cssi/SciSciGPT-SciSciNet huggingface dataset:
Oral Health and Care in the Intensive Care Unit: State of the Science

Oral health is influenced by oral microbial flora, which are concentrated in dental plaque. Dental plaque provides a microhabitat for organisms and an opportunity for adherence of the organisms to either the tooth surface or other microorganisms. In critically ill patients, potential pathogens can be cultured from the oral cavity. These microorganisms in the mouth can translocate and colonize the lung, resulting in ventilator-associated pneumonia. The importance of oral care in the intensive care unit has been noted in the literature, but little research is available on mechanical or pharmacological approaches to reducing oral microbial flora via oral care in critically ill adults. Most research in oral care has been directed toward patients' comfort; the microbiological and physiological effects of tooth brushing in the intensive care unit have not been reported. Although 2 studies indicated reductions in rates of ventilator-associated pneumonia in cardiac surgery patients who received chlorhexidine before intubation and postoperatively, the effects of chlorhexidine in reducing ventilator-associated pneumonia in other populations of critically ill patients or its effect when treatment with the agent initiated after intubation have not been reported. In addition, no evaluation of the effectiveness of pharmacological and mechanical interventions relative to each other or in combination has been published. Additional studies are needed to develop and test best practices for oral care in critically ill patients.
Enhancing Adolescent and Young Adult Oncology Research Within the National Clinical Trials Network: Rationale, Progress, and Emerging Strategies.

Adolescent and Young Adult Oncology (AYAO, including patients 15–39 years of age) is an emerging discipline in the field of cancer treatment and research. Poorer survival outcomes for this population and characteristic age-related challenges in care have called attention to the need for increased AYAO research. This chapter outlines pressing questions and reviews recent progress in AYAO research within the current organizational structure of the federal clinical trials enterprise, emphasizing how the United States National Cancer Institute’s National Clinical Trials Network (NCTN) has created novel opportunities for collaborative AYAO research among the pediatric and adult NCTN groups. Potential strategies for expanding AYAO research, both within the NCTN and with other partners in the federal and advocacy domains are identified.
Tissue oxygenation response to mild hypercapnia during cardiopulmonary bypass with constant pump output

Background Tissue oxygenation is the primary determinant of wound infection risk. Mild hypercapnia markedly improves cutaneous, subcutaneous (s.c.), and muscular tissue oxygenation in volunteers and patients. However, relative contributions of increased cardiac output and peripheral vasodilation to this response remains unknown. We thus tested the hypothesis that increased cardiac output is the dominant mechanism. Methods We recruited 10 ASA III patients, aged 40–65 yr, undergoing cardiopulmonary bypass for this crossover trial. After induction of anaesthesia, a Silastic tonometer was inserted s.c. in the upper arm. S.C. tissue oxygen tension was measured with both polarographic electrode and fluorescence-based systems. Oximeter probes were placed bilaterally on the forehead to monitor cerebral oxygenation. After initiation of cardiopulmonary bypass, in random order patients were exposed to two arterial CO2 partial pressures for 30 min each: 35 (normocapnia) or 50 mm Hg (hypercapnia). Bypass pump flow was kept constant throughout the measurement periods. Results Hypercapnia during bypass had essentially no effect on P a O 2 , mean arterial pressure, or tissue temperature. P a CO 2 and pH differed significantly. S.C. tissue oxygenation was virtually identical during the two P a CO 2 periods [139 (50–163) vs 145 (38–158), P=0.335] [median (range)]. In contrast, cerebral oxygen saturation (our positive control measurement) was significantly less during normocapnia [57 (28–67)%] than hypercapnia [64 (37–89)%, P=0.025]. Conclusions Mild hypercapnia, which normally markedly increases tissue oxygenation, did not do so during cardiopulmonary bypass with fixed pump output. This suggests that hypercapnia normally increases tissue oxygenation by increasing cardiac output rather than direct dilation of peripheral vessels.
Optimality of the Second Order Metrics of the M/M/2 System with Heterogeneous Service Rates

In a previous paper [4], we described an approach to improve the performance of the M/M/2 system by replacing its homogeneous servers with heterogeneous servers. Denoting by beta the ratio of the slow service rate to the fast service rate, we showed that there exists an optimal ratio at which the first order metrics reach their optimums. In the present work, we extend the study to the second order metrics. We first derive the distributions of the queuing time and system sojourn time, then prove the optimality of the second order metrics.
Ultrastructural evidence of cardiac damage resulting from thoracic irradiation and anthracyclines in the rat

