cssi/SciSciGPT-SciSciNet huggingface dataset:
Effectiveness of an Antimicrobial Stewardship Approach for Urinary Catheter–Associated Asymptomatic Bacteriuria

Importance Overtreatment of asymptomatic bacteriuria (ASB) in patients with urinary catheters remains high. Health care professionals have difficulty differentiating cases of ASB from catheter-associated urinary tract infections. Objectives To evaluate the effectiveness and sustainability of an intervention to reduce urine culture ordering and antimicrobial prescribing for catheter-associated ASB compared with standard quality improvement methods. Design, Setting, and Participants A preintervention and postintervention comparison with a contemporaneous control group from July 2010 to June 2013 at 2 Veterans Affairs health care systems. Study populations were patients with urinary catheters on acute medicine wards and long-term care units and health care professionals who order urine cultures and prescribe antimicrobials. Intervention A multifaceted guidelines implementation intervention. Main Outcomes and Measures The primary outcomes were urine cultures ordered per 1000 bed-days and cases of ASB receiving antibiotics (overtreatment) during intervention and maintenance periods compared with baseline at both sites. Patient-level analysis of inappropriate antimicrobial use adjusted for individual covariates. Results Study surveillance included 289 754 total bed-days. The overall rate of urine culture ordering decreased significantly during the intervention period (from 41.2 to 23.3 per 1000 bed-days; incidence rate ration [IRR], 0.57; 95% CI, 0.53-0.61) and further during the maintenance period (to 12.0 per 1000 bed-days; IRR, 0.29; 95% CI, 0.26-0.32) ( P P P Conclusions and Relevance A multifaceted intervention targeting health care professionals who diagnose and treat patients with urinary catheters reduced overtreatment of ASB compared with standard quality improvement methods. These improvements persisted during a low-intensity maintenance period. The impact was more pronounced in long-term care, an emerging domain for antimicrobial stewardship.
Asthma risk factors.

Background Bronchial asthma is one of the most common chronic diseases in childhood, with a current prevalence of 6% to 9%, but a prevalence that is increasing at an alarming rate. Asthma is a complex genetic disorder with strong environmental influence. It imposes a growing burden on our society in terms of morbidity, quality of life, and healthcare costs. Despite large-scale efforts, only a few asthma genes have been confirmed, suggesting that the genetic underpinning of asthma is highly complex. Methods A review of the literature was performed regarding atopic and nonatopic asthma risk factors, including environmental risk factors and genetic studies in adults and children. Results Several environmental risk factors have been identified to increase the risk of developing asthma such as exposure to air pollution and tobaccos smoke as well as occupational risk factors. In addition atopy, stress, and obesity all can increases the risk for asthma in genetically susceptible persons. Conclusion Asthma represents a dysfunctional interaction with our genes and the environment to which they are exposed, especially in fetal and early infant life. The increasing prevalence of asthma in all age groups indicate that our living environment and immunity are in imbalance with each other reacting with airway inflammation to the environmental exposures and often non-harmful proteins, such as allergens causing the current “asthma and allergy epidemic.” Because of the close relationship between asthma and chronic rhinosinusitis, it is important that otolaryngologists have a good understanding of asthma, the etiologic factors associated with disease, and its evaluation and management.
Swelling behavior of nanoscale, shape- and size-specific, hydrogel particles fabricated using imprint lithography

Recently a number of hydrogel-based micro- and nanoscale drug carriers have been reported including top down fabricated, highly monodisperse nanoparticles of specific sizes and shapes. One critical question on such approaches is whether in vivo swelling of the nanoparticles could considerably alter their geometry to a point where the potential benefit of controlling size or shape could not be realized. Little has been reported on experimental characterization of the swelling behavior of nanoscale hydrogel structures, and current theoretical understanding is largely based on bulk hydrogel systems. Using atomic force microscopy (AFM) and environmental scanning electron microscopy (ESEM) capsules, we have characterized the swelling behavior of nano-imprinted hydrogel particles of different sizes and aspect ratios. Our results indicate a size-dependent swelling which can be attributed to the effect of substrate constraint of as-fabricated particles, when the particles are still attached to the imprinting substrate. Numerical simulations based on a recently developed field theory and a nonlinear finite element method were conducted to illustrate the constraint effect on swelling and drying behavior of substrate-supported hydrogel particles of specific geometries, and compared closely with experimental measurements. Further, we present a theoretical model that predicts the size-dependent swelling behavior for unconstrained sub-micron hydrogel particles due to the effect of surface tension. Both experimental and theoretical results suggest that hydrogel swelling does not significantly alter the shape and size of highly crosslinked nanoscale hydrogel particles used in the present study.
Hierarchical bivariate time series models: a combined analysis of the effects of particulate matter on morbidity and mortality.

