cssi/SciSciGPT-SciSciNet huggingface dataset:
A quality improvement project to reduce the intraoperative use of single-dose fentanyl vials across multiple patients in a pediatric institution.

Summary Objective The use of a single-dose vial across multiple patients presents a risk to sterility and is against CDC guidelines. We initiated a quality improvement (QI) project to reduce the intraoperative use of single-dose vials of fentanyl across multiple patients at Cincinnati Children's Hospital Medical Center (CCHMC). Methods The initial step of the improvement project was the development of a Key Driver Diagram. The diagram has the SMART aim of the project, key drivers inherent to the process we are trying to improve, and specific interventions targeting the key drivers. The number of patients each week receiving an IV dose of fentanyl, from a vial previously accessed for another patient was tracked in a high turnover operating room (OR). The improvement model used was based on the concept of building Plan–Do–Study–Act (PDSA) cycles. Tests of change included provider education, provision of an increased number of fentanyl vials, alternate wasting processes, and provision of single-use fentanyl syringes by the pharmacy. Results Prior to initiation of this project, it was common for a single fentanyl vial to be accessed for multiple patients. Our data showed an average percentage of failures of just over 50%. During the end of the project, after 7 months, the mean percentage failures had dropped to 5%. Preparation of 20 mcg single-use fentanyl syringes by pharmacy, combined with education of providers on appropriate use, was successful in reducing failures to below our goal of 25%. Conclusions Appropriately sized fentanyl syringes prepared by pharmacy, education on correct use of single-dose vials, and reminders in the OR, reduced the percentage of patients receiving a dose of fentanyl from a vial previously accessed for another patient in a high-volume otolaryngology room.
An Ambient Temperature Molten Sodium–Vanadium Battery with Aqueous Flowing Catholyte

In this study, we have investigated the key factors dictating the cyclic performance of a new type of hybrid sodium-based flow batteries (HNFBs) that can operate at room temperature with high cell voltages (>3 V), multiple electron transfer redox reactions per active ion, and decoupled design of power and energy. HNFBs are composed of a molten Na–Cs alloy anode, flowing aqueous catholyte, and a Na-β″-Al2O3 solid electrolyte as the separator. The surface functionalization of graphite felt electrodes for the flowing aqueous catholyte has been studied for its effectiveness in enhancing V2+/V3+, V3+/V4+, and V4+/V5+ redox couples. The V4+/V5+ redox reaction has been further investigated at different cell operation temperatures for its cyclic stability and how the properties of the solid electrolyte membrane play a role in cycling. These fundamental understandings provide guidelines for improving the cyclic performance and stability of HNFBs with aqueous catholytes. We show that the HNFB with aqueous V-ion cat...
CAG repeat length and suicidality in Huntington’s disease

The purpose of this study was to determine if a correlation exists between suicide and CAG repeat length in Huntington’s disease. Methodology: A case-control study using the COHORT Study de-identified database was conducted. Responses were collected from 163 participants. Depression, substance abuse history and use of benzodiazepines were covariates. Responses to the UHDRS behavioral section pertaining to the frequency and severity of suicidal ideation (“feels life is not worth living”, “has suicidal thoughts”) were analyzed. Results: Despite taking depression, benzodiazepine use, and history of substance abuse into account, there was a predictive relationship between CAG repeat length and frequency of suicidal ideation (p = .010). When the effect of depression was taken into account, there was no significant relationship between CAG repeat length and the severity of suicidal ideation. Recommendations: The findings from this quantitative analysis supported using CAG length in a clinician’s risk factor assessment to determine the frequency of suicidality.
Games without Frontiers: Whither Information Security and Privacy?

The past decade has clearly shown that even the best security solutions won't eliminate threats once and for all, and that there will always be "unknown unknowns." However, new large-scale technologies and threat types require novel, sophisticated solutions to meet our current and future security and privacy demands.
Changes in Interpretation in the Archaeology of the Central Mississippi Valley since 1983

The status of archaeological research is summarized since the publication of Archaeology of the Central Mississippi Valley in 1983. Extensive research dealing with the Paleoindian period and the Pl...
Portmanteau test and simultaneous inference for serial covariances

The paper presents a systematic theory for asymptotic inferences based on autocovariances of stationary processes. We consider nonparametric tests for serial correlations using the maximum (or L∞) and the quadratic (or L2) deviations of sample autocovariances. For these cases, with proper centering and rescaling, the asymptotic distributions of the deviations are Gumbel and Gaussian, respectively. To establish such an asymptotic theory, as byproducts, we develop a normal comparison principle and propose a sufficient condition for summability of joint cumulants of stationary processes. We adapt a blocks of blocks bootstrapping procedure proposed by Kunsch (1989) and Liu and Singh (1992) to the L∞ based tests to improve the finite-sample performance. AMS 2000 subject classifications: Primary 60F05, 62M10; secondary 62E20.
SPREAD OF EPIDEMIC INFECTION AMONG NEWBORN INFANTS.

