cssi/SciSciGPT-SciSciNet huggingface dataset:
Use of Rheolytic Thrombectomy in Treatment of Acute Massive Pulmonary Embolism

PURPOSE The 6-F Xpeedior (AngioJet; Possis Medical, Minneapolis, MN) rheolytic thrombectomy catheter (RTC) uses high velocity saline jets for thrombus aspiration, maceration, and evacuation, through the Bernoulli principle. The purpose of this study was to evaluate the efficacy of thrombus removal using the RTC in patients with acute massive pulmonary embolism (PE). MATERIALS AND METHODS Seventeen patients (mean age, 51.7 + 16.6 years; range, 30–86 years; 9 men, 8 women) with massive PE initially diagnosed by computed tomography (CT) or VQ scan and confirmed by pulmonary angiography were treated with the RTC. All patients had acute onset of PE symptoms and all presented with hemodynamic compromise and dyspnea. Ten of 17 patients had enough residual thrombus to warrant adjuvant catheter directed thrombolytic infusion with reteplase. Six patients had contraindications to thrombolytic therapy. One patient presented with renal cell carcinoma and tumor embolus as suspected cause of PE. Angiographic and clinical outcomes during the hospital stay were evaluated. RESULTS The RTC was successfully delivered and operated via a 0.035-inch guide wire in all attempted cases. Treatment resulted in immediate angiographic improvement and initial relief of PE symptoms (improvement in dyspnea and oxygen saturation) in 16 of 17 patients. One patient developed heart block during the procedure, and further treatment with the RTC was discontinued. Bradycardia occurred in one patient (managed with lidocaine). After thrombectomy, 10 patients received adjunctive reteplase thrombolysis for treatment of residual thrombus, and 12 received inferior vena cava (IVC) filters. In the patient with renal cell carcinoma, histopathologic analysis of the evacuated material confirmed tumor origin of the embolism. There were two deaths, both within 24 hours of treatment and secondary to PE. One death occurred in a patient who had only minimal thrombus removal after treatment with the RTC and no thrombolysis. The remaining 15 patients showed continued improvement in PE symptoms and were eventually discharged from the hospital with mean length of stay 10.3 + 6.5 days (range, 5–30 days). CONCLUSIONS Rheolytic thrombectomy can be performed effectively in patients with massive PE. However, a large portion of the patients in this study underwent adjuvant overnight thrombolytic infusion. Further evaluation in a larger cohort of patients is warranted to assess whether this treatment may offer an alternative or complement to thrombolysis or surgical thrombectomy.
Positive Conditioned Reinforcement via Free-Operant Avoidance: An Extinction Test

5 rats were trained on a free-operant avoidance schedule R-S = 20 min., S-S = 5 min., 3 with a response-produced stimulus and 2 without. As tested by avoidance extinction (shock removal) the response-produced stimulus had no conditioned reinforcing properties in those Ss trained without this response-produced stimulus. Ss trained with the response-produced stimulus did not show negatively accelerated response rates in the first extinction period when this stimulus was delivered. This conditioned reinforcing effect was of short durability.
Testing concepts and applications for the Strategic Defense Initiative (SDI)

The potential application of automatic test concepts to elements of the Strategic Defense Initiative (SDI) program, which include ground surveillance tracking satellites, exoatmospheric re-entry interceptor subsystems, and the SDI battle management system which will be used for command, control, and communications, and to simulate and validate the SDI battle concept, is explored. The discussion centers on the technology and possible systems that may benefit from current or future automatic test equipment (ATE) technology, and potential test requirements these systems may carry. Current and projected SDI funding levels, current schedules, and targeted deployment data are also discussed and tied in to the approach, which revolves around the concept of applying automatic testing to the Strategic Defense Initiative. >
A method for estimating the proportion of nonresponsive traffic at a router

In this paper, a scheme for estimating the proportion of the incoming traffic that is not responsive to congestion at a router is presented. The idea of the proposed scheme is that if the observed queue length and packet drop probability do not match the predictions from a model of responsive (TCP) traffic, then the error must come from nonresponsive traffic; it can then be used for estimating the proportion of nonresponsive traffic. The proposed scheme is based on the queue length history, packet drop history, and expected TCP and queue dynamics. The effectiveness of the proposed scheme over a wide range of traffic scenarios is corroborated using ns-2-based simulations. Potential applications of the proposed algorithms in traffic engineering and control are discussed.
Kinesin-1 tail autoregulation and microtubule-binding regions function in saltatory transport but not ooplasmic streaming.