SUMMARY In this paper we develop a hierarchical bivariate time series model to characterize the relationship between particulate matter less than 10 microns in aerodynamic diameter ( PM 10) and both mortality and hospital admissions for cardiovascular diseases. The model is applied to time series data on mortality and morbidity for 10 metropolitan areas in the United States from 1986 to 1993. We postulate that these time series should be related through a shared relationship with PM 10. At the first stage of the hierarchy, we fit two seemingly unrelated Poisson regression models to produce city-specific estimates of the log relative rates of mortality and morbidity associated with exposure to PM 10 within each location. The sample covariance matrix of the estimated log relative rates is obtained using a novel generalized estimating equation approach that takes into account the correlation between the mortality and morbidity time series. At the second stage, we combine information across locations to estimate overall log relative rates of mortality and morbidity and variation of the rates across cities. Using the combined information across the 10 locations we find that a 10 µg/m 3 increase in average PM 10 at the current day and previous day is associated with a 0.26% increase in mortality (95% posterior interval −0.37, 0.65), and a 0.71% increase in hospital admissions (95% posterior interval 0.35, 0.99). † To whom correspondence should be addressed.
To Retire or Not to Retire? That Is the Question

During the 1960s, there was extensive hiring of college and university faculty members. This large group of professors are now at or nearing retirement age. Concerns about the economy, the availability of good health insurance, increased life expectancy, and removal of mandatory retirement laws may influence decisions about when to retire. Although references about enjoying retirement are readily available, less information appears to exist about the decision-making process for faculty members. This article provides some initial information for faculty members facing the possibility of retirement as well as calls for the development of a discussion forum about retirement devoted to psychology faculty.
Bioethical Aspects of HIV Infection in Children

The care of HIV-infected children is fraught with many bioethical conflicts and dilemmas that require careful attention if care is to be provided appropriately. Understanding of the interplay of such general principles as autonomy, nonmaleficence, confidentiality, and veracity helps to clarify the nature of specific conflicts. This article addresses both general principles and their specific applications to pediatric patients with HIV infection. It addresses these matters from the points of view both of patients and parents. It shows why conflict is practically inevitable, and it points the way toward prevention and resolution of conflict. Practical guidelines are provided in relation to the critical problem of disclosure of diagnosis to the patient.
SHOULD PALEONTOLOGISTS USE “PHYLOGENETIC” NOMENCLATURE?

“What's the use of their having names”, the Gnat said, “if they won't answer to them?”. “No use to them” said Alice; “but its useful to the people that name them, I suppose. If not, why do things have names at all?” Alice Through the Looking Glass. Lewis Carroll (1871). Thanks to the Linnaean system of Biological Nomenclature systematics these days is an ordered discipline. Debates over specifics still abound, but there is little argument that taxonomy should reflect the current state of our phylogenetic knowledge. However, recent proposals to replace the historically developed and universally utilized Linnaean system of Biological Nomenclature with an alternative “phylogenetic” system of nomenclature (PN; formulated as the draft PhyloCode [http://www.ohiou.edu/phylocode]; e.g., Cantino and de Queiroz, 2000; see Nixon and Carpenter, 2000 for exhaustive citations) are flawed because they are founded on the misconception that Linnaean classification cannot (and therefore currently does not) accurately represent phylogeny. This is not the case—the ranked Linnaean system is a hierarchy, but then again, so is a cladogram and hence the former can mirror the latter. Although implementation of the proposed PhyloCode would result in huge implications within biological systematics in general (Nixon and Carpenter, 2000; Forey, 2001; Schuh, submitted), some workers (e.g., Brochu and Sumrall, 2001) have argued that proposals to implement this new system of “phylogenetic” nomenclature are a “good thing” for paleontology in particular. Since viewpoints contrary to the PhyloCode have already been aired elsewhere (e.g., Dominguez and Wheeler, 1997; Moore, 1998; Benton, 2000; Nixon and Carpenter, 2000; Forey, 2001), my aim here is to highlight a few areas of PN that make it an especially problematic proposal for paleontologists. The PhyloCode is a draft proposal to replace the current system of supposedly “non-phylogenetic” Linnaean taxonomy with …
Refining the Risk for Atrial Fibrillation.

> You can’t prevent what you can’t predict > > –K.M. Mac Aulay Atrial fibrillation (AF) is a global public health problem characterized by dramatically increasing prevalence, significantly associated morbidity and mortality, and ominously spiraling healthcare costs. Thus, the lifetime risk for AF in individuals over the age of 40 in the United States is ≈1 in 4 and the risk of stroke, heart failure, and death is increased in affected individuals.1–5 Although currently estimated to be present in ≈2 million persons, it is expected that as many as 12 million people will have AF by 2050.6 Not surprisingly, AF is responsible for significant US healthcare costs, which are estimated to exceed 6 billion dollars annually.7 Accordingly, identifying the risk factors for the development of AF and strategies to reduce risk and, thereby prevent AF is a high priority of the American Heart Association.8 See Article by Russo et al The established modifiable risk factors for AF include hypertension, diabetes mellitus, previous cardiovascular disease, obesity, and cigarette smoking.9 However, after considering these risk factors, considerable residual risk remains. In the Framingham cohort, hypertension, prevalent heart disease, diabetes mellitus, and cigarette smoking accounted for 44% of the risk in men and 58% of the risk in women.10 In the Atherosclerosis Risk in Communities (ARIC) study, 57% of incident AF cases during a 17-year follow-up could be explained by having at least 1 borderline or elevated risk factor (hypertension, obesity, diabetes mellitus, cigarette smoking, and previous heart disease); the most important contributor was hypertension, which accounted for approximately a quarter of the AF burden.11 A heritable component undoubtedly accounts for some of the residual risk. …
Contributions to the Chemical Bacteriology of Sewage

