cssi/SciSciGPT-SciSciNet huggingface dataset:
Ultraviolet Properties of Planetary Ices

Ultraviolet measurements of planetary ices have been pursued since the earliest days of the space program and have proved useful and enlightening, particularly when combined with measurements at longer wavelengths. This chapter provides a brief history of spacecraft measurements of planetary ices in the UV, a review of laboratory experiments and measurements, and an overview of the significant results from solar system observations.
Late vascular healing response to stents: new insights from optical coherence tomography.

As clinicians, we presume the vascular response to stent placement is complete and quiescent at 1 year after implant. By using optical coherence tomography (OCT) to examine bare-metal stents, in this issue of the Journal , Takano et al. ([1][1]) demonstrate that late restenosis and unstable plaque
Introduction and Theoretical Background

The Standard Model of particle physics has been tested by many experiments and has been shown to accurately describe particle interactions at the highest energies produced in the laboratory. The existence of a scalar particle, known as the Higgs boson, is central to the theory. The Higgs boson (“Higgs”) breaks electro-weak symmetry and provides mass to the elementary particles. Prior to the turn-on of the LHC, the Higgs was the only fundamental particle in the Standard Model that had not been observed.
Experiences of antihomosexual attitudes and young black men who have sex with men in the South: a need for community-based interventions

Abstract Purpose: In 2012, Jackson, Mississippi, had the third highest incidence rate of human immunodeficiency virus (HIV) among young Black men who have sex with men (MSM). The goal of this qualitative study (the initial phase of an HIV prevention clinical trial) was to explore how cultural norms regarding antihomosexual attitudes interfere with the safe sex practices and relationship norms of young Black MSM in Mississippi. Methods: Nine focus groups (N = 54) were conducted with young Black MSM aged 18–29. Participants were recruited through medical providers at local sexually transmitted infection clinics and through community organizers at local LGBT outreach programs. The data were analyzed through the use of grounded theory, multiple coders for consistency and intercoder reliability, and a qualitative data analysis software. Results: Three major themes were identified during the analysis: (1) resiliency and condom use, (2) inconsistent condom use among closeted young Black MSM, and (3) intimate par...
Bradyrhizobiaceae fam. nov

Bra.dy.rhi.zo.bi.a' ce.ae. M.L. neut. n. Bradyrhizobium type genus of the family; -aceae ending to denote family; M.L. fem. pl. n. Bradyrhizobiaceae the Bradyrhizobium family. Proteobacteria / Alphaproteobacteria / Rhizobiales / Bradyrhizobiaceae Keywords: Bradyrhizobium; Bradyrhizobiaceae
Metabolism of lecithin and virus-induced cell fusion.

SummaryHomogenates of BHK21-F cells which fused rapidly after inoculation with a high concentration of the parainfluenza virus SV5, or which fused more slowly with SV5 infection and virus multiplication, showed no greater breakdown of lecithin than uninoculated control cells. Cellular lecithin did not undergo appreciable hydrolysis in intact cells under conditions in which extensive cell fusion occurred. BHK21-F cells possess lysolecithinase activity, and the ability to convert lysolecithin to lecithin. The cells thus possess the pathways for elimination of the membrane-lytic agent lysolecithin. No phospholipase activities were found associated with purified SVS virions. We conclude that the cell fusion induced by this virus is not due to an effect on a major structural lipid such as lecithin.
New look at force-frequency relationship of human skeletal muscle: effects of fatigue

Binder-Macleod, Stuart A., Samuel C. K. Lee, April D. Fritz, and Lorin J. Kucharski. New look at force-frequency relationship of human skeletal muscle: effects of fatigue. J. Neurophysiol. 79: 1858...
Development of 550 kV SF_6 gas-insulated switchgear (GIS)’s bushings

Insulation structure,mechanical structure,tightness structure and test results of 550 kV SF6 gas-insulated switchgear(GIS)’s bushings were introduced.Based on 550 kV SF6 GIS bushing electric field model and optimum design,single shield structure was selected.High assurance coefficient for structure parts of bushings was checked by FEM method.Single-multiplex-seal groove cavity was designed for gas tightness of bushings.The type tests indicated that performance indexes of bushings are in concordance with the concerned standard and have a high tolerance.The bushings have good technique and economy indexes as well.
THE EFFECTS OF VARIOUS TYPES OF SPEECH OUTPUT ON LISTENER COMPREHENSION RATES

This paper reports the results of a study that investigated the effects of varying speech signals, passages, and questions on listener comprehension rates. The passages and comprehension questions used were taken from sample tests of the High School Equivalency Examination, the Scholastic Aptitude Test, and the Graduate Record Examination. These passages were then recorded using four speech output types: synthesized speech, digitized speech at a rate of 9600 bps, digitized speech at a rate of 2400 bps, and natural (human) speech. A reading group was also used in this study for control purposes. Results indicated statistically significant differences in comprehension rates between the natural speech group and the synthesized and 2400 bps digitized speech groups. Significant passage and question type effects were also found. These results and the voice output guidelines derived from this study are discussed in this paper.
Manipulating magnetic devices with spin-orbit torques

