cssi/SciSciGPT-SciSciNet huggingface dataset:
Improving Medical Practice: A Conceptual Framework

PURPOSE The purpose of this article is to produce a relatively simple conceptual framework for guiding and studying practice improvement. METHODS I summarize the lessons from my experience with a variety of quality improvement research studies during the last 30 years, supplemented with relevant literature from both medicine and other industries about the issues associated with successful quality improvement. RESULTS My experience suggests that organizational leadership with an urgent vision for change, ability to manage the change process, and selection of systematic changes capable of fulfilling the vision are each critical for successful quality improvement. Published literature from other industries emphasizes the importance of a goal-directed change process managed by leaders who recognize the need to engage their employees and other leaders in a disciplined but flexible way that accommodates external and internal factors and uses teams and group learning. It also suggests the importance of organizational context and the level of external and internal barriers and facilitators for change. The resulting model proposes that priority, change process, and care process content are necessary for measurable improvements in quality of care and patient outcomes, although internal and external barriers must also be attended to and addressed. CONCLUSION This framework may provide a guide to those in the front lines of care who would like to make the care transformations that are needed to greatly improve care. It may also be helpful to those who are developing or testing interventions and recruiting medical practices for such change efforts.
Dynamic Scaled Sampling for Deterministic Constraints

Deterministic and near-deterministic relationships among subsets of random variables in multivariate systems are known to cause serious problems for Monte Carlo algorithms. We examine the case in which the relationship Z = f(X1;:::;Xk) holds, where each Xi has a continuous prior pdf and we wish to obtain samples from the conditional distribution P (X1;:::;Xkj Z = s). When f is addition, the problem is NP-hard even when the Xi are independent. In more restricted cases|for example, i.i.d. Boolean or categorical Xi|ecient exact samplers have been obtained previously. For the general continuous case, we propose a dynamic scaling algorithm (DYSC), and prove that it hasO(k) expected running time and nite variance. We discuss generalizations of DYSC to functions f described by binary operation trees. We evaluate the algorithm on several examples.
Response to Evolution and Hypertension: Is the Renin System Necessary?

Gavras and Brunner1 make the salient point that the renin– angiotensin–aldosterone system (RAAS) is not completely suppressed by our habitually high sodium intake. From an evolutionary standpoint, this is perhaps to be expected, because the system was presumably adapted for sodium conservation, …
Growth Factors in Milk as Mediators of Infant Development

INTRODUCTION 147 EPIDERMAL GROWTH FACTOR (EGF) 148 Background and General Physiological Function 148 Milk Concentration and Sources 149 Effects on the Neonate 151 INSULIN, RELAX]N, AND INSULIN-LIKE GROWTH FACTOR-I AND -ll ....... 154 Background ~ General Physiological Function 154 l~.sulin 154 R¢laxin 156 IGF.I., IGF.II., AND IGF-BINDING PROTEINS 157 OTHER PEFrIDE GROWTH FACTORS IN MILK 159 CONCLUDING REMARKS 160
Spatial Distribution and Parasitism of Leaf Galls Induced by Callirhytis cornigera (Hymenoptera: Cynipidae) on Pin Oak

Callirhytis cornigera (Osten Sacken) is a gall wasp that has alternating agamic and sexual generations that develop in large, woody stem galls and small, blister-like leaf galls, respectively, on pin oak, Quercus palustris Muenchhausen. We assessed the spatial distribution of the leaf galls within leaves, shoots, canopy levels, and whole trees, and examined the relationship between leaf gall density and various tree parameters. Within leaves, proportionately more galls were located on primary lateral veins (59.5%) or midveins (38.1%), as compared with the petioles (2.0%) or secondary lateral veins (0.4%). As many as 18 galls occurred on individual leaves, but most leaves contained 0–4 galls. Some current-year shoots contained as many as 132 leaf galls, but most shoots had <20 galls. Leaf gall density did not vary significantly among heights within individual tree canopies, but was highly variable between trees. Leaf gall density at the whole tree level was not related to the tree’s rate of leaf- or shoot expansion. There was no relationship between tree-wide density of leaf galls and overall levels of foliar nitrogen, nonstructural carbohydrates, or protein binding capacity. The leaf galls supported a complex of hymenopteran parasitoids, including Aprostocetus spp., Pentastichus spp. (Eulophidae), Sycophila spp., Eurytoma sp. (Eurytomidae), Brasema sp. (Eupelmidae), and Ormyrus labotus Walker (Ormyridae). Parasitoids and inquilines accounted for nearly 80% mortality of C. cornigera within leaf galls; however, parasitism was only weakly density-dependent, regardless of spatial scale. Implications of these findings for management of C. cornigera are discussed.
The Devil's Rope