The N-terminal head domain of kinesin heavy chain (Khc) is well known for generating force for transport along microtubules in cytoplasmic organization processes during metazoan development, but the functions of the C-terminal tail are not clear. To address this, we studied the effects of tail mutations on mitochondria transport, determinant mRNA localization and cytoplasmic streaming in Drosophila. Our results show that two biochemically defined elements of the tail – the ATP-independent microtubule-binding sequence and the IAK autoinhibitory motif – are essential for development and viability. Both elements have positive functions in the axonal transport of mitochondria and determinant mRNA localization in oocytes, processes that are accomplished by biased saltatory movement of individual cargoes. Surprisingly, there were no indications that the IAK autoinhibitory motif acts as a general downregulator of Kinesin-1 in those processes. Time-lapse imaging indicated that neither tail region is needed for fast cytoplasmic streaming in oocytes, which is a non-saltatory bulk transport process driven solely by Kinesin-1. Thus, the Khc tail is not constitutively required for Kinesin-1 activation, force transduction or linkage to cargo. It might instead be crucial for more subtle elements of motor control and coordination in the stop-and-go movements of biased saltatory transport.
Enantioselective Synthesis of (+)-Majusculone

The first enantioselective synthesis of a chamigrane sesquiterpene, (+)-majusculone, has been completed. The quaternary center was generated asymmetrically by alkylidene carbene insertion, with retention of absolute configuration, from a diastereomerically pure ketal.
Excitations of/on Fractal Networks

Fractal symmetry (dilation invariance), as opposed to Euclidean symmetry (translation invariance), requires three dimensionalities to contain a physical description of the excitations of a fractal network: d, the Euclidean (or embedding) dimension; D, the Hausdorff (or fractal) dimension; and , the fracton (or spectral) dimension. The dynamical properties of percolarting networks are examined in this context. The vibrational density of states and the vigrational excitation dispersion law are calculated. The former is shown to be proportional to ωd−1 in the phonon or long length scale reggime. A crossover is found at frequency ωc, proportional to (p−pc) v[1+(θ/2)], where p is the bond occupancy probability and pc the critical percolation bond occupancy. Here, v is the correlation fength exponent, and θ is the exponent appropriate to the range dependence of the diffusion constant [D(r) ∝ r−θ]. At ωc, a scaling argument shows that a reasonably rapid rise occurs in the vibrational density of states, to which we shall refer as a “fracton edge.” For frequencies higher than ωc, the vibrational density of states continues to rise, but at a slower rate, proportional to . The excitations in this regime are termed “fractons.” It is shown that the electrical conductance on a fractal network also depends on D and . Use is made of Anderson localization scaling theory to show that, for < 2, the fracton eigenstates are localized. Very recent inelastic neutron diffraction measurements of the vibrational excitations of fused silica are shown to exhibit a density of states which agrees in form remarkably closely with a recent scaling model of phonon to fracton crossover.
Mismatched or Maligned?: A Race Crit's Qualitative Analysis of African American Males in Law School

As a prosecutor for approximately a dozen years, I tried to implement the judicial ideology of blind justice. My interdisciplinary approach connecting law with education and cultural studies has led me to believe that another kind of "blindness" – colorblind – is both unhelpful and unconscionable. Researchers, such as Professor Richard Sander and Thomas Sowell, have argued that there is often a “mismatch” between African American students and their institutions of higher education, resulting in lower levels of success for such students. Another implication of the mismatch theory is that affirmative action policies, that may have helped these students gain admission to top-tier universities, are failing because the students are not “succeeding” at these institutions or after graduation.My study’s purpose is to investigate, compare, and contrast the experiences of African American former law school students attending less-selective and more-selective law schools. An integral part will be a consideration of their “costs” and “benefits” suggested by the mismatch theorist. This will be a qualitative study, focusing on case studies of approximately 10 African American law school graduates but also including approximately 6 members of faculty and administration. I will conduct in-depth, structured interviews with study participants to gain an understanding of their law school and post-graduation experiences. Thereafter, the interviews will be coded, sorted, and triangulated for validity. Other sources of information will include interviews with faculty, the students’ undergraduate and law school grade point averages, law school aptitude test scores, rankings within their schools, job opportunities, experiences taking the bar examination, and career satisfaction.My primary aim is to provide a rich, contextualized, and nuanced picture of each participant’s law school and post-graduation experiences, so that we may better understand the applicability and accuracy of the mismatch hypothesis.
Calibration of Car-Following Models Considering the Impacts of Warning Messages from Tablet/Smartphone Application

The phenomenon of car-following is special in traffic operations. Traditional car-following models can well describe the reactions of the movements between two concessive vehicles in the same lane within a certain distance. With the invention of connected vehicle technologies, more and more advisory messages are in development and applied in our daily lives, some of which are related to the measures and warnings of speed and headway distance between the two concessive vehicles. Such warnings may change the conventional car-following mechanisms. This paper intends to consider the possible impacts of in-vehicle warning messages to improve the traditional car-following models, including the General Motor (GM) Model and the Linear (Helly) Model, by calibrating model parameters using field data from an arterial road in Houston, Texas, U.S.A. The safety messages were provided by a tablet/smartphone application. One exponent was applied to the GM model, while another one applied to the Linear (Helly) model, both were on the stimuli term “difference in velocity between two concessive vehicles”. The calibration and validation were separately conducted for deceleration and acceleration conditions. Results showed that, the parameters of the traditional GM model failed to be properly calibrated with the interference of in-vehicle safety messages, and the parameters calibrated from the traditional Linear (Helly) Model with no in-vehicle messages could not be directly used in the case with such messages. However, both updated models can be well calibrated even if those messages were provided. The entire research process, as well as the calibrated models and parameters could be a reference in the on-going connected vehicle program and micro/macroscopic traffic simulations.
The Role of Location and Cost in Individual Choices of Transportation Improvement Projects