The present paper contains the results of the chemical and bacteriological examination of sewage, with the object, in the first place, of ascertaining the species of organisms herein contained, and, in the second, of determining some of their chemical characteristics. Of late years attention has chiefly been paid to the study of pathogenic organisms, whilst the far more numerous class of saprophytic organisms, which, although not issociated with disease, nevertheless play a most important part in nature, has only been examined by a few investigators.
Phase Diagram for Reversibly-Assembled Rod-Like Aggregates: Nematic, Columnar and Crystalline Ordering

Aqueous solutions of amphiphilic molecules which reversibly assemble into well defined polydisperse rod-like aggregates display a characteristic sequence of lyotropic mesophases including translational as well as orientational ordering. We have developed a model for such systems which incorporates a phenomenological description of aggregate assembly with a scaled particle calculation of the configurational entropy in the fluid dimensions and a cell theory description of the configurational entropy in the translationally ordered dimensions. The model reproduces many of the features seen in the experimental phase diagrams, including regions of isotropic, nematic, columnar and crystalline stability. In addition to the calculated phase diagram, related aggregate size distributions are reported.
A rash during surgery: rounding up the usual suspects.

A 72-year-old woman with a medical history of allergic rhinitis, food allergy, non-IgE-mediated reactions to medications, spinal stenosis and previous laminectomy presented to our institution for thoracic decompression laminectomy, facetectomy and foraminotomy. During the procedure, 5 min after chlorhexidine application and prior to surgical incision, she developed a blanching urticaria on her back (figure 1). The patient had no associated angio-oedema, hypotension, respiratory failure or anaphylaxis. Figure 1 Blanching urticaria (A) on patient’s back 5 min after application of antiseptic agent. Patient's back (B) with complete resolution of urticaria within an hour and 45 min. Surgery was cancelled. She was treated with diphenhydramine 50 mg intravenously …
Cognitive Behavioral Therapy for Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) can develop after exposure to trauma and is associated with intrusions of the trauma memory, arousal, reactivity, and avoidance symptoms, along with negative alterations in cognitions and mood. PTSD is a debilitating, and often chronic, disorder responsible for significant individual and societal costs. The gold standard treatment for PTSD is cognitive behavioral therapy (CBT) which includes four primary components: (a) psychoeducation, (b) anxiety management, (c) exposure, and (d) cognitive restructuring. Two specific interventions, prolonged exposure (PE) and cognitive processing therapy (CPT), have the most research support and can dramatically reduce PTSD symptoms, ameliorate the impact of comorbid mental health problems, and improve quality of life. Although CBT is the first-line treatment for PTSD, psychopharmacological interventions, particularly serotonin-targeting medications, are also helpful as adjunctive treatments for PTSD. The efficacy of CBT is well established, yet many individuals fail to access or complete these treatments. Given the impact of PTSD and its associated disability and cost, continued efforts are needed to ensure that these treatments are disseminated to individuals in need and to maximize engagement in these treatments.
Calculation Model for DC Biasing Current Based on Finite Element Analysis

In this paper,a modeling method for DC bias calculation is proposed based on the combination of finite element analysis and analytical method.This method greatly improves the calculation precision and efficiency,conducive to the evaluation and suppression of DC biasing current.
Functional Site Discovery in a Sulfur Metabolism Enzyme by Using Directed Evolution

In human pathogens, the sulfate assimilation pathway provides reduced sulfur for biosynthesis of essential metabolites, including cysteine and low-molecular-weight thiol compounds. Sulfonucleotide reductases (SRs) catalyze the first committed step of sulfate reduction. In this reaction, activated sulfate in the form of adenosine-5'-phosphosulfate (APS) or 3'-phosphoadenosine 5'-phosphosulfate (PAPS) is reduced to sulfite. Gene knockout, transcriptomic and proteomic data have established the importance of SRs in oxidative stress-inducible antimicrobial resistance mechanisms. In previous work, we focused on rational and high-throughput design of small-molecule inhibitors that target the active site of SRs. However, another critical goal is to discover functionally important regions in SRs beyond the traditional active site. As an alternative to conservation analysis, we used directed evolution to rapidly identify functional sites in PAPS reductase (PAPR). Four new regions were discovered that are essential to PAPR function and lie outside the substrate binding pocket. Our results highlight the use of directed evolution as a tool to rapidly discover functionally important sites in proteins.
Happiness is an Emotion