Barbed wire, in the bureaucratic context, has a quality that is often exhibited by a program, a policy, an agency, an individual?or even a theory. It is a quality of compulsion, of force. It is deployed for what the administrator?like the rancher?considers to be a useful purpose. It controls, limits. It can hurt; it can dig into the flesh. At a minimum, it denies passage. It serves (as in "services") to keep them in (e.g., as in "corrections services"), or to keep them out (e.g., as in "immigration and naturalization services"). It is impersonal, harsh and metallic (iron as in "cage")?either in the flesh or metaphorically. We should become more conscious of the nature of the barbed wire in bureaucracy, and I recommend that PA Theory should seek a full understanding of administrative barbed wire. I want to point toward what is controlling and painful in the texts and sub-texts of bureaucratic bodies. This is important for any PA attempt to contribute even more toward achieving social justice. The notion and importance of barbed wire should become clearer when I provide some examples of three types of bureaucratic context that exhibit barbed wire.
Abstract P249: Urinary Cadmium and Cardiovascular Health: Findings from the Survey of the Health of Wisconsin

Mounting evidence in both human and animal studies suggest cadmium exposure increases the risk for cardiovascular disease morbidity and mortality. Recent evidence have found associations between cadmium exposures and mortality in the general US population, however, studies of incident CVD events have been mixed. Consequently, there is a need to better understand determinants of variations in cadmium exposure and the association of current population exposure levels with cardiovascular risk factors in diverse population-based studies. Data from a sub-sample of 300 participants from the 2008-11 waves of the Survey of the Health of Wisconsin (SHOW) were used to study the association between urinary cadmium levels and cardiovascular health. SHOW is based on a probabilistic statewide sample of adult (21-74 years old) residents of the state of Wisconsin. Good cardiovascular health (CVH) was defined as recommended by the American Heart Association, using a combination of “ideal or intermediate” levels of seven factors and health behaviors (body mass index, cholesterol, glucose, diet, physical activity, blood pressure and smoking). Associations of log-linear estimates of creatinine-adjusted cadmium levels (ug/g creatinine) and CVH were examined using logistic and linear regression models. Covariates included individual-level demographics (race/ethnicity and gender), SES (median family income and education), smoking status (current or former vs. non), and diet (fruits and vegetable consumption). Urinary cadmium levels (ug/g creatine) were statistically higher than comparable national estimates among women (geometric mean = .36;95% CI =.30-.44) and populations living 200% above federal poverty estimates (geometric mean =.32; 95% CI .28-.38). Higher cadmium levels were associated with good CVH (OR 1.4; 1.06-1.90). Using linear regression log-cadmium levels were inversely associated with BMI (s=-1.04; p-value=.002) after adjustment for sociodemographic, smoking and dietary factors. Stratified analyses found associations held among non-smokers but not current or former. Cadmium was not associated with any other individual CVH factors. Paradoxically, findings suggest that urinary cadmium levels, a marker of chronic cadmium exposure, are associated with high SES, lower levels of BMI and good cardiovascular health in this population based sample, further exploration and long-term follow-up are warranted.
The Creation of an Asian Economic Zone and the Pursuit of Sovereignty

The possible creation of an Asian Economic Zone has been debated quite often in the last years. This is not shared by countries specially attached to the strict dimension of national sovereignty. The worldly trends of globalization and interdependence turn it into an urgency as Asia is required to consolidate its position in a world of regions and regionalisms.
Predictors of vaginal mesh exposure after midurethral sling placement: a case–control study

Female stress urinary incontinence is highly prevalent, and synthetic midurethral sling placement is the most common type of anti-incontinence surgery performed in the USA. We aimed to identify risk factors associated with surgery used to treated vaginal mesh exposure after midurethral sling placement for stress urinary incontinence. We identified women who underwent anti-incontinence procedures from January 2002 through December 2012. Patients with vaginal mesh exposure undergoing surgical repair after midurethral sling placement were compared with a control group without mesh exposure in a 1:3 ratio. Patients with ObTape sling placement (Mentor Corporation) were excluded. Logistic regression models were used to evaluate associations between clinical risk factors and vaginal mesh exposure. Overall, 2,123 patients underwent primary sling placement, with 27 (1.3 %) having vaginal mesh exposure necessitating surgical repair. Patients with mesh exposure were more likely to have undergone previous bariatric surgery (P = 0.008), hemoglobin <13 g/dL (P = 0.006), premenopausal status (P = 0.008), age <50 years (P = 0.001), and the retropubic approach to sling placement (P = 0.03). Multivariate analysis identified these risk factors: previous bariatric surgery (odds ratio [OR], 7.0; 95 % CI, 1.1–61.4), retropubic approach (OR, 5.7; 95 % CI, 1.1–107.0), preoperative hemoglobin <13 g/dL (OR, 2.8; 95 % CI, 1.1–7.5), and premenopausal status (OR, 2.6; 95 % CI, 1.0–7.3). Among postmenopausal patients, those with mesh exposure were significantly more likely to receive preoperative estrogen therapy (OR, 12.4; 95 % CI, 2.7–57.8). Previous bariatric surgery, retropubic approach, premenopausal status, and lower preoperative hemoglobin were associated with a significantly increased risk of surgery for vaginal mesh exposure after midurethral sling placement. Recognizing these factors can improve preoperative patient counseling.
Separation Characteristics of Manganese as a Surrogate for Americium during the Distillation Operations of Pyroprocessing