Abstract The effects of radiation combined with Adriamycin (ADR) or Dibydroxyanthmquinone (DHAQ, NSC 279836) on the induction of cardiomyopathy in the rat were investigated using electron microscopy. Rats were treated with ADR or DHAQ at 2.5, 5.0, or 10 mg/kg ip; thoracic irradiation at 12, 15, 18, 21, or 24 Gy of 25 MV X rays; or a combination of either drug at 5.0 mg/kg plus 15 Gy X rays. Survival times were observed to be linear, inverse functions of the dose of drug or radiation received. Combinations of ADR plus radiation produced an increased lethality while the combination of DHAQ and radiation produced similar lethality as DHAQ alone. Even for treatments that resulted in animal lethality, there was little histological evidence of abnormality observed is heart tissues by light microscopy. On the other hand, electron microscopic examination of cardiac tissues demonstrated dramatic decreases in mitochondrial number and destruction of mitochondrial structure. The treatments could be arranged in order of increasing severity of the damage produced as follows: 5 mg/kg ADR, 15 Gy X ray, 5 mg/kg DHAQ, 5 mg/kg ADR + 15 Gy X ray, 24 Gy X ray, and 5 mg/kg DHAQ + 15 Gy X ray. In several cases, mitochondrial abnormalities were sufficient so as to allow ardiomyopathy to be cited as the cause of death. These results indicate that electron microscopy can be used to document cellular changes that may only be functionally expressed as long-term normal tissue damage or animal lethality. The fording that DHAQ can produce significant cardiotoxicity, and that this cardiotoxicity is enhanced by concomitant thoracic irradiation, suggest caution while this drug is being investigated for clinical use.
Operating Experience with a High Current Cs+1 Injector for Heavy Ion Fusion

The construction and assembly of a Cs ion injector consisting of a pulsed source and 3 pulsed drift tubes has been complete since April, 1980. The measurement program, underway since then to characterize the beam, has been interspersed with the development of diagnostic equipment. The Cs contact ionization source and each of the 3 drift tubes are driven by 500 kV Marx generators. The injector has been operated reliably at 300 kV/stage at a repetition rate of 1 pulse/4 sec. About 105 pulses have been accumulated. The space charge limited diode and drift tube acceleration system were designed with the aid of the EGUN code of Herrmannsfeldt. Measurements of the beam envelope have been made by means of a movable biased charge collector. Good agreement with the EGUN calculation is found. Measurements of the beam emittance have been made at the exit of the third drift tube. The normalized emittance ? ?N = 2 x 10-6 ? m-rad is of better optical quality than that required for further acceleration and transport in a Heavy Ion Fusion (HIF) Induction Linac Driver.
Cells to Surgery Quiz: November 2014

a. MSCs are activated by proinflammatory mediators. b. MSCs inhibit proinflammatory mediators. c. MSCs modulate all three phases of wound healing. d. MSCs have been safely applied to human cutaneous wounds. e. All of the above. Cells to Surgery Quiz: November 2014 Mohammad-Ali Yazdani Abyaneh1, Robert D. Griffith1, Leyre Falto-Aizpurua1 and Keyvan Nouri1 Journal of Investigative Dermatology (2014) 134, e7. doi:10.1038/jid.2014.395
High level transgene expression in plant cells : Effects of a strong scaffold attachment region from tobacco

We have previously shown that yeast scaffold attachment regions (SARs) flanking a chimeric beta-glucuronidase (GUS) reporter gene increased per-copy expression levels by 24-fold in tobacco suspension cell lines stably transformed by microprojectile bombardment. In this study, we examined the effect of a DNA fragment originally identified in a tobacco genomic clone by its activity in an in vitro binding assay. The tobacco SAR has much greater scaffold binding affinity than does the yeast SAR, and tobacco cell lines stably transformed with constructs containing the tobacco SAR accumulated greater than fivefold more GUS enzyme activity than did lines transformed with the yeast SAR construct. Relative to the control construct, flanking the GUS gene with plant SARs increased overall expression per transgene copy by almost 140-fold. In transient expression assays, the same construct increased expression only approximately threefold relative to a control without SARs, indicating that the full SAR effect requires integration into chromosomal DNA. GUS activity in individual stable transformants was not simply proportional to transgene copy number, and the SAR effect was maximal in cell lines with fewer than approximately 10 transgene copies per tobacco genome. Lines with significantly higher copy numbers showed greatly greatly reduced expression relative to the low-copy-number lines. Our results indicate that strong SARs flanking a transgene greatly increases expression without eliminating variation between transformants. We propose that SARs dramatically reduce the severity or likelihood of homology-dependent gene silencing in cells with small numbers of transgenes but do not prevent silencing of transgenes present in many copies.
Hidden Markov Models as a Support for Diagnosis: Formalization of the Problem and Synthesis of the Solution

In modern information infrastructures, diagnosis must be able to assess the status or the extent of the damage of individual components. Traditional one-shot diagnosis is not adequate, but streams of data on component behavior need to be collected and filtered over time as done by some existing heuristics. This paper proposes instead a general framework and a formalism to model such over-time diagnosis scenarios, and to find appropriate solutions. As such, it is very beneficial to system designers to support design choices. Taking advantage of the characteristics of the hidden Markov models formalism, widely used in pattern recognition, the paper proposes a formalization of the diagnosis process, addressing the complete chain constituted by monitored component, deviation detection and state diagnosis. Hidden Markov models are well suited to represent problems where the internal state of a certain entity is not known and can only be inferred from external observations of what this entity emits. Such over-time diagnosis is a first class representative of this category of problems. The accuracy of diagnosis carried out through the proposed formalization is then discussed, as well as how to concretely use it to perform state diagnosis and allow direct comparison of alternative solutions.
Understanding and modeling the internet topology: economics and evolution perspective