Magnetic devices are a leading contender for the implementation of memory and logic technologies that are non-volatile, that can scale to high density and high speed, and that do not wear out. However, widespread application of magnetic memory and logic devices will require the development of efficient mechanisms for reorienting their magnetization using the least possible current and power. Until recently, the most-efficient known mechanism for manipulating magnetization in practical device geometries was spin-transfer torque from a spin-polarized current. However, this “conventional” spin-transfer torque faces a fundamental limit in efficiency — it can be no stronger than the equivalent of one unit of hbar angular momentum transferred per unit charge in the applied current. I will discuss recent experiments which indicate that new mechanisms based on spin-orbit interactions can be used to generate current-induced torques that are orders of magnitude more efficient than this previous limit.
Modern management of phagocyte defects

Phagocytic neutrophil granulocytes are among the first immune cells active at sites of infection, forming an important first-line defense against invading microorganisms. Congenital immune defects concerning these phagocytes may be due to reduced neutrophil numbers or function. Management of affected patients depends on the type and severity of disease. Here, we provide an overview of causes and treatment of diseases associated with congenital neutropenia, as well as defects of the phagocytic respiratory burst.
Swab touch spray mass spectrometry for rapid analysis of organic gunshot residue from human hand and various surfaces using commercial and fieldable mass spectrometry systems

Abstract Organic gunshot residues, specifically methyl centralite (1,3-dimethyl-1,3-diphenylurea) and ethyl centralite (1,3-diethyl-1,3-diphenylurea), are characteristic compounds for which forensic analysts test when determining if an individual has discharged a firearm. These distinctive compounds have long been analyzed by several instrumental techniques, many of which involve extensive sample preparation or have lengthy analysis times. Presented here is an ambient ionization method that requires no sample preparation, offers real-time analysis, and can be paired with a portable ion trap mass spectrometer for in-situ analysis. Swab touch spray ionization utilizes a rayon-tipped swab that has an aluminum wire handle which can simply be swabbed over the area of interest. After contacting the hands of the shooter, or other surfaces, the swab simply has solvent applied to the rayon tip and a high voltage applied to the aluminum handle. This process generates ions that the mass spectrometer will use to determine if the organic gunshot residues are present. Mass spectrometry allows for the direct confirmation of organic gunshot residue on suspects hands, confirmed through tandem mass spectrometry. Additional benefits of swab touch spray ionization are that the swabs are commercially available, they are sterile, and they are individually packaged to prevent contamination. The swabs are also forensically feasible because they are sealed prior to delivery by the vendor with a tamper-proof label. Here we have shown that this ambient ionization method allows for the direct swabbing of suspected shooters hands for trace residues and confirm the presence of the two organic gunshot residues investigated.
Catalytic [2 + 2 + 2] cycloaddition with indium( iii )-activated formaldimines: a practical and selective access to hexahydropyrimidines and 1,3-diamines from alkenes

Catalytic [2 + 2 + 2] cycloaddition with imines has, for the first time, been developed as a practical and selective approach for direct construction of hexahydropyrimidine derivatives from various alkenes. With formaldimines as reagents and simple InCl3 as the catalyst, this ionic [2 + 2 + 2] approach is applicable for a wide scope of alkenes and allenes with various electronic and steric properties, as well as substitution patterns. Through facile hydrolysis of the resulting hexahydropyrimidines, this catalytic process also provides a new synthetic strategy for the aminomethylamination of alkenes and allenes to practically access 1,3-diamine derivatives.
Combining Mass-Integration Strategies

The previous three chapters set the stage for developing mass-integration strategies. Chapter 3, Benchmarking Process Performance Through Overall Mass Targeting, presented several approaches to the determination of overall mass targets depending on the type and extent of available data. These targets are identified ahead of detailed design. As mentioned in Chapter 3, Benchmarking Process Performance Through Overall Mass Targeting, these targets can be attained by a combination of strategies, where impact is a measure of the effectiveness of the proposed solution in partially reaching the target. The cumulative impact of all the strategies yields the desired target. Acceptability is a measure of the likelihood of a proposed strategy to be accepted and implemented by the plant. Chapters 4, Direct-Recycle Networks: Graphical and Algebraic Targeting Approaches, and 5, Synthesis of Mass-Exchange Networks, gave important classes of systematic mass-integration tools associated with identifying such strategies. Direct recycle was covered by Chapter 4, Synthesis of Mass-Exchange Networks, as a key element in no/low-cost strategies involving segregation, mixing, and rerouting of streams without the addition of new equipment. The synthesis of mass-exchange networks was described in Chapter 5, Synthesis of Mass-Exchange Networks, as an illustration of the addition of new units (interception) and the selection or substitution of solvents to achieve a separation task. This chapter combines the tools presented in the previous three chapters. First, the process representation from a species viewpoint is presented. Then, the combination of mass-integration tools is demonstrated through the applicability to a case study on the production of acrylonitrile.
Antibiotic elution from acrylic bone cement loaded with high doses of tobramycin and vancomycin

