients in neural signals driven by transient fluctuations in network synchrony. Synchrony may also act as a unifying phenomenon for the pathophysiological observations reported in Parkinson's disease. Here, simultaneous recordings from motor cortices show that increases in network beta synchrony anticipate episodes of beta bursting. We furthermore identify beta bursting as being associated with changes in waveform shape and increases in phase-amplitude coupling. Our results identify network synchrony as a driver of various pathophysiological observations reported in the literature and account for inconsistencies in the literature by virtue of the temporally variable nature of the phenomenon.
Determination of the pesticides Chlorpropham, Propham, Propoxur, and Terbucarb by low temperature phosphorimetry

Simple, direct, and sensitive low temperature phosphorimetric methods for the determination of Chlorpropham, Propham, Propoxur, and Terbucarb in EPA solvent are described. The minimum detectable amounts are 0.01 p. p. m. for Chlorpropham and Propham and 0.02 and 0.3 p. p. m. for Propoxur and Terbucarb respectively. The ranges of linearity of the analytical calibration graphs are 0.05-7.5, 0.05–10, 0.5–50, and 1–50 p. p. m. for Chlorpropham, Propham, Propoxur, and Terbucarb respectively. The procedure for Chlorpropham has been applied to the analysis of a solid commercial formulation.
Seizures and Status Epilepticus

Seizures are one of the most common neurological emergencies encountered by clinicians. Status epilepticus in particular is one of the most serious forms of seizure emergencies associated with considerable morbidity and mortality. However, much has been learned about the pathophysiology and epidemiology of the condition which has led to a paradigm shift in the definition and management of this condition. This chapter explores the current understanding of seizures with an emphasis on status epilepticus. Epidemiology, etiology, diagnosis, and therapeutic interventions are discussed and protocols for successful management are outlined.
The effect of transfusion of blood products on ventricular assist device support outcomes.

Aims Perioperative blood transfusions are common among patients undergoing left ventricular assist device (LVAD) implantation. The association between blood product transfusion at the time of LVAD implantation and mortality has not been described. Methods and results This was a retrospective cohort study of all patients who underwent continuous flow LVAD implantation at a single, large, tertiary care, academic centre, from 2008 to 2014. We assessed used of packed red blood cells (pRBCs), platelets, and fresh frozen plasma (FFP). Outcomes of interest included all-cause mortality and acute right ventricular (RV) failure. Standard regression techniques were used to examine the association between blood product exposure and outcomes of interest. A total of 170 patients were included in this study (mean age: 56.5 ± 15.5 years, 79.4% men). Over a median follow-up period of 11.2 months, for every unit of pRBC transfused, the hazard for mortality increased by 4% [hazard ratio (HR) 1.04; 95% CI 1.02-1.07] and odds for acute RV failure increased by 10% (odds ratio 1.10; 95% CI 1.05-1.16). This association persisted for other blood products including platelets (HR for mortality per unit 1.20; 95% CI 1.08-1.32) and FFP (HR for mortality per unit 1.08; 95% CI 1.04-1.12). The most significant predictor of perioperative blood product exposure was a lower pre-implant haemoglobin. Conclusions Perioperative blood transfusions among patients undergoing LVAD implantation were associated with a higher risk for all-cause mortality and acute RV failure. Of all blood products, FFP use was associated with worst outcomes. Future studies are needed to evaluate whether pre-implant interventions, such as intravenous iron supplementation, will improve the outcomes of LVAD candidates by decreasing need for transfusions.
Organizational Form and Expense Preference: Spanish Experience

This article investigates the effect of alternative ownership structures, stock versus mutual, on the cost of production of Spanish depository institutions. By introducing a stochastic frontier analysis in estimating the best–practiced expense–preference behaviour, the empirical approach adjusts for the possibility that the two sectors of the banking industry employ different production technologies and finds evidence that is consistent with expense–preference behaviour by the mutual savings banks.
Anesthesia Morbidity and Mortality in the Oral Surgery Office

