cssi/SciSciGPT-SciSciNet huggingface dataset:
A 6-year review of total parenteral nutrition use and association with late-onset acute respiratory distress syndrome among ventilated trauma victims.

Abstract Aim To establish whether total parenteral nutrition (TPN) for ventilated trauma victims is associated with late-onset acute respiratory distress syndrome (ARDS) independent of ventilation and transfusion parameters. Method Intensive care unit data over 6 years from a level I centre regarding all trauma victims ≥16 years old who underwent mechanical ventilation within the first 48 h of admission were examined. Patients were prospectively followed for late ARDS. Variables were examined for significant changes over time and independent associations with late ARDS were determined. Results Of 2346 eligible patients among whom 404 (17.2%) were exposed to TPN, 192 (8.2%) met criteria for late ARDS. The incidence of late ARDS among those exposed to TPN was 28.7% (116/404) compared with 3.9% (76/1942) among those not so exposed. Adjustments for potential confounding associated risk factors were made. Conclusions TPN administration is independently associated with late ARDS, and its use among critically ill trauma victims should be carefully scrutinised.
Thrombin and NAD(P)H Oxidase–Mediated Regulation of CD44 and BMP4-Id Pathway in VSMC, Restenosis, and Atherosclerosis

To characterize novel signaling pathways that underlie NAD(P)H oxidase-mediated signaling in atherosclerosis, we first examined differences in thrombin-induced gene expression between wild-type and p47phox(-/-) (NAD[P]H oxidase-deficient) VSMC. Of the 9000 genes analyzed by cDNA microarray method at the G1/S transition point, 76 genes were similarly and significantly modulated in both the cell types, whereas another 22 genes that encompass various functional groups were regulated in NAD(P)H oxidase-dependent manner. Among these 22 genes, thrombin-induced NAD(P)H oxidase-mediated regulation of Klf15, Igbp1, Ak4, Adamts5, Ech1, Serp1, Sec61a2, Aox1, Aoh1, Fxyd5, Rai14, and Serpinh1 was shown for the first time in VSMC. The role of NAD(P)H oxidase in the regulation of a subset of these genes (CD44, BMP4, Id1, and Id3) was confirmed using modulators of reactive oxygen species (ROS) generation, a ROS scavenger and in gain-of-function experiments. We then characterized regulation of these genes in restenosis and atherosclerosis. In both apoE(-/-) mice and in a mouse vascular injury model, these genes are regulated in NAD(P)H oxidase-dependent manner during vascular lesion formation. Based on these findings, we propose that NAD(P)H oxidase-dependent gene expression in general, and the CD44 and BMP4-Id signaling pathway in particular, is important in restenosis and atherosclerosis.
Focus, Intensity, and Tenacity (FIT) Training: A relapse prevention-based intervention to stop the downward spiral

AbstractRelapse prevention (RP) training prepares individuals to self-manage behavior to respond appropriately in high-risk situations. FIT (Focus, Intensity, and Tenacity) Training, an RP-based intervention, is designed to prevent or stop relapse into negative self-talk that can lead to the downward spiral. Athletes identify situational triggers and appropriate behavioral and cognitive responses to challenging situations to help ensure optimal performance. An example of successfully implementing FIT Training with a high-potential team is presented. RP/FIT Training can serve as an important intervention to prevent/stop relapse and to ensure the successful transfer of mental skills in competitive situations.
Flight Activity of the Threecornered Alfalfa Hopper (Homoptera: Membracidae) in Soybean

Threecornered alfalfa hopper, Spissistilus festinus (Say), flight studies conducted with yellow sticky traps (3 m tall) in soybean, Glycine max (L.) Merr., showed that movement is primarily within 33 cm above the substrate. Two peaks in flight activity were detected in 1986 and one in 1987; significantly more males than females were trapped. Lateseason population peaks were detected by sweep net samples but not by sticky traps. Prevailing wind, sunny and shady exposures on sticky traps, and adjacent crops appeared to have no effect on trap catches. The proportion of nongravid females increased near the end of the growing season.
The F-actin bundler α-actinin Ain1 is tailored for ring assembly and constriction during cytokinesis in fission yeast

The actomyosin contractile ring is a network of cross-linked actin filaments that facilitates cytokinesis in dividing cells. Contractile ring formation has been well characterized in Schizosaccharomyces pombe, in which the cross-linking protein α-actinin SpAin1 bundles the actin filament network. However, the specific biochemical properties of SpAin1 and whether they are tailored for cytokinesis are not known. Therefore we purified SpAin1 and quantified its ability to dynamically bind and bundle actin filaments in vitro using a combination of bulk sedimentation assays and direct visualization by two-color total internal reflection fluorescence microscopy. We found that, while SpAin1 bundles actin filaments of mixed polarity like other α-actinins, SpAin1 has lower bundling activity and is more dynamic than human α-actinin HsACTN4. To determine whether dynamic bundling is important for cytokinesis in fission yeast, we created the less dynamic bundling mutant SpAin1(R216E). We found that dynamic bundling is critical for cytokinesis, as cells expressing SpAin1(R216E) display disorganized ring material and delays in both ring formation and constriction. Furthermore, computer simulations of initial actin filament elongation and alignment revealed that an intermediate level of cross-linking best facilitates filament alignment. Together our results demonstrate that dynamic bundling by SpAin1 is important for proper contractile ring formation and constriction.
R&D Intensity, Ability Indicators, and Executive Compensation