Accounts of happiness in the philosophical literature see it as either a judgment of satisfaction with one’s life or as a balance of positive over negative feelings or emotional states. There are sound objections to both types of account, although each captures part of what happiness is. Seeing it as an emotion allows us to incorporate both features of the accounts thought to be incompatible. Emotions are analyzed as multicomponent states including judgments, feelings, physical symptoms, and behavioral dispositions. It is shown that prototypical happiness contains all these components, and each is explicated. The concept of happiness, like the concepts of other emotions, is a cluster concept. The features of such concepts are made clear. Happiness is shown to be similar to other emotions in many respects, including the phenomenon of adaptation, the “paradox of happiness,” and the existence of both paradigm and borderline instances. The account allows us to capture all that was right in earlier accounts while avoiding objections to them.
Parameter estimation of finite mixtures for image processing using the EM algorithm and information criteria

A method for parameter estimation in image classification or segmentation is studied within the statistical frame of finite mixture distributions. The method models an image as a finite mixture. Each mixture component corresponds to an image class. Each image class is characterized by parameters such as the intensity means, the standard deviation, and the number of image pixels in that class. The method uses a maximum likelihood (ML) approach to estimate the parameters of each class, and uses the information criteria of Akaike (AIC) and/or Schwarz (MDL) to determine the number of classes in the image. In computing the ML solution of the mixture, the method adopts the expectation maximization (EM) algorithm. The initial estimation and convergence of the ML-EM algorithm are studied. The parameters estimated from a simulated phantom are very close to those of the phantom. The determined number of image classes agrees with that of the phantom. The accuracies in determining the number of image classes using AIC and MDL are compared. The MDL criterion performs better than the AIC criterion. A modified MDL shows further improvement. >
Parallel empirical stochastic branch and bound for large-scale discrete optimization via simulation

Real-life simulation optimization applications often deal with large-scale simulation models that are time-consuming to execute. Parallel computing environments, such as high performance computing clusters and cloud computing services, provide the computing power needed to scale to such applications. In this paper, we show how the Empirical Stochastic Branch and Bound algorithm, an effective globally convergent random search algorithm for discrete optimization via simulation, can be adapted to a high-performance computing environment to effectively utilize the power of parallelism. We propose a master-worker structure driven by MITRE's Goal-Directed Grid-Enabled Simulation Experimentation Environment. Numerical experiments with the popular Ackley benchmark test function and a real-world simulation called runwaySimulator demonstrate the number of cores needed to achieve a good scaled efficiency of parallel empirical stochastic branch and bound for increasing levels of simulation run times.
Generation of Human Hair Cells In Vitro: Is It All about How the Wnt Blows?

Screening for small molecules or drugs that can protect or restore mechanosensory hair cells has been hampered by limited cell numbers. In Nature Biotechnology, Koehler et al. (2017) have developed a human organoid-based approach using basic developmental principles to generate large numbers of bonafide hair cells in vitro.
Quality Interpersonal Care A STUDY OF AMBULATORY SURGERY PATIENTS' PERSPECTIVES

Examining outcome criteria that measure quality is one way of evaluating patient care and emotional support. The method used in this study shows the actual effects of interventions in patient education. The findings suggest that not all patients perceived that the quality criteria that measure emotional support and patient teaching were met. Certain variables were identified as explaining the patients' perception of quality. For example, although patients perceived surgeons who spent time with them before and after surgery to have improved interpersonal quality, they perceived the ambulatory surgery site that required professional nurses to demonstrate caring and concern as providing better quality care. Furthermore, the teaching that enabled most patients to acquire adequate knowledge of self-care was done at the time of discharge, with the family present, and did not rely on written pamphlets, although written instructions were included in the teaching. This examination of different nursing approaches suggests that variations in interventions have a major impact on the outcomes of care. Even with cost-containment measures that threaten to diminish quality, professional nurses can provide direction in establishing quality standards of ambulatory surgery care. There are identifiable nursing interventions that can be implemented to maintain quality. Consistent review of prior nursing care can provide professional nurses with information on meeting quality standards and suggest new approaches to patient care.
Perceptual Implications of Level- and Frequency-Specific Deviations from Hearing Aid Prescription in Children.

Background The purpose of providing amplification for children with hearing loss is to make speech audible across a range of frequencies and intensities. Children with hearing aids (HAs) that closely approximate prescriptive targets have better audibility than peers with HA output below prescriptive targets. Poor aided audibility puts children with hearing loss at risk for delays in communication, social, and academic development. Purpose The goals of this study were to determine how well HAs match prescriptive targets across ranges of frequency and intensity of speech and to determine how level- and frequency-dependent deviations from prescriptive target affect speech recognition in quiet and in background noise. Study sample One-hundred sixty-six children with permanent mild to severe hearing loss who were between 6 months and 8 years of age and who wore HAs participated in the study. Data collection and analysis Hearing aid verification and speech recognition data were collected as part of a longitudinal study of communication development in children with HAs. Hearing aid output at levels of soft and average speech and maximum power output were compared with each child's prescriptive targets. The deviations from prescriptive target were quantified based on the root-mean-square (RMS) error and absolute deviation from target for octave frequencies. Children were classified into groups based on the number of level-dependent deviations from prescriptive target. Frequency-specific deviations from prescriptive target and sensation levels (SLs) were used to estimate the proximity of fittings across the frequency range. Lexical Neighborhood Test (LNT) word recognition in quiet and Computer-Assisted Speech Perception Assessment (CASPA) phoneme recognition in noise were compared across level-dependent error groups and as a function of SL at 4 kHz. Results Children who had deviations from prescriptive target at all three input levels had poorer LNT word recognition in quiet than children who had fittings that matched prescriptive target within 5 dB RMS at all three input levels. Children with lower 4 kHz SLs through their HAs had poorer LNT recognition in quiet and CASPA phoneme recognition in noise than children with higher aided SLs. Conclusions Children with HAs fitted to provide audibility for speech across a range of inputs and frequencies had better speech recognition outcomes than peers with HAs that were not optimally fitted to prescriptive targets.
Better to Stay Home: Evaluating the Impact of Day Reporting Centers on Offending:

This article reports the findings of a quasi-experimental evaluation of community resource centers (CRCs)—nonresidential, day reporting centers employed for recent parolees. CRC participants (n = 2...
Interchangeable Use of Proton Pump Inhibitors Based on Relative Potency

Although proton pump inhibitors (PPIs) are widely used, their relative potency and ideal dosing regimens remain unclear. We analyzed data from randomized clinical trials that performed pH testing in patients receiving solid-dose PPI formulations (omeprazole, esomeprazole, lansoprazole, pantoprazole, rabeprazole) for a minimum of 5 days. We used omeprazole equivalency and the surrogate biomarker, percentage time pH > 4 over a 24-hour period (pH4time), to compare PPI effectiveness for different PPIs given once, twice, or 3 times daily. We found that increasing strength of once-daily PPIs (9–64 mg omeprazole equivalents) increased pH4time linearly from approximately 10.0 to 15.6 hours; higher doses produced no further increase in pH4time. Increasing the frequency to twice-daily PPI increased pH4time linearly, from approximately 15.8 to 21.0 hours. Three-times daily PPIs performed similarly to twice-daily PPIs. The costs of PPIs varied greatly, but the cost variation was not directly related to potency. We conclude that PPIs can be used interchangeably based on potency. Using twice-daily PPIs is more effective in increasing efficacy increasing once-daily PPI dosage. Omeprazole and lansoprazole (30 mg) and 20 mg of esomeprazole rabeprazole are functionally equivalent.
Innovative ordinariness and ritual change in a Jerusalem Minyan

In this article, I present an ethnographic analysis of ritual change in the communal prayers of a Jerusalem congregation that promotes gender equality within the framework of Orthodox-oriented halakha. While scholars have examined how ritual change in Jewish communities develops through the reinterpretation and reutilization of religious texts, practices and objects, my fieldwork reveals how change is shaped by people’s habitus – their ways of being in the world. Communal prayers in this congregation exemplify what I call an “innovative ordinariness” of religious change. Members view and experience their communal rituals as “ordinary” due to their perception of their prayer hall as a familiar spatial and auditory environment. This ordinariness facilitates creative and innovative uses of religious practices. The data outlined here are based on field research during which I participated in the congregation’s services and communal activities, and held interviews and informal conversations with member...
Proprietary control in cyberspace: three moments of copyright growth in China:

Drawing on critical research on the political economy of the media and intellectual property rights (IPR), this research examines copyright growth in China’s digital media. It sees copyright develo...
Mouse Steroid Sulfotransferases: Substrate Specificity and Preliminary X-Ray Crystallographic Analysis

Abstract Three mouse cytosolic sulfotransferases were expressed in Escherichia coli cells in order to study their substrate specificities toward natural as well as synthetic steroid hormones. The K m and V max values confirmed the high substrate specificity of estrogen and hydroxysteroid sulfotransferases toward estradiol and dehydroepiandrosterone, respectively. In sharp contrast, the synthetic estrogen diethylstilbestrol was metabolized efficiently by both enzymes to its disulfate ester. These sulfotransferases display highly stereospecific sulfotransferase activity for sulfating only the trans -isomer of diethylstilbestrol. Crystals suitable for high-resolution structure determination of estrogen sulfotransferase were grown with polyethylene glycol. The crystals belong to the orthorhombic space group P2 1 2 1 2, and diffracted to 2.5 A.
Correlation of Brain NADH Redox State, K+, PO2 and Electrical Activity During Hypoxia, Ischemia and Spreading Depression

The normal functioning brain requires a continuous supply of blood in order to obtain glucose as well as oxygen. Any change in the oxygenation of the tissue will result in an impairment of the normal function. Most of the oxygen taken up by the brain is consumed by the mitochondria in order to supply the large amount of ATP needed. A major part of the ATP is used by the ATPase system in order to keep the neurons in the polarized state. Figure 1 shows in a schematic way the interrelation between the energy production system and the pumping activity going on in the membranes. In order to understand the connection between various events occurring in the brain in vivo, one has to measure as many parameters as possible from the same site.
Leon Ehrenpreis, Recollections from the Recent Decades

Leon Ehrenpreis was an outstanding world-class mathematician and a wonderful, warm person. I had a privilege to consider myself his friend for the last two decades. It is hard to do justice to his manifold mathematics and personality, but I will try to at least add some recollections to this tribute volume.
Temporal Trends and Risk Factors for Postcolonoscopy Colorectal Cancer.

