cssi/SciSciGPT-SciSciNet huggingface dataset:
Graduate Medical Education across National Boundaries

The Accreditation Council for Graduate Medical Education (ACGME) is a professional organization that accredits over 9,300 graduate medical education (residency and fellowship) programs in the United States. It receives no funds from any other corporate entity; it is funded solely through its accreditation services. After receipt of numerous requests to accredit programs outside the United States, ACGME created the Accreditation Council for Graduate Medical Education - International (ACGME-I) to work with educational programs and institutions in other countries. ACGME-I accreditation incorporates many of the structural elements of ACGME accreditation, while being mindful of local customs, societal issues, and history in which the international program resides. It does not intend to place a United States model in other countries, but rather to adapt what we have learned to the local educational environment. The ACGME believes that its work, along with that of others, can help improve world health through physician education.
Sublineage structure analysis of Mycobacterium tuberculosis complex strains using multiple-biomarker tensors

Strains of Mycobacterium tuberculosis complex (MTBC) can be classified into major lineages based on their genotype. Further subdivision of major lineages into sublineages requires multiple biomarkers along with methods to combine and analyze multiple sources of information in one unsupervised learning model. Typically, spacer oligonucleotide type (spoligotype) and mycobacterial interspersed repetitive units (MIRU) are used for TB genotyping and surveillance. Here, we examine the sublineage structure of MTBC strains with multiple biomarkers simultaneously, by employing a tensor clustering framework (TCF) on multiple-biomarker tensors. Simultaneous analysis of the spoligotype and MIRU type of strains using TCF on multiple-biomarker tensors leads to coherent sublineages of major lineages with clear and distinctive spoligotype and MIRU signatures. Comparison of tensor sublineages with SpolDB4 families either supports tensor sublineages, or suggests subdivision or merging of SpolDB4 families. High prediction accuracy of major lineage classification with supervised tensor learning on multiple-biomarker tensors validates our unsupervised analysis of sublineages on multiple-biomarker tensors. TCF on multiple-biomarker tensors achieves simultaneous analysis of multiple biomarkers and suggest a new putative sublineage structure for each major lineage. Analysis of multiple-biomarker tensors gives insight into the sublineage structure of MTBC at the genomic level.
Hydrogen Bonding Control of Molecular Self-Assembly

In this short review we describe approaches to the design and construction of synthetic molecules that mimic the process of self organization that is at the heart of biological complexity. Multi-subunit enzymes, viruses, and higher order DNA structures are formed by the non-covalent association of many smaller components. This self-assembly is controlled by the nature, number and orientation of interacting groups on the surface of the subunits. The central problem lies in overcoming the unfavorable entropy of multi-subunit association by significant enthalpic contribution from the binding of complementary regions on the subunits. We will place particular emphasis on the design of synthetic molecules that use hydrogen bonding interactions to control the formation of aggregates of well-defined structure.
How Often Do Duplicated Genes Evolve New Functions

A recently duplicated gene can either fix a null allele (becoming a pseudogene) or fix an (advantageous) allele giving a slightly different function, starting it on the road to evolving a new function. Here we examine the relative probabilities of these two events under a simple model. Null alleles are assumed to be neutral; linkage effects are ignored, as are unequal crossing over and gene conversion. These assumptions likely make our results underestimates for the probability that an advantageous allele is fixed first. When new advantageous mutations are additive with selection coefficient s and the ratio of advantageous to null mutations is rho, the probability an advantageous allele is fixed first is ([1 - e-s]/[rho S] + 1)-1, where S = 4Nes with Ne the effective population size. The probability that a duplicate locus becomes a pseudogene, as opposed to evolving a new gene function, is high unless rhoS > 1. However, even if advantageous mutations are very rare relative to null mutations, for sufficiently large populations rhoS > 1 and new gene function, rather than pseudogene formation, is the expected fate of most duplicated genes.
Noninvasive Diagnosis of Upper Extremity Arterial Disease

Diagnosis of upper extremity arterial disease is complex as ischemia of the upper extremity may be caused by systemic disease as well as localized manifestations of atherosclerosis. For chronic disorders of upper extremity ischemia, Raynaud’s syndrome is often the initial presenting symptom. Noninvasive testing for upper extremity arterial disease includes digital pressures, segmental arm pressures, arterial waveforms using photoplethysmography and/or continuous wave Doppler, and testing for cold-induced vasospasm as well as evaluation with duplex ultrasound for evidence of arterial stenosis or aneurysm. Noninvasive studies facilitate the diagnosis of vasospasm when bilateral abnormalities of digit circulation are induced by cold or emotional stimuli with normal findings at rest. Systemic disorders of digital circulation are characterized by bilateral abnormalities of digital circulation at rest with normal findings proximal to the wrist. More proximal lesions are diagnosed by abnormalities of segmental pressures or duplex findings suggestive of aneurysm or stenosis. Applied properly, with background knowledge of the conditions resulting in upper extremity ischemia, the combination of the history and physical examination, plain x-rays of the shoulder and neck, blood tests, and noninvasive and possibly invasive examinations of the arteries of the upper extremity arteries can in the large majority cases determine the etiology of upper extremity ischemia and guide treatment.
Hydrogen Mobility at High Concentrations