We examine the relation between R&D intensity and the weights on ability indicators and financial performance measures in CEO compensation. The CEO’s technology-related ability is likely more important in R&D intensive firms. Therefore, we predict that these firms place higher weights on indicators of technology-related ability, using the compensation contract as a screening device to mitigate the adverse selection problem. Both accounting and market performance measures are likely noisier in R&D intensive firms. Therefore, we predict that these firms rely less on short-term incentives tied to concurrent earnings and stock returns and rely more on long-term equity incentives. We test these predictions using hand-collected data on the education and professional background of the CEOs in Execucomp during 1992-2006. The results support our predictions and are robust. While prior research examined performance compensation in the context of moral hazard, our findings suggest that compensation based on ability indicators plays a screening role in the context of adverse selection.
Comparison of Percutaneous Renal Mass Biopsy and R.E.N.A.L. Nephrometry Score Nomograms for Determining Benign Vs Malignant Disease and Low-risk Vs High-risk Renal Tumors.

Objective To compare the accuracies of renal mass biopsy (RMB) and R.E.N.A.L. nephrometry score (RNS) nomograms for predicting benign vs malignant disease, and low- vs high-risk renal tumors. Materials and Methods We included 281 renal masses in 277 patients who had complete RNS, preoperative RMB, and final pathology from renal surgery for clinically localized renal tumors. RMB and final pathology were determined to be benign or malignant, and malignancies were classified as low-risk (Fuhrman grade I/II) or high-risk (Fuhrman grade III/IV) (benign included in low-risk group). Previously published RNS nomograms were used to determine probabilities of any cancer and high-risk cancer. The gamma statistic was used to assess strength of association between RMB or RNS with final pathology. Results Of the 281 masses, 13 (5%) and 268 (95%) were confirmed benign and malignant, respectively, and 155 (55%) and 126 (45%) were confirmed low-risk and high-risk, respectively, on final pathology. The areas under the curve of the RNS nomograms for benign vs malignant disease and for low-risk vs high-risk renal tumors were 0.56 and 0.64, respectively. Concordances for predicting benign vs malignant disease were 99% for RMB ( P P = .16, gamma 0.38). Concordances for predicting low-risk vs high-risk renal tumors were 67% for RMB ( P P Conclusion Although RNS nomograms are useful for discriminating between benign vs malignant renal masses, and low-risk vs high-risk renal tumors, they are outperformed by RMB.
Dyscalculia and Attention Deficit Subtypes

The association of specific academic deficits with attention deficit disorder (ADD) subtypes was determined in 20 students (ages 8-12) with ADD with hyperactivity (ADD/H) compared to 20 with ADD without hyperactivity (ADD/noH), at the Department of Educational Psychology, University of Texas at Austin, TX.
Start Me Up: When Exploring Entrepreneurial Intentions, Think EQ Not IQ

This paper addresses the proposition of emotional intelligence (EQ) as an antecedent of entrepreneurial intentions. I review the relevant theoretical backgrounds in support of an intentions-based model to explain entrepreneurship behavior, and examine the influence of the theory of emotional intelligence in shaping an entrepreneur’s attitudes, behaviors, and the eventual decision of launching a business. I suggest that entrepreneurial EQ positively influences entrepreneurial intentions. In an era of global expansion, companies are seeking innovative ways to increase international market share, boost revenues, improve levels of employee engagement, and elevate managerial performance and reduce expenses (Altman, Shactman & Eilat, 2006; Wensveen, 2015). This study focuses on managers within a specific organization, as opposed to individuals looking to start new businesses. As such, it aims to contribute to the existing stream of literature by focusing on the entrepreneurial intentions of a global, supply-chain management firm’s area managers, who are starting new value propositions. The aviation supply-chain environment is critical because over the next twenty years, there is an expected revenue stream of $5.2 trillion USD (Boeing Market Outlook, 2014).
Secure communication and signal processing in inertial navigation systems

This paper focuses on secure communication, data-analytic signal processing and robust algorithms for inertial navigation systems (INSs). Middleware, software, data processing and algorithms are studied. We examine and report high-impact technology developments as applied to current and next generations of INSs. We research advanced microelectronic, processing and software solutions. New architectures, algorithms and protocols for robustly reconfigurable networked inertial systems are studied. Examining advanced-technology inertial measurement units with application-specific integrated circuits, long-standing problems are solved. The INSs impediments are minimized by using intelligent processing schemes, consistent algorithms and software. Precision, accuracy, resolution, stability, bandwidth and dynamic range are improved by attenuating noise, reducing static error and minimizing dynamic error. We present results on secure communication for transmitting mission critical data over heterogeneous networks.
A Leadership Framework for Culture Change in Health Care