Transportation improvement programming is a process in which substantial resources are allocated to transportation infrastructure projects based on public input. This article reports on individual choice making in the context of a Web-based platform for public participation in transportation improvement programming. Based on the locations of the proposed transportation projects, we determined the extent to which the location and the cost of transportation projects informed individual choices regarding selections of road and transit projects. The presented analysis aims at uncovering factors that inform the choices of individuals in the context of transportation improvement programming along the dimensions of self-centered and selfless decision making. Such insight garners understanding of the requirements of and expectation toward Web-based public participation systems and participatory processes. Our results indicate a prevalence of preferences for projects within the vicinity of the individual’s home, w...
A Waveform for 5G: Guard Interval DFT-s-OFDM

Delay spread can be detrimental to communication systems. Orthogonal Frequency Division Multiplexing (OFDM)/Discrete Fourier Transform-spread-OFDM (DFT-s- OFDM) based systems (for e.g., Long Term Evolution (LTE), WiFi, etc.) tackle delay spread by adding a cyclic prefix (CP) before the start of the OFDM symbol. The duration of the CP is pre-determined and is set according to channel delay spread characteristics or to fit a certain frame duration. Moreover, the CP does not carry any useful data and represents an overhead that needs to be minimized. In this paper, we propose the use of DFT-s-OFDM with flexible, configurable guard interval (GI) of variable size. We call the resulting waveform GI-DFT-s-OFDM. The length of the GI can be adjusted to accommodate the maximum delay spread in a given scenario or for a particular user (UE). Additionally, the GI may carry a sequence that can be used for time/frequency synchronization. We also discuss system design based on GI-DFT-s-OFDM, giving possible options for the GI sequence. The proposed waveform has good Peak-to- Average Power Ratio (PAPR) with out-of-band emissions similar to OFDM/DFT-s-OFDM.
Endophyte-host associations in forage grasses. XI: A proposal concerning origin and evolution

Epichloe typhina and fungi thought to be closely related to it are widespread as endophytes in the Poaceae. Based on biological features of the fungus-host relationship, associations may be classified as one of three types. In type 1 associations, stromata form on most of the plants harboring endophytes. This type of association has been found in several subfamilies of grasses and sedges. In type 2 associations, stromata are formed on very few of the numerous infected individuals, while in type 3 associations stromata have not been observed on infected plants. The latter two associations are known to occur only in the subfamily Festucoideae. It is evident that coevolution has occurred between Epichloe spp. and festucoid grasses resulting in the evolution of mutualisms from primarily pathogenic relationships. It is suggested that this has occurred by selection of grass individuals which possessed the ability to suppress stromata formation by the endophytes. The mechanism for suppression of stromata may involve production of alkaloids which inhibit growth of these fungi.
Looking ahead? Computerized maze task performance by chimpanzees (Pan troglodytes), rhesus monkeys (Macaca mulatta), capuchin monkeys (Cebus apella), and human children (Homo sapiens).

Human and nonhuman primates are not mentally constrained to the present. They can remember the past and – at least to an extent – anticipate the future. Anticipation of the future ranges from long-term prospection such as planning for retirement to more short-term future oriented cognition such as planning a route through a maze. Here we tested a great ape species (chimpanzees), an Old World monkey species (rhesus macaques) a New World monkey species (capuchin monkeys) and human children on a computerized maze task. All subjects had to move a cursor through a maze to reach a goal at the bottom of the screen. For best performance on the task, subjects had to “plan ahead” to the end of the maze to move the cursor in the correct direction, avoid traps, and reverse directions if necessary. Mazes varied in difficulty. Chimpanzees were better than both monkey species, and monkeys showed a particular deficit when moving away from the goal or changing directions was required. Children showed a similar pattern to monkeys regarding the effects of reversals and moves away from the goal, but their overall performance in terms of correct maze completion was similar to the chimpanzees. The results highlight similarities as well as differences in planning across species and the role that inhibitory control may play in future oriented cognition in primates.
Estimating fresh biomass of maize plants from their RGB images in greenhouse phenotyping