The loss of americium metal during the pyroprocessing of used nuclear fuel has long been a concern due to its high vapor pressure relative to the operating conditions of the process. Of the two high temperature vacuum operations (distillation and casting) performed during pyroprocessing, the distillation operation would incur significantly more americium losses by several orders of magnitude. The distillation operation is required for the removal of cadmium from the transuranic products. Thus, a series of tests were initiated to investigate the evaporative characteristics of manganese as a surrogate for americium during distillation operations. The results for the separation of manganese are presented from the test program and compared against modeled data. Based on the modeling of manganese, similar data were calculated for americium evaporation during a typical liquid cathode operation in the cathode processor. It is anticipated that less than 0.15 wt.% of the americium will be lost during the distillat...
The Gradient Flow of the L2 Curvature Functional with Small Initial Energy

We investigate the low-energy behavior of the gradient flow of the L2 norm of the Riemannian curvature on a four-manifold. In particular we show that if the initial energy is chosen small enough with respect to the initial Sobolev constant and the H1 norm of the gradient vector then the flow exists for all time and converges to a flat metric. We also improve the regularity requirement for the flow proved in Streets (J. Geom. Anal. 18:249, 2008) in the case of four-manifolds.
Effects of Flipping the Principles of Microeconomics Class: Do Class Frequency and Duration Matter?

Flipping the principles of microeconomics classroom significantly improves student learning outcomes; however, it remains unclear as to if the effect differs depending upon the duration and frequency of class meeting times. This paper investigates if the quantitative effects of flipping on student outcomes differ by class frequency and duration. It further evaluates if student perceptions about flipping vary depending on the day and frequency of class meetings. This paper shows that the effect of flipping on student learning outcomes does not vary with class duration and frequency. Students in the flipped class setting reported significantly more active learning and were significantly more likely to recommend the professor to other students than those in a traditional setting. The results documented in this study suggest that an instructor wishing to flip his or her course should feel confident to teach and flip whichever course schedule fits their comfort and style most and supports their students, department, and school needs.
Economic feasibility and infrastructure optimization of in-motion charging of electric vehicles using wireless power transfer

The economic feasibility and infrastructure optimization of in-motion wireless power transfer (WPT) in the U.S. is evaluated using dynamic vehicle models integrated with GPS stamped real world drive cycle data. Results show total vehicle level savings greater than the WPT electric vehicle (EV) purchase price with a societal level infrastructure payback time of 11.3 years at 25% fleet penetration for deployment in the U.S. Optimizing the technology for consumer satisfaction shows that up to 99% of light duty real world drive cycles are satisfied with a 25 mile on-board electrical range utilizing 50 kW in-motion WPT. Additionally, in-motion WPT satisfies 92.6% of consumers, representing a 50% increase in the consumer satisfaction of low-range EVs.
Maternal and infant outcomes following third trimester exposure to marijuana in opioid dependent pregnant women maintained on buprenorphine

Abstract Background To determine whether maternal and infant outcomes are associated with exposure to marijuana during the third trimester in a population of opioid dependent pregnant women maintained on buprenorphine. Methods This retrospective cohort study of 191 maternal-infant dyads exposed to buprenorphine during pregnancy examines a variety of variables including gestational age, birthweight, method of delivery, Apgar scores at one and five minutes, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS in infants exposed to marijuana during the third trimester as compared to infants not exposed to marijuana during the third trimester. Results Analyses failed to support any significant relationship between marijuana use in the third trimester and a variety of maternal and infant outcomes. Two important variables – the likelihood of requiring pharmacologic treatment for NAS (27.6% in marijuana exposed infants vs. 15.7% in non-marijuana exposed infants, p = 0.066) and the duration of infant hospital stay (7.7 days in marijuana exposed infants vs. 6.6 days in non-exposed infants, p = 0.053) trended toward significance. Conclusions Preliminary results indicate that marijuana exposure in the third trimester does not complicate the pregnancy or the delivery process. However, the severity of the infant withdrawal syndrome in the immediate postnatal period may be impacted by marijuana exposure. Because previous study of prenatal marijuana exposure has yielded mixed results, further analysis is needed to determine whether these findings are indeed significant.
Evolution: A Parthenogenetic Nematode Shows How Animals Become Sexless

Summary Most animals have male and female sexes, implying that sex is ancient and beneficial; yet some have survived for millions of years without sex. The genome of the parthenogenetic nematode Diploscapter pachys gives clues as to how ‘ancient asexual' animals can exist.
Studying de-implementation in health: an analysis of funded research grants