The roles of crystal structure, hydrogen site occupancy, phase transition, and isotope substitution on the hydrogen diffusion behavior will be considered. After brief discussions of general diffusion concepts and the experimental methods that have been most often used to determine the hydrogen mobility in the high concentration metal hydride phases, the nuclear magnetic resonance techniques that have been extensively applied in hydride diffusion studies will be reviewed in some detail. The emphasis will be on relating measured nuclear relaxation times with diffusion parameters as well as NMR techniques to directly measure the hydrogen diffusion constants. The diversity of diffusion behavior will be illustrated with several specific metal hydride systems including: PDHx, γ-TiHx and structurally related TiCuH, and VHx. Plausible models of the microscopic diffusion mechanisms will also be presented and compared with the observed diffusion behavior in these systems.
Chapter 9.: Helping Individuals Withdraw from Psychiatric Drugs

Many counselors, psychologists, and social workers assist clients to take psychotropic drugs but recoil from helping clients to rethink drug use or stop taking drugs. They might fear resisting the prevailing ideology, violating “standards of care,” or contradicting physicians' advice. This article discusses withdrawal emergent reactions from prescribed psychotropic drugs and proposes a rational, person-centered approach to help adults stop taking medication. It considers assessment, collaboration with physicians and pharmacists, the client's fear of withdrawal, the importance of gradual taper, and the monitoring of withdrawal emergent reactions. For practitioners who do not personally endorse drug use, it suggests guidelines for adhering to the best standards of care and consent. It also discusses legal and ethical issues related to therapists' concerns and clients' rights. Professionals' and consumers' roles vis-a-vis medication are changing, and a large evidence base documents the risks of medi...
Extreme collaboration

For engineers comfortable with the noise and distraction of working closely together, a technology "war room" at the Jet Propulsion Laboratory is the perfect environment for speeding delivery of space mission design proposals.
Functional gallbladder disease: Operative trends and short-term outcomes

Background Due to increasing rates of functional gallbladder disease (FGBD), we used national data to compare rates, patient characteristics, and outcomes of cholecystectomy for FGBD with the more defined diagnosis of biliary colic. Methods The American College of Surgeons National Surgical Quality Improvement Program was reviewed for elective cholecystectomies from 2005–2013. The proportion of cholecystectomies performed for FGBD was assessed over time using a 2-sided Cochran-Armitage test for trend. Cholecystectomy for FGBD was compared with that for biliary colic using univariate analysis, multivariable logistic, and Cox proportional hazard regressions. Results Of 156,322 patients undergoing cholecystectomy, 5,161 (3.3%) had FGBD. FGBD as an indication for cholecystectomy remained stable over time (3.4% in 2006 to 3.2% in 2013, P = .29). Compared with biliary colic, patients with FGBD were more likely .05). While differences in outcomes were seen on univariate analysis, on multivariable analysis, only duration of stay was significantly less for FGBD than biliary colic. Surgery residents were involved in 61.2% of the biliary colic versus 53.9% of FGBD cases (P Conclusion The rate of FGBD as an indication for cholecystectomy is not increasing overall, but cholecystectomy may be more commonly performed at nonacademic hospitals. While cholecystectomy for FGBD appears safe, the outcomes are comparable to cholecystectomy for biliary colic and thus are not without risk.
Rodent control in rodent burrows in urban residential areas of Wuhan city

Objective To investigate characteristics of rodent burrows in urban residential area outdoor and improve rodent control efficacy of rodent burrows.Methods Rodent burrows were sorted and covered with corrugated paper,active burrows were checked in 1,3,7,14 days.In contrast area rodent burrows were covered,active burrows were checked and 30 g of bromadiolone paddy bait was placed in each for one day.The procedures were repeated in 1 and 2 weeks.In test area rodent control was carried out according to operating rules.Results Rodent burrows could be sorted into 5 types in appearance.The rates of active burrows of 1,3,7,14 days were 21.2%,35.5%,43.9% and 51.4% respectively.The deratization rates of contrast and test area were 10.0% and 90.4%,RPI was 10.6.Conclusion The experience of estimating active rodent burrows in appearance is not reliable,while it is reliable to cover rodent burrows with corrugated paper and check for active burrows in 7 days.Rodent control operating rules is more accordant to integrated pest management(IPM)theory.
Research on Transmission Performance of GridFTP in Grid

Proceeding from the data transmission service in grid,the data transmission function and principle were analyzed about GridFTP in Globus.The transmission was tested respectively in two modes,namely FTP protocol mode,GridFTP protocol command line mode.So the parameters,such as transfer time,throughput and total data size,were got on the different transport modes and parallelism of the GridFTP protocol.The experiments show that the GridFTP protocol has obvious advantages when transferring large data,and that parallel data transfer increase the transmit throughput more than the original.This research results have practical significance in exploring the access to improve performance of mass data transmission and to promote the application of grid technology.
The Blalock-Taussig shunt. Low risk, effective palliation, and pulmonary artery growth.