High throughput phenotyping (HTP) is an emerging frontier field across many basic and applied plant science disciplines. RGB imaging is most widely used in HTP to extract image-based phenotypes such as pixel volume or projected area. These image-based phenotypes are further used to derive plant physical parameters including plant fresh biomass, plant dry biomass, water use efficiency etc. In this paper, we investigated the robustness of regression models to predict fresh biomass of maize plants from image-based phenotypes. Data used in this study were from three different experiments. Data were grouped into five datasets, two for model development and three for independent model validation. Three image-derived phenotypes were investigated: BioVolume, Projected.Area.1, and Projected.Area.2. Models were assessed with R2, Bias, and RMSEP (Root Mean Squared Error of Prediction). The results showed that almost all models were validated with high R2 values, indicating that these digital phenotypes can be useful to rank plant biomass on a relative basis. However, in many occasions when accurate prediction of plant biomass is needed, it is important for researchers to know that models that relate image-based phenotypes to plant biomass should be carefully constructed. Our results show that the range of plant size and the genotypic diversity of the calibration sets in relation to the validation sets have large impact on the model accuracy. Large maize plants cause systematic bias as they grow toward the top-view camera. Excluding top-view images from modeling can there benefit modeling for the experiments involving large maize plants.
John Updike's dental odyssey

Les memoires de John Updike sont un ouvrage de references sur les dents, les dentistes et les soins dentaires recueillis a partir de son experience personnelle
The Meaning of the Term and its Scope

Now that we know, or believe we know, the history of the term and its new meaning, we must admit that this meaning is by no means clear. Let me quote a footnote from a historian’s work published in 1955.
Renal Infarction : An Unusual Complication of Cocaine Abuse

A 63-year-old African American man presented with severe epigastric pain of 1 day's duration. The pain was sharp and continuous and radiated toward the left flank. There were no aggravating or relieving factors or previous similar episodes.
Engagement and Retention of Ethnically Diverse Adolescents to a Voluntary, School-Based Alcohol Use Intervention

Author(s): Bacio, Guadalupe A; Garcia, Tracey A; Anderson, Kristen G; Brown, Sandra A; Myers, Mark G
Engaged in teaching, and scholarship too: economics faculty productivity at national liberal arts colleges

This study examines the research productivity of economists affiliated with the top 100 national liberal arts colleges in the USA. Based on our findings, we are able to draw comparisons between research effort today and research patterns presented in earlier literature. According to one research ranking presented here, the top economics departments across liberal arts institutions are Claremont McKenna College, Middlebury College, Williams College, Wellesley College and Trinity College. When an alternative metric is used, Rhodes College, Agnes Scott College and Hope College enter the mix. Lastly, we provide a ranking of the top economists who are affiliated with national liberal arts institutions. These results reveal that a larger proportion of the top economists hold the rank of associate professor than what is shown in previous studies, and that research output at liberal arts institutions is relatively concentrated in one or a few scholars.
Modeling and experimental validation of narrow beam propagation through a turbid harbor

Narrow-beam laser communication (lasercom) can enable high-rate, long-range undersea communication. Light in the beam is absorbed and scattered by suspended particulates, altering the spatial, angular, and temporal properties of the transmitted light. Development of high quality data links is aided by accurate simulations that can be adapted to different water conditions, from turbid harbors, to clear oceans, and even laboratory test beds with artificial scatterers. To this end we have developed a method to create an empirical scattering function from volume scattering function measurements that can be used to generate random scattering angles in an undersea optical propagation simulator. This method is presented, along with cross validation of its predictions during a recent narrow-beam communication demonstration in Narragansett Bay, Middletown, RI, USA. VSF measurements taken during the trials were used to run the simulator and the results are shown to agree with in situ images of the pupil and focal planes of the communication laser beam.
Aggressive Behavior and Cannabis Use

Motivated by the large public health impact of aggressive behavior and cannabis use, we reviewed the international empirical literature to assess the evidence for supporting either the cooccurrence hypothesis or the directional hypothesis (ie, aggressive behavior leading to cannabis use, or cannabis use leading to aggressive behavior). Support for any of these hypotheses has implications for preventive interventions targeting either the underlying causes of both behaviors, or by specifically targeting one of these behaviors as a risk factor for the other. Despite the theoretical and empirical evidence supporting a positive association between early childhood aggressive behavior and cannabis use later in life, the causal relationship remains unsupported. In addition, inconsistent results were found for the interrelationship between these two behaviors during adolescence. We cited several study characteristics as plausible culprits for these inconsistent results, and suggested future research efforts.
An integral lens on Patrick Geddes