Studying de-implementation—defined herein as reducing or stopping the use of a health service or practice provided to patients by healthcare practitioners and systems—has gained traction in recent years. De-implementing ineffective, unproven, harmful, overused, inappropriate, and/or low-value health services and practices is important for mitigating patient harm, improving processes of care, and reducing healthcare costs. A better understanding of the state-of-the-science is needed to guide future objectives and funding initiatives. To this end, we characterized de-implementation research grants funded by the United States (US) National Institutes of Health (NIH) and the Agency for Healthcare Research and Quality (AHRQ). We used systematic methods to search, identify, and describe de-implementation research grants funded across all 27 NIH Institutes and Centers (ICs) and AHRQ from fiscal year 2000 through 2017. Eleven key terms and three funding opportunity announcements were used to search for research grants in the NIH Query, View and Report (QVR) system. Two coders identified eligible grants based on inclusion/exclusion criteria. A codebook was developed, pilot tested, and revised before coding the full grant applications of the final sample. A total of 1277 grants were identified through the QVR system; 542 remained after removing duplicates. After the multistep eligibility assessment and review process, 20 grant applications were coded. Many grants were funded by NIH (n = 15), with fewer funded by AHRQ, and a majority were funded between fiscal years 2015 and 2016 (n = 11). Grant proposals focused on de-implementing a range of health services and practices (e.g., medications, therapies, screening tests) across various health areas (e.g., cancer, cardiovascular disease) and delivery settings (e.g., hospitals, nursing homes, schools). Grants proposed to use a variety of study designs and research methods (e.g., experimental, observational, mixed methods) to accomplish study aims. Based on the systematic portfolio analysis of NIH- and AHRQ-funded research grants over the past 17 years, relatively few have focused on studying the de-implementation of ineffective, unproven, harmful, overused, inappropriate, and/or low-value health services and practices provided to patients by healthcare practitioners and systems. Strategies for raising the profile and growing the field of research on de-implementation are discussed.
Echo: A large display interactive visualization of ICU data for effective care handoffs

One of the significant challenges of care transitions in Intensive Care Units (ICUs) is the lack of effective support tools for outgoing clinicians to find, filter, organize, and annotate information that can be effectively handed off to the incoming team. We present a large display interactive multivariate visual approach, aimed towards supporting clinicians during the transition of care. We first provide a characterization of the problem domain in terms of data and tasks, based on an observation session at the University of Illinois Hospital, and on interviews with several biomedical researchers and ICU clinicians. Informed by this experience, we design a scalable, interactive visual approach that supports both overview and detail views of ICU patient data, as well as anomaly detection, comparison, and annotation of the data. We demonstrate a large-display implementation of the visualization on an existing anonymized ICU dataset. Feedback from domain experts indicates this approach successfully meets the requirements of effective care transitions.
Four-point bending as a method for quantitatively evaluating spinal arthrodesis in a rat model.

The most common method of evaluating the success (or failure) of rat spinal fusion procedures is manual palpation testing. Whereas manual palpation provides only a subjective binary answer (fused or not fused) regarding the success of a fusion surgery, mechanical testing can provide more quantitative data by assessing variations in strength among treatment groups. We here describe a mechanical testing method to quantitatively assess single-level spinal fusion in a rat model, to improve on the binary and subjective nature of manual palpation as an end point for fusion-related studies. We tested explanted lumbar segments from Sprague–Dawley rat spines after single-level posterolateral fusion procedures at L4–L5. Segments were classified as ‘not fused,’ ‘restricted motion,’ or ‘fused’ by using manual palpation testing. After thorough dissection and potting of the spine, 4-point bending in flexion then was applied to the L4–L5 motion segment, and stiffness was measured as the slope of the moment–displacement curve. Results demonstrated statistically significant differences in stiffness among all groups, which were consistent with preliminary grading according to manual palpation. In addition, the 4-point bending results provided quantitative information regarding the quality of the bony union formed and therefore enabled the comparison of fused specimens. Our results demonstrate that 4-point bending is a simple, reliable, and effective way to describe and compare results among rat spines after fusion surgery.
Tylomys panamensis (Panamá climbing rat)

Within the genus Tylomys the diploid number varies considerably. Pathak et al. was able to trace the homology of practically every element by G-banding. T. panamensis has the highest diploid number of this group recorded thus far.
Mutational analysis of the variant surface glycoprotein GPI-anchor signal sequence in Trypanosoma brucei.

The variant surface glycoproteins (VSG) of Trypanosoma brucei are anchored to the cell surface via a glycosylphosphatidylinositol (GPI) anchor. All GPI-anchored proteins are synthesized with a C-terminal signal sequence, which is replaced by a GPI-anchor in a rapid post-translational transamidation reaction. VSG GPI signal sequences are extraordinarily conserved. They contain either 23 or 17 amino acids, a difference that distinguishes the two major VSG classes, and consist of a spacer sequence followed by a more hydrophobic region. The ω amino acid, to which GPI is transferred, is either Ser, Asp or Asn, the ω+2 amino acid is always Ser, and the ω+7 amino acid is almost always Lys. In order to determine whether this high conservation is necessary for GPI anchoring, we introduced several mutations into the signal peptide. Surprisingly, changing the most conserved amino acids, at positions ω+1, ω+2 and ω+7, had no detectable effect on the efficiency of GPI-anchoring or on protein abundance. Several more extensive changes also had no discernable impact on GPI-anchoring. Deleting the entire 23 amino-acid signal sequence or the 15 amino-acid hydrophobic region generated proteins that were not anchored. Instead of being secreted, these truncated proteins accumulated in the endoplasmic reticulum prior to lysosomal degradation. Replacing the GPI signal sequence with a proven cell-surface membrane-spanning domain reduced expression by about 99% and resulted not in cell surface expression but in accumulation close to the flagellar pocket and in non-lysosomal compartments. These results indicate that the high conservation of the VSG GPI signal sequence is not necessary for efficient expression and GPI attachment. Instead, the GPI anchor is essential for surface expression of VSG. However, because the VSG is a major virulence factor, it is possible that small changes in the efficiency of GPI anchoring, undetectable in our experiments, might have influenced the evolution of VSG GPI signal sequences.
Calcium Signaling: NO Synthase