The Blalock-Taussig shunt has been used at our institution in 64 infants with cyanotic congenital heart disease who required palliation. Thirty-one of these children were less than 2 months of age at the time of operation. There were no early shunt closures. There were two hospital deaths (3%). There was only one hospital death in the 31 patients less than 60 days old. According to a life-table analysis, 87% ± 9% (± 95% confidence limits) of the shunts were functioning at I year and 78% ± 12% at 2 years. Results are similar in the subgroup of children less than 60 days of age at the time of operation or in the subgroup of children weighing less than 3,999 gm at operation. In infants with small pulmonary arteries, pulmonary arterial growth was excellent (ipsilateral pulmonary artery/descending aorta ratio 0.70 → 0.95 in 550 days, p
Valores e instituciones estadunidenses desde una perspectiva occidental comparativa

This essay analyzes the exceptional character of American institutions and values compared to those of Europe and Canada. Since the revolution, the United States rose as the country whose beliefs and ideology have endured to model its democratic practice and institutions. Freedora, equality, individualism, popuhsm, and "laissez-faire" have been the five distinctive elementa of this creed. Based on these five concepta, a comparison Ulustrating the peculiarity of the United States in issues like education, the individual, equality of opportunities, religion, and ideology, is developed. Five elementa which in retum, have also created particular political institutions like a two-party systera, a constitution and a power equilibrium.
Identification of a new population of Anelpistina inapendicata (Insecta: Zygentoma: Nicoletiidae).

In the Grutas de Cacahuamilpa National Park area in Guerrero, Mexico, there is a plethora of tremendously diverse types of caves. The area is also a hotspot for troglobitic nicoletiid diversity. Within just a five km radius, four different species have been described inhabiting caves. It would appear that speciation for nicoletiids within this karstic region is high, with most species endemic to single caves. We identify a new cave locality for Anelpistina inappendicata . Both caves are environmentally very different, suggesting that the species is a generalist, capable of coping with extremely different conditions varying in humidity, substrate conditions, and availability of food. A short discussion is provided for why the species may not have a broader geographical distribution.
An ultra-wideband 0.18 /spl mu/m SiGe BiCMOS LNA for 3.1 GHz to 10.6 GHz wireless receivers

Ultra wideband (UWB) radio emerges as a very promising wireless communication technology due to its many advantages: i.e., 7.5 GHz spectrum bandwidth, very high data rate, very low power consumption, etc. This paper presents a fully integrated 3.1-10.6 GHz low-noise amplifier (LNA) designed for UWB applications. The LNA uses shunt-series feedback topology architecture to achieve desirable ultra broadband gain and noise performance. The LNA is implemented in a commercial 0.18 mum in SiGe BiCMOS process and the measured specifications are: an adequate ultra broadband gain of 17.4 dB-7.1 dB, a low noise figure (NF) of 3.2 dB-5.5 dB across 3.1-10.6 GHz bandwidth, a very low DC power consumption of less than 10 mW at 3V supply, S11 of less than -6 dB, and S22 of less than -5 dB
Targets for Radionuclide Imaging of Cardiac Allograft Rejection

Radionuclide imaging of the myocardium can target receptor or transport systems that are present under normal or abnormal conditions.1–6 Targeting normal systems makes abnormal tissue appear as a decrease in the signal. Conversely when abnormal states are targeted, there is minimal localization in normal tissue, but abnormalities are detected by increased tracer deposition. Table 1 summarizes some of the targets that have been utilized to detect attributes of the normal heart.
Center of Excellence for Mobile Sensor Data-to-Knowledge (MD2K)

The Center of Excellence for Mobile Sensor Data-to-Knowledge (MD2K) is enabling the collection of high-frequency mobile sensor data for the development and validation of novel multisensory biomarkers and sensor-triggered interventions.
The Deteriorating Dynamics of Public Debts Across Countries within the European Monetary Unification in Comparison with Countries Outside the European Monetary

The main aim of this study is to analyze the evolution of public debts and general government deficits/surplus across European countries within and outside the monetary unification. In particular, this study compares the dynamics of public debts and general government deficits between European countries within and outside the monetary unification for the preceding and subsequent period the introduction of the Euro currency. Statistical analyses show that the evolution of public debts is significantly different between European countries. Nations within the European monetary unification seem to have, from 2001 onwards, a deteriorated sovereign debts and general government deficits in comparison to countries outside the European monetary unification. This dissimilar evolution of public debts and general government deficits between European countries can be due to manifold factors. Moreover, these asymmetric paths of public debts and general government deficits across European countries may be one of contributing factors that generates uncertain scenarios and negative socioeconomic effects on patterns of growth of the overall European Union economy.
Enhancing Person-Centered Care in Long-Term Care.