Epidemic infection in the newborn nursery can best be prevented by (1) excluding infants of infected mothers, (2) excluding personnel who have active infection, and (3) careful housekeeping.Few hospitals deal realistically with the problem of relieving from duty nursery personnel who have active infection. Intelligent control of an outbreak of infection requires an understanding of the multiple sites of proliferation of the pathogen. The chain of infection from older to younger infants must be broken.
Silent coronary artery disease. Two-step exercise test for diagnosis.

Every person 35 years of age or older should have an annual physical examination, with a chest x-ray and an electrocardiogram. Even if the latter is negative and the patient has no complaints, he should be given the two-step or an equivalent exercise test. A positive test result suggests myocardial ischemia, with increased risk of cardiac morbidity or death, even in the asymptomatic person. A negative response has been statistically proved to indicate a favorable prognosis.
Watching Signaling in Action: Single Molecule Studies of a Reaction Circuit Involved in Chemotaxis.

Just as you move to the kitchen in the morning when you smell coffee brewing, single-cell animals move to their meal once they sense nutrients. In both cases, you and the amoeboids use surface sensory molecules, such as G protein-coupled receptors, to detect critical nutrients (i.e., coffee), which trigger a series of protein associations and reactions on the inner surface of the plasma membrane that ultimately allow for actin rearrangement and forward movement.
Outcome analysis of Kaschin-Beck disease investigation in Sichuan Province in 2006

Objective To explore the condition of Kaschin-Beck disease (KBD)in Sichuan Province. Methods In 20 KBD endemic counties,children were taken right hand X-ray,meanwhile adult KBD prevalence was investigated.Child hair and main food were sampled to test the level of selenium.Results The clinically detected rate was 1.02% in children,X-ray detection rate was 2.12%(0～13.16%) on average,above 10.00% in 13 villages.KBD was detected in 27.02% (3.34%～53.08%) of the adults,among whom 16.73% were of degreeⅠ,7.79% of degreeⅡ,2.49% of degreeⅢ.The selenium level was (0.289±0.079)mg/kg and (0.023±0.021) mg/kg in child hair and food,respectively.Conclusions In most of the regions,child KBD have been controlled,but new cases are emerging,and adult KBD is still seriously prevailing.
Assessing the clinical effectiveness of an algorithmic approach for mucosal lichen planus (MLP): A retrospective review.

Background Mucosal lichen planus (MLP) is a therapeutic challenge in need of a new treatment approach because of its debilitating effect on patient's quality of life. Objective We sought to evaluate a standardized treatment plan for patients with MLP. A second objective was to describe the effect of mycophenolate mofetil in this patient population. Methods The study retrospectively analyzed 53 patients with MLP treated using a standardized algorithm. The number of MLP lesions, disease activity, and pain at the last visit were compared with baseline scores determined at the initial visit. Results were analyzed using the paired samples t test and confirmed with the Wilcoxon matched pairs signed rank test. Results The average number of lesions was reduced from 3.77 to 1.67 ( P P P Limitations This study was a retrospective analysis of a small patient population. There was no universal symptom severity scale used at the time of treatment for some patients. Conclusion The standardized treatment plan reduced symptoms for patients with MLP. Mycophenolate mofetil appears to be a reasonable treatment option for these patients.
Factors that Influence Undergraduate Information-seeking Behavior and Opportunities for Student Success

Abstract Informed from a survey we administered to undergraduate students on their information seeking behavior, we identify variables that influence how students conduct their search for sources, what types of sources they select, and what attributes of their sources they value. These variables relate to student academic characteristics, demographics, and actions that have been taken by instructors and library staff. With a thorough understanding of students' information seeking process and its influences, we find opportunities for instructors and librarians to have a positive influence.
Translating pharmacodynamic biomarkers from bench to bedside: analytical validation and fit-for-purpose studies to qualify multiplex immunofluorescent assays for use on clinical core biopsy specimens

Multiplex pharmacodynamic (PD) assays have the potential to increase sensitivity of biomarker-based reporting for new targeted agents, as well as revealing significantly more information about target and pathway activation than single-biomarker PD assays. Stringent methodology is required to ensure reliable and reproducible results. Common to all PD assays is the importance of reagent validation, assay and instrument calibration, and the determination of suitable response calibrators; however, multiplex assays, particularly those performed on paraffin specimens from tissue blocks, bring format-specific challenges adding a layer of complexity to assay development. We discuss existing multiplex approaches and the development of a multiplex immunofluorescence assay measuring DNA damage and DNA repair enzymes in response to anti-cancer therapeutics and describe how our novel method addresses known issues.
RELATIONSHIP BETWEEN β-ADRENERGIC RECEPTOR AND SPECIFIC MYOCARDIAL PROTEIN SYNTHESIS

ABSTRACT Injection of isoproterenol (ISP) in rat caused a sharp rise in heart rate (HR) and a significant fall in systolic blood pressure (BP). There was a three-fold increase in protein synthesis of left ventricle and actomyosin fraction. Propranolol (PROP) reduced HR significantly but not BP. It also inhibited the increase in protein synthesis induced by ISP. The results demonstrate a direct interrelationship between β-adrenergic receptor and the synthesis of the contractile myocardial protein.
From Wetland to Saltland: Natural Obstacles and Socioecological Consequences in the Production of Solar Salt in Venezuela