SUMMARY The anesthesia surveys conducted over the past 25 years provide a reference data base for future surveys on anesthesia morbidity and mortality. This article presents some of the difficulties encountered in attempting to arrive at an accurate number for various untoward events. Currently we can estimate, in a general way, the likelihood of any particular oral surgeon experiencing an office tragedy. The anecdotal reports of specific instances of anesthesia complications may help oral and maxillofacial surgeon-anesthetists to avoid or minimize the effects of untoward events on patients. The wisest course of action an oral and maxillofacial surgeon can take is to carefully screen patients presenting for general anesthesia; to provide a safe, light, well-monitored anesthetic utilizing all of our current knowledge; and to be ready to manage any untoward event should it occur.
Exploring adults as support persons for improved pre-exposure prophylaxis for HIV use among select adolescents and young adults in the Deep South.

Purpose Pre-exposure prophylaxis for HIV (PrEP) is an effective yet underutilized biomedical tool for adolescents and young adults' (AYA) HIV prevention due to barriers such as PrEP adherence. We assessed HIV prevention knowledge, attitudes and beliefs from adults who self-identified as a primary support person to an AYA. Methods We surveyed AYA primary support persons at an academic hospital. Univariate and multivariate regression analyses were completed to identify factors associated with the belief AYAs engaging in HIV-associated behaviors should use PrEP and willingness to support AYAs on PrEP. Results 200 primary support persons completed the survey. Participants were predominately female (77%) and black (56%). Nearly all primary support persons believed AYAs engaging in HIV-associated behaviors should take PrEP (94%) and 98% would support an AYA taking PrEP via transportation to appointments, assistance with refilling prescriptions, medication reminders, or encouragement. Conclusions Primary support persons are willing to support AYAs using PrEP.
Innovation Law and Policy Choices for Climate Change-Related Public–Private Partnerships

The impacts and costs of climate change will depend substantially upon the rapid development and widespread dissemination of a wide variety of new climate change mitigation and adaptation technologies. This chapter addresses the choices that government policy-makers and private actors must and will make within the innovation policy system to fund and develop climate change related mitigation and adaptation technologies (whether or not subject to IP rights) as well as to transfer those technologies around the world to address climate change-related needs. The emphasis on public-private partnerships (PPPs) to achieve the sustainable development goals (SDGs), including use of PPPs to address climate and energy SDGs, requires careful calibration of the many different law and policy choices.
Impact of point-of-care ultrasound on treatment time for ectopic pregnancy.

Abstract Background Point-of-care ultrasound (POCUS) is useful in the evaluation of early pregnancy by confirming intrauterine pregnancy and recognizing hemorrhage from ectopic pregnancy. We sought to determine whether transabdominal POCUS by itself or in conjunction with consultative radiology ultrasound (RADUS), reduces Emergency Department (ED) treatment time for patients with ectopic pregnancy requiring operative care, when compared to RADUS alone. A secondary objective was to determine whether the incorporation of POCUS reduces time to operative care for patients with ruptured ectopic pregnancy specifically, when compared to RADUS alone. Methods We performed a retrospective review of patients admitted for operative management of ectopic pregnancy. We excluded patients with known ectopic pregnancy and/or imaging prior to arriving to the treatment area, found not to have an ectopic pregnancy, or did not undergo operative care. Descriptive statistics, classical and nonparametric statistical analysis, and linear regression were performed. Results There were 220 patients admitted with ectopic pregnancy, 111 met exclusion criteria, yielding 109 for analysis. Of 109, 36 received POCUS (23/36 also had RADUS), while 73 received RADUS only. Among the POCUS group 31/36 (86%) were classified as ruptured versus 47/73 (64%) in the RADUS group. The average ED treatment time in the POCUS group for all admitted ectopic pregnancies was 157.9 min (standard deviation [SD] 101.3) versus 206.3 min (SD 76.6) in the RADUS group (p = 0.0141). The median time to operating room (OR) for ruptured ectopic pregnancies was 203.0 min (interquartile range [IQR] 159.0) in the POCUS group versus 293.0 min (IQR 139.0) in the RADUS group (p = 0.0002). Regression analysis of the primary outcome was limited by multiple interactions and sample size. When controlling for race, positive shock index and ED visit time, POCUS was found to be associated with a significantly shorter time to OR among ruptured ectopic pregnancies compared to RADUS (p = 0.0052). Conclusion Compared to RADUS alone, incorporation of POCUS was associated with significantly faster ED treatment time for all ectopic pregnancies and significantly faster time to OR for ruptured ectopic pregnancies, even when combined with RADUS. When controlling for clinical differences, time to OR was still faster for patients who underwent POCUS. The integration of POCUS should be considered to expedite care for patients with ectopic pregnancy requiring operative care.
Rejection-Identification: An Examination of Group-Level and Individual-Level Discrimination Among Hispanic Immigrants:

This study investigates the Rejection-Identification Model (RIM) by examining impacts of group-level and personal experiences with discrimination on different measures of ethnic identity and cultur...
How can belief be akratic

Akratic belief, or belief one believes one should not have, has often been thought to be impossible. I argue that the possibility of akratic belief should be accepted as a pre-theoretical datum. I distinguish intuitive, defensive, systematic, and diagnostic ways of arguing for this view, and offer an argument that combines them. After offering intuitive examples of akratic belief, I defend those examples against a common argument against the possibility of akratic belief, which I call the Nullification Argument. I then offer an Argument from Belief Attribution, using a discussion of the marks by which we typically attribute belief to defend attributions of akratic belief. I conclude by offering a way to explain what is puzzling about akratic belief, while allowing that it is possible.
The Effect of the Severity of Preoperative Back Pain on Patient-Reported Outcomes, Recovery Ratios, and Patient Satisfaction Following Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF).

Background Limited literature has addressed impact of preoperative back pain severity on patient-reported outcome measures (PROMs), recovery ratios (RRs), and patient satisfaction following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Methods MIS TLIFs were retrospectively identified and grouped: preoperative visual analog scale (VAS) back ≤7 or VAS back >7. PROMs, including PROMIS-PF, VAS back and leg, Oswestry Disability Index (ODI), and SF-12 Physical Composite Score and Mental Composite Score (MCS), were collected pre- and postoperatively. A PROM’s RR was calculated as proportion of postoperative improvement to overall potential improvement. Results In total, 740 patients were included: 359 patients with VAS back ≤7 and 381 patients with VAS back >7. The VAS back >7 cohort reported significantly greater postoperative inpatient pain (P ≤ .003, both). All preoperative and the following postoperative PROMs favored the VAS back ≤7 cohort: PROMIS-PF 2-years, VAS back overall, SF-12 Physical Composite Score 12 weeks and 1 year, SF-12 MCS 6 weeks/12 weeks, VAS leg 6 weeks, 12 weeks, 6 months, and 2 years, and ODI overall (P ≤ 0.048, all). The VAS back >7 cohort demonstrated greater delta PROMs for all VAS back and ODI except 2 years (P ≤ 0.021, all). A greater proportion of patients in the VAS back >7 group achieved minimal clinically important difference for VAS back overall, ODI 6 weeks/12 weeks, PROMIS-PF 6 weeks, and SF-12 MCS 6 weeks/6 months (P ≤ 0.044, all). The VAS back>7 cohort RR was significantly greater for VAS back 6 months and VAS leg 6 months/2 years (P ≤ 0.034, all). The VAS back ≤7 cohort’s postoperative satisfaction was significantly greater for VAS back 12 weeks, VAS leg 12 weeks, and ODI 6 weeks/12 weeks (P ≤ 0.046, all). Conclusions Patients with greater preoperative back pain demonstrated significantly worse postoperative scores for most PROMs at most time points and significantly worse patient satisfaction for disability, back and leg pain at multiple time points.
Autonomic dysfunction and cardiovascular risk in post-traumatic stress disorder.