Fellow Clinical Gerontologists,As the Associate Editor of Long Term Care for Clinical Gerontologist (CG), I am pleased to introduce this special issue on Long-Term Care (LTC) to the CG readership. ...
Exploring the Origins of Snow Drought in the Northern Sierra Nevada, California

AbstractThe concept of snow drought is gaining widespread interest as the climate of snow-dominated mountain watersheds continues to change. Warm snow drought is defined as above- or near-average a...
Developmental Change in Sibling Support and School Commitment Across Adolescence

School commitment typically declines across adolescence, but the family-level factors that explain this decline have not been fully characterized. This study investigated sibling support as a family resource in predicting school commitment across 7th-10th grade using a sample of 444 adolescents (Mages = 12.61, 13.59, 14.59, 15.58 years). Results showed that sibling support linearly increased and school commitment decreased and stabilized, independently, over time. Sibling support positively predicted school commitment in seventh grade and across time, suggesting that having supportive siblings may help to offset adolescents' declines in school commitment. Furthermore, having a brother enhanced this association versus having a sister. These findings provide insight into ways to help youth maintain school commitment across the middle- to high school transition.
What is the natural measurement unit of temperament: single traits or profiles?

There is fundamental doubt about whether the natural unit of measurement for temperament and personality corresponds to single traits or to multi-trait profiles that describe the functioning of a whole person. Biogenetic researchers of temperament usually assume they need to focus on individual traits that differ between individuals. Recent research indicates that a shift of emphasis to understand processes within the individual is crucial for identifying the natural building blocks of temperament. Evolution and development operate on adaptation of whole organisms or persons, not on individual traits or categories. Adaptive functioning generally depends on feedback among many variable processes in ways that are characteristic of complex adaptive systems, not machines with separate parts. Advanced methods of unsupervised machine learning can now be applied to genome-wide association studies and brain imaging in order to uncover the genotypic–phenotypic architecture of traits like temperament, which are strongly influenced by complex interactions, such as genetic epistasis, pleiotropy and gene–environment interactions. We have found that the heritability of temperament can be nearly fully explained by a large number of genetic variants that are unique for multi-trait profiles, not single traits. The implications of this finding for research design and precision medicine are discussed. This article is part of the theme issue ‘Diverse perspectives on diversity: multi-disciplinary approaches to taxonomies of individual differences9.
Exploratory Analytical Modeling Methods

In analyzing and testing unexplored areas of health services management research in which theories have not yet matured, exploratory statistical analysis (ESA) gives researchers a wide variety of possibilities. Researchers should be open to unforeseen discoveries, especially in the case of weak theories that specify only that variables are related to each other (Hartwig and Dearing, 1979).
Regulation and function of cellular gene products involved in UV and chemical mutagenesis in E. coli.

The past few years have seen a remarkable increase in our understanding of the strategies employed by cells in dealing with damage to their genetic material. Of particular interest has been the recognition that mutagenesis by a variety of agents including UV, methyl methanesulfonate (MMS), and 4-nitroquinoline-1-oxide (NQO) is not a passive process. Rather it requires the intervention of a cellular system which processes damaged DNA in such a way that mutations result. Mutagenesis is not a necessary consequence of DNA damage since, if this system is inactivated, no mutations result. In this paper we would like to summarize some of the recent work of our lab on the cellular molecular mechanisms involved in UV and chemical mutagenesis.
Echelle Spectra of a Large Sample of Planetary Nebula Nuclei

We have undertaken at Palomar Observatory to obtain high resolution spectra of a large sample of planetary nebula nuclei (PNN) in order to systematically investigate their spectral morphologies and then to derive temperatures and surface gravities by comparing absorption line profiles to model atmospheres. We have taken as our sample all those central stars of planetary nebulae within 1.3 kpc of the sun according to the distance determinations of Daub (Ap. J., 260, 612, 1982); of the 94 objects in this unbiased sample, 64 are in the sky visible from Palomar and 33 have central stars bright enough to be observed at a resolution of 5 000 with an “echellette” spectrograph on the 5-m Hale telescope, leaving 7 PNN (11% of the northern sample of 64 PNN) which are too faint to be observed at present.
Copper Transparent Antennas on Flexible Glass by Subtractive and Semi-Additive Fabrication for Automotive Applications

There has been an increasing need for antennas in automotive applications, for communications applications, such as cellular, satellite radio, and the burgeoning fields of selfdriving/ networked vehicles and 5G. These applications demand alternatives to traditional vehicle antennas, including transparent antennas able to be unobtrusively mounted to vehicle windows. Flexible glass provides a high quality transparent and flexible substrate for the fabrication of these antennas, and that is amenable to low cost roll-to-roll manufacturing. Sheet scale prototype transparent antennas were fabricated in copper using etch back and semi-additive processes, with conventional processes and facilities, and using materials and processes amenable to roll-to-roll fabrication. This shows that flexible glass could be used in existing lines and facilities with little modification, in addition to roll-to-roll processing. Fabricated antennas were tested on-vehicle and show good performance, with similar gain figures for baseline solid antennas, etched transparent antennas, and semi-additive transparent antennas.
Information Security: Going Digital (Invited Lecture)