Article-at-a-Glance Background In 2005, Ascension Health's strategic direction sharpened the focus of its 2002 Call to Action to provide "Healthcare That Works, Healthcare That Is Safe, and Healthcare That Leaves No One Behind, for Life," Ascension Health has used a framework, the Five Cs of Culture Change, to address the call to action—comprehension (understanding the problem), compassion (spirituality and commitment), collaboration (teaming between subcultures and providers), coordination (system processes, infrastructure, and ideation), and convergence (leadership of local culture with spread and dissemination of new norms in a rapid way). The Five Cs of Culture Change and Culture Surveys Climate (or culture) of safety results are provided from a baseline systemwide survey of front-line caregivers' assessments of teamwork and patient safety. The findings are aggregated at the hospital level, clinical area level, and caregiver role level, and fed back to executives, managers, and front-line caregivers. The final major element of culture change, and arguably the most important, involves the leadership and fortitude necessary to stimulate convergence of the culture on a new way of doing things. Conclusion Ascension Health will continue to use a systemwide culture survey for front-line assessments' of safety and teamwork across all clinical areas and to discover best practices and track progress in improving performance.
Performance Analysis of TaSiO x Inspired Sub-10 nm Energy Efficient In 0.53 Ga 0.47 As Quantum Well Tri-Gate Technology

In this paper, for the first time, the performance analysis of short channel In0.53Ga0.47As quantum well (QW) 3-D tri-gate technology with advanced high- $\kappa $ gate dielectric, TaSiOx is presented. We benchmark the projected performance of sub-10 nm In0.53Ga0.47As transistor technology as a function of fin width, fin aspect ratio, and gate length scaling based on present-day lithographic advancement aiding InGaAs QW tri-gate technology as a replacement to Si for sub-10 nm transistor technology. The highly scaled oxide (EOT ~ 12 $\mathring {\text{A}}$ ) while retaining superior interfacial properties ( $\text{D}_{\mathrm{ it}}~\sim ~4\times 10^{11}$ cm−2eV−1) provides higher ON current for given idle performance. Furthermore, the simulated In0.53Ga0.47As tri-gate transistor exhibits superior gate electrostatic control with low OFF-state current ( $\text{I}_{\mathrm{ OFF}}$ ) ~ 24.5 nA/ $\mu \text{m}$ , peak transconductance ( $g_{m}$ ) ~ 2 mS/ $\mu \text{m}$ and high ${I} _{\mathrm{ ON}}/{I} _{\mathrm{ OFF}}$ ratio $\sim ~2.3\times 10^{3}$ , aiding the case of alternate channel transistors for high-speed and low-power CMOS logic.
Effects of dietary selenium and moisture on the physical activity and thyroid axis of cats.

Summary Consumption of canned cat food is considered a risk factor for the development of feline hyperthyroidism. Because selenium and water are substantially higher in canned diets compared to dry diets, objectives of this study were to determine whether increased dietary selenium or water alters the function of the hypothalamic–pituitary–thyroid axis and leads to an increase in activity level. Employing a 28-day latin square design with a 14-day washout, six lean, neutered male domestic shorthair cats were fed (i) commercially available adult dry feline diet containing 0.8 ppm selenium (control), (ii) control diet with added sodium selenite to achieve a dietary selenium concentration of 1.125 ppm (selenium treatment) and (iii) the control diet with additional water to achieve a moisture content of 75% wt/wt (water treatment). Water consumption was determined using deuterium oxide washout. Actical activity monitors were placed on each cat's collar to allow quantification of the activity of each cat. Circulating serum T3 and T4 was measured on days 0, 14, and 28. On day 28, a thyrotropin-releasing hormone (TRH) stimulation test was conducted to determine treatment effects on serum concentrations of thyroid hormones. There was a significant increase in daily water consumption with dietary water treatment (192 ml ± 7.85 SEM) compared to the control (120 ml ± 20.4) and selenium (116 ml ± 14.6) treatments. Both water and selenium treatments were associated with greater (p < .05) activity over that of the control treatment by 20.5% and 11% respectively. Serum TT3 AUC concentrations (0–4 hr) of TRH stimulation tests were greater (p < .05) by 16% with water compared to control treatments. The results of this study indicate that dietary water content may alter the function of the thyroid axis and that this effect is associated with an increase in physical activity.
Altered translation initiation of Gja1 limits gap junction formation during epithelial–mesenchymal transition

Epithelial-mesenchymal transition (EMT) is activated during development, wound healing, and pathologies including fibrosis and cancer metastasis. Hallmarks of EMT are remodeling of intercellular junctions and adhesion proteins, including gap junctions. The GJA1 mRNA transcript encoding the gap junction protein connexin43 (Cx43) has been demonstrated to undergo internal translation initiation, yielding truncated isoforms that modulate gap junctions. The PI3K/Akt/mTOR pathway is central to translation regulation and is activated during EMT, leading us to hypothesize that altered translation initiation would contribute to gap junction loss. Using TGF-β-induced EMT as a model, we find reductions in Cx43 gap junctions despite increased transcription and stabilization of Cx43 protein. Biochemical experiments reveal suppression of the internally translated Cx43 isoform, GJA1-20k in a Smad3 and ERK-dependent manner. Ectopic expression of GJA1-20k does not halt EMT, but is sufficient to rescue gap junction formation. GJA1-20k localizes to the Golgi apparatus, and using superresolution localization microscopy we find retention of GJA1-43k at the Golgi in mesenchymal cells lacking GJA1-20k. NativePAGE demonstrates that levels of GJA1-20k regulate GJA1-43k hexamer oligomerization, a limiting step in Cx43 trafficking. These findings reveal alterations in translation initiation as an unexplored mechanism by which the cell regulates Cx43 gap junction formation during EMT.
Thermal Energy Storage Configurations for Small Modular Reactor Load Shedding