ABSTRACTThis article provides a critical analysis of the process involved in transforming small-scale artisanal production of solar salt into large-scale industrial production by Produsal in Los Olivitos Wildlife Refuge and Fishing Reserve in Lake Maracaibo, Venezuela. In doing so, it highlights the socioecological impacts resulting from this process in the wetland and the fishing community of Ancon de Iturre. Using political economy of nature as a theoretical framework, especially notions of the formal subsumption of nature, materiality of natural resources, and the commodification of nature, this article explores how the biophysical characteristic of salt and the ecosystem where it is contained present a specific set of natural obstacles for its production; the different strategies used by Produsal to overcome these obstacles; and the social and ecological contradictions embedded in the process.
On fracture analysis of dental restorative materials under combined tensile-shear loading

Abstract Dental resins, which are used in dentistry as restorative materials, are subjected to combined shear and tensile loads during their lifetime. In this paper, mixed-mode fracture behavior of two types of dental resins is studied using different fracture criteria, with special focus on strain-based criteria. It is shown that the traditional fracture criteria, which only take into account singular terms of the crack tip stress/strain fields, are not able to properly predict the fracture test data for these materials. An extended maximum tangential strain criterion considering effect of first nonsingular strain term, as well as the singular strain terms, is then employed to predict the fracture test data. It is demonstrated that the extended maximum tangential strain criterion presents more accurate predictions of the test data than the traditional fracture criteria.
A damage model for structures with degrading response

Summary The paper presents a hysteretic damage model for the response simulation of structural components with strength and stiffness deterioration under cyclic loading. The model is based on 1D continuum damage mechanics and relates any 2 work-conjugate response variables such as force-displacement, moment-rotation, or stress-strain. The strength and stiffness deterioration is described by a continuous damage variable. The formulation uses a criterion based on the hysteretic energy and the maximum or minimum deformation for damage initiation with a cumulative probability distribution function for the damage evolution. A series of structural component response simulations showcase the ability of the model to describe different types of hysteretic behavior. The relation of the model's damage variable to the Park-Ang damage index is also discussed. Because of its consistent and numerically robust formulation, the model is suitable for the large-scale seismic response simulation of structural systems with strength and stiffness deterioration.
The effect of social geographic factors on the untreated tooth decay among head start children.

Background: Disparities among untreated dental caries exist for children from low-income families in the United States. Understanding of the mechanism of the disparities is required to reduce it and social geographic factors are one of the important influences. Although the effect of fluoridated water has been well reported, studies of other sociogeograpic factors, such as the density of available dentists, are still very limited. The objective of this study is to explore the effect of sociogeographic factors on the number of primary teeth with untreated dental caries among children from low-income families who are enrolled in Head Start programs throughout Northeast Ohio of the United States. Material and Methods: This was a cross-sectional chart review study. Three hundred-eighty-eight charts were reviewed, and the number of primary teeth with untreated dental caries (dt) and the children’s addresses were re trieved. The sociogeographic variables, including fluoridated water availability and the density of available dentists who accept a government-supported insurance (Medicaid dentists), were collected. Results: The mean (standard deviation) of children’s age was 3.51 (1.14) years with a range of 7 months to 5 years. A negative binomial regression model analysis, which used dt as a dependent variable and children’s characteristic factors (i.e. age, gender, insurance type, and total number of primary teeth) and sociogeographic factors (i.e. Po pulation, total number of Medicaid dentists, density of Medicaid dentist, and Fluoride water availability) of cities, as independent variables, demonstrated that only the density of Medicaid dentist in the sociogeographic factors indicated a significant effect (Estimated s-Coefficients (Standard Errors)=-0.003 (0.002), p =0.030). Conclusions: This study demonstrated a significant negative association between the density of available dentists and untreated dental caries among children from low-income families in Head Start programs in Northeast Ohio. Increasing available dentists may be a strategy to reduce the number of early childhood caries.
Evolving roles of preservation professionals: Trends in position announcements from 2004 to 2015

As research libraries continue to expand the scope of content they acquire, manage, and make accessible, the preservation charge within organizations is broadening. Libraries and other cultural heritage institutions must balance the preservation of books, manuscripts, archives, and audiovisual materials with born-digital and digitized content. As preservation challenges and strategies evolve, professional positions in preservation must also evolve to meet the needs of academic and other cultural institutions. The ability to quantify how preservation positions are changing, and to identify the required skill sets and educational backgrounds needed for preservation professionals, is central to navigating this shift. To begin to address this, the authors collected and analyzed announcements for professional preservation positions in libraries and archives from 2004 through 2015. They compared the contents of announcements between earlier and more recent years to identify potential trends in preservation employment.
Penetrating Abdominal Trauma

The goal of managing patients with penetrating abdominal trauma is to quickly and efficiently assess injuries and establish treatment priorities. The focus of the primary survey is resuscitation with continuous assessment of vital signs and control of hemorrhage. This is followed by a detailed secondary survey and initiation of definitive care; this is influenced by the hemodynamic stability of the patient as well as the location and mechanism of their injury.
Simulating DDoS attacks on the US fiber-optics internet infrastructure