Background Colonoscopy is effective for colorectal cancer (CRC) prevention, yet patients may develop CRC despite adhering to screening/surveillance intervals. There are limited data on predictive factors associated with these postcolonoscopy CRCs (PCCRCs). We aimed to measure PCCRC rates and identify risk factors for PCCRC. Methods We performed a case-control study, comparing patients with PCCRCs to spontaneous CRCs diagnosed during a 12.5-year period at an academic medical center. PCCRCs were defined as CRCs diagnosed in between guideline-recommended screening/surveillance intervals. Results During the 12.5-year period, of 1266 CRCs diagnosed, 122 (10%) were PCCRCs. 70% of PCCRCs were diagnosed within 5 years of a prior colonoscopy. There was an increasing trend for PCCRC rates in recent years [odds ratio (OR), 2.78; 95% confidence interval (CI), 1.51-5.09], with PCCRCs comprising 13.6% of cancers diagnosed in 2016 as compared with 5.7% of cancers diagnosed in 2005. Older age (OR per year, 1.02; 95% CI, 1.01-1.04), proximal colonic location (OR, 1.99; 95% CI, 1.20-3.33) and early stage (OR, 2.57; 95% CI, 1.34-4.95) were associated with PCCRCs. In total, 41% of PCCRCs were diagnosed by a different physician from the physician who did the prior colonoscopy, and 42% of physicians did not diagnose any of their PCCRC cases. Conclusions PCCRC rates are rising in recent years, likely reflecting the widespread adoption of colonoscopy as a primary screening tool, and are more common in older patients and those with proximal, early-stage tumors. The finding that a large proportion of PCCRCs are diagnosed by a different physician raises the concern that physicians are unaware of their own patients' PCCRCs.
EALBA: Energy Aware Load Balancing Algorithm for IoT Networks

The Internet of Things (IoT) is a paradigm and combines many a technology. In IoT, the devices communicate with each other and to the sink. Since millions of devices are going to be connected to the internet and the devices / nodes / sensors / objects are energy constrained, energy is an important factor in IoT. Load balancing protocol plays a critical role in designing IoT environment as the devices are constraint in nature. This paper deals with energy aware load balancing algorithm for IoT network using event rate. The life time of the devices are enhanced in this proposed method.
“We are not ignorant”: Transnational migrants’ experiences of racialized securitization:

This paper examines the dynamics of racialized securitization for transnational migrants across multiple borders—from Central America toward Mexico and the United States. Rather than a singular pro...
Abstract TP14: Predictors of Neurological Worsening Among Patients Presenting With Large Vessel Occlusions and Mild Symptoms

Introduction: We aim to evaluate the predictors of poor neurological outcome among patients presenting with large vessel occlusion (LVO) and mild symptoms who did not undergo upfront thrombectomy. ...
A generational acoustic analysis of Mexican Spanish and English vowels

Multiple studies have suggested that the Spanish vowel system is stable, with little to no variation (Delattre, 1996; Quillis and Esgueva, 1983), while others have also noted variation in monolingual Spanish (Boyd-Bowman, 1952; Canellada and Vicente, 1960; Delforge, 2008; Lipski, 1990; Lope-Blanch, 1964; Marin Galves, 1995; Matluck, 1952; Quilis, 1999; Quilis and Esgueva, 1983) and bilingual Spanish in the United States (Fought, 1999; Godinez and Maddieson, 1985; Konopka and Pierrehumbert, 2008; Konopka, 2011; Ronquest, 2013; Willis, 2005). This study analyzes the vowel quality and duration of Spanish and English vowels by Mexican and Mexican-American speakers across different sociolinguistic generations in the United States (Silva-Corvalan, 1994), which has been absent from previous literature. An examination of the different generations is needed to account for the differing levels of Spanish and English use in the United States, as well as to examine how production of speech may change across generations. Results indicate all generations exhibit significant unstressed vowel reduction, though there is variation across the different groups. The amount of centralization and reduction also increases for each subsequent generation. In addition, Spanish influence is evident in the production of both G1 and G3 groups, though there is also evidence for acquired English speech. Multiple studies have suggested that the Spanish vowel system is stable, with little to no variation (Delattre, 1996; Quillis and Esgueva, 1983), while others have also noted variation in monolingual Spanish (Boyd-Bowman, 1952; Canellada and Vicente, 1960; Delforge, 2008; Lipski, 1990; Lope-Blanch, 1964; Marin Galves, 1995; Matluck, 1952; Quilis, 1999; Quilis and Esgueva, 1983) and bilingual Spanish in the United States (Fought, 1999; Godinez and Maddieson, 1985; Konopka and Pierrehumbert, 2008; Konopka, 2011; Ronquest, 2013; Willis, 2005). This study analyzes the vowel quality and duration of Spanish and English vowels by Mexican and Mexican-American speakers across different sociolinguistic generations in the United States (Silva-Corvalan, 1994), which has been absent from previous literature. An examination of the different generations is needed to account for the differing levels of Spanish and English use in the United States, as well as to examine how production of speech may change across generatio...
Race, Family, and the Plantation Legacy in United States and Caribbean Writers