Nitric oxide (NO) is an important signal and effector molecule in animal physiology. NO is generated from l -arginine by the NO synthases (NOSs). Three NOSs have been characterized in animals: neuronal NOS (nNOS, type I), cytokine-inducible NOS (iNOS, type II), and endothelial NOS (eNOS, type III). Importantly, the activities of all three depend on their binding calmodulin (CaM). CaM binds reversibly to eNOS and nNOS in response to elevated Ca 2+ concentrations and so their activities are regulated by intracellular Ca 2+ . By contrast, iNOS binds CaM independent of Ca 2+ concentrations and is therefore continuously active after it is expressed. Because it is unusual for a redox enzyme like NOS to be controlled by a Ca 2+ -binding protein, the NOS–CaM interaction has provided new insight into some aspects of protein structure and function.
To Be Quiet and Very Much Interested

In Vanity Fair, Becky Sharp is described as a Siren: half sweet and compliant angel and, hidden below the waterline, half monster. Becky’s performance as a proper lady is effective because it relies on the universal human desire to be loved and, if love is not forthcoming, flattered. Like Adam Smith, Becky Sharp understands the power of vanity, the corrupted cousin of sympathy. To explain how sympathy works, Adam Smith refers to the heroes in tragedy and romance. We enter into their situation and experience feelings analogous to theirs. In real life as in the theater, we enjoy the harmony of sentiments that exists between actor and spectator. We like to be able to bring someone else’s case home to ourselves just as we expect others to experience fellow-feeling with us in both our sorrow and our joy. This desire for sympathy can lead us to play a part in hopes that our spectators may like us better or admire us more. For the vain, outward praise and recognition are more important than an inner sense of praiseworthiness. Becky Sharp knows, as does Smith, that most people are vain and therefore easily manipulated through flattery. But unlike Smith, Becky seeks to exploit the vanity of others for her own gain. Men in particular make for willing victims as they are less used to playing a part the way women are and fail to see through the “arts” Becky and other women employ to use men to better their own condition.
Police Misconduct (Introduction)

This essay is an introduction to the Police Misconduct chapter in Legal Issues Across the Globe, Volume I. From the publisher: "Legal Issues Across the Globe is an academic series showcasing the diversity of legal approaches to issues making headlines worldwide. Each chapter is devoted to a single topic and presents twelve country essays examining how the nation’s history and culture have influenced legislative and judicial actions." In general terms, defining wrongdoing by public officials, including police officers, is relatively easy. Misconduct falls into one of three categories: malfeasance, or the performance of unlawful acts; misfeasance, which is the performance of otherwise lawful acts in an unlawful or wrongful way; and nonfeasance, or the failure to perform a legally required act. Regulating misconduct, however, is far more complicated than defining it. The essays in this chapter offer valuable insights into legal regulation in different countries and contexts, including reflections on the nature of police misconduct as a social and legal problem. Modern societies need, and largely want, police forces that can respond to a range of emergencies. For that reason officers are granted special coercive authority: they can invade privacy, confiscate property, restrict liberty, and engage in violence beyond what would be permissible for non-officers. But the special powers that officers are granted bring with them the potential for abuse. Herein lies the perennial paradox of regulating police misconduct: societies can increase the effectiveness of policing by giving officers more authority, but doing so increases the risk that such authority will be misused. On the other hand, societies can reduce the risk of police misconduct by strictly limiting officers’ authority, but doing so can inhibit effective law enforcement. As preeminent police scholar Herman Goldstein wrote in the 1970s, regulating the police involves balancing society’s need for order against individuals’ desire for freedom. As the essays in this chapter demonstrate, different countries have found different ways to strike that balance. There are common threads, however, that help develop a framework to better understand the regulation of policing. The essays reflect not only a variety of regulatory approaches but also how the law and police misconduct share a complicated and multifaceted relationship. The chapter, which is not provided here in its entirety, features essays (by other authors) that discuss the legal regulation of police misconduct in Brazil, Egypt, India, Mexico, Papua New Guinea, the Philippines, South Africa, Spain, Thailand, Ukraine, the United Kingdom, and the United States.
Educating the Next Generation of Public Health Social Work Leaders: Findings from a Summit.