Abstract Patrick Geddes is a significant figure in the landscape and urban planning canon. In addition to situating cities within a regional context and advancing a socioecological understanding of urbanization, he viewed cities as the principal artifact of, and theater wherein, human culture evolves. This expansive view of cities may be one of the more challenging aspects of Geddes’ legacy to assimilate. Working during a late 19th and early 20th century period when the limitations of modernity were becoming increasingly apparent, much of Geddes’ aspirational thinking can be seen as an effort to create what he described as a “larger modernism.” In this regard, Geddes can be counted amongst those whom we portray as integrative holistic thinkers, people whose worldview draws them toward meaning-making narratives and frameworks that include the many dimensions of the human condition. Today, a new generation of holistic approaches called “metatheories” – and “integral theory” in particular – provides an orienting lens through which to review, assess, and potentially extend the work of Geddes in the 21st century. Towards that goal, this article first provides an introductory primer to some of Geddes’ noteworthy “thinking machines” as well as integral theory. We then assess correspondence between the two, focusing on Interdisciplinary Holism; Evolution, Development and Complex Systems; Human Agency and Ethics; and Spirituality. A closing discussion addresses prospects for future research, and suggests that the holistic, evolutionary, and generative orientation of our principal subjects may have particular relevance in an anthropogenic biosphere characterized, in part, by significant environmental challenges and the concentration of humans in cities.
Nutrient limitation of terrestrial free-living nitrogen fixation

Nitrogen (N) fixation by free-living bacteria is a primary N input pathway in many ecosystems and sustains global plant productivity. Uncertainty exists over the importance of N, phosphorus (P) and molybdenum (Mo) availability in controlling free-living N fixation rates. Here, we investigate the geographic occurrence and variability of nutrient constraints to free-living N fixation in the terrestrial biosphere. We compiled data from studies measuring free-living N fixation in response to N, P and Mo fertilizers. We used meta-analysis to quantitatively determine the extent to which N, P and Mo stimulate or suppress N fixation, and if environmental variables influence the degree of nutrient limitation of N fixation. Across our compiled dataset, free-living N fixation is suppressed by N fertilization and stimulated by Mo fertilization. Additionally, free-living N fixation is stimulated by P additions in tropical forests. These findings suggest that nutrient limitation is an intrinsic property of the biochemical demands of N fixation, constraining free-living N fixation in the terrestrial biosphere. These findings have implications for understanding the causes and consequences of N limitation in coupled nutrient cycles, as well as modeling and forecasting nutrient controls over carbon-climate feedbacks.
Research Collaboration in a Communication Rights Campaign: Lessons Learned:

In building public support for social change, activists in communities of color routinely approach broader audiences via news media. Communities of color, however, routinely face disparities that limit their access to media including local news media outlets. This lack of access mirrors inequalities in political, social, and economic arenas and can slow public awareness campaigns to address disparities in health, environmental, and other quality-of-life issues. I describe two community-based collaborative action research studies that documented and challenged how local television newscasts underrepresented and misrepresented three communities of color in Boston. The linkage between communication rights and campaigns to address quality-of-life issues is presented, as well as unresolved challenges in the collaborative research process. The study has implications for environmental health campaigns.
Towards a Knowledge-Based Approach for Generating Video Descriptions

Existent video description approaches advocated in the literature rely on capturing the semantic relationships among concepts and visual features from training data specific to various datasets. Naturally, their success at generalizing the video descriptions for the domain is closely dependent on the availability, representativeness, size and annotation quality of the training data. Common issues are overfitting, the amount of training data and computational time required for the model. To overcome these issues, we propose to alleviate the learning of semantic knowledge from domain-specific datasets by leveraging general human knowledge sources such as ConceptNet. We propose the use of ConceptNet as the source of knowledge for generating video descriptions using Grenander's pattern theory formalism. Instead of relying on training data to estimate semantic compatibility of two concepts, we use weights in the ConceptNet that determines the degree of validity of the assertion between two concepts based on the knowledge sources. We test and compare this idea on the task of generating semantically coherent descriptions for videos from the Breakfast Actions and Carnegie Mellon's Multimodal activities dataset. In comparison with other approaches, the proposed method achieves comparable accuracy against state-of-the-art methods based on HMMs and CFGs and generate semantically coherent descriptions even when presented with inconsistent action and object labels. We are also able to show that the proposed approach performs comparably with models trained on domain-specific data.
Preempting the Second Contradiction: Solar Geoengineering as Spatiotemporal Fix

Climate change is increasingly understood as a potential crisis for global financial stability and thus liberal-capitalist hegemony. The primary crisis management strategy is “green capitalism”—ren...
Precision Energy Measurements with the MSU Cyclotron

This paper describes the technique currently being used at the Michigan State University Cyclotron Laboratory for the precise determination of nuclear excitation energies and nuclear reaction Q-values. In this work we are using a recently described1 calibration procedure for nuclear emulsions in an Enge split-pole magnetic spectrograph to obtain typical uncertainties of 0.1–1. keV in measurements of particle energies in the 20–40 MeV range. The choice of energy standards, a description of our calibration procedure, and some recent results are presented in the following sections.
FACTORS AFFECTING ANAEROBIC STABILIZATION DURING BIOLOGICAL PHOSPHORUS REMOVAL