In this paper, we seek to understand the intrinsic reasons for the well-known phenomenon of heavy-tailed degree in the Internet AS graph and argue that in contrast to traditional models based on preferential attachment and centralized optimization, the Pareto degree of the Internet can be explained by the evolution of wealth associated with each ISP. The proposed topology model utilizes a simple multiplicative stochastic process that determines each ISP's wealth at different points in time and several "maintenance" rules that keep the degree of each node proportional to its wealth. Actual link formation is determined in a decentralized fashion based on random walks, where each ISP individually decides when and how to increase its degree. Simulations show that the proposed model, which we call Wealth-based Internet Topology (WIT), produces scale-free random graphs with tunable exponent α and high clustering coefficients (between 0.35 and 0.5) that stay invariant as the size of the graph increases. This evolution closely mimics that of the Internet observed since 1997.
Mapping translation ’hot-spots’ in live cells by tracking single molecules of mRNA and ribosomes

Messenger RNA localization is important for cell motility by local protein translation. However, while single mRNAs can be imaged and their movements tracked in single cells, it has not yet been possible to determine whether these mRNAs are actively translating. Therefore, we imaged single β-actin mRNAs tagged with MS2 stem loops colocalizing with labeled ribosomes to determine when polysomes formed. A dataset of tracking information consisting of thousands of trajectories per cell demonstrated that mRNAs co-moving with ribosomes have significantly different diffusion properties from non-translating mRNAs that were exposed to translation inhibitors. These data indicate that ribosome load changes mRNA movement and therefore highly translating mRNAs move slower. Importantly, β-actin mRNA near focal adhesions exhibited sub-diffusive corralled movement characteristic of increased translation. This method can identify where ribosomes become engaged for local protein production and how spatial regulation of mRNA-protein interactions mediates cell directionality.
Change in State Supreme Court Elections: Is Voting Becoming More Partisan?

Judicial elections, particularly elections to state supreme courts, have generated substantial commentary over the last decade. Observers have asserted that elections have become more hotly contested, nastier, more expensive, and more divisive. This paper focuses on the question of whether elections are increasingly partisan. Using a data set of all statewide partisan and nonpartisan elections since 1946 plus a subset of retention elections from that same period, patterns of partisanship in voting are examined. The results of the analysis show that in some circumstances voting patterns in state supreme court elections have become more partisan. Elections that are explicitly partisan have not changed. The change has occurred in a subset of the states employing nonpartisan elections. The states that have experienced this change are those where the state supreme court has been called upon to decide questions where the issues align with partisan divisions (death penalty, same-sex marriage, abortion, property rights, tort reform). Where strong partisan patterns have occurred in retention elections these patterns typically arise in the wake of a controversial decision dealing with one of the partisan-aligned issues. The paper concludes by observing that if courts deal with issues that activate partisan divisions, it is not surprising that voters, given the opportunity, will respond in a way that reflects those same partisan divisions. Importantly, the retention elections associated with the so-called “merit” system do not escape this pattern when the justices of the courts who must stand for retention decide divisive issues.
MOLECULAR MODELLING, 3D-QSAR, AND DRUG DOCKING STUDIES ON THE ROLE OF NATURAL ANTICOAGULANT COMPOUNDS IN ANTITHROMBOTIC THERAPY

Thromboembolic disorders are the leading cause of human mortality. Therefore, development of effective anticoagulant therapy is critical. Factor XIIIA (FXIIIA) protein is a crucial factor in the blood coagulation cascade, and hence it is a vital target for evolution of new antithrombotic agents. Structure-function studies of clotting factor active sites, clot formation, and thrombus structure have gained prominence in the efforts to develop novel anticoagulants. Factor XIIIA was homology modelled with the human transglutaminase-2 crystal structure as a base template for BLAST analysis. Docking and comparative binding site analysis revealed active site residue conservation and inhibitor-protein interactions. Nineteen small molecules possessing suspected anticoagulant properties were successfully docked into the FXIIIA active site following the best CoMFA and CoMSIA prediction values. Dabigatran etexilate was anticipated to be the best FXIIIA inhibitor among the nineteen anticoagulants with the highest binding affinity for the FXIIIA protein and the highest FlexX dock score of -29.8 KJ/mol. Structural properties of FXIIIA inhibitors with increased antithrombotic activity were predicted by this docking study.
Urban Resource Teachers and Their Needs

handicapping conditions provide a significant portion of services for the disabled. Besides offering direct instruction, they serve as diagnosticians, program planners, and consultant-liaison personnel to other teachers and parents (McLoughlin & Kass, 1978). The role of the resource teacher is particularly popular because it enables disabled students to receive support from these specialists on a part-time basis and prevents them from being isolated from their normally developing peers. Thus, this flexible, multidimensional role has been used to considerable benefit for students and teachers. For
Using a Weather-based Data Driven Approach For Landslide Prediction