The increased penetration of intermittent renewable energy technologies such as wind and solar power can strain electric grids, forcing carbon-based and nuclear sources of energy to operate in a lo...
RIDGE ESTIMATORS AS CONSTRAINED GENERALIZED LEAST SQUARES

Publisher Summary Ridge regression has been an extremely popular topic in the statistical literature over the last decade. The dominance of mean square error consideration in the ridge regression literature has to some extent mitigated the practical importance of other criteria, which can lead to the adoption of a ridge type estimator. The ridge estimator form can be justified in toto as a constrained least squares solution and, in a Bayesian context, as the mean of a posterior distribution. This chapter presents the extension of these justifications to a regression model with an error term possessing an arbitrary covariance matrix and to derive a ridge form compatible with generalized least squares (rather than ordinary least squares). Hsu and Puterman have considered ridge estimators in this class. In particular, these authors derive an analytic expression for the mean square error of the ordinary ridge estimator in the presence of autocorrelated errors. They also derive, and with Monte Carlo simulations examine the performance of, a generalization of ridge regression emanating from generalized least squares.
Cavia porcellus (Guinea pig)

Only the two largest pairs of autosomes and the X chromosome are individually identifiable. Pairing of all other autosomes and identification of the Y are arbitrary. In females, one entire X and possibly the short arm of the second X are late replicating. Several teams of investigators have found that the short arm of the largest subtelocentric autosomes is polymorphic. It may be completely absent, a single, knob-like structure (as shown here), or two such structures with a secondary constriction separating these two components. Cohen and Pinsky, from their breeding studies, concluded that the polymorphism is a result of deletion and duplication of the short arm, so that the karyotypes presented here should be considered normal.
The Role of Lipoproteins in Atherogenesis

Lipoproteins unquestionably play a crucial role in atherogenesis, since populations around the world which have low plasma cholesterol levels do not experience much clinical atherosclerotic disease, regardless of the presence of other risk factors such as smoking and hypertension. Current knowledge about the role of lipoproteins in atherogenesis can be categorized into four general areas. The first concerns the transport and distribution of lipoproteins within the arterial wall. The most remarkable fact here is that the tissue concentration of low density lipoproteins (LDL) in the arterial intima is very high compared to all other connective tissues in the body.
Use of electronic medical record templates improves quality of care for patients with infantile spasms.

Background:Infantile spasms (IS) is a neurologic disorder of childhood where time to treatment may affect long-term outcomes. Due to the clinical complexity of IS, care can be delayed.Objective:To ...
Factors associated with boarding and length of stay for pediatric mental health emergency visits

Abstract Objective To determine demographic and clinical risk factors associated with boarding (length of stay ≥24 h) for pediatric mental health emergency department (ED) visits. Methods This is a retrospective cross-sectional analysis of mental health visits identified by diagnosis codes for children 5–18 years old presenting to a tertiary pediatric ED in 2016. We performed multivariate logistic regression to identify demographic and clinical factors associated with boarding. Results There were 1746 mental health visits and 386 (22%) visits had length of stay ≥24 h. In the multivariate logistic regression model, factors associated with boarding included: private insurance (OR 1.59, 95% CI 1.15, 2.19) and having both private and public insurance (OR 1.68, 95% CI 1.16, 2.43) relative to public insurance; presentation during a school month (OR 2.17, 95% CI 1.30, 3.63); physical or chemical restraint use (OR 4.80, 95% CI 2.61, 8.84); comorbid autism or developmental delay (OR 1.82, 95% CI 1.35, 2.46); prior psychiatric hospitalization (OR 2.55, 95% CI 1.93, 3.36); and reasons for presentation of agitation, aggression, or homicidal ideation (OR 2.76, 95% CI 1.40, 5.45), depression, self-injury, or suicidal ideation (OR 2.79, 95% CI 1.45, 5.40), and bipolar, mania, or psychosis (OR 5.78, 95% CI 2.36, 14.09) relative to anxiety. Conclusions Insurance status, presentation month, restraint use, autism or developmental delay comorbidity, prior psychiatric hospitalization, and reason for presentation are associated with pediatric mental health ED boarding. Resources should be directed to improve the mental health care system for children with identified risk factors for boarding.
MRI quantitation of abdominal skeletal muscle correlates with CT-based analysis: implications for sarcopenia measurement

Sarcopenia is associated with poor outcomes in a variety of conditions, including malignancy. Abdominal skeletal muscle area (SMA) segmentation using computed tomography (CT) has been shown to be a...
Additive Manufacturing of RF Metal-Insulator-Metal (MIM) Capacitors on Flexible Substrate

This study aims to demonstrate the fabrication of radio-frequency (RF) metal-insulator-metal (MIM) polyimide capacitors on a flexible Kapton ™ (polyimide film) substrate using a purely additive manufacturing technology. The aerosol jet printing technology can effectively replace the use of bulky lumped components in the RF circuits such as filters, matching networks, oscillators, resonators, and mixers. Two capacitor geometries with areas of 0.25, and 0.5625 mm2have been printed. Optical profilometry of the printed metal capacitor plates and the polyimide (insulation) film show that they have average thicknesses of $\pmb{2.34 \pm 0.22\mu} \mathbf{m}$ and $\pmb{4.05 \pm 0.44\mu} \mathbf{m}$ , respectively. The measured capacitance for the set of capacitors are $\pmb{1.746\pm 0.231}\ \mathbf{pF}$ and $\pmb{2.513\pm 0.133}\mathbf{pF}$ , which is equivalent to a capacitance tolerance of 10% and 5%, respectively. The S-parameters were measured using the vector network analyzer up to frequency of 50 GHz and a lumped circuit model is extracted and presented through the Smith Chart using Advanced Design System TM. Moreover, the results of normalized measured capacitance and conductance as a function of temperature, adhesion, temperature (100°C/ice bath) cycling, and the maximum operating voltage of the capacitor are presented.
The Effects of 24-Hour Neurosurgical Call on Fine Motor Dexterity, Cognition, and Mood.