Network-based attacks like the distributed denial-of-service (DDoS) attacks are not new, but we are beginning to see attacks of unprecedented scale. Examples of such attacks include the 2016 attack on DYN INC that crippled a part of the Internet for hours, and the attack on Liberia, which partially brought down the African nation. Limitations in identifying vulnerable Internet infrastructure and testing possible defense strategies are a part of the problem. We need a simulation testbed that can reflect the complexity of the Internet, yet allows to swiftly test attacks, providing insights that can apply to real-world attack scenarios. In this research, we have designed a test-bed that mirrors the Internet infrastructure of the US and can simulate the Internet traffic flow patterns for different attack targets. We also estimate the degradation in the quality-of-service and the number of users impacted in two attack scenarios.
Effect of implementation of a surgical safety checklist on perioperative and postoperative complications at an academic institution in North America.

Objective To evaluate the efficacy of a surgical safety checklist (SSC) in reducing perioperative and postoperative complications. Study design Before-and-after intervention study. Animals Client-owned dogs (n = 633) and cats (n = 44). Methods Consecutive surgeries were enrolled in the study. The "before" phase consisted of 267 surgeries performed without an SSC (SSC- ) followed by 75 SSC- surgeries in which a trained observer was in the operating room to detect possible complications. An SSC was then implemented in the operating rooms during 1 week. The "after" phase consisted of 58 surgeries in which a safety checklist (SSC+ ) and an observer were used and 277 SSC+ surgeries without an observer. Complications were prospectively recorded when witnessed by the observer, and all other perioperative complications were retrospectively recorded from veterinary records and client telephone communication. Results There were more perioperative and postoperative complications when surgeries were performed without an SSC (140/342 [40.9%; 95% CI, 35.7%-46.4%]) than there were when surgeries were performed with an SSC (98/335 [29.3%; 95% CI, 24.4%-34.4%]; P = .002). Surgical checklist use, presence of an observer, American Society of Anesthesiologists score, and anesthesia time were all independently associated with the odds of complications. Conclusion Implementation of an SSC in an academic teaching hospital decreased the odds of perioperative and postoperative surgical complications. Clinical significance This study supports the use of an SSC to prevent surgical complications in veterinary teaching hospitals.
Polarization at Membrane-Solution Interfaces in Reverse Osmosis (Hyperfiltration)

The study of electrical potential differences between electrolyte solutions separated by desalination membranes had led to the conclusion that not only ion-exchange membranes used in electrodialysis but also modified cellulose acetate membranes, used in reverse osmosis, often contain fixed charges.
Negotiating with Information and Communication Technology in a Cross-Cultural World

This chapter introduces the benefits and challenges of using information and communication technology (ICT)-based channels for negotiation. Applying a number of key theories from the field of communications—Media Richness Theory, Channel Expansion Theory, and Media Synchronicity Theory—it explains the ways in which people use communication media and the ways in which any given media affects the communication it conveys. These theories are applied to negotiation, to frame challenges that online negotiation poses to successful negotiation—and to provide guidelines for overcoming them and for utilizing ICT beneficially. These issues are considered in light of ICT-based negotiation’s use for cross-cultural negotiation in the modern business world.
One month of nitrous oxide abuse causing acute vitamin B 12 deficiency with severe neuropsychiatric symptoms.

A 21-year-old university student studying abroad in the USA presented to the emergency department with double vision, lower extremity weakness with difficulty ambulating and other neuropsychiatric symptoms. MRI of the brain and spinal cord were normal. Vitamin B12 was 78 pg/mL (58 pmol/L, reference 211–911 pg/mL). The patient had been using nitrous oxide capsules used for whipped cream recharging, which she obtained from other students, a few times daily for a month for the purpose of anxiety relief. The patient was not a vegan or vegetarian. The patient was treated with intramuscular vitamin B12 repletion with partial resolution of neurologic symptoms and discharged on vitamin B12 supplementation.
The scope of viral causation of human cancers: interpreting virus density from an evolutionary perspective.

Most known oncogenic viruses of humans use DNA as their genomic material. Research over the past quarter century has revealed that their oncogenicity results largely from direct interference with b...
Gay Ascesis: Ethics of Strategic Disorientation and the Pedagogies of Friendship

This chapter examines the relationship between Foucault’s provocative statements about homosexual ascesis based on friendship and pedagogy. The chapter situates pedagogy as an affective aspect of friendship within specific time/spaces. The chapter argues that a homosexual ascesis as friendship involves a strategic disorientation of the self, in relation to the self and to others. It is through various affective pedagogical aspects of pleasure and power which can produce disorientation that allows one to escape oneself.
Mucosal-associated invariant T (MAIT) cells mediate protective host responses in sepsis

Abstract Sepsis is a systemic inflammatory response to infection and a leading cause of death. Mucosal-associated invariant T (MAIT) cells are innate-like T cells enriched in mucosal tissues that recognize bacterial ligands. We investigated MAIT cells during clinical and experimental sepsis, and their contribution to host responses. In experimental sepsis, MAIT-deficient mice had significantly increased mortality and bacterial load, and reduced tissue-specific cytokine responses. MAIT cells of WT mice expressed lower levels of IFN-γ and IL-17a during sepsis compared to sham surgery, changes not seen in non-MAIT T cells. MAIT cells of patients presenting with sepsis were significantly reduced in frequency, more activated, and had decreased IFN-γ production when stimulated, compared to healthy donors and paired 90-day post-sepsis samples. Our data suggest that MAIT cells are highly activated and become dysfunctional during clinical sepsis, and contribute to tissue-specific cytokine responses that are protective against mortality during experimental sepsis.
Mild traumatic brain injury/concussion and female sexuality, a scoping review of the literature.