Landslides are one of the most damaging geohazard phenomena in terms of historical death tolls and socio-economic losses. We are using a data driven approach to forecast landslides by combining multiple parameters including weather conditions, slope height, soil density, vegetation, and drainage area. The current paper specifically focuses on results from analysis of how weather-related patterns affect landslides. We use threshold-based, supervised, and unsupervised learning methods to describe long-term (from one month to several months) and short-term (hours to days) weather patterns that in combination are correlated with landslide occurrence. We use clustering techniques to partition the feature space according to landslide likelihood allowing us to create more granular forecasts specific to a given multi-dimensional weather pattern.
Autonomous measurement of ingestion and digestion processes in free-swimming sharks

SUMMARY Direct measurement of predator feeding events would represent a major advance in marine trophic ecology. To date, devices available for empirically quantifying feeding in free-swimming fishes have relied on measuring stomach temperature, pH or physical motility, each of which has major practical limitations. We hypothesized that the considerable physical changes that occur in the stomachs of carnivorous predators during the processes of ingestion and digestion should be quantifiable using bulk electrical impedance measured across paired electrodes. We used a prototype archival data logging tag to record changes in impedance inside the stomachs of captive free-swimming tiger and sandbar sharks over multiple, successive feeding events. Feeding and digestion events produced characteristic changes in electrical impedance of the stomach contents, identifiable as five successive phases: (1) pre-ingestion (empty stomach), (2) ingestion, (3) chemical ‘lag’, (4) mechanical ‘chyme’ and (5) stomach emptying. The duration of the chyme phase was positively related to meal size.
Morphological characteristics of Dentostomella translucida , a nematode (Oxyuroidea) found in Mongolian gerbils

Dentostomlla translucida Schulz & Krepkorgorskaja (1932) was found in the small intestine of the Mongolian gerbil, Meriones unguicilatus Milne-Edwards, housed at the small animal center at Brigham Young University, Provo, Utah. Pertinent taxonomical characteristics were studied to differentiate D. translucida from D. kuntzi (Myers 1961) D. grundmanni (Chitwood 1963), D. legerae (Quentin 1975), and D. karachiensis (Bilqees 1978). Dentostomella translucida is distinguished by a large, evenly proportioned body, the presence of five unequaled teeth per esophageal sector, and a spicule tip bifid in ventral view in males. This project included the analysis of the structure and histochemistry of the adult nematode cuticle layers and egg-shell layers through the use of light and electron microscopy. Embryonation of D. translucida eggs was attempted to recover various larval stages. Additional information on D. translucida includes the presence of six cuticle layers, one exogenous with three endogenous egg-shell layers, and an egg operculum similar to that of D. kuntzi .
How many hypersurfaces does it take to cut out a Segre class

Abstract We prove an identity of Segre classes for zero-schemes of compatible sections of two vector bundles. Applications include bounds on the number of equations needed to cut out a scheme with the same Segre class as a given subscheme of (for example) a projective variety, and a ‘Segre–Bertini’ theorem controlling the behavior of Segre classes of singularity subschemes of hypersurfaces under general hyperplane sections. These results interpolate between an observation of Samuel concerning multiplicities along components of a subscheme and facts concerning the integral closure of corresponding ideals. The Segre–Bertini theorem has applications to characteristic classes of singular varieties. The main results are motivated by the problem of computing Segre classes explicitly and applications of Segre classes to enumerative geometry.
Exploration on the Technical Orientation and Service Strategy of the Power Load Management System

The technical orientation of the power load management system should adapt to the change of the power supply-demand situation.According to the current power supply-demand situation,which is basically balance or a little bit surplus,power system reforming process and customers' new demand,this paper analyzes the power load management system of our country and the current state of its installation production,and presents the thinking about the technical orientation of power load management system and its service strategy.
Determination of antibiotics and preservatives in cosmetics by HPLC

Objective:To develop a HPLC method for determination of antibiotics and preservatives in cosmetics.Methods:By using the HPLC method,mobile phase was methanol-0.01 mol/L NaH2PO4(pH=4.35)and gradient elution was used to determine hydroquinone,phenol,antibiotics and preservatives in cosmetics.Results:They showed good linearity within the range of 1 μg/ml～200 μg/ml(r0.998),average recovery was 93.9%～109.0% and RSD3%.Conclusion:The HPLC method is simple,sensitive,and accurate and can be applied to determination of antibiotics and preservatives in cosmetic preparations.
The effects of low spinal injury on the latencies of cortical evoked responses from forelimb stimulation.