Because ‘going digital’ regards using digital technologies to fundamentally change the way things get done, information security is necessarily engaged in going digital. Society and science are going digital. For the sciences, this digitalization process invokes an emerging model of the science of design that incorporates the assembly of information systems from a wide variety of platform ecosystems. According to principles of bounded rationality and bounded creativity, this mode of design requires more creativity to develop needed functionality from a finite set of available platforms. Going digital requires more creativity in designers of all types of information systems. Furthermore, the designers’ goals are changing. The traditional model of information systems is representational: the data in the system represents (reflects) reality. Newer information systems, equipped with 3D printing and robotics actually create reality. Reality represents (reflects) the data in the system. This invited paper explores the example of information security. Designers of security for information systems not only must be more creative, they must design for more goals. The security task is no longer just protecting the digital system, the security task is protecting the products of the digital system. These innovations have particular implications for information systems curricula at university, too.
Appointment utilization as a trigger for palliative care introduction: A retrospective cohort study.

Background:Chronic kidney disease palliative care guidelines would benefit from more diverse and objectively defined health status measures.Aim:The aim is to identify high-risk patients from admini...
Enhancing the Structure of the WRF-Hydro Hydrologic Model for Semiarid Environments

AbstractIn August 2016, the National Weather Service Office of Water Prediction (NWS/OWP) of the National Oceanic and Atmospheric Administration (NOAA) implemented the operational National Water Mo...
Interethnic differences in pancreatic cancer incidence and risk factors: The Multiethnic Cohort

While disparity in pancreatic cancer incidence between blacks and whites has been observed, few studies have examined disparity in other ethnic minorities. We evaluated variations in pancreatic cancer incidence and assessed the extent to which known risk factors account for differences in pancreatic cancer risk among African Americans, Native Hawaiians, Japanese Americans, Latino Americans, and European Americans in the Multiethnic Cohort Study. Risk factor data were obtained from the baseline questionnaire. Cox regression was used to estimate the relative risks (RRs) and 95% confidence intervals (CIs) for pancreatic cancer associated with risk factors and ethnicity. During an average 16.9-year follow-up, 1,532 incident pancreatic cancer cases were identified among 184,559 at-risk participants. Family history of pancreatic cancer (RR 1.97, 95% CI 1.50-2.58), diabetes (RR 1.32, 95% CI 1.14-1.54), body mass index ≥30 kg/m2 (RR 1.25, 95% CI 1.08-1.46), current smoking (<20 pack-years RR 1.43, 95% CI 1.19-1.73; ≥20 pack-years RR 1.76, 95% CI 1.46-2.12), and red meat intake (RR 1.17, 95% CI 1.00-1.36) were associated with pancreatic cancer. After adjustment for these risk factors, Native Hawaiians (RR 1.60, 95% CI 1.30-1.98), Japanese Americans (RR 1.33, 95% CI 1.15-1.54), and African Americans (RR 1.20, 95% CI 1.01-1.42), but not Latino Americans (RR 0.90, 95% CI 0.76-1.07), had a higher risk of pancreatic cancer compared to European Americans. Interethnic differences in pancreatic cancer risk are not fully explained by differences in the distribution of known risk factors. The greater risks in Native Hawaiians and Japanese Americans are new findings and elucidating the causes of these high rates may improve our understanding and prevention of pancreatic cancer.
Spatial correlation of the thermally generated electromagnetic field in layered media

A general formulation for the cross-spectral density tensor enabling calculation of the spatial correlation of the thermally generated electromagnetic field in layered media is derived. The formulation is based on fluctuational electrodynamics, and is thus applicable in the near and far field of heat sources. The resulting cross-spectral density tensor is written in terms of a single integration over the parallel wavevector, as the angular integrations leading to numerical instability are evaluated analytically. Using this formulation, the spatial correlation length in the near field of a film made of silicon carbide (SiC) supporting surface phonon-polaritons (SPhPs) in the infrared is analyzed. It is shown that the spatial correlation length of a SiC heat source suspended in vacuum decreases substantially by decreasing its thickness owing to SPhP coupling. In the limit of a 10-nm-thick SiC film, the spatial correlation length is similar to that of a blackbody. The results also reveal that it is possible to control the spatial coherence of a thin SiC heat source via dielectric and metallic substrates, respectively allowing and preventing SPhP coupling. This suggests that active modulation of thermal emission via thin films supporting surface polaritons in the infrared is possible by using a phase change material substrate such as vanadium dioxide.
Designing for Relationality in Virtual Reality: Context-Specific Learning as a Primer for Content Relevancy