Two-stage revision treatment of prosthetic joint infection (PJI) frequently employs the use of a temporary bone cement spacer loaded with multiple antibiotic types. Tobramycin and vancomycin are commonly used antibiotics in cement spacers, however, there is no consensus on the relative concentrations and combinations that should be used. Therefore, the purpose of this study was to investigate the influence of dual antibiotic loading on the total antibiotic elution and compressive mechanical properties of acrylic bone cement. Varying concentrations of tobramycin (0-3 g) and vancomycin (0-3 g) were added either alone or in combination to acrylic cement (Palacos R), resulting in 12 experimental groups. Samples were submerged in 37°C saline for 28 d and sampled at specific time points. The collected eluent was analyzed to determine the cumulative antibiotic release. In addition, the cement's compressive mechanical properties and porosity were characterized. Interestingly, the cement with the highest concentration of antibiotics did not possess the best elution properties. Cement samples containing both 3 g of tobramycin and 2 g vancomycin demonstrated the highest cumulative antibiotic release after 28 d, which was coupled with a significant decrease in the mechanical properties and an increased porosity. The collected data also suggests that tobramycin elutes more effectively than vancomycin from cement. In conclusion, this study demonstrates that high antibiotic loading in cement does not necessarily lead to enhanced antibiotic elution. Clinically this information may be used to optimize cement spacer antibiotic loading so that both duration and amount of antibiotics eluted are optimized. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1078-1085, 2018.
Stress analysis on ultra-thin ground CMOS-MEMS wafers via micro-Raman spectroscopy

A back-side grinding CMOS-MEMS process is well established for thinning wafers down to tens of micrometres for use in stacking chips. As a result of the mechanical process, the wafer backside is compressively stressed. In this paper, authors investigate the influence of the backside induced stress in MEMS/CMOS wafers thinned down to 35∼275 μm by means of a micro-Raman technique. We found that the grinding process used did not add a significantly stress on the thinned MEMS wafer. In contrast, a severe compressive stress with a wide range of stress distribution was found on the thinned CMOS wafer.
Causes of Troponin Elevation and Associated Mortality in Young Patients.

Abstract Background While increased serum troponin levels are often due to myocardial infarction, increased levels may also be found in a variety of other clinical scenarios. Although these causes of troponin elevation have been characterized in several studies in older adults, they have not been well characterized in younger individuals. Methods We conducted a retrospective review of patients 50 years of age or younger who presented with elevated serum troponin levels to 2 large tertiary care centers between January 2000 and April 2016. Patients with prior known coronary artery disease were excluded. The cause of troponin elevation was adjudicated via review of electronic medical records. All-cause death was determined using the Social Security Administration's death master file. Results Of the 6081 cases meeting inclusion criteria, 3574 (58.8%) patients had a myocardial infarction, while 2507 (41.2%) had another cause of troponin elevation. Over a median follow-up of 8.7 years, all-cause mortality was higher in patients with nonmyocardial infarction causes of troponin elevation compared with those with myocardial infarction (adjusted hazard ratio [HR] 1.30; 95% confidence interval [CI], 1.15-1.46; P P P P = .013). However, mortality was lower in patients with myocarditis compared with those with an acute myocardial infarction (adjusted HR 0.43; 95% CI:, 0.31-0.59; P Conclusion There is a broad differential for troponin elevation in young patients, which differs based on demographic features. Most nonmyocardial infarction causes of troponin elevation are associated with higher all-cause mortality compared with acute myocardial infarction.
Diallel analysis of sweetpotatoes for resistance to sweetpotato virus disease

Sweetpotato virus disease (SPVD) is due to the dual infection and synergistic interaction of Sweetpotato feathery mottle potyvirus (SPFMV) and Sweetpotato chlorotic stunt crinivirus(SPCSV), and causes up to 98% yield loss in sweetpotato in East Africa. This study was conducted to determine the inheritance of resistance to SPVD in sweetpotato and to estimate the nature of genetic variance. Ten parental clones varying in reaction to SPVD were crossed in a half diallel mating design to generate 45 full-sib families. The families were graft-inoculated with SPCSV and SPFMV to induce SPVD and evaluated for resistance in a randomized complete block design at two sites in Namulonge, Uganda during 1998–2000. In serological assays for SPFMV and SPCSV,resistance to symptom development and recovery from initial systemic SPVD symptoms, characterised resistant genotypes. Genetic component analysis showed significant effects for both general combining ability (GCA) and specific combining ability (SCA) for resistance to SPVD. GCA to SCA variance component ratios were large (0.51–0.87), hence GCA effects were more important than SCA effects. Resistant parents exhibited high GCA indicating that additive gene effects were predominant in the inheritance of resistance to SPVD and recovery. Narrow-sense heritability (31–41%) and broad-sense heritability (73–98%) were moderate to high, indicating that rapid genetic gains for SPVD resistance could be accomplished by mass selection breeding techniques. Two genotypes, New Kawogo and Sowola, had high negative GCA effects and had several families in specific crosses,which exhibited rapid recovery from SPVD,and are promising parents for enhancement of SPVD resistance and recovery.
Optimizing backtrack search for all solutions to conjunctive problems