The American Congress of Rehabilitation Medicine (ACRM) in 2010 called for more head injury research on gender disparities to bridge the gender gap for the short-and long-term effects of TBI, including sexual and reproductive outcomes. In this paper, we review the state of the literature before and after the ACRM announcement, and evaluate how research teams have considered females and mildly injured TBI(mTBI)/concussion groups in post-TBI-related changes in sexual functioning. The research question for this scoping review was “what is the state of the literature in the evaluation of post-TBI sexual changes for women, and individuals with mTBI?” Using the 2010 ACRM call for action as a line of demarcation, we compared our findings before and after the 2010 announcement. We identified 9 research studies that addressed sexual functioning changes in females and mTBI/concussion groups. Four of the nine were published before the 2010 ACRM announcement, and five were published after. The representation of female research participants increased steadily over the 28-year timespan. The proportion of individuals with mTBI included in the post-2010 era was higher than the earlier time period. Consistently, women with mTBI reported more adverse sexual outcomes compared to male cohorts, orthopaedic, and non-injured comparison groups. This observation persisted regardless of recruitment site (rehabilitation center/Emergency Department (ED)/Community) or time of outcome assessment (acute versus chronic). The findings also remained despite the heterogeneity of survey questionnaires used to evaluate sexual functioning outcomes. Excluding the most recent 2019 study, none of the research groups compared the findings by TBI severity, making it difficult to fully understand how concussion-related sexual changes compare to more severe forms of the head injury. The long term impacts of the sexual changes, such as infertility and relationship discord were also absent across all studies; even though most evaluated outcomes chronically (some as far out as 20 years post injury). The number of publications in the era before the ACRM call for action and afterwards were almost identical. In order to tailor interventions for the appropriate groups of TBI patients, more neurosexuality research is needed to increase awareness of the importance of sexuality as a health outcome for individuals with neurodisabilities.
In Situ Dynamics during Heating of Copper-Intercalated Bismuth Telluride

Summary The presence of a van der Waals gap within layered materials enables the intercalation of guest species, which can be used for tuning properties. The introduction of intercalant species may also lead to structural transformations across a range of temperatures and use conditions, but we have a limited understanding of the high-temperature evolution of intercalated layered materials. Here, we use in situ transmission electron microscopy to investigate temperature-dependent structural evolution of Bi2Te3, a layered material with well-known application as a thermoelectric, which contains intercalated Cu. As temperature is increased, the initially disordered Cu undergoes local ordering within the van der Waals gap, along with anisotropic sublimation behavior of the crystals. As the temperature is raised further, layered Cu2Te crystals nucleate and grow with a crystallographic relationship to the Bi2Te3 lattice. Notably, the presence of Cu decreases the thermal stability of the Bi2Te3 and substantially alters the transformation pathways during heating.
Transient global amnesia does not increase the risk of subsequent ischemic stroke: a propensity score-matched analysis.

Data regarding the risk of cerebrovascular events following transient global amnesia (TGA) remain controversial. While some neuroradiological studies suggest an underlying cerebrovascular etiology, results from the clinical studies have been largely conflicting. We, therefore, aimed to evaluate the risk of ischemic stroke in a large, nationally representative sample of patients with TGA. We utilized the Nationwide Readmissions Database 2010–2015 to identify all hospitalizations with the primary discharge diagnosis of TGA. We selected a 2% random sample of all elective admissions to be included as controls. A propensity score-matched analysis was performed to match patients with TGA and the controls. The primary outcome was readmission due to ischemic stroke up to 1 year following discharge from the index hospitalization, assessed using the Kaplan–Meier survival analysis in the propensity-matched groups. There were 24,803 weighted hospitalizations due to TGA (mean ± SD age: 65.6 ± 10.4 years, female: 54.9%) and 699,644 corresponding controls. At baseline, patients with TGA were significantly older, more likely to be male, and had a higher prevalence of hypertension, hyperlipidemia, coronary artery disease, cerebrovascular disease, and migraine, as compared to the controls. However, after propensity score matching, we obtained 21,202 cases and 21,293 well-matched corresponding controls, and the risk of readmission due to ischemic stroke in patients with TGA was not different compared to the control group (HR: 1.13, 95% CI 0.62–2.05, P 0.686) during the mean (SD) follow-up period of 192.2 (102.4) days. After adjustment for demographics and cerebrovascular risk factors, TGA is not associated with an increased risk of subsequent ischemic stroke.
A SARS CoV-2 nucleocapsid vaccine protects against distal viral dissemination