AbstrcatA previous report showed that following spinal cord transection well below the C7 level in cats, later components of the cortical somatic evoked potential (SEP) (40 msec or longer) produced in response to median or radial nerve stimulation were abnormal (Katz et al., 1977). Evidence presented here shows that early components of the radial nerve SEP are also altered following spinal cord transection. Latencies of both early and late components were increased as higher functional transections ofthe spinal cord were made. This monotonic increase in latency of the primary components supports the hypothesis that the results may be due to increasing loss of excitatory input. Correlation of latency change with level of injury may serve as a useful diagnostic tool.
Influence of Dietary Methionine on Selenomethionine Metabolism in Rats

The sulfur analogs of selenium (Se) compounds have the greatest influence on Se metabolism. For example, methionine (MET) has a greater influence upon selenomethionine (SEM) than upon selenocysteine metabolism (1,2). Sulfur supplementation of Se-deficient animals can lessen the effects of Se deficiency (3), possibly by diverting Se compounds to glutathione peroxidase (GPX) precursors. MET supplementation has been shown to increase erythrocyte (RBC) GPX activity in humans (4) and plasma, liver and heart GPX activity in rats (5). The magnitude of difference in tissue Se deposition between selenite and SEM is dependent upon the level of these Se forms fed (6). The purpose of this study was to investigate the influence of different levels of MET on SEM metabolism as measured by Se deposition in tissues, GPX activity, Se excretion and percentage of Se associated with GPX tissues.
Conflict Initiating Factors and Management Styles in Family and Nonfamily Intergenerational Relationships: Young Adults’ Retrospective Written Accounts:

Using a content analytic approach, this study examined young adults’ retrospective written accounts about their perceived communication with family and nonfamily elders in conflict situations to uncover conflict initiating factors and management styles. Results revealed that old-to-young criticism (especially in nonfamily contexts) and competition were the most frequently reported conflict initiating factor and management style in intergenerational relationships. Also, results indicated that family elders’ use of the competing and avoiding styles were reciprocated by young adults.
Combinatorial Testing of Software with Binary Inputs: A State-of-the-Art Review

Combinatorial methods are useful and effective approaches for software testing. In this paper, we provide a brief review of the research results in one area of combinatorial methods applications: software with binary or Boolean inputs. This includes the testing of logical expressions that is crucial for many safety-critical applications such as avionics software and computer systems at nuclear power plants. We consider three different aspects of this research direction: (1) effectiveness of combinatorial testing with binary inputs, (2) combinatorial test generation, and (3) comparison combinatorial testing with other approaches for testing logical expressions.
Sources and Number of Coupons for Cigarettes and Snus Received by a Cohort of Young Adults.

Purpose:To examine the sources of tobacco coupons and their influence on susceptibility to snus use.Design:Cohort study.Setting:Minnesota Adolescent Community Cohort Study.Subjects:A population-bas...
A family-centered intervention for the transition to living with multiple myeloma as a chronic illness: A pilot study

Patients with multiple myeloma and their family caregivers must master self-management tasks related not only to the disease and treatment, but also associated with transitioning to living with chronic illness. The aim of this study was to assess the feasibility, acceptability, safety, and fidelity of an intervention that had a psychoeducational approach and included a low-impact, home-based walking activity. A secondary aim was to obtain preliminary data of the effect of the intervention, as compared to an attention control group, on anxiety, activation for self-management, fatigue, depression and health-related quality of life (HRQOL). A sample of 15 adult patients with multiple myeloma and their family caregivers were randomized into either an intervention or attention-control group. The intervention was delivered to the dyad in one session and booster calls were made at 1 and 3 weeks. The control group received printed educational resources and telephone contacts. Measures were done at baseline, and 6 and 12 weeks. Descriptive statistics were used. The intervention was safe, feasible, and acceptable to patients and caregivers. Fidelity was high for the initial session, but low with booster calls. Improvement in scores for activation, fatigue, depression, anxiety, physical HRQOL, and emotional distress was seen in at least 40% of patients in the intervention group. Fewer caregivers in the intervention group showed improvement on the outcome variables. Leveraging a behavioral strategy such as walking, along with supportive and educational resources, is promising for promoting well-being within the patient/caregiver dyad. Further refinement of the intervention is needed to strengthen its efficacy for the caregiver and exploratory work is essential to understand the interpersonal supportive processes associated with the walking activity.
Approaching Computer Science Education Through Making

All too often, discussions of computer science education are constrained by notions unequal to the task of advancing education—notions such as “skill acquisition” or “national competitiveness”. We are told by many scholars, businesspeople, and policy-makers that computer science is necessary for students because “the workplace demands 21st-century skills”, or “many jobs will be opening up in technical areas”. These sentiments are simply too trite to motivate clear thinking about computer science education—and for that matter, they are too trite to motivate the students themselves. A more fertile foundation for discussion is to think of education as a process through which students create an intellectual autobiography—a narrative that supplies them with such things as lifelong projects and abiding interests. In approaching computer science education from this angle, it is especially helpful to begin with the many strengths and occasional weaknesses of the resurgent “maker movement” in American youth culture. By thinking of computer science as a discipline of construction and expressive creation, we can achieve a fresh perspective on increasingly stale issues such as “computational thinking”, “assessment of skills”, and “core curricula”.
Adverse pregnancy, birth, and infant outcomes in twins: effects of maternal fertility status and infant gender combinations; the Massachusetts Outcomes Study of Assisted Reproductive Technology.