ABSTRACTThis article reports the findings of a 2-day public health social work (PHSW) summit that brought together PHSW educators, practitioners, and administrators to generate ideas for preparing the next generation of PHSW leaders. Data from focus groups revealed four themes: the importance of PHSW in our healthcare delivery system, the need for public health social workers to develop their professional identity, the significance of branding/promoting PHSW, and the favorable consequences of infusing PHSW content into social work curricula. Attendees generated ideas for bringing PHSW forward and provided recommendations to accrediting bodies for highlighting the importance of PHSW.
Colorectal cancer in young patients: An institutional experience.

e15140Background: The incidence of colorectal cancer (CRC) in young patients (<50 years) is increasing but little is known about disease characteristics and treatment outcomes in this patient popul...
MicroRNA-210 Promotes Bile Acid-Induced Cholestatic Liver Injury by Targeting Mixed-Lineage Leukemia-4 Methyltransferase in Mice

Background and aims Bile acids (BAs) are important regulators of metabolism and energy balance, but excess BAs cause cholestatic liver injury. The histone methyltransferase mixed-lineage leukemia-4 (MLL4) is a transcriptional coactivator of the BA-sensing nuclear receptor farnesoid X receptor (FXR) and epigenetically up-regulates FXR targets important for the regulation of BA levels, small heterodimer partner (SHP), and bile salt export pump (BSEP). MLL4 expression is aberrantly down-regulated and BA homeostasis is disrupted in cholestatic mice, but the underlying mechanisms are unclear. Approach and results We examined whether elevated microRNA-210 (miR-210) in cholestatic liver promotes BA-induced pathology by inhibiting MLL4 expression. miR-210 was the most highly elevated miR in hepatic SHP-down-regulated mice with elevated hepatic BA levels. MLL4 was identified as a direct target of miR-210, and overexpression of miR-210 inhibited MLL4 and, subsequently, BSEP and SHP expression, resulting in defective BA metabolism and hepatotoxicity with inflammation. miR-210 levels were elevated in cholestatic mouse models, and in vivo silencing of miR-210 ameliorated BA-induced liver pathology and decreased hydrophobic BA levels in an MLL4-dependent manner. In gene expression studies, SHP inhibited miR-210 expression by repressing a transcriptional activator, Kruppel-like factor-4 (KLF4). In patients with primary biliary cholangitis/cirrhosis (PBC), hepatic levels of miR-210 and KLF4 were highly elevated, whereas nuclear levels of SHP and MLL4 were reduced. Conclusions Hepatic miR-210 is physiologically regulated by SHP but elevated in cholestatic mice and patients with PBC, promoting BA-induced liver injury in part by targeting MLL4. The miR-210-MLL4 axis is a potential target for the treatment of BA-associated hepatobiliary disease.
Ethics and Privacy I: Facial Recognition and Robotics

AI has raised major ethics and privacy concerns. We discuss briefly the meaning of ethics and privacy; how facial recognition programs pose possible major threats to privacy as exemplified by China’s photographing of potential naysayers in certain provinces; Alexa and comparable programs which may encode conversations and events that inhabitants are not aware of and may become subject to government seizure and use in criminal proceedings; Amazon’s Recognition program; a Code of Ethics for AI; fear of robotics’ domination of human persons; autonomous lethal weapons; and AI peace initiatives by Peace Machine, the United Nations, and the International Peace Institute.
Comparison of two cortical measures of binaural hearing acuity.

Multiple studies have demonstrated binaural hearing deficits in the aging and those with hearing loss. Consequently, there is great interest in developing efficient clinical tests of binaural heari...
Damage evolution in polymer due to exposure to high-pressure hydrogen gas

Abstract The use of hydrogen as a fuel is increasing exponentially, and the most economical way to store and transport hydrogen for fuel use is as a high-pressure gas. Polymers are widely used for hydrogen distribution and storage systems because they are chemically inert towards hydrogen. However, when exposed to high-pressure hydrogen, some hydrogen diffuses through polymers and occupies the preexisting cavities inside the material. Upon depressurization, the hydrogen trapped inside polymer cavities can cause blistering or cracking by expanding these cavities. A continuum mechanics–based deformation model was deployed to predict the stress distribution and damage propagation while the polymer undergoes depressurization after high-pressure hydrogen exposure. The effects of cavity size, cavity location, and pressure inside the cavity on damage initiation and evolution inside the polymer were studied. The stress and damage evolution in the presence of multiple cavities was also studied, because interaction among cavities alters the damage and stress field. It was found that all these factors significantly change the stress state in the polymer, resulting in different paths for damage propagation. The effect of adding carbon black filler particles and plasticizer on the damage was also studied. It was found that damage tolerance of the polymer increases drastically with the addition of carbon black fillers, but decreases with the addition of the plasticizer.
Regret Guarantees for Online Receding Horizon Learning Control

We address the problem of controlling an unknown linear dynamical system with general cost functions and affine constraints on the control input through online learning. Our goal is to develop an algorithm that minimizes the regret, which is defined as the difference between the cumulative cost incurred by the algorithm and that of a receding horizon controller (RHC) with full knowledge of the system and state and that satisfies the control input constraints. Such performance metric is harder than minimizing the regret w.r.t. the best linear feedback controller commonly adopted in the literature, because the linear controllers might be sub-optimal or violate the constraints throughout. By exploring the conditions under which sub-linear regret is guaranteed, we propose an online receding horizon controller that learns the unknown system parameter from the sequential observation along with the necessary perturbation for exploration. We show that the proposed controller's performance is upper bounded by $\tilde{\mathcal{O}}(T^{3/4})$ for both regret and cumulative constraint violation when the controller has preview of the cost functions for the interval that doubles in size from one interval to the next. We also show that improved upper bound of $\tilde{\mathcal{O}}(T^{2/3})$ can be achieved for both regret and cumulative constraint violation when the controller has full preview of the cost functions.
Reduced intramuscular blood flow correlates with more severe pathology in boys with Duchenne/Becker muscular dystrophy (P3.116)