Science achievement gaps exhibit racial disparities starting in primary grades and have been shown to persist through middle and high school. In turn, increasing positive attitudes toward science have been shown as one factor that affects academic achievement and motivation among K-12 students. Exploring novel ways that technology can influence diverse students’ attitudes toward science, and the design elements pertinent therein, is thus one prominent goal toward achieving science education for all. Leveraging the immersive nature of Virtual Reality 360 videos, we present a design-based research iteration testing how a novel technology-enhanced learning experience influenced close to 400 urban elementary students’ attitudes toward science. Using a two-way MANCOVA analysis, the data support that our design iteration emphasizing context-specific learning can prime students that do not see science as relevant to them to change these attitudes in significantly positive ways. Implications are discussed around relationality, technology use in urban schools, and local contexts as learning resources.
Autocatalytic tin - how to overcome process limitations to introduce a new solution for thick tin plating

The autocatalytic deposition of tin is gaining increasing interest as it offers several benefits compared to the immersion type deposition. Despite the fact that in contrast to the immersion plating process there is no technical limitation of the thickness of the tin deposit, it also allows the deposition of tin on different materials other than copper. With this, it can open up new application fields for plating deposits, which are not considered for electroless plating yet.Even though there is a great potential for this technology, there are limitations that have prevented the successful introduction of this process so far. One limitation of possible electrolyte formulations is for example, that the plating rate of the process is instable as it tends to drop already after few minutes of dwell time. One target of the investigations presented in this paper was to understand the root cause of this deposition rate drop. In order to clarify the reaction mechanisms different electrochemical approaches were used to determine the chemical background. It could be proven, that the Pyrophosphate which is used as complexing agent in many autocatalytic tin solutions [1], [2], [3], [4] adsorbs to the electrode surface and that due to that adsorption, the plating reaction of tin is inhibited.Based on this finding a bath formulation was created, which is able to overcome this inhibiting effect and providing a stable plating performance over the entire bathlife.In this paper exemplary tin deposits are presented which were plated with an autocatalytic electrolyte comparing their layer properties to those of other conventional final finishes like immersion tin or electroless nickel/immersion gold. To judge the performance of the final finish, solder wetting behavior and solder joint reliability were rated and compared. It is also shown, that the electrolyte solution can be tailored in composition and plating parameters to fulfill requirements such as defined layer roughness or the capability for plating of fine patterns.The presented results will allow to consider the autocatalytic tin deposition as a potential solution for specific applications in e.g. the IC substrate and µ-LED market.
Deep Learning Anomaly Detection methods to passively detect COVID-19 from Audio

The world has been severely affected by COVID-19, an infectious disease caused by the SARS-Cov-2 coronavirus. COVID-19 incubates in a patient for 7 days before symptoms manifest. The identification of the presence of COVID-19 is challenging as its symptoms are similar to influenza symptoms such as cough, cold, runny nose, and chills. COVID-19 affects human speech sub-systems involved in respiration, phonation, and articulation. We propose a deep anomaly detection framework for passive, speech-based detection of COVID-related anomalies in voice samples of COVID-19 affected individuals. The low percentage of positive cases and extreme imbalance in available COVID audio datasets present a challenge to machine learning classifiers but create an opportunity to utilize anomaly detection techniques. We investigate COVID detection from audio using various types of deep anomaly detectors and convolutional autoencoders. Contrastive loss methods are also explored to force our models to learn discrepancies between COVID and non-COVID cough data representations. In contrast with prior work that controlled data collection, our work focuses on crowdsourced datasets that are true representatives of the general population. In rigorous evaluation, the variational autoencoder with the elliptic envelope as the anomaly detector analyzing Mel Filterbanks audio representations performed best with an AUC of 0.65, outperforming the state of the art.
The Anesthetic Management of Patients Undergoing Nonintubated Video-Assisted Thoracic Surgery.

This review focuses on describing the procedural and anesthetic management of patients undergoing nonintubated video-assisted thoracoscopy surgery. Most thoracic surgery is performed under general endotracheal anesthesia with either a double lumen endotracheal tube or a bronchial blocker. In an attempt to lessen the incidence and severity of postoperative complications, the nonintubated video-assisted thoracoscopic technique was developed, where the surgical procedure is performed under regional anesthesia with sedation. Currently, this technique is recommended for the elderly and in patients with severe cardiopulmonary disease who are at increased risk of complications after general anesthesia. It is the role of the anesthesia team to assist in the decisions whether the patient is a candidate and which block should be performed and to carefully monitor these patients in the operating room. Nonintubated video-assisted thoracic surgery is an emerging technique with the goal of reducing postoperative complications. The anesthetic technique is highly variable and ranges from general anesthesia with a laryngeal mask airway with a truncal block to thoracic epidural anesthesia with minimal to no block. It is important to have excellent communication with the surgical team and the patient to ensure a safe, successful procedure.
Risk of herpesvirus, serious, and opportunistic infections in atopic dermatitis: a population-based cohort study.