The SARS CoV-2 pandemic has killed millions of people. This viral infection can also result in substantial morbidity, including respiratory insufficiency and neurological manifestations, such as loss of smell and psychiatric diseases. Most SARS CoV-2 vaccines are based on the spike antigen, and although they have shown extraordinary efficacy at preventing severe lung disease and death, they do not always confer sterilizing immune protection. We performed studies in K18-hACE2 mice to evaluate whether the efficacy of SARS CoV-2 vaccines could be augmented by incorporating nucleocapsid as a vaccine antigen. We vaccinated mice with adenovirus-based vaccines encoding spike antigen alone, nucleocapsid antigen alone, or combined spike and nucleocapsid antigens. Mice were then challenged intranasally with SARS CoV-2, and acute viral loads were quantified at a proximal site of infection (lung) and a distal site of infection (brain). Interestingly, the spike-based vaccine conferred acute protection in the lung, but not in the brain. The spike-based vaccine conferred acute protection in the brain only if combined with the nucleocapsid-based vaccine. These findings suggest that nucleocapsid-specific immunity is important for the distal control of SARS CoV-2, warranting the inclusion of nucleocapsid in next-generation COVID-19 vaccines.
COVID-19's Financial Impact on Primary Care Clinicians and Practices.

Introduction: Coronavirus disease 2019 (COVID-19) disrupted and undermined primary care delivery. The goal of this study was to examine the financial impacts the pandemic has had on primary care clinicians and practices. Methods: The American Academy of Family Physicians National Research Network and the Robert Graham Center distributed weekly surveys from March 27, 2020, through June 15, 2020, to a network of more than 1960 physicians. Responses to the question, “Could you please tell us about any financial impact the COVID-19 pandemic has had on your practice, if any?” were analyzed using a grounded theory approach of qualitative analysis. The number of unique respondents who answered the financial impact question totaled 461 over the 12 weeks. Results: Severe declines in patient visits, causing drastic revenue reductions, greatly impacted the ability to serve patients. Primary care clinicians and practices experienced significant changes in several areas about financial implications: patient visits, financial strain, staffing and telehealth. Discussion: Preliminary findings revealed that even with Coronavirus Aid, Relief, and Economic Security Act, also known as CARES Act, funding, business viability remains questionable for some primary care practices. Conclusions: Low patient visits directly resulted in decreased revenues, which in turn, impacted staffing decisions and fueled telehealth implementation. It is difficult to predict whether patient visits will increase after June. Alternate payment models could provide some financial stability and address business viability.
An Analysis of Terrorist Group Formation, 1860—1969

A number of new and exciting datasets on terrorist groups have been created in recent years. However, most data have limited temporal coverage. In this article, we explore a dataset of historical t...
nmT5 - Is parallel data still relevant for pre-training massively multilingual language models?

Recently, mT5 - a massively multilingual version of T5 - leveraged a unified text-to-text format to attain state-of-the-art results on a wide variety of multilingual NLP tasks. In this paper, we investigate the impact of incorporating parallel data into mT5 pre-training. We find that multi-tasking language modeling with objectives such as machine translation during pre-training is a straightforward way to improve performance on downstream multilingual and cross-lingual tasks. However, the gains start to diminish as the model capacity increases, suggesting that parallel data might not be as essential for larger models. At the same time, even at larger model sizes, we find that pre-training with parallel data still provides benefits in the limited labelled data regime
Circulating HMGB1 is elevated in veterans with Gulf War Illness and triggers the persistent pro-inflammatory microglia phenotype in male C57Bl/6J mice

Gulf War Illness (GWI) is a chronic, multi-symptom peripheral and CNS condition with persistent microglial dysregulation, but the mechanisms driving the continuous neuroimmune pathology are poorly understood. The alarmin HMGB1 is an autocrine and paracrine pro-inflammatory signal, but the role of circulating HMGB1 in persistent neuroinflammation and GWI remains largely unknown. Using the LPS model of the persistent microglial pro-inflammatory response, male C57Bl/6J mice injected with LPS (5 mg/kg IP) exhibited persistent changes in microglia morphology and elevated pro-inflammatory markers in the hippocampus, cortex, and midbrain 7 days after LPS injection, while the peripheral immune response had resolved. Ex vivo serum analysis revealed an augmented pro-inflammatory response to LPS when microglia cells were cultured with the 7-day LPS serum, indicating the presence of bioactive circulating factors that prime the microglial pro-inflammatory response. Elevated circulating HMGB1 levels were identified in the mouse serum 7 days after LPS administration and in the serum of veterans with GWI. Tail vein injection of rHMGB1 in male C57Bl/6 J mice elevated TNFα mRNA levels in the liver, hippocampus, and cortex, demonstrating HMGB1-induced peripheral and CNS effects. Microglia isolated at 7 days after LPS injection revealed a unique transcriptional profile of 17 genes when compared to the acute 3 H LPS response, 6 of which were also upregulated in the midbrain by rHMGB1, highlighting a distinct signature of the persistent pro-inflammatory microglia phenotype. These findings indicate that circulating HMGB1 is elevated in GWI, regulates the microglial neuroimmune response, and drives chronic neuroinflammation that persists long after the initial instigating peripheral stimulus.
National trends of utilization and readmission rates with intravascular ultrasound use for ST-elevation myocardial infarction