Objective: To relate intramuscular blood flow to the degree of muscle pathology in two ways: by comparing Duchenne muscular dystrophy (DMD) to Becker muscular dystrophy (BMD) and by correlation with muscle echointensity. Background: Intramuscular blood flow is thought to be reduced in D/BMD and may contribute to the pathology. Blood flow in small intramuscular vessels, unlike large vessels, cannot be quantified using color Doppler sonography. We use a previously developed protocol to quantify blood flow in small intramuscular vessels using power Doppler sonography in muscular dystrophy patients. Design/Methods: We obtained ultrasound images of the anterior forearm (AF) and tibialis anterior (TA) muscles of boys with D/BMD. We quantified the change in intramuscular blood flow between rest and after one minute of exercise, measured as a percentage of muscle area. We compared the change in blood flow between boys with DMD, BMD, and historic controls, and correlate blood flow to the mean echointensity (grey scale level) measured from the same muscle. Results: We imaged 8 boys with DMD and 3 boys with BMD ages 6–19 years old. Intramuscular blood flow (% median change (range)) in the AF was less in 7 of 8 forearms in DMD (0.25% (−0.47 – 2.19)) than the lowest BMD (2.46%(2.02 – 3.38), n=3) and the lowest historic control (2.16%). Intramuscular blood flow in the TA was lower in all (4/4) DMD (0.70% (0.16 – 1.89)) than the lowest BMD (5.08% (2.28 – 9.51), n=3) and the lowest historic control (3.91%). Intramuscular blood flow in boys with D/BMD decreased with higher muscle echogenicity (rs= −0.6, p=0.007). Conclusions: Intramuscular blood flow in boys with D/BMD can be quantified using power Doppler, and reduction correlates with more severe pathology in DMD compared to BMD and as measured by echointensity. Disclosure: Dr. Dietz has nothing to disclose. Dr. Connolly has received personal compensation for activities with Catabasis, Sarepta, BMSquibb, Fibrogen Therapeutics, Cytokinetics, Avexis, and Bamboo. Dr. Connolly has received research support from PTC Therapeutics, Serapta Therapeutics, Lilly, Fibrogen, Cytokinetics, Ionis, ISIS, Halo Therapeutics Dr. Golumbek has nothing to disclose. Dr. Zaidman has nothing to disclose.
3,4,5-Trimethoxy Substitution on an N-DMBI Dopant with New N-Type Polymers: Polymer-Dopant Matching for Improved Conductivity-Seebeck Coefficient Relationship.

Achieving high electrical conductivity and thermoelectric power factor simultaneously for n-type organic thermoelectrics is still challenging. By constructing two new acceptor-acceptor n-type conjugated polymers with different backbones and introducing the 3,4,5-trimethoxyphenyl group to form the new n-type dopant 1,3-dimethyl-2-(3,4,5-trimethoxyphenyl)-2,3-dihydro-1H-benzo[d]imidazole (TP-DMBI) , high electrical conductivity of 11 S cm -1 and power factor of 32 μW m -1 K -2 are achieved. Calculations using Density Functional Theory show that TP-DMBI presents a higher singly occupied molecular orbital (SOMO) energy level of -1.94 eV than that of the common dopant 4-(1, 3-dimethyl-2, 3-dihydro-1H-benzoimidazol-2-yl) phenyl) dimethylamine (N-DMBI) (-2.36 eV), which can result in a larger offset between the SOMO of dopant and lowest unoccupied molecular orbital (LUMO) of n-type polymers, though that effect may not be dominant in the present work. The doped polymer films exhibit higher Seebeck coefficient and power factor than films using N-DMBI at the same doping levels or similar electrical conductivity levels. Moreover, TP-DMBI doped polymer films offer much higher electron mobility of up to 0.53 cm 2 V -1 s -1 than films with N-DMBI doping, demonstrating the potential of TP-DMBI, and 3,4,5-trialkoxy DMBIs more broadly, for high performance n-type organic thermoelectrics.
Photoproduction of K^+ Mesons in Hydrogen

The photoproduction of K^+ mesons in hydrogen has been measured with the purpose of extending the previous CalTech measurements to smaller angles, and obtaining better absolute values for the cross sections. The technique of Donoho and Walker, using a magnetic spectrometer and a time-of-flight measurement to detect the K^+ mesons, was modified so as to achieve a better discrimination against pions and scattered protons. The results obtained are in fairly good agreement with the more extensive measurements made at Cornell by a somewhat different method.
An Analysis of Monthly Mean Wind Stress Over the Global Ocean

The annual mean and four monthly means are calculated for the global ocean wind stress fields. The main data base was gathered by observations along continental coasts and on shipping routes, expressed in terms of the monthly mean speed, eight direction categories, and the rms of the speeds. The stress fields were estimated by assuming a Gaussian distribution for the speed frequency distribution histogram. The resulting data set is concluded useful for general circulation modeling, although the 5 deg resolution could lead to an underestimation of the curl.
Laser Detection of Latent Fingerprints: Treatment with Glue Containing Cyanoacrylate Ester