Background It is unknown whether the risk of adverse outcomes in twin pregnancies among subfertile women, conceived with and without in vitro fertilization, differs from those conceived spontaneously. Objective We sought to evaluate the effects of fertility status on adverse perinatal outcomes in twin pregnancies on a population basis. Study Design All twin live births of ≥22 weeks' gestation and ≥350 g birthweight to Massachusetts resident women in 2004 through 2010 were linked to hospital discharge records, vital records, and in vitro fertilization cycles. Women were categorized by their fertility status as in vitro fertilization, subfertile, or fertile, and by twin pair genders (all, like, unlike). Women whose births linked to in vitro fertilization cycles were classified as in vitro fertilization; those with indicators of subfertility but without in vitro fertilization treatment were classified as subfertile; all others were classified as fertile. Risks of 6 adverse pregnancy outcomes (gestational diabetes, pregnancy hypertension, uterine bleeding, placental complications [placenta abruptio, placenta previa, and vasa previa], prenatal hospitalizations, and primary cesarean) and 9 adverse infant outcomes (very low birthweight, low birthweight, small-for-gestation birthweight, large-for-gestation birthweight, very preterm [ Results The study population included 10,352 women with twin pregnancies (6090 fertile, 724 subfertile, and 3538 in vitro fertilization). Among all twins, the risks for all 6 adverse pregnancy outcomes were significantly increased for the subfertile and in vitro fertilization groups, with highest risks for uterine bleeding (adjusted relative risk ratios, 1.92 and 2.58, respectively) and placental complications (adjusted relative risk ratios, 2.07 and 1.83, respectively). Among all twins, the risks for those born to subfertile women were significantly increased for very preterm birth and neonatal and infant death (adjusted relative risk ratios, 1.36, 1.89, and 1.87, respectively). Risks were significantly increased among in vitro fertilization twins for very preterm birth, preterm birth, and birth defects (adjusted relative risk ratios, 1.28, 1.07, and 1.26, respectively). Conclusion Risks of all maternal and most infant adverse outcomes were increased for subfertile and in vitro fertilization twins. Among all twins, the highest risks were for uterine bleeding and placental complications for the subfertile and in vitro fertilization groups, and neonatal and infant death in the subfertile group. These findings provide further evidence supporting single embryo transfer and more cautious use of ovulation induction.
Primary Esophageal Motility Disorders: Beyond Achalasia

The best-defined primary esophageal motor disorder is achalasia. However, symptoms such as dysphagia, regurgitation and chest pain can be caused by other esophageal motility disorders. The Chicago classification introduced new manometric parameters and better defined esophageal motility disorders. Motility disorders beyond achalasia with the current classification are: esophagogastric junction outflow obstruction, major disorders of peristalsis (distal esophageal spasm, hypercontractile esophagus, absent contractility) and minor disorders of peristalsis (ineffective esophageal motility, fragmented peristalsis). The aim of this study was to review the current diagnosis and management of esophageal motility disorders other than achalasia.
The Effects of Gender, Dysphoria, and Performance Feedback on the Accuracy of Self-Evaluations

Two experiments tested hypotheses derived from previous research by Beyer (1990, 1998, 1999a; Beyer & Bowden, 1997) and research on depressive realism. It was predicted that gender differences in the accuracy of self-evaluations of performance will be found on a mathematics test (masculine task), but not on an English test (feminine task) or on history and geography tests (neutral tasks). Furthermore, it was hypothesized that dysphorics are not more accurate self-evaluators than are nondysphorics and that the effect of gender on the accuracy of self-evaluations is moderated by dysphoria. Finally, it was predicted that the provision of performance feedback does not moderate the effect of gender on the accuracy of self-evaluations. These hypotheses were supported. The implications of these findings are discussed.
E-034 Beyond large vessel occlusion strokes: distal occlusion thrombectomy

Introduction Endovascular therapy is the standard of care for the treatment of proximal large vessel occlusion strokes (LVOS). Its safety and efficacy in the treatment of distal intracranial occlusions has not been well studied. Methods We retrospectively reviewed a prospectively collected endovascular database (September 2010-December 2015, n=898) for all patients with distal intracranial occlusions treated with endovascular therapy. Distal occlusions were defined as any occlusion of the anterior cerebral artery (ACA), any occlusion of the posterior cerebral artery (PCA), or any occlusion at or distal to the middle cerebral artery (MCA)-M3 opercular segment. Results Distal occlusions were treated in 70 patients. The mean age was 66+/-14% and 57% of the patients were male. Thirty-one (44%) of the patients received IV-tPA. The median pre-procedure NIHSS was 19 (IQR, 13–23). The distal occlusion was the primary treatment location in 54 patients and in 16 patients the distal occlusion was treated as a rescue strategy after successful treatment of a proximal LVOS. The locations of the primary cases were MCA-M3 (n=21), ACA with a concomitant MCA-M1 or MCA-M2 (n=16), ACA alone (n=9), PCA (n=6), and ACA with a concomitant MCA-M3 (n=2). The locations of the rescue cases were MCA-M3 (n=8), ACA (n=7), and both MCA-M3 and ACA (n=1). The most common treatment modalities employed were intra-arterial tPA (n=37, 52%), small (3 mm) stent-retrievers (n=24, 33%), and thromboaspiration (n=30, 42%). Near or complete reperfusion (mTICI 2b-3) was achieved in 56 cases (80%). Overall, there were 5 (7%) cases of any parenchymal hematoma (PH). However, two of the PHs were in patients with both a MCA-M1 and an ACA occlusion, and both of these hemorrhages were in the MCA territory. Thus only 3 PHs (4.3%) occurred in the territory of the treated distal occlusion with two of these patients also receiving IV tPA. At 90 days, 24 patients (40%) had a mRS of 0–2 and 13 (21%) had died. Conclusions Distal intracranial occlusions can be treated safely and successfully with endovascular therapy. Although promising our results need to be corroborated by larger prospective controlled studies. Disclosures J. Grossberg: None. L. Rebello: None. M. Bouslama: None. D. Haussen: None. M. Frankel: None. R. Nogueira: None.
Patients' Perceptions of the Benefits of Pharmaceutical Care