BACKGROUND Concerns regarding the effects of fatigue on physician performance and quality of life lead to the implementation of duty hour restrictions for residents by the Accreditation Council for Graduate Medical Education (ACGME). These restrictions have been met by strong criticism from the neurosurgical community. This is partly due to a lack of objective evidence that fatigue results in decrements in professional function in neurological surgeons. There is also concern that the restrictions have diminished clinical and operative experience as well as the development of professional responsibility in residency. OBJECTIVE To evaluate whether 24-hour neurosurgical call has an objective impact on fine motor dexterity, cognitive thinking skills, and mental well-being. METHODS Subjects were tested before and after taking 24 hours of neurosurgical call. We evaluated fine motor dexterity using the Vienna Test System Motor Performance Series, cognitive thinking abilities using a battery of paper-pencil neuropsychological tests, and mental well-being using the Profile of Mood States. Results: A total of 27 subjects were included in this study, 12 seasoned to neurosurgical call and 15 naive to neurosurgical call. The seasoned subjects demonstrated no statistically significant change in performance after call on any of the tests for fine motor dexterity or cognitive thinking abilities. The nonseasoned subjects demonstrated multiple decrements in fine motor dexterity and cognitive thinking abilities after taking call. In the Motor Performance Series, they had a statistically significant decrease in the speed of untargeted movements in the nondominant hand during the tapping test (p = 0.002), and a decline in the precision of fine motor movements and information processing as evidenced by an increase in the number of errors of the dominant hand in the line tracking test (p = 0.014). There was a statistically significant decline in their immediate memory during Hopkins Verbal Learning Test (p = 0.025), and complex attention, mental flexibility, and visual-motor speed in the Trail Making Test (p = 0.03). The Profile of Mood States found no difference in feelings of anger (p = 0.54), tension (p = 0.358), or depression (p = 0.65). There were increased feelings of confusion (p < 0.001) and decreased feelings of vigor (p < 0.001) and friendliness (p = 0.001). Nonseasoned subjects had an increase in total mood disturbance (p = 0.012) but seasoned subjects did not (p = 0.083). Conclusion: Our results suggest that fatigue-induced decrements in professional function can be ameliorated by experience with prolonged duty hours. In contrast to nonseasoned subjects, those who were conditioned to 24-hour neurosurgical call demonstrated resilience in fine motor dexterity and cognitive thinking skills, and exhibited no change in total mood disturbance. An argument can be made that we are turning the neurosurgical training paradigm upside down with the current ACGME duty hour restrictions.
Treatable Movement Disorders of Infancy and Early Childhood

Movement disorders in childhood can be difficult to diagnose early. Disease processes present variably and can mimic each other. It is particularly important to remain vigilant for the subset of these movement disorders that are treatable. These disorders can be managed with (1) treatments specific to the disease that substantially reduce symptoms; (2) treatments that can prevent progression; (3) treatments that can hasten recovery; or (4) surveillance and management of the associated, sometimes life-threatening, comorbidities. Here, we present a practical and phenomenology-oriented framework for diagnosing and managing these treatable movement disorders of infancy and early childhood.
Bio-Behavioral Indices of Emotion Regulation: Potential Targets for Treatment in Addiction

Emotion regulation and the manner in which it is comprised play a key role in the motivation for drugs and alcohol. As such, the bio-behavioral processes underpinning aspects of emotion regulation behavior may provide expedient targets for treatment development. This review will examine some of the robust emotional, psychophysiological, and neurobiological adaptations that sub-serve affect regulation behaviors during early abstinence from addiction and assess their potential as targets for treatment development. During early abstinence from addiction, individuals report problems with emotional awareness and impulse control during distress as well as enhanced, persistent negative mood in the face of acute psychological stress. In line with this, psychophysiological research studies have used non-affective indices of emotional awareness to show poor interoceptive accuracy. Moreover, imaging research has highlighted hypofunctional prefrontal circuitry in regulatory brain regions and amygdala/insula adaptations that are also compatible with decrements in emotional awareness, enhanced provoked dysphoria and decreased impulse control. There is also some evidence to suggest that targeting these indices of emotion regulation behavior using mindfulness-based meditation and medication therapies may be effective in improving outcome. The biological construct of emotion regulation has helped to provide an important heuristic framework within which to develop novel treatment markers. However, there remains a need for more contextual and situational-based research to achieve a more holistic understanding of emotion regulation for improved clinical application.
Laws and Ethics Related to Emotional Support Animals