We consider the problem of minimizing depth-first search effort for the generation of all solutions to a problem stated as a conjunction of subproblems. For a sequence of subproblems that share no variables, the effort is minimized by ordering the sub-problems in decreasing ratio of NC(N-1), where N and C are the number of solutions and the search effort of obtaining a solution to the subproblem. If a conjunctive problem has an arbitrary number of subproblems sharing variables among them, we assume that in the solution sets of the subproblems, each argument variable is bound to elements of its domain with equal frequency. Under this uniform distribution assumption, we derive a set of necessary conditions that must be satisfied by an optimal depth-first sequence. If the distribution assumption does not hold for a conjunctive problem, then the search effort can be optimized only if the sequencing of subproblems is suitably interleaved with the actual enumeration of solutions to the problem.
DEXTROCARDIA AS THE TIP OF THE ICEBERG

In the classic form of dextrocardia, the relative positions of the atria, ventricles, and great vessels are inverted which maintains atria-ventricular-great vessel concordance. The frequency of associated congenital heart defects is rare with concordance. In cases of disconcordance, the frequency of
A contextual and temporal algorithm for driver drowsiness detection.

Abstract This study designs and evaluates a contextual and temporal algorithm for detecting drowsiness-related lane. The algorithm uses steering angle, pedal input, vehicle speed and acceleration as input. Speed and acceleration are used to develop a real-time measure of driving context. These measures are integrated with a Dynamic Bayesian Network that considers the time dependencies in transitions between drowsiness and awake states. The Dynamic Bayesian Network algorithm is validated with data collected from 72 participants driving the National Advanced Driving Simulator. The algorithm has a significantly lower false positive rate than PERCLOS—the current gold standard—and baseline, non-contextual, algorithms under design parameters that prioritize drowsiness detection. Under these parameters, the algorithm reduces false positive rate in highway and rural environments, which are typically problematic for vehicle-based detection algorithms. This algorithm is a promising new approach to driver impairment detection and suggests contextual factors should be considered in subsequent algorithm development processes. It may be combined with comprehensive mitigation methods to improve driving safety.
Einstein’s Reversal of the Boltzmann Principle and Particle Statistics

Instead of defining entropy as proportional to the logarithm of complexion function as in the Boltzmann principle, Einstein insisted that a complexion function should be defined in terms of the entropy. It is shown explicitly for the case of particle statistics that the Boltzmann principle is an approximation to Einstein’s reversal when the entropy is the Shannon-Jaynes entropy, i. e. a Shannon entropy in an appropriate physics context.
Long-Term Studies of the Chimpanzees of Gombe National Park, Tanzania

The study of chimpanzees at Gombe National Park, which has continued for over 50 years, has yielded many discoveries that would have been impossible without long-term data. The basic data collection procedure has remained constant since the early 1970s, with a team of Tanzanian field assistants conducting all-day focal follows of individual chimpanzees in the Kasekela (1974–present) and Mitumba (1994–present) communities. Field assistants record map location and party composition at 15-min intervals and keep a continuous record of the focal subject’s feeding behavior and narrative notes on behavior, including mating, agonistic interactions, tool use, hunting, boundary patrols, and intergroup interactions. Field assistants have also monitored the unhabituated Kalande community since 1999. A relational database developed from these data provides a powerful tool for analyzing long-term patterns. Studies using this database in combination with new technologies have deepened our understanding of chimpanzee pathogens, genetics, hormones, tool use, hunting, meat sharing, social relationships, habitat use, dispersal, life histories, and demography. This chapter focuses on life histories and demography, followed by a section that highlights findings on two topics for which long-term data have proven especially informative: intergroup aggression and disease ecology.
The Neurobiological Basis of Sleep and Sleep Disorders

The functions of sleep remain a mystery. Yet they must be important since sleep is highly conserved, and its chronic disruption is associated with various metabolic, psychiatric, and neurodegenerat...
The Risk of Major Cardiovascular Events for Adults With Transfemoral Amputation

It is well-known that the risk of cardiac disease is increased for those with lower-limb amputations, likely as a result of the etiology of the amputation. Using a longitudinal population-based dataset, we examined the association between transfemoral amputation (TFA) status and the risk of experiencing a major cardiac event for those undergoing either dysvascular or traumatic amputations. The association of receiving a prosthesis with the risk of experiencing a major cardiac event was also examined. Study Population: All individuals with TFA (N 162), i.e. knee disarticulation and transfemoral amputation, residing in Olmsted County, MN, between 1987 and 2014. Each was matched (1:10 ratio) with non-TFA adults on age, sex, and duration of residency. Data Analysis: A competing risk Cox proportional hazard model was used to estimate the relative likelihood of an individual with a TFA experiencing a major cardiac event in a given time period as compared to the matched controls. The cohort was divided by amputation etiology: dysvascular vs trauma/cancer. Additional analysis was performed by combining all individuals with a TFA to look at the relationship between prosthesis receipt and major cardiac events. Individuals with a dysvascular TFA had an approximately four-fold increased risk of a cardiac event after undergoing an amputation (HR 3.78, 95%CI: 3.07–4.49). These individuals also had an increased risk for non-cardiac mortality (HR 6.27, 95%CI: 6.11–6.58). The risk of a cardiac event was no higher for those with a trauma/cancer TFA relative to the able-bodied controls (HR 1.30, 95%CI: 0.30–5.85). Finally, there was no difference in risk of experiencing a cardiac event for those with or without prosthesis (HR 1.20, 95%CI: 0.55–2.62). The high risk of initial mortality stemming from an amputation event may preclude many amputees from cardiovascular disease progression. Amputation etiology is also an important factor: cardiac events appear to be more likely among patients with a dysvascular TFA. Providing a prosthesis does not appear to be associated with a reduced risk of a major cardiac event following amputation.
Site of Care and Health Outcomes of Veterans Undergoing Maintenance Dialysis.