Abstract Background Patients with post-traumatic stress disorder (PTSD) have an increased risk for cardiovascular disease. The underlying mechanisms are unclear but impaired autonomic function may contribute. However, research in this field has shown contradictory results and the causal links between PTSD, autonomic dysfunction, and cardiovascular risk remain unknown. This brief review summarizes the current knowledge on alterations in autonomic function and cardiovascular risk in patients with PTSD. Literature search strategy A PubMed search of the literature was performed using the following keywords: autonomic function, heart rate variability, blood pressure variability, sympathetic activity, baroreflex function, and cardiovascular risk in combination with PTSD. Evidence-based studies conducted between 2000 and 2021 were selected. Results In total 1221 articles were identified and of these, 61 (48 original research papers, 13 review articles) were included in this review. Many, though not all, studies have reported increased activity of the sympathetic nervous system and decreased activity of the parasympathetic nervous system (namely, autonomic imbalance) in PTSD patients. There seems to be enough evidence to suggest impairments in baroreflex function in PTSD, leading to blood pressure dysregulation. It appears that the chronicity of PTSD diagnosis and symptom severity are independent risk factors for cardiovascular disease, which may be linked with impaired autonomic function. Conclusions Increased cardiovascular risk may be associated with autonomic dysfunction in PTSD. Whether autonomic dysfunction can serve as a biomarker for the onset and progression of PTSD remains to be determined. It also needs to determine if autonomic imbalance increases the risk of developing PTSD.
ABCA1 is Necessary for Bexarotene-Mediated Clearance of Soluble Amyloid Beta from the Hippocampus of APP/PS1 Mice

Alzheimer’s disease (AD) is characterized by impaired clearance of amyloid beta (Aβ) peptides, leading to the accumulation of Aβ in the brain and subsequent neurodegeneration and cognitive impairment. ApoE plays a critical role in the proteolytic degradation of soluble forms of Aβ. This effect is dependent upon lipidation of ApoE by ABCA1-mediated transfer of phospholipids and cholesterol. ApoE and ABCA1 are induced by the action of the RXR agonist, bexarotene. We have previously shown that bexarotene reduces Aβ levels in AD mouse models and we have hypothesized that this effect requires ABCA1-mediated lipidation of ApoE. To test this hypothesis, we crossed ABCA1-deficient (ABCA1 KO) mice with the APP/PS1 model of AD. Aged ABCA1 WT and ABCA1 KO APP/PS1 mice were treated for 7 days with vehicle or bexarotene (100 mg/kg/day). Bexarotene reduced levels of soluble Aβ 1–40 and 1–42 in the hippocampus of ABCA1 WT but not ABCA1 KO APP/PS1 mice. In contrast, insoluble levels of Aβ, and plaque loads were unaffected by bexarotene in this study. ABCA1 KO mice had increased levels of inflammation compared with ABCA1 WT mice. Bexarotene also increased most inflammatory gene markers evaluated. The effect of bexarotene on microglial inflammatory profiles, however, was independent of ABCA1 genotype. Importantly, bexarotene ameliorated deficits in novel object recognition in ABCA1 WT but not ABCA1 KO APP/PS1 mice. These data indicate that ABCA1-induced lipidation of ApoE is necessary for the ability of bexarotene to clear hippocampal soluble Aβ and ameliorate cognitive deficits.
Sildenafil Treatment Improves the Maternal Syndrome in the Preeclamptic Dahl Salt Sensitive (S) Rat

Preeclampsia (PE), a hypertensive disorder of pregnancy, is detrimental to both mother and fetus; however, there is currently no effective treatment for PE. We hypothesized that sildenafil, a phosp...
A survey of techniques for designing and managing microgrids