ABSTRACT Laboratory and pilot-plant scale research was conducted to Investigate the occurrence of COD stabilization in the anaerobic reactor of biological phosphorus removal systems. Initial efforts in the laboratory established the existence of anaerobic stabilization. Subsequent efforts investigated the effects of influent substrate, sludge age, and other operating conditions on the extent of anaerobic stabilization, in an effort to establish the primary mechanism responsible for such stabilization. It was determined that sludge age does effect anaerobic stabilization but the composition of the influent substrate is the primary factor that determines its extent. It was concluded that the normal growth of fermenting bacteria is the principal mechanism of anaerobic stabilization.
Modeling Ultracapacitors as Fractional-Order Systems

Ultracapacitors display long-term transients lasting for many months. This paper shows that these long-term transients can be accurately represented using a fractional-order system model for the ultracapacitor impedance. Time-domain data is used to determine the impedance transfer-function coefficients. A circuit realization for the ultracapacitor is given which explicitly shows the fractional-order component. These long-term transient models will allow the development of improved ultracapacitor management systems.
A Poem: Biological Oppressions

To be a woman, is to acknowledge defeat, for men always have the power to hold you down and, on you repeatedly beat. Women are second-class citizens, who are objectified through a chauvinistic lens.
Morbidity and mortality factors in twins. An epidemiologic approach.

Epidemiologic factors leading to increased morbidity and mortality in twin pregnancies and infants have been reviewed. Most of the excess mortality in twins is accounted for by prematurity. A small but significant component of this excess mortality is also accounted for by near-term twins.
REIFICATION: a defense of lukács’s original formulation

This essay offers a defense of Lukacs’s original formulation of the concept of reification (Verdinglichung), with a particular emphasis on defending the Marxist social-ontological commitmen...
Evaluation of Worksite Wellness Nutrition and Physical Activity Programs and Their Subsequent Impact on Participants' Body Composition.

Background. Adult obesity is globally recognized as a public health concern. As adults spend most of their weekdays at work, worksite wellness programs may include topics of nutrition education and physical activity to improve an employee’s body composition. However, results are inconsistent with the impact they have on employees’ body composition. Objective. The purpose of this systematic review was to evaluate worksite wellness nutrition and physical activity programs and their subsequent impact on participants’ body composition. Methods. Extraction of articles was completed through 4 databases: PubMed, CINAHL, SCOPUS, and PsycINFO using keywords such as “nutrition and physical activity interventions/programs” and “weight.” A 9-point inclusion criterion was established. Evaluation of the articles was assessed using the Academy of Nutrition and Dietetics Evidence-Based Manual. Results. A total of 962 articles were identified. Twenty-three met the inclusion criterion. Seventeen studies resulted in a change in body composition (e.g., decreased BMI (kg/m2), waist circumference, and body fat percentage), and six studies did not show any changes. Programs that had professionals frequently interact with participants, regardless if the interactions were done daily, weekly, or monthly, led to a change in body composition. Additionally, programs that incorporated a motivation theory and provided content relevant to participants’ needs resulted in a change in body composition. Conclusion. Evidence supports that future worksite wellness programs that are designed using a motivational theory and content that is created relevant to participants’ needs and that has frequent interactions with participants may result in a change in body composition.
Choosing a Medication

A 29-year-old woman presents to an obesity medicine specialist for weight management. Her body mass index (BMI) is 32 kg/m2 (198 lbs, 5′6″), and she suffers from depression, irritable bowel syndrome with diarrhea (IBS-D), and migraines. Her medications are oral contraceptive pills, sertraline 150 mg daily, and sumatriptan 50 mg as needed for migraines, which occur two to four times per month. She has lost weight successfully several times in the past through diet and exercise; however, she always regains the weight. A few months ago, she started a low carbohydrate diet and an exercise routine. After losing 8 pounds (206 ➔ 198 lbs), she quickly reached a weight plateau despite ongoing diet and exercise. She is very frustrated and does not understand why she is unable to lose weight and maintain weight loss. She denies history of anxiety or nephrolithiasis. Her exam is within normal limits, and her laboratory data reveal no abnormalities besides low high-density lipoprotein (HDL), high low-density lipoprotein (LDL), and elevated triglycerides.
Prenatal Risk for ASD: Fetal Cortisol Exposure Predicts Child Autism-Spectrum-Disorder Symptoms

The etiology of autism spectrum disorder (ASD) is multifactorial and complex and likely involves interactions among genetic, epigenetic and environmental factors. With respect to environmental influences, a growing literature implicates intrauterine experiences in the origin of this pervasive developmental disorder. In this prospective longitudinal design, we examine the hypothesis that fetal exposure to maternal cortisol may confer ASD risk. In addition, because ASD is four times more prevalent in males than females and because sexually dimorphic responses to intrauterine experiences are commonly observed, we examine whether or not any associations differ by fetal sex. Maternal plasma cortisol was measured at 15, 19, 25, 31, and 37 weeks' gestation in a sample of 84 pregnant women. ASD symptoms were assessed in their 5-year old children with the Social Communication Questionnaire (SCQ). Fetal exposure to lower levels of maternal cortisol was associated with higher levels of ASD symptoms among boys only. The observed hypocortisolemic profile exhibited by these mothers may indicate a risk factor that precedes the stress of caregiving for a child with ASD and may not be solely a consequence of the stress of caregiving as previously thought. Further, these findings confirm the value of examining prenatal hormone exposures as predictors of ASD risk and support the premise that altered prenatal steroid exposures may play a role in the etiology of ASD.
Early Management of Unilateral Vocal Fold Paralysis