Dialysis care is a covered benefit for all veterans enrolled in the Department of Veterans Affairs (VA), and the majority of these enrollees can qualify for the Medicare ESKD program regardless of age ([1][1]). Because of the VA’s limited dialysis capacity (74 clinics with outpatient dialysis
Aviation impact on air quality present day and mid-century simulated in the Community Atmosphere Model (CAM)

Abstract The projected increase in global air traffic raises concerns about the potential impact aviation emissions have on climate and air quality. Previous studies have shown that aircraft non-landing and take-off (non-LTO) emissions (emitted above 1 km) can affect surface air quality by increasing concentrations of ozone (O3) and fine particles (PM2.5). Here, we examine the global impacts of aviation non-LTO emissions on surface air quality for present day and mid-century (2050) using the Community Atmosphere Model with Chemistry, version 5 (CAM5). An important update in CAM5 over previous versions is the modal aerosol module (MAM), which provides a more accurate aerosol representation. Additionally we evaluate of the aviation impact at mid-century with two fuel scenarios, a fossil fuel (SC1) and a biofuel (Alt). Monthly-mean results from the present day simulations show a northern hemisphere (NH) mean surface O3 increase of 1.3 ppb (2.7% of the background) and a NH maximum surface PM2.5 increase of 1.4 μg/m3 in January. Mid-century simulations show slightly greater surface O3 increases (mean of 1.9 ppb (4.2%) for both scenarios) and greater PM2.5 increases (maximum of 3.5 μg/m3 for SC1 and 2.2 μg/m3 for Alt). While these perturbations do not significantly increase the frequency of extreme air quality events (increase is less than 1.5%), they do contribute to the background concentrations of O3 and PM2.5, making it easier for urban areas to surpass these standards.
Abstract 201: Travel Distance Among Publicly Insured Infants With Operable Congenital Heart Disease

Background: Infants with congenital heart disease (CHD) often require surgery within the first year of life, but may live far from congenital heart centers (CHCs) that can perform these surgeries. ...
Negotiating Contemporary Hindu Beliefs and Practices in the United States

Major religions maintain adherence to the guiding force of a literary canon in shaping morality and ethical behaviour in the believer. Hinduism's various strains of orthodoxy and orthopraxy create a pluralistic confusion for the casual onlooker attempting to systematize a code of conduct for practising Hindus. Doctrinal beliefs such as samsara, karma, reincarnation, moksha, and practices of various meditations, yogas, or dietary restrictions, are recognizable features of Hinduism in popular culture. However, the variation in religious ideology among believing individuals should be assessed in light of contemporary philosophy and social science. The purpose of this article is to investigate, through qualitative interviews, the contemporary negotiation of religious beliefs and practices in two Hindu communities in order to provide a context to a dialogue of what it means to be Hindu in the United States.
Use of non-insulin diabetes medicines after insulin initiation: A retrospective cohort study

Background Clinical guidelines recommend that metformin be continued after insulin is initiated among patients with type 2 diabetes, yet little is known regarding how often metformin or other non-insulin diabetes medications are continued in this setting. Methods We conducted a retrospective cohort study to characterize rates and use patterns of six classes of non-insulin diabetes medications: biguanides (metformin), sulfonylureas, thiazolidinediones (TZDs), glucagon-like peptide 1 receptor agonists (GLP1 receptor agonists), dipeptidyl peptidase 4 inhibitors (DPP4 inhibitors), and sodium-glucose co-transporter inhibitors (SGLT2 inhibitors), among patients with type 2 diabetes initiating insulin. We used the 2010–2015 MarketScan Commercial Claims and Encounters data examining 72,971 patients with type 2 diabetes aged 18–65 years old who initiated insulin and had filled a prescription for a non-insulin diabetes medication in the 90 days prior to insulin initiation. Our primary outcome was the proportion of patients refilling the various non-insulin diabetes medications during the first 90 days after insulin initiation. We also used time-to-event analysis to characterize the time to discontinuation of specific medication classes. Results Metformin was the most common non-insulin medication used prior to insulin initiation (N = 53,017, 72.7%), followed by sulfonylureas (N = 25,439, 34.9%) and DPP4 inhibitors (N = 8,540, 11.7%). More than four out of five patients (N = 65,902, 84.7%) refilled prescriptions for any non-insulin diabetes medications within 90 days after insulin initiation. Within that period, metformin remained the most common medication with the highest continuation rate of 84.6%, followed by SGLT2 inhibitors (81.9%) and TZDs (79.3%). Sulfonylureas were the least likely medications to be continued (73.6% continuation) though they remained the second most common medication class used after insulin initiation. The median time to discontinuation varied by therapeutic class from the longest time to discontinuation of 26.4 months among metformin users to the shortest (3.0 months) among SGLT2 inhibitor users. Conclusion While metformin was commonly continued among commercially insured adults starting insulin, rates of continuation of other non-insulin diabetes medications were also high. Further studies are needed to determine the comparative effectiveness and safety of continuing insulin secretagogues and newer diabetes medications after insulin initiation.
From Opportunities to Outcomes: The Wikipedia-Based Writing Assignment