Background Staphylococcal and herpes simplex virus (HSV) infections are commonly recognized in atopic dermatitis (AD) but less is known about other types of infections. Objectives To determine the risk of herpesvirus infections, serious infections, and opportunistic infections in patients with AD. Methods We conducted a population-based cohort study using UK-based electronic medical records data. Patients with AD were each matched to up to 5 unaffected patients on age, practice, and index date. AD severity was defined using treatments. The outcomes were incident herpesvirus infections (cytomegalovirus [CMV], Epstein-Barr virus [EBV], HSV, or varicella zoster virus [VZV]), serious infections, and opportunistic infections. Results 409,431 children and 625,083 adults with AD were matched to 1,809,029 children and 2,678,888 adults without AD, respectively. In adjusted Cox regression models, children and adults with AD had 50-52% greater risk of HSV and 18-33% greater risk of VZV, with risk increasing in parallel with AD severity. CMV risk was elevated among children with AD (HR 2.50 [1.38-4.54]) and adults with severe AD (4.45 [1.76-11.25]). Patients with AD had 26-40% increase in risk of serious infections, with severe AD carrying greatest risk. Although rare, opportunistic infections were not associated with AD in children but were associated with all severities of AD in adults (overall HR 1.31 [1.20-1.42]). All estimates remained consistent after excluding patients receiving immunosuppressive treatments for AD. Conclusions AD is significantly associated with herpesvirus infections, serious infections, and opportunistic infections in a dose-responsive manner with severity. AD may increase susceptibility to infections exclusive of immunosuppressive medications.
Abstract MP17: Cumulative Risks for Hypertension In Middle-Aged White and African American Men and Women

Intro: Despite the high prevalence of hypertension (HTN) and the disproportionate burden of HTN-related diseases in African Americans (AA), the long-term risks for incident HTN for AA men and women, compared with whites, are poorly described. Methods: We conducted an individual-level pooled analysis of participants from The Atherosclerosis Risk in Communities and The Framingham Offspring Studies with baseline prevalence and follow-up data on HTN and medication use. HTN was defined as elevated levels and/or medication use at ≥2 consecutive exams. We quantified the long-term risk for stage I (untreated BP≥140/90 mm Hg), stage II (untreated BP≥160/100 mm Hg) and ≥ Stage I HTN or blood pressure medication use separately, using competing risk models to assess incidence from index age 55 years (y) through age 70y to 85y, adjusted for baseline prevalence and competing risks of death. Analyses were stratified by race and sex. Results: There were 11,405 White and 2,886 AA participants (55% and 64% female, respecti...
Laboratory Results That Should Be Ignored

There are instances in which the results of a laboratory test must be reported, but should be ignored by the clinician. Some are accurate findings without clinical significance, but most are spurious results caused by an error somewhere in the testing cycle. Any abnormal laboratory result should raise 2 basic questions: First, what is the clinical relevance of the result? Second, what actions should be taken? This article examines the range of reasons why some laboratory results should be ignored. It examines the causes of spurious results and examines mechanisms to improve communication to convey such reports to the clinician in a more meaningful fashion. The ultimate goals are improved patient outcomes and better utilization of resources. Specific issues to be addressed in this commentary include the need to expand quality programs to address the entire testing cycle, root causes of spurious lab results in clinical and anatomic pathology laboratories, the critical involvement of clinicians in the quality improvement process, and the role of interpretative reporting to reduce medical errors related to spurious results. Many spurious results will not be identified by quality programs that address only the analytic phase. Joint efforts by clinicians and laboratorians can improve detection of errors and reduce the potential for patient harm and waste.
Glutamate suppresses GABA release via presynaptic metabotropic glutamate receptors at baroreceptor neurones in rats.

The nucleus tractus solitarii (NTS) is essential for coordinating arterial baroreflex control of blood pressure. The primary baroreceptor afferent fibres make their first excitatory synaptic contact at second-order NTS neurones with glutamate as the major neurotransmitter. Glutamate regulates its own release by activating presynaptic metabotropic glutamate autoreceptors (mGluRs) on the baroreceptor central terminals to suppress its further release in frequency-dependent manner. γ-Aminobutyric acid (GABA) interneurones provide the major inhibitory synaptic input. It is the integration of excitatory and inhibitory inputs that shapes the NTS output of baroreceptor signals. We hypothesized that glutamate released from the primary central afferent terminals can spill over to presynaptic mGluRs on GABA interneurones to suppress GABA release at the second-order baroreceptor neurones. We assessed GABA transmission in second-order baroreceptor neurones identified by attached aortic depressor nerve (ADN) boutons. The medial NTS was stimulated to evoke GABA inhibitory postsynaptic currents (eIPSCs). Glutamate spillover, generated by brief 2 s, 25 Hz trains of stimuli applied to the tractus solitarius (TS), induced a small (10%) but significant reduction in the eIPSC amplitudes. The depression was enhanced to a 25% decrease by increasing glutamate in the cleft with a glutamate-uptake inhibitor (M-trans-pyrrolidine-2,4-dicarboxylic acid, 1 μm), blocked by a Group II mGluR antagonist (LY341495, 200 nm) and mimicked by a Group II agonist ((2S,3S,4S)-CCG/(2S,1′S,2′S)-2-carboxycyclopropyl; L-CCG-I). A presynaptic mGluR locus was established by the mGluR agonist-mediated increase in the paired-pulse ratio of two consecutive eIPSCs in conjunction with the decrease in the first eIPSC, and a decrease in the frequency (39–46% reduction at EC50 concentration), but not amplitude, of spontaneous and miniature GABA IPSCs. The data indicate that endogenous glutamate activation of Group II presynaptic mGluRs can decrease GABA release at the first central synapses, suggesting a heterosynaptic role for the Group II mGluRs in shaping baroreceptor signal transmission.
Comparison of Hypnotherapy with Systematic Relaxation in the Treatment of Cigarette Habituation.