Recent trends of rising demands of electricity for supporting critical infrastructure have led to increasing interest in microgrids. Microgrids hold the promise of being the reliable and economically viable electric system which can greatly improve the efficiency, resiliency and eco-friendliness of future smart grid. Recently, several techniques have been proposed to managing microgrids. In this paper, we present a survey of techniques proposed for designing and controlling microgrids. The aim of this paper is to provide insights to the power-system engineers and researchers into techniques for managing the challenges of microgrids like voltage/frequency control, islanding, stability, power quality and economic optimization.
Social Provisions and the Life of Civil Society in Europe: Rethinking Public and Private

This article discusses the critical role that social provisioning played in forming and maintaining communities across the longue duree of European history. Based on evidence from urban Europe in particular, the study suggests the importance of the early creation of a sphere of civil society here. Civil society was marked by the presence of both voluntary and civic associations, many of them designed for the care of the “honorable” or “house” poor. Although filled with the activities of “private” citizens, civil society was an eminently public sphere. It provided men and, more importantly, women with opportunities to extend their lives beyond the domestic to participate in organized associational life. Two types of community, based on confessional and civic affiliation, were especially important in shaping early modern societies and the poor relief organizations that helped to bind them together.The study argues that these types of community persisted well beyond the early modern period, leaving a legacy ...
A Metric for Quantifying Similarity between Timing Constraint Sets in Real-Time Systems

Real-time systems are systems in which their timing behaviors must satisfy a specified set of timing constraints and they often operate in a real-world environment with scarce resources. As a result, the actual runtime performance of these systems may deviate from the design, either inevitably due to unpredictable factors or by intention in order to improve system’s other Quality-of-Service (QoS) properties. In this article, we first introduce a new metric, timing constraint set similarity, to quantify the resemblance between two different timing constraint sets. Because directly calculating the exact value of the metric involves calculating the size of a polytope which is a #P-hard problem, we instead introduce an efficient method for estimating its bound. We further illustrate how this metric can be exploited for improving system predictability and for evaluating trade-offs between timing constraint compromises and the system’s other QoS property gains.
Factor Analyses of the Allen Barriers to Treatment Instrument in a Sample of Women Seeking Outpatient Treatment for Substance Abuse

Abstract Objective: Women are less likely than their male counterpartsto seek treatment for substance abuse. The AllenBarriers to Treatment Instrument (ABTI) was devel-oped in 1994 to measure barriers to treatment fromthe perspective of substance-abusing women. Thefactor structure of the ABTI has not been adequatelyvalidated, and the instrument has therefore beenunderused as a clinical and research tool. The pur-pose of this study was to replicate and validate thefactor structure of the ABTI in a sample of womenseeking outpatient substance abuse treatment. Methods: Confirmatory and exploratory factor analyses of theABTI were conducted in a sample of 77 womencompleting intake for substance abuse treatment. Results: The originally proposed factors could not be repli-cated in this sample. Item-level analyses revealed3 distinct factors that seemed to be clinically inter-pretable and descriptive of ‘‘barriers to treatment.’’The new factors were labeled ‘‘Functional Barriers,’’‘‘Relational Barriers,’’ and ‘‘Affective Barriers.’’
Quitting Tobacco: Let’s Keep Talking to Parents