BACKGROUND Randomized trials have confirmed that intravascular ultrasound (IVUS) guidance for percutaneous coronary interventions (PCI) improves long-term clinical outcomes. However, data on real-world utilization of IVUS in ST-elevation myocardial infarction (STEMI) and the impact on short to mid-term outcomes are scarce. We sought to evaluate the utilization and the readmission rates for IVUS-guided PCI in the setting of STEMI. METHODS Hospitalizations with a primary diagnosis of STEMI undergoing PCI were included from the Nationwide Readmissions Database (NRD) during 2012-2017. RESULTS Among 809,601 hospitalizations with STEMI undergoing PCI, 33,644 (4.2%) underwent IVUS-guided PCI. IVUS use increased from 4.2% in 2012 to 5.6% in 2017 (p < .0001). After matching, in-hospital mortality was significantly lower with IVUS use (3.9% vs. 4.6%, p < .0001). The overall readmission rates were similar in both groups. We found that readmission rates due to acute MI at 6 months (5.7% vs. 6%, p = .045) and 11 months (5.1% vs. 6.5%, p = .005) as well as the PCI and mortality rates during readmission at 11 months (2.1% vs. 3%, p = .008, and 0.7% vs. 1.4%, p = .002, respectively) were significantly lower in the IVUS group. CONCLUSIONS The utilization of IVUS in STEMI appears to be slowly increasing. Although overall readmission rates were similar, IVUS was associated with lower in-hospital mortality, lower rates of readmission due to acute MI at 6 and 11 months, as well as lower PCI and mortality at 11 months. Randomized trials evaluating long-term benefits of IVUS in STEMI are needed.
ETIOLOGY AND OUTCOME OF ESOPHAGEAL STRICTURE AMONG CHILDREN: LOCAL DATA FROM TERTIARY CARE CHILDREN HOSPITAL OF MULTAN, PAKISTAN

OBJECTIVES: To find out the etiology and outcome in terms of clinical improvement among children having esophageal stricture (ES). METHODS: This prospective study was conducted from July 2019 to March 2020 at Children’s Hospital, Multan, Pakistan on diagnosed patients of ES, ageing <15 years. Demographic details, different etiologies, location of the ES and treatment outcome were recorded. After initial management, endoscopy and dilatation was done at 6 weeks. Patients were followed-up for at least 12 weeks. RESULTS: Out of 32 children with ES, 19 (59.4%) were males. Mean age of children was 36.58±19.6 months. Twenty-four (75%) patients had proximal and 8 (25%) had distal stricture. Chemical burn (n=23; 71.9%) and esophageal atresia (n=4: 12.5%) were commonest causes of ES. Dilatation and surgery were performed in 21 (65.6%) cases followed by dilatation only in 10 (31.3%) cases and surgery alone in one (3.1%) case. In patients with chemical burns, majority (n=16/23; 69.6%) required both dilatation and surgery. Overall outcome of treatment options was good in 62.5% (n=20/32) patients. Outcome was good in 61.9% (n=13/21) of patients requiring both dilatation and surgery and 70% (n=7/10) in patients having dilatation alone (p=0.385). Outcome was good in 69.6% (n=16/23) of patients with chemical burns and 70% (n=7/10) in patients with dilatation only (p=0.385). Mortality rate was 3.1% (n=1). CONCLUSION: Chemical burn and esophageal atresia were the commonest causes of ES. Outcome of all procedures was good in 62.5% cases and had no significant relationship with causes and site of ES or types of treatment.
Ionic strength dependent forces between end-grafted Poly(sulfobetaine) films and mica

Abstract The molecular surface properties of zwitterionic polymer coatings are central to their ultra-low fouling properties and effectiveness as steric stabilizers in concentrated salt solutions. Here, Surface Force Apparatus measurements quantified the molecular forces between end-grafted poly(sulfobetaine) methacrylate thin films and mica, as a function of the chain grafting density and ionic strength. These results demonstrate that, at the ionic strengths considered, end-grafted poly(sulfobetaine) films can be described by models for polymers in good solvent. Parameters determined from data fits to the Milner-Witten-Cates or Dolan and Edwards models for dense or dilute chains, respectively, varied with ionic strength, in ways that reflect poly(sulfobetaine) swelling and the increased excluded volume strength of chain segments. These force measurements provide new insight into how polymer coverage and salt cooperate to regulate repulsive poly(sulfobetaine) steric barriers. These findings have implications for the design of grafted poly(sulfobetaine) as colloidal stabilizers or nonfouling surface coatings.
Chloride ion transport and mass balance in a metropolitan area using road salt