Because of the methodological deficiencies in this area of research, it is impossible to make any valid conclusions about whether hypnosis itself is effective in the treatment of cigarette habituation. In this study, 87 volunteers who wanted to quit cigarette smoking were assigned randomly to the experimental hypnosis group, the comparison relaxation group, and the waiting list control group. Ss in the treatment groups had four weekly 50-minute, individual sessions. Four months after the completion of treatment, Ss were administered a questionnaire and a hypnotic susceptibility scale. Ss in the hypnosis group who were in the upper two-thirds of the group in terms of hypnotic susceptibility reduced their cigarette consumption substantially more than Ss in the relaxation group who were in the upper two-thirds of the group in terms of hypnotic susceptibility. Therefore, the hypnotic state appears to be therapeutic for individuals who can enter medium or deep states of hypnosis.
Bax is not the heterodimerization partner necessary for sustained anti-photoreceptor-cell-death activity of Bcl-2.

PURPOSE. Ectopic expression of Bcl-2 in photoreceptors of certain mouse models of retinitis pigmentosa (RP) temporarily slows disease progression. The temporary effect produced by Bcl-2 may result from insufficient levels of functional complexes between Bcl-2 and additional proteins necessary for maintaining the anti-apoptotic activity of Bcl-2. Although the overexpression of Bax generally induces apoptosis, Bax exerts anti-apoptotic properties when complexed with Bcl-2 in certain cell culture systems. These studies were designed to determine whether coexpression of Bcl-2 and Bax would improve the neuroprotective effect provided by Bcl-2 alone in photoreceptors of mice with autosomal dominant RP (adRP). METHODS. Transgenic mice were produced that overexpressed Bax and Bcl-2 specifically in photoreceptor cells, using the murine opsin promoter to drive transgene expression. These mice were crossed with an adRP mouse model, to assess the effect of coexpression of Bax and Bcl-2 on retinal degeneration. Morphologic analysis was performed on retinas isolated at various developmental times to monitor disease progression. RESULTS. Ectopic expression of Bax in photoreceptors resulted in extensive rod cell death dependent on the level of Bax transgene expression. Although Bcl-2 was able to inhibit Bax-induced photoreceptor cell death, the coexpression of Bcl-2 and Bax in photoreceptors of mice with adRP did not enhance the protective effect against photoreceptor cell death exerted by Bcl-2 alone. CONCLUSIONS. Coexpression of Bax and Bcl-2, at the levels produced in the transgenic lines, does not extend the temporary neuroprotective effect produced by Bcl-2 in photoreceptors of mice with adRP.
Impact of multiple operators on diagnostic yield of EBUS-TBNA

Background EBUS-TBNA is usually performed by a limited number of operators in each institution in order to achieve optimal yield by accumulating individual expertise. We aimed to assess the diagnostic performance and safety of EBUS-TBNA when this procedure is learned by every trainee. Methods All consecutive patients undergoing EBUS-TBNA were prospectively included since the introduction of EBUS in our institution in January 2008 until December 2011. Each procedure was done by 2 or 3 operators including 1 senior supervisor. Rapid on-site cytologic evaluation (ROSE) was performed since June 2011. Predicting factors for the diagnostic accuracy of EBUS-TBNA were analyzed per patient and per sampled lymph node. Results 15 operators performed EBUS-TBNA in 160 patients. Definitive diagnosis was available for 156 patients (mean age 59.4±14.6 years, 38.5% F). Lymph nodes were malignant in 53.2%. Overall diagnostic accuracy was 82.7% (95% CI 76.4–88.2) and 90.3% (95% CI 81.9–97.2) for NSCLC and SCLC (n=72). Overall diagnostic accuracy tended to increase over years: 70.6%, 81.8%, 82.9% and 85.9% in 2008, 2009, 2010 and 2011 respectively (p=0.51). Subgroup analysis showed no significant influence of ROSE, number of sampled nodes per case, localization and size of lymph node and SUV max . Complications were restricted to 3 minor endobronchial bleeding. Conclusions At Geneva University Hospitals, EBUS-TBNA performance increased over years following well-known learning curves. Yet, in our setting, EBUS- learning curve seemed rather center-than operator-related. Providing on site direct supervision by a senior-experienced operator, EBUS is indeed constantly performed by junior operators without affecting the performance of the method.