Valerie Loichot’s Orphan Narratives: The Postplantation Literature of Faulkner, Glissant, Morrison, and Saint-John Perse explores the ways plantation culture and its powerful reverberations stretch from the Caribbean through the United States South to the Midwest in the writings of four authors imbricated in that culture. Reading elements of what she calls the postplantation as hemispherically widespread, she presents a methodology of approaching this topic that could have a significant impact on framing Caribbean-United States critical discourse.
La articulación de la materia narrada en Las Sergas de Esplandián

La novela es uno de los vehiculos artisticos que mejor han representado el pensar del ser humano a traves del tiempo; de aqui el interes imperecedero en su desarrollo desde su genesis. Esto conllevara no solo una evolucion ideologica que dictara parametros tanto con respecto al “contenido” como a las estrategias narrativas que siguen transmutandose. El mecanismo del cruce de historias revela como cambia de intencion el mensaje de Montalvo al concluir el Amadis de Gaula con Las Sergas de Esplandian. El cambio ocurre al ver la narracion como una gran orquestacion sintetica y simbolica del acontecer, en la que la casualidad de la aventura caballeresca es reemplazada por la causalidad del creyente.
Oxygenation extremes after traumatic brain injury transiently affect coagulation

Abstract Introduction Trauma patients may become hypoxic or iatrogenically hyperoxic in the early post-injury period. While both extremes of oxygenation may be harmful following injury, the mechanism has yet to be elucidated. We hypothesized that hypoxia or hyperoxia would induce changes in coagulation, creating a secondary insult exacerbating the primary injury. Materials and methods Mice underwent traumatic brain injury (TBI) or sham and were subsequently exposed to room air or brief hypoxia (15% FiO2) then sacrificed at intervals. Another cohort of uninjured mice underwent more prolonged hypoxia (10% FiO2) or hyperoxia (60% FiO2). Platelet function was evaluated by ADP- or ASPi-induced impedance aggregometry and viscoelastic coagulation parameters were assessed with rotational thromboelastometry. Results In uninjured mice, ADP-induced platelet aggregation was acutely increased after prolonged hypoxia, but this difference did not persist at 6 h. Hypoxic and hyperoxic TBI mice had increased ADP induced platelet aggregation at 1 h compared to the normoxia group. TBI mice demonstrated an early increased platelet aggregation after hypoxia or hyperoxia. Viscoelastic coagulation parameters were similar between hypoxic, hyperoxic and room air groups at 1 h and 6 h. However, ROTEM clotting time and clot formation time were prolonged and maximal clot firmness were lower in sham TBI/hypoxia mice at 24 h. Conclusion Post-TBI hypoxia and hyperoxia resulted in transiently increased platelet aggregation in response to ADP, without lasting effecting on platelet function or coagulation. Hypoxia also induced delayed hypocoagulability after platelet aggregation normalized. Brief changes in oxygenation may temporally affect coagulation and platelet aggregation, which could contribute to physiologic secondary injury after trauma.
Narrative Mapping: Participant-Generated Visual Methodology for Health Communication Research and Pedagogy.

Narrative mapping is a newly emergent form of participant-generated visual methodology. This essay differentiates narrative mapping from other visual methodologies and from other genres of mapping ...
The Health Equity Through Aging Research And Discussion (HEARD) Study: A Proposed Two-Phase Sequential Mixed-Methods Research Design To Understand Barriers And Facilitators Of Brain Donation Among Diverse Older Adults

Brain donation in studies on aging remains a critical pathway to discovering and improving preventive measures and treatments for Alzheimer's dementia and related disorders. Brain donation for research is almost exclusively obtained from non-Latinx Whites of higher socioeconomic status in the United States. Despite persistent efforts, it has been difficult to obtain consent for brain donation among diverse participants. Hence, our understanding of Alzheimer's dementia and related disorders remains incomplete. The purpose of this methodological paper was to propose and outline a two-phase sequential mixed-methods research study design to identify barriers and facilitators of brain donation among diverse older adults. The first phase will consist of qualitative focus groups using a three (participant minority status: African American, Latinx, or White of lower income) by two (participant brain donation decision: consented or declined) design. The second phase will include statistical analyses of quantitative measures of existing data representing categories of variables that may be associated with decision making regarding brain donation. Next steps must include conducting qualitative focus groups and subsequent data analyses, resulting in overarching themes. Afterward, qualitative themes will be operationalized using quantitative variables for statistical analyses. This proposed study design can provide the foundation for developing and implementing effective and culturally competent survey instruments, educational tools, and intervention strategies in an effort to facilitate brain donation among diverse older adults.
Solubilization of coals by reductive alkylation

Abstract Anthracite, bituminous and subbituminous coal when treated with naphthalene anion in tetrahydrofuran added negative charges to form the corresponding coal anions. Alkylation of bituminous and subbituminous coal anion with ethyl iodide resulted in the addition of 16 and 14 ethyl groups per 100 carbon atoms. The alkylated coals were 88 and 45% soluble in benzene. The molecular weights of the benzene-soluble portions of the bituminous and subbituminous coal were respectively 2000 and 700. An attempt to add alkyl groups to anthracite anion was not successful.
Christian Education Foundations: Retrospects and Prospects