[1] In the Twin Cities metropolitan area (TCMA) of Minneapolis/St. Paul, Minnesota, an estimated 317,000 metric tons (t) of road salt were used annually for road deicing between 2000 and 2005. To determine the annual retention of road salt, a chloride budget was conducted for a 4150 km2 watershed encompassing the populated areas of the TCMA. In addition to inflows and outflows in the major rivers of the TCMA, multiple sources of chloride were examined, but only road salt and wastewater treatment plant (WWTP) effluents were large enough to be included in the analysis. According to the chloride budget, 235,000 t of chloride entered the TCMA annually with the Mississippi and Minnesota rivers, and 355,000 t exited through the Mississippi River. Of the 120,000 t of chloride added annually to the rivers inside the TCMA watershed boundaries, 87,000 t came from WWTPs and 33,000 t came from road salt. Of the 142,000 t of chloride applied annually in the TCMA watershed as road salt (241,000 t NaCl), only 23% (33,000 t) were exported through the Mississippi River and 109,000 t or 77% were retained in the TCMA watershed. Chloride budgets for 10 subwatersheds within the TCMA analyzed in a similar way, gave an average chloride retention rate of 72%. The retention is occurring in the soils, surface waters (numerous lakes, wetlands, and ponds) and in the groundwater. Chloride concentrations in many of these urban water bodies are now considerably higher than the presettlement background levels of less than 3 mg/L with concentrations as high as 2000 mg/L in shallow groundwater wells. The continued accumulation of chloride in the groundwater and surface waters is a cause for concern.
Integrating disruption-prone links into reliable networks: a transmission control protocol friendly approach

Although progress has been made to satisfy mobility at the network's edge, much work remains for deeper mobility requirements. In many emergency or military applications, fixed network infrastructure may not be available or even possible. As mobile military data requirements grow, and spectrum limitations increase, systems must better utilise the diminishing available bandwidth of wireless radio frequency and free space optical links. To achieve better utilisation, disruption-prone networks require disruption-tolerant protocols or localised buffering to mask disruptions. Transmission control protocol (TCP)/IP assumes reliable links and performs well in networks with congestion dominated packet losses, but poorly with link failure dominated packet losses. Although TCP might be altered for disruptive environments, evolutionary reasons make it difficult to do so well without partitioning networks into reliable and disruption-tolerant systems. Instead, the authors examine transport layer aware helper protocols, with intermediate buffering in routers, to assist TCP across disruption-prone network portions. The buffering does not require TCP modifications at communicating nodes and integrate well with existing routers (i.e. TCP friendly). Experimental results show that TCP can reliably establish and maintain connections under poor link availability using the buffering protocol. Few TCP connections complete without it.
ON STABILITY OF VISCOPLASTIC SYSTEMS WITH THERMO-MECHANICAL COUPLING†

Abstract : The stability of equilibrium configurations of thermo -mechanically coupled systems in the plastic and the viscoplastic range is examined through simple examples and by dimensional analysis. A uniform fully-insulated thin-walled tube twisted into the inelastic range is studied first. The material is idealized as linear work-hardening viscoplastic with a current yield stress which decreases linearly with increase in temperature. Any annealing or age-hardening or similar influence of time at temperature is supposed negligible. A local stability criterion beta > 1 governs, where beta is the ratio of the heat stored in the material to the heat generated by inelastic deformation with a given temperature rise. Neither viscosity nor heat conduction enters into the stability or instability of this homogeneous system. They both play a role in successive modifications of the simple model which demonstrate the stabilizing effect of heat transfer to the surroundings and of the heat capacity in regions of material below yield. (Author)
Predicting the permeability of sediments entering subduction zones

Using end-member permeabilities defined by a worldwide compilation of sediment permeabilities at convergent margins, we compare permeability predictions using a geometric mean and a two-component effective medium theory (EMT). Our implementation of EMT includes a threshold fraction of the high-permeability component that determines whether flow occurs dominantly in the high- or low-permeability component. We find that this threshold fraction in most cases is equal to the silt + sand-sized fraction of the sediment. This suggests that sediments undergoing primary consolidation tend to exhibit flow equally distributed between the high- and low-permeability components. We show that the EMT method predicts permeability better than the weighted geometric mean of the end-member values for clay fractions <0.6. This work provides insight into the microstructural controls on permeability in subducting sediments and valuable guidance for locations which lack site-specific permeability results but have available grain-size information.
PCI DSS and the legal framework for security: An update on recent developments and policy directions

This article provides an update of recent legal and legislative developments and commentary on policy directions affecting data security within the payment card industry and related networks.
Field theory tests for correlators in the AdS-CFT correspondence

The order ${g}^{2}$ radiative corrections to all two- and three-point correlators of the composite primary operators $\mathrm{Tr}{X}^{k}$ are computed in $\mathcal{N}=4$ supersymmetric Yang-Mills theory with the gauge group $\mathrm{SU}(N).$ Corrections are found to vanish for all $N.$ For $k=2$ this is a consequence of known superconformal nonrenormalization theorems, and for general $k$ the result confirms an $\stackrel{\ensuremath{\rightarrow}}{N}\ensuremath{\infty},$ fixed large ${g}^{2}N$ supergravity calculation and further conjectures by S. Lee et al., hep-th/9806074. A three-point correlator involving $\mathcal{N}=4$ descendents of $\mathrm{Tr}{X}^{2}$ is calculated, and its order ${g}^{2}$ contribution also vanishes, giving evidence for the absence of radiative corrections in correlators of descendent operators.