Abstract Objective To investigate patients' perceptions of the benefits of regular participation in pharmaceutical care services. Design Written survey of a convenience sample. Setting Pharmacist-run anticoagulation clinic in a Veterans Administration Medical Center. Patients 154 patients who had regularly scheduled appointments in the clinic. Interventions Patients were asked to complete a written survey. The survey was read to those who had trouble reading it. Main Outcome Measures Patients' perceptions about the benefit of services provided in the clinic and the relationship between those services and reduced risks of medication-related problems. Results All components of anticoagulant-related pharmaceutical care were rated as at least fairly beneficial. Monitoring of warfarin blood levels and information on the appropriate use of warfarin were rated highest. The perceived benefits of the pharmaceutical care components were associated with patients' perceptions of the extent to which pharmaceutical care reduced their risk of experiencing blood clots or warfarin-related problems. Patients also perceived that their risk of developing blood clots or bleeding problems would be higher if they did not regularly visit the anticoagulation clinic. Conclusion Patients' perceptions of the benefits of pharmaceutical care were associated with the perceived threat reduction capacity of the pharmacist's services. Pharmaceutical care providers may be able to enhance patient participation in their services by educating patients on the risks of medication-related problems and how frequent monitoring of key clinical indicators may help reduce those risks.
The Influence of Palliative Care Consultation on Health-Care Resource Utilization During the Last 2 Months of Life: Report From an Integrated Palliative Care Program and Review of the Literature:

Background:We reviewed 104 consecutive deaths of veterans receiving care in the Dayton VA Medical Center from October 10, 2015 to April 11, 2016. The purpose of our study was to test our hypothesis that palliative care consultation would be associated with reduced health care resource utilization for individuals approaching end of life.Methods:Medical records were reviewed and data entry recorded on a spreadsheet. Non-parametric statistical methods were used to compare four outcome variables from veterans with palliative care consultation (PCC) vs. those without PCC. These variables included the number of ED visits, hospitalizations, hospital days, and ICU days all during the last two months of life. Predictor variables included PCC vs. no PCC and PCC before vs. PCC during the last two months of life. The study sample was comprised of 102 patients after excluding two outlier cases with ethical challenges in surrogate decision-making.Results:Of the 102 consecutive veteran deaths, palliative care consultati...
An Examination of Changes in Social Disparities in Health Behaviors in the US, 2003-2015.

Objectives Due to growing health disparities, federal and philanthropic agencies have empha-sized reducing health disparities in their preventive health efforts. This study determined the status of disparities in health behaviors in the last 13 years in the United States. Methods Data were obtained from the Behavioral Risk Factor Surveillance Systems in odd years (2003-2015). Health behaviors were dichotomized to reflect met fruit and vegetable (FV) consumption and physical activity (PA) recommendations, non-cigarette smoking, non-heavy drinking, and non-binge drinking. Overall and sociodemographic characteristic-specific disparities ratios for each behavior were calculated. Linear trend analyses were calculated to determine disparities change across the years. Results Overall disparities fluctuated across the years. Linear trend analyses confirmed that education-specific and income-specific disparities' contribution to overall disparities increased for all behaviors. Sex-specific disparities' contribution decreased for all behaviors except non-cigarette smoking. Age-specific disparities' contribution decreased for all behaviors except non-binge drinking. Race/ethnicity-specific disparities' contribution to overall disparities increased for FV and non-cigarette smoking, but decreased for the other behaviors. Conclusions The results suggest health disparities in preventive health behaviors in the last 13 years have not improved. Tailored interventions, systemic and policy changes, and/or inclusive population efforts should be initiated to reduce disparities in preventive health for the most- divergent groups identified in the results.
Marital Interaction and Posthospital Adjustment

A study is aimed at determining what kinds of frustrations constitute the greatest threat to the adaptation of wives who are former patients
A Case-study Approach to Managerial Decision Making

Today's community recreation programs exist in dynamic and uncertain environments that are often characterized by complex stakeholder relationships and rapid change. Economic conditions, socio-poli...
Cost Inflation in Intercollegiate Athletics: And Some Modest Proposals for Controlling It