Abstract Over the past decade, compositionists have made a number of claims about opportunities presented by Wikipedia for teaching writing. The encyclopedia allows for transparent observation of concepts and skills related to process, research, collaboration, and rhetoric. Beyond observation, Wikipedia allows for public writing with an authentic audience, which often results in increased motivation. Much of this early research has dealt in opportunities and possibilities: speculation about how Wikipedia sponsors particular pedagogies and learning outcomes, and there remains a need for more empirical evidence. This article presents select data from a recent large-scale study conducted by the Wiki Education Foundation that begins to meet this need, and that confirms and extends research from the computers and writing community. Key findings from this research include positive evaluations of Wikipedia-based assignments in general, as well as positive evaluations concerning the capacity of Wikipedia-based assignments to teach critical thinking skills, source evaluation and research, public writing, literature review and synthesis, and peer review. This study also adds significantly to our field’s knowledge of how contextual factors related to the course and assignment affect students’ evaluation of a Wikipedia-based assignment. Finally, this article suggests key recommendations for teaching with Wikipedia based on these findings.
Effect of Fluctuating Extreme Temperatures on Tranexamic Acid.

Introduction:Tranexamic acid (TXA) is an antifibrinolytic agent shown to reduce morbidity and mortality in hemorrhagic shock. It has potential use in prehospital and wilderness medicine; however, in these environments, TXA is likely to be exposed to fluctuating and extreme temperatures. If TXA degrades under these conditions, this may reduce antifibrinolytic effects.Problem:This study sought to determine if repetitive temperature derangement causes degradation of TXA.Methods:Experimental samples underwent either seven days of freeze/thaw or heating cycles and then were analyzed via mass spectrometry for degradation of TXA. An internal standard was used for comparison between experimental samples and controls. These samples were compared to room temperature controls to determine if fluctuating extreme temperatures cause degradation of TXA.Results:The coefficient of variability of ratios of TXA to internal standard within each group (room temperature, freeze, and heated) was less than five percent. An independent t-test was performed on freeze/thaw versus control samples (t = 2.77; P = .17) and heated versus control samples (t = 2.77; P = .722) demonstrating no difference between the groups.Conclusion:These results suggest that TXA remains stable despite repeated exposure to extreme temperatures and does not significantly degrade. These findings support the stability of TXA and its use in extreme environments.
Comparing methods of grouping hospitals.

OBJECTIVE To compare the performance of widely used approaches for defining groups of hospitals and a new approach based on network analysis of shared patient volume. STUDY SETTING Non-federal acute care hospitals in the United States. STUDY DESIGN We assessed the measurement properties of four methods of grouping hospitals: hospital referral regions (HRRs), metropolitan statistical areas (MSAs), core-based statistical areas (CBSAs), and community detection algorithms (CDAs). DATA EXTRACTION METHODS We combined data from the 2014 American Hospital Association Annual Survey, the Census Bureau, the Dartmouth Atlas, and Medicare data on interhospital patient travel patterns. We then evaluated the distinctiveness of each grouping, reliability over time, and generalizability across populations. PRINCIPLE FINDINGS Hospital groups defined by CDAs were the most distinctive (modularity = 0.86 compared to 0.75 for HRRs and 0.83 for MSAs; 0.72 for CBSA), were reliable to alternative specifications, and had greater generalizability than HRRs, MSAs, or CBSAs. CDAs had lower reliability over time than MSAs or CBSAs (normalized mutual information between 2012 and 2014 CDAs = 0.93). CONCLUSIONS Community detection algorithm-defined hospital groups offer high validity, reliability to different specifications, and generalizability to many uses when compared to approaches in widespread use today. They may, therefore, offer a better choice for efforts seeking to analyze the behaviors and dynamics of groups of hospitals. Measures of modularity, shared information, inclusivity, and shared behavior can be used to evaluate different approaches to grouping providers.
Screening urinalysis demonstrates that haematuria is a frequent finding in persons with haemophilia treated at a paediatric haemophilia treatment centre