The use of animals for therapeutic benefit is well-established. For example, for individuals with a disability such as blindness, trained service dogs can enhance the ability to live independently and participate fully in society. An emotional support animal (ESA) is an untrained animal that is used to support a person disabled by an emotional or mental disorder. For an animal to qualify as an ESA, a mental health or medical professional needs to write a letter saying that the animal is needed for the mental health of the person with the disability. This article describes the legal framework for service animals and ESAs, as well as the differences between them. We summarize information about the Americans with Disabilities Act, the Fair Housing Act, the Air Carrier Access Act, and other laws governing an individual's right to be accompanied by a support animal. We also summarize the clinical research on ESAs and argue that, although there are few studies on the clinical effectiveness of ESAs, a broader body of research indicates that animals may have positive clinical effects on medical and mental illness. Finally, we suggest there is a need for further research and provider education on ESAs.
Integration of Risk Survival Measures Estimated From Pre- and Posttreatment Computed Tomography Scans Improves Stratification of Patients With Early-Stage Non-small Cell Lung Cancer Treated With Stereotactic Body Radiation Therapy.

Purpose To predict overall survival of patients receiving stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (ES-NSCLC), we developed a radiomic model that integrates risk of death estimates and changes based on pre- and posttreatment computed tomography (CT) scans. We hypothesize this innovation will improve our ability to stratify patients into various oncologic outcomes with greater accuracy. Methods and Materials Two cohorts of patients with ES-NSCLC uniformly treated with SBRT (a median dose of 50 Gy in 4-5 fractions) were studied. Prediction models were built on a discovery cohort of 100 patients with treatment planning CT scans, and then were applied to a separate validation cohort of 60 patients with pre- and posttreatment CT scans for evaluating their performance. Results Prediction models achieved a c-index up to 0.734 in predicting survival outcomes of the validation cohort. The integration of the pretreatment risk of survival measures (risk-high vs risk-low) and changes (risk-increase vs risk-decrease) in risk of survival measures between the pretreatment and posttreatment scans further stratified the patients into 4 subgroups (risk: high, increase; risk: high, decrease; risk: low, increase; risk: low, decrease) with significant difference (χ2 = 18.549, P = .0003, log-rank test). There was also a significant difference between the risk-increase and risk-decrease groups (χ2 = 6.80, P = .0091, log-rank test). In addition, a significant difference (χ2 = 7.493, P = .0062, log-rank test) was observed between the risk-high and risk-low groups obtained based on the pretreatment risk of survival measures. Conclusion The integration of risk of survival measures estimated from pre- and posttreatment CT scans can help differentiate patients with good expected survival from those who will do more poorly following SBRT. The analysis of these radiomics-based longitudinal risk measures may help identify patients with early-stage NSCLC who will benefit from adjuvant treatment after lung SBRT, such as immunotherapy.
THE MOSDEF SURVEY: EXCITATION PROPERTIES OF z ∼ 2.3 STAR-FORMING GALAXIES*

Author(s): Shapley, AE; Reddy, NA; Kriek, M; Freeman, WR; Sanders, RL; Siana, B; Coil, AL; Mobasher, B; Shivaei, I; Price, SH; Groot, LD | Abstract: We present results on the excitation properties of z ∼ 2.3 galaxies using early observations from the MOSFIRE Deep Evolution Field (MOSDEF) Survey. With its coverage of the full suite of strong rest-frame optical emission lines, MOSDEF provides an unprecedented view of the rest-frame optical spectra of a representative sample of distant star-forming galaxies. We investigate the locations of z ∼ 2.3 MOSDEF galaxies in multiple emission-line diagnostic diagrams. These include the [O iii]λ5007/Hβ vs. [N ii]/Hα and [O iii]λ5007/Hβ vs. [S ii]λλ6717, 6731/Hα "BPT" diagrams, as well as the O32 vs. R23 excitation diagram. We recover the well-known offset in the star-forming sequence of high-redshift galaxies in the [O iii]λ5007/Hβ vs. [N ii]/Hα BPT diagram relative to Sloan Digital Sky Survey star-forming galaxies. However, the shift for our rest-frame optically selected sample is less significant than for rest-frame-UV selected and emission-line selected galaxies at z ∼ 2. Furthermore, we find that the offset is mass-dependent, only appearing within the low-mass half of the z ∼ 2.3 MOSDEF sample, where galaxies are shifted toward higher [N ii]/Hα at fixed [O iii]/Hβ. Within the [O iii]λ5007/Hβ vs. [S ii]/Hα and O32 vs. R23 diagrams, we find that z ∼ 2.3 galaxies are distributed like local ones, and therefore attribute the shift in the [O iii]λ5007/Hβ vs. [N ii]/Hα BPT diagram to elevated N/O abundance ratios among lower-mass () high-redshift galaxies. The variation in N/O ratios calls into question the use at high redshift of oxygen abundance indicators based on nitrogen lines, but the apparent invariance with redshift of the excitation sequence in the O32 vs. R23 diagram paves the way for using the combination of O32 and R23 as an unbiased metallicity indicator over a wide range in redshift. This indicator will allow for an accurate characterization of the shape and normalization of the mass-metallicity relationship over more than 10 Gyr.
Clinical Characterization of Mogamulizumab-Associated Rash During Treatment of Mycosis Fungoides or Sézary Syndrome.