It has previously been shown that fuming with glue containing cyanoacrylate ester can be valuable in the development of latent fingerprints. Glue-treated fingerprints can provide improved detail via fluorescence under ultraviolet and blue-green argon-ion laser illumination. In addition, glue treatment can be effectively combined with dusting using fluorescent powder, staining using fluorescent dye, and the ninhydrin/zinc chloride method, together with laser examination.
Exploring Preservice Teachers’ Mental Models of the Environment

A major premise underlying this chapter is that if preservice teachers are aware of their mental models of the environment, they will want to develop more accurate images that inform how they will teach about the environment in the future. This chapter describes how we used drawings as a survey tool to uncover preservice teachers’ mental models of the environment, our findings, and programmatic changes that we implemented as a response to our study. Building on previous science education research using drawings that describe preservice teachers’ beliefs about the subject of science, we developed the Draw-An-Environment Test (DAET). We then developed a rubric based on the NAAEE Guidelines for the Preparation and Professional Development of Environmental Educators (2004) for scoring the drawings, the Draw-An-Environment Test Rubric (DAET-R), to quantitatively analyze the data collected using the DAET.
Transmission Lines and Plane Waves

This chapter contains sections titled: Transmission Line Theory Wave Equations and General Solutions Plane Waves Generated by A Current Sheet Reflection and Transmission Plane Waves in Anisotropic and Bi-Isotropic Media References Problems
HELICAL TOMOTHERAPY SETUP VARIATIONS IN CANINE NASAL TUMOR PATIENTS IMMOBILIZED WITH A BITE BLOCK

The purpose of our study was to compare setup variation in four degrees of freedom (vertical, longitudinal, lateral, and roll) between canine nasal tumor patients immobilized with a mattress and bite block, versus a mattress alone. Our secondary aim was to define a clinical target volume (CTV) to planning target volume (PTV) expansion margin based on our mean systematic error values associated with nasal tumor patients immobilized by a mattress and bite block. We evaluated six parameters for setup corrections: systematic error, random error, patient-patient variation in systematic errors, the magnitude of patient-specific random errors (root mean square [RMS]), distance error, and the variation of setup corrections from zero shift. The variations in all parameters were statistically smaller in the group immobilized by a mattress and bite block. The mean setup corrections in the mattress and bite block group ranged from 0.91 mm to 1.59 mm for the translational errors and 0.5°. Although most veterinary radiation facilities do not have access to Image-guided radiotherapy (IGRT), we identified a need for more rigid fixation, established the value of adding IGRT to veterinary radiation therapy, and define the CTV-PTV setup error margin for canine nasal tumor patients immobilized in a mattress and bite block.
SYNTHESIS OF RIBONUCLEIC ACID BY X-IRRADIATED BACTERIA

Frampton, E. W. (The University of Texas M. D. Anderson Hospital and Tumor Institute, Houston). Synthesis of ribonucleic acid by X-irradiated bacteria. J. Bacteriol. 87:1369–1376. 1964.—Postirradiation synthesis of total ribonucleic acid (RNA) and of RNA components was measured after exposure of Escherichia coli B/r to X rays. Net synthesis of RNA measured by the orcinol reaction and by the incorporation of uridine-2-C14 was depressed in irradiated cells, but paralleled the period of postirradiation growth (30 to 40 min). Incorporation of uridine-2-C14, added after net synthesis of RNA had ceased, detected an apparent turnover in a portion of the RNA. Irradiated cells retained their ability to adjust RNA synthesis to growth rate. After a shift-down in growth rate, irradiated cells incorporated radioactive uridine, while the net synthesis of RNA ceased—presumptive evidence for a continued synthesis of messenger RNA. Chloramphenicol addition (100 μg/ml) did not influence the total amount of RNA synthesized. Synthesis of ribosomes and transfer RNA preceded by 0, 5, 10, and 15 min of postirradiation incubation was observed by the resolution of cell-free extracts on sucrose density gradients. Little immediate influence of irradiation could be detected on the synthesis of 50S and 30S ribosomes. A decline was observed in the synthesis of 50S ribosomes with continued postirradiation incubation; 30S ribosomes, ribosomal precursors, and 4S RNA continued to be synthesized.
Fluid-property effects on flow-generated waves on a compliant surface

An experimental study of the influence of liquid viscosity and viscoelasticity on flow-generated waves on a compliant surface has been conducted in a rotating-disk geometry. Over the entire range of liquid properties studied, each test gave a well-defined critical onset flow velocity above which waves were present and below which no waves were observed. This onset velocity increased with increasing fluid viscosity, and for sufficiently high viscosities the onset occurred when the flow on the disk was laminar rather than turbulent. The effects of liquid viscoelasticity were examined in the turbulent flow using dilute solutions of high-molecular-weight polymers. This type of viscoelasticity had little influence on the onset flow velocity in these circumstances, but did make the wave structure on the surface more regular in appearance than when the liquid was Newtonian. In all cases the wave structure produced a dramatic increase in drag similar to that expected for a rough surface. For the viscoelastic fluid, however, the increase in drag was much less than for a viscous fluid of the same viscosity.