* Abbreviations: CEASE — : Clinical and Community Effort Against Secondhand Smoke Exposure SHS — : secondhand smoke About 18% of the US adult population smoke cigarettes,1 a major decline from 1960s rates. Yet astoundingly, more than half of US children have evidence of tobacco smoke exposure.2 Children’s exposure to secondhand smoke (SHS) comes mainly from the home.2 Pediatricians see these children every day and are well aware of health consequences. However, clinicians may wonder whether it is useful to spend limited office time discussing quitting with parents. The study by Winickoff et al3 in this issue of Pediatrics reaffirms that counseling parents about quitting tobacco can yield results. An earlier publication about the Clinical and Community Effort Against Secondhand Smoke Exposure (CEASE) Program showed that CEASE was successfully implemented in pediatric office practices. Intervention practices were given CEASE training and materials, thus changing office systems to provide evidence-based assistance to parents who smoke. In interviews after visits, parents in intervention practices were 12 times more likely to report that pediatricians provided meaningful tobacco control assistance, compared with reports from control practices. “Meaningful assistance” was defined as counseling (eg, discussing stop-smoking strategies) beyond … Address correspondence to Sophie J. Balk, MD, 1621 Eastchester Rd, Bronx, NY 10461. E-mail: sbalk{at}montefiore.org
Interaction of Curare and Related Substances with Acetylcholine Receptor-Like Protein

Existence of a receptor protein for acetylcholine has been postulated, and the hypothesis has been supported by experiments in intact cells. A protein from electric tissue has now been obtained in solution; there is striking parallelism between the ability of this protein to bind acetylcholine analogs and the effects of such analogs on electrical manifestations of intact electroplax.
Hypertonic saline resuscitation attenuates pulmonary apoptosis in rats through a PI3K-Akt independent pathway

Abstract Introduction. Resuscitation with racemic lactated Ringer’s solution (LR) induces pulmonary apoptosis by increasing the levels of pro-apoptotic protein called bad protein. Paradoxically, phosphorylation of bad protein (p-bad) creates a prosurvival environment. The PI3K-Akt pathway is known to be responsible for phosphorylation of multiple proteins such as bad and eNOS. Hypertonic saline (HTS) resuscitation attenuates posthemorrhagic shock pulmonary apoptosis through an unknown mechanism. This study was designed to investigate whether the effects of HTS are meditated through the PI3k-Akt pathway. Methods. Sprague-Dawley rats ( n = 20, 5/g) were subjected to a modified volume controlled hemorrhagic shock and randomized as follows: (1) sham hemorrhage (SH), (2) hemorrhage and no resuscitation (NR), (3) resuscitation with racemic LR, three times the volume of shed blood (LR), (4) resuscitation with 7.5% HTS (HTS, 9.7 ml/kg). Lung tissue was obtained 2 h postresuscitation and Western blotting was used to measure the expression of total and phosphorylated Akt, bad, and eNOS proteins. Results. The expression of total bad protein (pro-apoptotic) increased and phosphorylated bad (prosurvival) decreased significantly following resuscitation with LR ( P Conclusions. Resuscitation with racemic lactated Ringer’s promotes pulmonary apoptosis by restricting PI3K-Akt pathway-dependent phosphorylation of bad protein. Hypertonic saline, on the other hand, attenuates pulmonary apoptosis through a PI3K-Akt-independent mechanism.
Induction of parturition in the mare with prostaglandin F2α

Abstract Thirty-one mares of Quarter Horse and Thoroughbred breeding were utilized in two experiments to evaluate the efficacy of prostaglandin F2α (PGF2α)_for induction of equine parturition and to monitor the effects of this treatment on viability of the resulting foals. Three of five mares given 5 mg PGF2α (im) on day 338 of gestation foaled 19.6 ± 8.2 hr postinjection. In the second experiment immediately following 3 daily injections of 10 mg estradiol cypionate (ECP) given on days 326, 327 and 328 of gestation, seven mares were infused (iv) with PGF2α at the rate of 1.3 mg/hr for 24 hr or until parturition occurred. Four of the seven mares foaled in 8.8 ± 1.8 hr after the start of infusion. Side effects including sweating, hypothermia, increased respiration rate and diarrhea were evident in both injected and infused mares, but effects were transient. Neither the injection, nor infusion route of administration of PGF1α adversely affected the viability of foals. However, some mares induced to foal 12 days prior to expected parturition had foals with slightly weaker pasterns than those of control mares.