Importance Mogamulizumab is a monoclonal antibody against CCR4 approved for treatment for mycosis fungoides (MF) and Sezary syndrome (SS). Mogamulizumab-associated rash (MAR) is difficult to differentiate from cutaneous MF or SS, which can lead to unnecessary discontinuation of drug use because of concern for severe drug reaction or incorrect presumption of disease relapse or progression in the skin. Objective To examine the most common clinical presentations of MAR in patients with MF or SS and the diagnostic and management challenges. Design, setting, and participants This retrospective case series assessed patients from a multidisciplinary cutaneous lymphoma clinic and supportive oncodermatology clinic at a major academic referral center who had a diagnosis of MF or SS and received mogamulizumab from January 1, 2013, to January 1, 2020. Treatment was followed by new or worsening rash with skin biopsy results compatible with drug eruption determined by clinicopathologic correlation and molecular testing to exclude active malignant disease. Exposures At least 1 dose of mogamulizumab. Main outcomes and measures Mogamulizumab-associated rash was characterized by clinical features, including time to onset, clinical presentation, histopathologic features, and management approach. Results The study included 19 patients with MF or SS who developed MAR (median age, 65 years; age range, 38-82 years; 10 [52.6%] male). Median time to MAR onset was 119 days (range, 56 days to 3.8 years). Patients with MAR exhibited 4 predominant clinical presentations: (1) folliculotropic MF-like scalp plaques with alopecia, (2) papules and/or plaques, (3) photoaccentuated dermatitis, and (4) morbilliform or erythrodermic dermatitis. The most common anatomical region involved was the head and neck, including the scalp. Histopathologic findings were variable and did not correspond to primary clinical morphologic findings. Immunohistochemistry and T-cell clonality ancillary testing were helpful to distinguish MAR from disease. Most patients with MAR (14 of 19) discontinued mogamulizumab treatment; however, no life-threatening severe cutaneous adverse drug reactions occurred, and the decision for drug therapy cessation was usually multifactorial. Four patients were treated again with mogamulizumab with no life-threatening drug-related events. Approaches to management of MAR include topical corticosteroids, systemic corticosteroids, and/or methotrexate. Conclusions and relevance This case series found that mogamulizumab-associated rash had a heterogeneous clinical presentation with variable and delayed onset in patients with MF or SS. Mogamulizumab-associated rash exhibited a predilection for the head and neck and was difficult to clinically distinguish from relapse or progression of disease. Recognition of the most common clinical presentations can help prevent unnecessary discontinuation of mogamulizumab treatment. The presence of MAR does not necessitate permanent discontinuation of or avoidance of retreatment with mogamulizumab.
Pheochromocytoma and Paraganglioma in Pregnancy: a New Era

Pheochromocytoma and paraganglioma (PPGL) in pregnancy is a rare entity and management of these patients is fraught with uncertainty. Our objective is to review current literature and discuss diagnosis and management of these patients. Outcomes of PPGL in pregnancy have improved in recent years. The greatest risk for adverse maternal and fetal outcomes is the diagnosis of PPGL after delivery. Alpha- and beta-adrenergic blockade is well tolerated and is associated with less adverse outcomes. Antepartum surgery is not associated with improved maternal or fetal outcomes. Biochemical testing and cross-sectional imaging should be performed prior to conception for patients with a known germline variant associated with PPGL. Medical therapy should be initiated when PPGL is diagnosed in pregnancy. Antepartum surgery should be reserved for special circumstances. Case detection testing in high-risk patients can identify PPGL before pregnancy.
Distributionally Constrained Black-Box Stochastic Gradient Estimation and Optimization

We consider stochastic gradient estimation using only black-box function evaluations, where the function argument lies within a probability simplex. This problem is motivated from gradient-descent optimization procedures in multiple applications in distributionally robust analysis and inverse model calibration involving decision variables that are probability distributions. We are especially interested in obtaining gradient estimators where one or few sample observations or simulation runs apply simultaneously to all directions. Conventional zeroth-order gradient schemes such as simultaneous perturbation face challenges as the required moment conditions that allow the "canceling" of higher-order biases cannot be satisfied without violating the simplex constraints. We investigate a new set of required conditions on the random perturbation generator, which leads us to a class of implementable gradient estimators using Dirichlet mixtures. We study the statistical properties of these estimators and their utility in constrained stochastic approximation, including both Frank-Wolfe and mirror descent update schemes. We demonstrate the effectiveness of our procedures and compare with benchmarks via several numerical examples.
Spatial Configuration and Time of Day Impact the Magnitude of Urban Tree Canopy Cooling