Early management of unilateral vocal fold paralysis (UVFP) includes behavioral, medical, and surgical interventions in the first 6 months after the onset of paralysis. There is no universal algorithm for the early management of UVFP. The patient’s symptoms and expectations shape treatment choices. The most common, and very effective, treatment employed during acute management of glottal incompetence from UVFP is temporary injection laryngoplasty. Although patients often most appreciate the voice quality improvement after vocal fold augmentation, the improved swallowing function and cough effectiveness are most important. In patients who have minimal or no symptomatic repercussions from their UVFP, observation is a reasonable option. Early treatment of UVFP is driven by the patient’s symptoms (swallowing difficulties, voice requirements), underlying medical comorbidities, and their own desires for treatment. Understanding and discussing the expected natural evolution of UVFP is critical in the decision-making process. We are at the dawn of developing new treatments to restore dynamic vocal fold motion by manipulating the microenvironment surrounding injured nerves. Although these treatments are in their infancy, the concept of advancing treatment of UVFP beyond traditional static treatments is exciting.
Assessing a Survey: Motivations of Collaborative Consumption of Clothing

An alternative strategy in which consumers can contribute to sustainable efforts is through collaborative consumption (CC). Derived from consumer behavior theories, the Attitudinal Model of Collaborative Consumption of Clothing (AMCC) summarizes the underlying motivations to collaboratively consume clothing. These motivations include:1) sustainability,2) enjoyment, 3) reputation, and 4) economic benefits. According to the AMCC,these motivations contribute to a positive attitude that then leads to CC behavior. The researchers subsequently developed a survey to assess CC given the AMCC. The purpose of this study was to assess the developed survey and the AMCC. Findings revealed (N = 279) the survey represented three primary motivations: 1) sustainability/economic, 2) enjoyment, and 3) reputation. The AMCC was modified to demonstrate these three motivations influenced each other,as well as, “behavior intent” that subsequently impacted behavior. Only sustainability/economic benefits positively and directly influenced actual behavior. Practical implications include incorporating these findings in marketing campaigns to stimulate CC with clothing.
The Reliability of Fibro-test in Staging Orthotopic Liver Transplant Recipients with Recurrent Hepatitis C.

Background and Aims: Liver biopsy remains the gold standard for staging of chronic liver disease following orthotopic liver transplantation. Noninvasive assessment of fibrosis with Fibro-test (FT) is well-studied in immunocompetent populations with chronic hepatitis C virus infection. The aim of this study is to investigate the diagnostic value of FT in the assessment of hepatic fibrosis in the allografts of liver transplant recipients with evidence of recurrent hepatitis C. Methods: We retrospectively compared liver biopsies and FT performed within a median of 1 month of each other in orthotopic liver transplantation recipients with recurrent hepatitis C. Results: The study population comprised 22 patients, most of them male (19/22), and with median age of 62 years. For all patients, there was at least a one-stage difference in fibrosis as assessed by liver biopsy compared to FT, while for the majority (16/22) there was at least a two-stage difference. The absence of correlation between the two modalities was statistically demonstrated (Mann-Whitney U test, p = 0.01). In detecting significant fibrosis (a METAVIR stage of F2 and above), an FT cut-off of 0.5 showed moderate sensitivity (77%) and negative predictive value (80%), but suboptimal specificity (61%) and positive predictive value (58%). Conclusions: In post-transplant patients with recurrent hepatitis C, FT appears to be inaccurately assessing the degree of allograft fibrosis, therefore limiting its reliability as a staging tool.
How to understand and teach P values: a diagnostic test framework.

Abstract Objectives The aim of the tutorial is to help educators address misconceptions about P values and provide a tool that can be used to teach a more contemporary interpretation. Study Design and Setting A scripted tutorial using problem-based learning and a diagnostic test analogy to deconstruct the misunderstandings about P values and develop a more Bayesian approach to study interpretation. Results A diagnostic test analogy is an effective teaching tool. Learners' understanding of Bayes’ theorem in diagnostic testing can be used as a bridge to the realization that the prestudy probability of a true difference is crucial for study interpretation. The analogy has several caveats and shortcomings. The limitations of this analogy and the conceptual difficulties with the Bayesian study analyses are addressed. Conclusion P values do not provide the information many assume they do–they are not equivalent to a probability of a chance finding. This tutorial helps move learners from these incorrect notions to new insights.
Start Spreading the News: New York’s Post-Election Audit Has Major Flaws

Post-election audits should provide the public with evidence that election results are fair and accurate. However, New York state’s current audit has no guarantees that erroneously reported election results will be caught and corrected at a high rate. When outcome-changing tabulation errors are confined to a single machine, the New York audit will fail 97% of the time. The story is not much better when a handful of machines are affected. On the other hand, a risk-limiting audit with a 5% risk limit is statistically guaranteed to catch at least 95% of wrong outcomes. We simulate audits of precinct level election returns from the 2016 presidential race to illustrate the differences. We recommend replacing the current New York audit with a risk-limiting audit.
Critical aspects of packaging, storage, preparation, and administration of mRNA and adenovirus-vectored COVID-19 vaccines for optimal efficacy.