Introduction Haematuria is a recognized complication of haemophilia A and B (HA, HB). Adult persons with haemophilia (PWH) have a higher prevalence of renal disease than the general population. There is limited literature investigating the prevalence of haematuria in paediatric PWH. Aim Our paediatric haemophilia treatment centre (HTC) had previously used quality improvement methods to increase the frequency of screening urinalyses at annual comprehensive visits. We retrospectively reviewed the data collected to determine the prevalence of haematuria and explore for associations in those with haematuria. Methods Retrospective chart review to identify the frequency of haematuria on screening urinalysis in all male PWH ≥2 years old. Haematuria was defined as ≥3 red blood cells (RBCs) per high power field. Univariate logistic regression was performed to evaluate for associations with haematuria. Results A total of 93 patients met eligibility criteria. Sixty-seven with HA (11 mild, 17 moderate, 39 severe) and 26 with HB (three mild, 16 moderate, seven severe). Forty-two of ninety-three (45%) patients were identified as having haematuria (median RBCs 7, mean RBCs 332). Of those with haematuria, 76% were identified by screening UA, as opposed to clinical symptoms, and 52% had recurrent haematuria. Older age and HA were associated with an increased likelihood of haematuria. Conclusions Our study demonstrated that the prevalence of haematuria was high in PWH treated at our paediatric HTC. Future investigation is needed to determine the population-wide prevalence of haematuria in paediatric PWH and its impact on renal function.
Passive acoustic monitoring of ship sounds in Lake Superior

Monitoring freshwater ecosystems using passive acoustics is a largely unexplored approach, despite having the potential to yield information about the biological, geological and anthropogenic activity of a lake or river system. Minnesota, nicknamed “land of 10 000 lakes,” provides an interesting case study, because of the opportunity to compare the soundscape during winter with up to 100% ice cover and no vessel transits, to the open water soundscape during busy summer shipping season. Passive acoustic monitoring was conducted in the coastal waters of the western arm of Lake Superior, close the Duluth port, from October 2018 to September 2019. By combining long-term acoustic monitoring data with AIS vessel-tracking data and acoustic propagation modelling (bathymetry, sound speed profiles and seafloor properties) a quantitative method for determining the impact of vessel noise on the soundscape has been established. Median broadband sound pressure level (100–12 000 Hz) was significantly lower in winter compared to summer. However, during ice free months tankers and cargo vessels played a key role in the daily soundscape increasing the intensity by >30 dB between 300 and 1,000 Hz. Moving forward, baseline sound levels provide vital evidence for scientists and governing bodies to make proactive decisions for soundscape conservation.
The Struggle to Belong and Thrive

Academic struggles played a role in the majority of students’ decision to switch out of STEM. They also undermined students’ belief that they had made the right choice in pursuing a STEM major and could succeed in earning a STEM degree. As described in Chap. 7, academic problems were particularly acute for students in gateway courses, but they were not confined to courses taught by “weed out” methods. They could also manifest as difficulties with STEM curricula or as conceptual problems at any point in students’ trajectories. Common problems included encountering STEM content that was “hard”—whether intrinsically or situationally. They also arose as students sought to demonstrate their conceptual understanding in assessments, and could be reflected in the grades and GPA that they earned. These struggles challenged students’ views of their competence and caused them to doubt that they “belonged” in a STEM program. A student’s sense of belonging in a STEM discipline was also shaped by classroom and program climates, most especially by interactions with instructors and peers. This chapter reviews findings about how STEM students experienced these struggles to thrive academically and to develop a sense of belonging. It also highlights particular risks that differentiate switchers from persisters.
Assembling a Torus: Family Mobilities in an Immersive Mathematics Exhibition

In this article, we report on a video-based field study of an intergenerational family’s enactment of a mathematical object (a torus) in the context of an immersive mathematics exhibition in a scie...
Quantifying CH4 concentration spikes above baseline and attributing CH4 sources to hydraulic fracturing activities by continuous monitoring at an off-site tower

Abstract Hydraulic fracturing (hydrofracking) for natural gas has increased rapidly in the area of the Marcellus Shale in the last thirty years and estimates of CH4 emissions from hydrofracking operations are still uncertain. Previous studies on CH4 emissions at hydrofracking operations have used bottom-up approaches collected at discrete timepoints or discrete aerial surveys covering a wide spatial area, constraining the temporal scale of inference regarding these emissions. This project monitored atmospheric CH4 concentrations and stable carbon isotopes at a half-hourly temporal resolution from a 20-m tower downwind of a hydrofracking well pad in West Virginia for eighteen months. We collected four months of baseline observations prior to onsite well development to construct an empirical artificial neural-network model of baseline CH4 concentrations. We compared measured CH4 concentrations against the ANN-modeled CH4 baseline to identify CH4 concentration spikes that coincided with different stages of onsite well development, from the baseline period through fracking. CH4 concentration spikes were significantly more frequent than baseline conditions during the vertical drilling and fracking phases of operations. We found that the median magnitude of CH4 concentration spikes during the vertical drilling phase was 316% larger than that of the baseline phase, and the median magnitude of CH4 concentration spikes was 509% larger in the hydraulic stimulation (fracking) stage compared to the baseline phase. We also partitioned the sources of measured CH4 concentrations to biogenic ruminant and geologic shale gas isotopic signatures by measuring 13CH4 gas at high temporal resolution and using a source-partitioning 13CH4 model. The measured median value of half-hourly CH4 concentration spikes attributed to a geologic shale gas isotopic origin was 27% larger than the median CH4 concentration spikes attributed to ruminants, and the maximum half-hourly CH4 concentration spike attributed to shale gas was up to 179% higher than maximum CH4 concentration spike for ruminant-dominated half-hours. This study developed a framework for off-site, single tower measurements to identify CH4 concentration spikes associated with the phases of unconventional natural gas well development in a complex CH4 emissions airshed.
Paradoxes of professional autonomy: a qualitative study of U.S. neonatologists from 1978‐2017