Tree cover is generally associated with cooler air temperatures in urban environments but the roles of canopy configuration, spatial context, and time of day are not well understood. The ability to examine spatiotemporal relationships between trees and urban climate have been hindered by lack of appropriate air temperature data and, perhaps, by overreliance on a single "tree canopy" class, obscuring the mechanisms by which canopy cools. Here, we use >70,000 air temperature measurements collected by car throughout Washington, DC, USA in predawn (pd), afternoon (aft), and evening (eve) campaigns on a hot summer day. We subdivided tree canopy into "soft" (over unpaved surfaces) and "hard" (over paved surfaces) canopy classes and further partitioned soft canopy into distributed (narrow edges) and clumped patches (edges with interior cores). At each level of subdivision, we predicted air temperature anomalies using generalized additive models (GAM) for each time of day. We found that the all-inclusive "tree canopy" class cooled linearly at every time (pd = 0.5 ± 0.3 °C, aft = 1.8 ± 0.6 °C, eve = 1.7 ± 0.4 °C), but could be explained in the afternoon by aggregate effects of predominant hard and soft canopy cooling at low and high canopy cover, respectively. Soft canopy cooled nonlinearly in the afternoon with minimal effect until ~40% cover but strongly (and linearly) across all cover fractions in the evening (pd = 0.7 ± 1.1 °C, aft = 2.0 ± 0.7 °C, eve = 2.9 ± 0.6 °C). Patches cooled at all times of day despite uneven allocation throughout the city, whereas more distributed canopy cooled in predawn and evening due to increased shading. This later finding is important for urban heat island mitigation planning since it is easier to find planting spaces for distributed trees rather than forest patches.
Measurements of isobaric LLV equilibria of the 1,1,4,4-tetramethyl-2-tetrazene-water binary system: novel experimental approach and modeling essays

The present study was carried out in the frame of the optimization of the synthesis process of 1,1,4,4-tetramethyl-2-tetrazene (TMTZ), a prospective liquid propellant. The liquid–liquid (LL) equilibria of the TMTZ + H2O binary system were studied under atmospheric pressure and in the temperature range from 278.15 up to 348.15 K. These results established the conditions leading to a spontaneous demixing of TMTZ from the aqueous synthesis solutions. The experimental study of the liquid–vapor (LV) equilibria of the TMTZ + H2O system using DSC, under atmospheric pressure, highlighted the various equilibrium domains involved in the distillation step. Besides, a heteroazeotropic invariant was identified at TH = 366.3 K for x (TMTZ) = 0.254. Lastly, the thermodynamic modeling of those equilibria, using various models (Van Laar, NRTL, Wilson), enabled to improve the experimental results in order to enhance the extraction conditions leading to the production of ultra-pure TMTZ.
Combining Virtual Reality and Behavioral Health to Promote Pain Resiliency: Analysis of a Novel BioPsychoSocial Modality for Solving Pain in the Workplace.

The use of virtual reality in treating pain symptoms is a new and emerging modality that has gained more traction, especially in light of the COVID-19 pandemic, which has led to a rise in the remote care of patients. Our study tested the effectiveness of a home-based pain relief program that utilized virtual reality and behavioral health for treating acute and chronic pain. Retrospective Cohort Study. Due to the remote nature of the pain clinic during the COVID-19 pandemic, patients with work-related injuries were considered for inclusion in a 90-day Harvard MedTech Vx Pain Relief Program, which consisted of home-based virtual reality therapy (VRT) and tailored behavioral therapy that was conducted through phone consultations. Both the VRT and behavioral therapy focused on the specific workplace injury and centered around setting three personal goals for each patient that were considered meaningful to them. The progress towards achieving these goals was then tracked. The primary outcome of the retrospective analysis was pain scores after completion of home-based VRT. Secondary outcomes included: change in opioid therapy (opioid consumption), psychological awareness/perception of pain, level of immersion, and overall improvement/achievement in patient goals. A total of 36 patients (16 male and 20 female) with acute and chronic pain secondary to workplace injuries were included; these injuries severely limited their activities of daily living and reduced their quality of life. During the course of VRT and after completion of the 90-day program, patients experienced a substantial immediate and legacy pain relief. Specifically, patients reported an average 40% reduction in pain while utilizing the program and an additional 2.8 h of continued pain relief at the conclusion of 90 days. Further, 69% of patients also reported either a decrease in opioid use or complete cessation after VRT. The majority of patients also reported reduced depression, fatigue, and sleep disturbance. The Harvard MedTech Vx Therapy appears to be an effective tool in the treatment of pain and the psycho-social issues associated with pain. This translates into a greater degree of pain resiliency and an overall improvement in general wellness and improved workplace functionality.
Shared Determinants for Human Papillomavirus and COVID-19 Vaccination Intention: An Opportunity for Resource Consolidation.

Purpose This study aimed at targeting shared factors that influence the prevention of multiple diseases, which can help address various health problems simultaneously. We identified correlates of human papillomavirus (HPV) vaccination that overlap with COVID-19 vaccination. Design Cross-sectional survey data. Setting Online Qualtrics recruitment panel. Subject Religious parents of 342 adolescents who were unvaccinated for HPV (response rate was 68.1%). Measures Outcome variables were COVID-19 vaccination intention for (1) self, (2) child, and (3) HPV vaccination intention for child. Independent variables were psychological factors. Covariates were sociodemographic and socioeconomic factors. Analysis We conducted multivariate linear regressions on each outcome variable after controlling for covariates. Result Some psychological correlates of HPV overlapped as protective factors for all three outcomes. Higher perceived vulnerability of child to HPV was associated with higher vaccination intention against COVID-19 for self (β = .37, 95% confidence interval [CI] = .25-.48), child (β = .32, .21-.44), and HPV for child (β = .38, .27-.49). Higher perceived response efficacy of HPV vaccine was associated with greater vaccination intention against COVID-19 for self (β = .46, .33-.59), child (β = .41, .28-.53), and HPV for child (β = .75, .64-.85). Conclusion Given the overlap in HPV and COVID-19 vaccination correlates, interventions should target shared factors that address both diseases to maximize public health efforts. A major limitation of this study is the inability to measure the actual vaccination behavior.