COVID vaccines are fast approaching review by the The United States Food and Drug Administration (FDA) for consideration of Emergency Use Authorization (EUA) or Expanded Access (EA) status. Each vaccine has different packaging and requirements for storage, preparation, and administration. These practical aspects are important to prepare healthcare providers who will be receiving and administering these vaccines and in order to preserve the optimal immunogenicity and efficacy of each administered vaccine. Several of these vaccines require ultra-cold or have cold-storage requirements that are different than what vaccine administrators are prepared for. The information provided is specific to each manufacturer, recognizing COVID vaccine development is an evolving process with frequently occurring modifications.
Psychosocial Syndemics and Multimorbidity in Patients with Heart Failure

Heart failure (HF) is a common cause of hospitalization and mortality in older adults. HF is almost always embedded within a larger pattern of multimorbidity, yet many studies exclude patients with complex psychiatric and medical comorbidities or cognitive impairment. This has left significant gaps in research on the problems and treatment of patients with HF. In addition, HF is only one of multiple challenges facing patients with multimorbidity, stressful socioeconomic circumstances, and psychosocial problems. The purpose of this study is to identify combinations of comorbidities and health disparities that may affect HF outcomes and require different mixtures of medical, psychological, and social services to address. The syndemics framework has yielded important insights into other disorders such as HIV/AIDS, but it has not been applied to the complex psychosocial problems of patients with HF. The multimorbidity framework is an alternative approach for investigating the effects of multiple comorbidities on health outcomes. The specific aims are: (1) to determine the coprevalence of psychiatric and medical comorbidities in patients with HF (n = 535); (2) to determine whether coprevalent comorbidities have synergistic effects on readmissions, mortality, self-care, and global health; (3) to identify vulnerable subpopulations of patients with HF who have high coprevalences of syndemic comorbidities; (4) to determine the extent to which syndemic comorbidities explain adverse HF outcomes in vulnerable subgroups of patients with HF; and (5) to determine the effects of multimorbidity on readmissions, mortality, self-care, and global health. Study Registration: clinicaltrials.gov identifier: NCT04637776.
COVID-19 and disconnected youth: Lessons and opportunities from OECD countries.

Aims:This paper highlights how the novel coronavirus pandemic (COVID-19) has amplified economic instability and health risks for disconnected youth and young adults (YYA). We offer a brief review o...
MPN-314: Improved Survival of Patients with Primary Myelofibrosis in the Last Decade at a Large Single Academic Center

Context: Improved outcome of patients with primary myelofibrosis (PMF) in the last decade remains debatable, owing to inconsistent reports. Objective: To determine whether the outcome of PMF patients has changed in the last decade (after the year 2010). Patients and Design: Retrospective study of 882 PMF patients (diagnosed within one year from presentation) who came to our institution between 1986 and 2020. Total of 882 patients were enrolled; 383 (43%) presented before 2010. Main Outcomes: Overall survival (OS) of patients who presented before and after the year 2010 was measured and compared (Kaplan–Meier analysis with log-rank test). Major clinical features at presentation were compared between groups using χ2 or Fisher’s exact test. Results: Patients after 2010 had superior OS to patients who presented before 2010, with respective medians of 61 (95% CI: 52–70) and 44 (95% CI: 36–52) months (p Conclusions: Our single-institution analysis of the survival trends among a large cohort of 882 patients with PMF demonstrates an improvement in survival in the last decade.
Improving Auditors’ Review of Inconsistent Audit Evidence

We examine audit reviewers’ detection of conclusion deficiencies, which occur when preparers draw inappropriate inferences about the audit evidence set as a whole. These deficiencies are particularly concerning when the evidence set contains inconsistencies (i.e., items that do not uniformly support the client’s assertions). We argue that reviewers with a promotion focus detect more conclusion deficiencies than reviewers with a prevention focus. A promotion focus is a frame of mind that broadens attention and encourages big picture thinking, while a prevention focus narrows focus and encourages avoiding mistakes. In two experiments, we provide evidence that a promotion focus improves reviewers’ detection of conclusion deficiencies when considering inconsistent evidence. Specifically, we find that a promotion focus increases reviewers’ holistic thinking, documentation of inconsistencies among evidence items, and the communication of significant issues to the engagement manager, which increases the likelihood that the issues will be resolved appropriately.