It is no secret that college sports are big business. In 2006, the latest year for which budget information is available, the biggest of America’s big-time intercollegiate athletic programs reported total revenues of $241,365,000 (National Collegiate Athletic Association 2008: 18). Set against total expenses amounting to $101,805,000 the same fiscal year, participating in NCAA-sanctioned regular season and postseason play netted the school an eye-popping $139,560,000. Even more remarkably, nearly all of the revenue credited to 2006’s top college sports program actually was generated directly by athletics-related activities, such as ticket sales, stadium concessions, alumni contributions, guarantees, conference distributions, and licensing agreements; “allocated revenue”, including direct and indirect institutional support, student fees, and other transfers from external sources accounted for only $4,530,000 or slightly less than 1.9% of the total (National Collegiate Athletic Association 2008: 21).
Modeling of Combustion Phenomena

Scale modeling of combustion phenomena is considered in different contexts, ranging from power production by fossil fuels to damage by hostile fires. Since descriptions of combustion require a relatively large number of nondimensional groups, combustion modeling is comparatively challenging. Rather than viewing this difficulty as a source of despair, the complexity can be considered to provide a wider range of options for extracting worthwhile information from careful observations performed in experiments designed on the basis of alternative approaches to scale modeling. Combustion offers more possibilities for utilization of inaccurate “partial modeling” for enhancing understanding. Specific examples addressed include cold-flow modeling, Froude-number scaling, pressure modeling and microgravity droplet combustion. Through these examples it is concluded that a rich variety of advances can be made by modeling of combustion phenomena.
Accounting for Variability in Large-Scale Cluster Power Models

Presented in March, 2011 at the Exascale Evaluation and Research Techniques Workshop (EXERT), held at the International Conference on Architectural Support for Programming Languages and Operating Systems (ASPLOS).
Comparison of fractionated and single session radiosurgery for radiation resistant brain metastases.

2091 Background: Melanoma and renal cell carcinoma are commonly called radiation resistant tumors due to the decreased response rate to traditional radiation (1.8-2 Gy /Fraction). Large brain metas...
Practical approaches to maximizing the resolution of sparker seismic reflection data

Sparkers are a type of sound source widely used by the marine seismic community to provide high-resolution imagery of the shallow sub-bottom (i.e., < 1000 m). Although sparkers are relatively simple, inexpensive, and high-frequency (100–2500 Hz) sources, they have several potential pitfalls due to their complicated and unpredictable signature. In this study we quantify the source characteristics of several sparker systems and develop a suite of simple processing approaches for both single channel and multi-channel sparker data. In all cases, the results show improved vertical resolution and reflection coherency. Correcting for small static variations in multi-channel seismic (MCS) data is a critical first step to preserve the broad frequency content during stacking, and to reduce the shot-to-shot variability of outgoing and incoming signals. Application of predictive deconvolution to static-corrected, post-stack traces suppresses short-path multiples and restores the latent high-resolution reflection patterns. However, if shot-to-shot source signatures are recorded directly, pre-stack deterministic deconvolution followed by post-stack predictive deconvolution produces the most robust results. Processing sparker data without broadband techniques results in less confident or completely missed interpretations when compared to the broadband equivalent. If processed correctly, marine sparker data can provide exceptional sub-bottom imagery that rivals other more repeatable marine seismic sources (e.g., high-frequency air-guns).
The maximum luminosity of fast radio bursts

Under the assumption that fast radio bursts (FRBs) are from coherent curvature emission powered by the dissipation of magnetic energy in the magnetosphere of neutron stars, we predict a maximum isotropic equivalent luminosity of (~2x10^{47} erg/s) min({\rho}^2, B{\rho}^{4/3}{\nu}^{-2/3}), where {\rho} is the curvature radius of the magnetic field lines near the source region in units of 10 km, B is the local magnetic field strength in units of 10^{16} G, and {\nu} is the FRB wave frequency in units of GHz. This is because the electric field responsible for accelerating the radiating particles becomes close to the quantum critical field strength and is then quickly shielded by Schwinger pairs within a nano-second. Future observations should be able to confirm this cut-off luminosity and hence provide a unique probe of the source location and magnetic field strength. We discuss how the maximum luminosity affects the observed flux distributions for repeating bursts from the same object and for the entire FRB population.
Impedance and Noise Characterizations of Utah and Microwire Electrode Arrays

This paper presents an in-depth noise and impedance characterization of two of the most widely used microelectrode arrays (the Utah Electrode Array (UEA) and the Tucker-Davis Technologies (TDT) Microwire Array) and provides quantitative analysis of how properties change when implanted in rodent cortex. Custom low-noise circuits and de-embedding methods were designed to acquire ${\rm{nV}}/\sqrt {{\rm{Hz}}} $ noise power spectral densities from high-impedance electrodes. A total of 80 electrodes were implanted across five rats and measured under deep anesthesia, demonstrating a 1.5× to 3× increase in noise and 2.25× to 9× in impedance compared to in vitro measurements. Low-frequency biological noise was also observed and studied through postmortem measurements. These results are informative for designing neural interfacing systems for both neuroscience and medical applications.