Christian education foundations are discussed from the perspective of two veteran professors comparing the landscapes from the 1980s and now 2020 to gain an understanding of where we were and where...
Pharmacologic Thromboprophylaxis Other Than Aspirin Is Associated With Increased Risk for Procedural Intervention for Arthrofibrosis After Anterior Cruciate Ligament Reconstruction

Purpose To compare rates of procedural intervention for arthrofibrosis following anterior cruciate ligament reconstruction (ACLR) among patients who were not prescribed any pharmacologic thromboprophylaxis compared with patients who were prescribed aspirin and to patients who were prescribed other agents. Methods A search of a national insurance claims database was performed to identify all patients who underwent ACLR from 2007 to 2017 who were active within the database at a minimum of 6 months before and 18 months after their surgery. The primary outcome studied was a subsequent procedure for arthrofibrosis, manipulation under anesthesia, and lysis of adhesions (MUA/LOA). Patients who filled a prescription for aspirin, low-molecular weight heparin, direct factor Xa inhibitors, fondaparinux, and warfarin within 2 days after their surgery were included and those who filled a prescription within 3 months before surgery were excluded. Thromboprophylaxis status was defined as no thromboprophylaxis, aspirin, and any agent other than aspirin. Logistic regression analysis was performed to determine the association between prophylaxis status and MUA/LOA. Results Of the 14,081 patients in our final surgical population, 191 patients had MUA/LOA and 13,890 patients did not. In total, 499 patients were prescribed pharmacologic prophylaxis. Rates of MUA/LOA across groups were 1.3% in the group with no thromboprophylaxis, 1.9% in the group prescribed aspirin, and 4.3% in the group prescribed any agent other than aspirin. Only the group prescribed an agent other than aspirin was significantly associated with subsequent procedure for arthrofibrosis (odds ratio 2.6, 95% confidence interval 1.3-4.8, P = .004). Conclusions Patients who were prescribed a pharmacologic agent other than aspirin had a 2.6 times greater likelihood of requiring a procedural intervention for arthrofibrosis following ACLR compared with patients who were not prescribed a thromboprophylaxis agent Level of Evidence III, Retrospective Cohort Study
Goats in Schools: Parental Attitudes and Perceived Benefits

Animal interactions can provide numerous benefits for child development and education. In the United States, goats are increasingly used in urban farm to school (FTS) programs to enhance children's...
Ehrlichia-induced hemophagocytic lymphohistiocytosis in a pediatric kidney transplant recipient

Background Kidney transplant patients are susceptible to a variety of infections in the post-transplant period due to the use of immunosuppressant medications. Ehrlichiosis is a rare infection in solid organ transplant recipients with signs and symptoms that mimic rejection and other viral infections. Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal hyperinflammatory syndrome that can be triggered by infections. Methods We describe a pediatric kidney transplant recipient who experienced secondary HLH due to ehrlichiosis within the initial post-transplant month. Result Our patient improved after treatment with doxycycline, corticosteroids, and intravenous immunoglobulin (IVIG). Conclusion Clinicians should consider infections such as ehrlichiosis as a potential cause of illness in febrile solid organ transplant recipients in immediate post-transplant period, especially when accompanied by a compatible exposure history.
Pre-release efficacy assessment of the leaf-mining moth Digitivalva delaireae (Lepidoptera: Glyphipterigidae), a potential biological control agent for Cape-ivy, Delairea odorata (Asteraceae), in western North America

The leaf-mining moth Digitivalva delaireae Gaedike & Kruger (Lepidoptera: Glyphipterigidae) is a potential biological control agent for the invasive vine Cape-ivy, Delairea odorata Lemaire (Asteraceae), in western North America, where two morphological varieties (stipulate and exstipulate) of Cape-ivy occur. Two laboratory experiments were conducted to assess (1) the oviposition preference of D. delaireae for either of the two varieties and (2) its impact on plant performance using low and high densities of the moth on both varieties. There was no difference between the two varieties in the proportion of leaves oviposited on or damaged by D. delaireae. Similarly, the effect of D. delaireae herbivory on plant performance was not influenced by Cape-ivy variety. Independent of moth density treatment (low or high), herbivory by D. delaireae resulted in an overall reduction in plant growth and biomass accumulation, and Cape-ivy was unable to compensate for D. delaireae damage: mean relative growth rate, main stem length increment, dry shoot biomass, and leaf mass fraction were reduced 22%, 27%, 22%, and 17% in plants exposed to D. delaireae herbivory compared to unexposed plants. These results indicate that once released, D. delaireae has the potential to negatively affect stem growth, biomass accumulation and rate of stand expansion of Cape-ivy in the field.
The reduction of switching VR impact on PCB signals

Noise caused by switching voltage regulator (VR noise) can have big impact on system performance, causing signal integrity (SI) / power integrity (PI) issues. This paper introduces systematic ways of reducing VR noise at source, in coupling path and at receiver. Examples are also shared.