The professional autonomy of physicians often requires they take responsibility for life and death decisions, but they must also find ways to avoid bearing the full weight of such decisions. We conducted in-person, semi-structured interviews with neonatologists (n = 20) in four waves between 1978 and 2017 in a single Midwestern U.S. city. Using open coding analysis, we found over time that neonatologists described changes in their sense of professional autonomy and responsibility for decisions with life and death consequences. Through the early 1990s, as neonatology consolidated as a profession, physicians simultaneously enjoyed high levels of professional discretion and responsibility and were often constrained by bioethics and the law. By 2010s, high involvement of parents and collaboration with multiple subspecialties diffused the burden felt by individual practitioners, but neonatology's professional autonomy was correlatively diminished. Decision-making in the NICU over four decades reveal a complex relationship between the professional autonomy of neonatologist and the burden they bear, with some instances of ceding autonomy as a protective measure and other situations of unwelcomed erosion of professional autonomy that neonatologists see as complicating provision of care.
ORGANIZATIONAL BEHAVIOR AND MANAGEMENT: The Effect of Nonprofit Hospital Acquisitions on Hospital Community Benefit Spending

Research Objective The Internal Revenue Service (IRS) has required nonprofit hospitals to document their community benefit spending in order to justify their tax exemption since 2009. This spending has potential to improve social welfare and should be considered, along with efficiency and prices of traditional hospital services, when evaluating the impact of acquisitions. Existing evidence links variation in spending to local needs, priorities of hospital boards, and financial performance. We hypothesize that independent hospitals have stronger ties to local communities than centralized hospital systems. Local leadership may translate into higher spending on community health improvement activities. Acquisition‐related changes in leadership may influence community benefit spending decisions to reflect the acquirer’s priorities, as well as changes that reflect financial performance. The rapid pace of nonprofit hospital consolidation has made independent hospitals increasingly rare, and the impact of nonprofit acquisitions on the level and type community benefit spending is unknown, despite the promising potential to improve social welfare. We aim to fill this gap.
When Disaster Strikes: The Role of the Family Nurse Practitioner in Providing Primary Health Care

Natural disasters can create a tremendous burden on existing health-care systems, negatively impacting the capacity to deliver timely and critical services to those in need. Lack of timely access to health care is noted as one of the leading causes of mortality following disasters, leading to negative health outcomes. On the front line of disaster care are nurse practitioners (NPs), who have a long history, dating back to the 1960s of providing health care to vulnerable populations in urban and rural areas. The largest percentage of NPs, 66.9%, are certified as family nurse practitioners (FNPs) and practice across diverse health-care sites including community-based, acute and long-term care, and academic settings. FNPs provide a broad range of family-focused health-care services to patients across the life span: from infants to adolescents to adults and the elderly (American Association of Nurse Practitioners (AANP), NP fact sheet. Retrieved from https://www.aanp.org/about/all-about-nps/np-fact-sheet, 2019). Awareness of the importance of their role in providing primary care services following a natural disaster has increased, considering historic weather-related disasters such as Hurricanes Katrina, Harvey, and Maria that have impacted individuals, families, and entire communities. FNPs can attend to the physical health needs of people with mental disorders as well as the mental health needs of those suffering from chronic diseases.
The Michelson-Pease centennial

On the Monday evening of December 13, 1920, the first interferometric measurement of a stellar angular diameter was made. This talk commemorates the centennial of that landmark of observational astrophysics. It resulted from the collaboration of Albert Michelson, America’s first science Nobel laureate, and Francis Pease, the brilliant engineer-turned astronomer who designed the Mount Wilson 100-inch telescope and much of its instrumentation. This paper is a brief overview of how that measurement came to be made with a focus on the founding pioneers of interferometry and the small group of Mount Wilson astronomers who, in the 1920s, launched optical interferometry on the trajectory toward today’s facilities employing multiple-telescope, optical/infrared interferometric arrays.
Inguinoscrotal herniation of the bladder: A rare case of obstructive uropathy

Inguinoscrotal herniation of the bladder is a rare presentation of inguinal hernia that can result in significant complications if untreated. We describe a case of an elderly male with a delayed presentation of bladder herniation resulting in severe acute kidney injury requiring urgent placement of nephrostomy tubes. Ultimately surgery is required for definitive management.
Predictors of Retention and Recidivism of Justice-Involved Women in a Community-Based Gender-Responsive CBT Program:

The purpose of this study was to evaluate pretreatment differences between program completers and noncompleters, as well as those who recidivated and those who did not, among a sample of 112 justic...