cssi/SciSciGPT-SciSciNet huggingface dataset:
Survey of status of safety injection in vaccination in Fenghua City

Objective To understand the current status of safe injection of preventive inoculation of each vaccination station in Fenghua City and improve safe injection.Methods The current status of safe injection of preventive vaccination in 18 vaceination stations were surveyed by field and questionnaire survey.Results All the vaccination stations were provided with disposable sy- tinges and recycled medical rubbish.The safe injection rate was over 96.00%;The training rate on safe injection was up to 96. 86%;The correct answer rate concerning safe injection was between 63.45%～88.28%,being 85.92%～98.59% at city/county level and 36.49%～79.73% at township level.Conclusion It was very necessary to strengthen the training of vaccinators at grassroots level so as to raise their awareness of safe injection.
Elevated Glutamate Levels in the Left Dorsolateral Prefrontal Cortex Are Associated with Higher Cravings for Alcohol.

Background Quantifying craving longitudinally during the course of withdrawal, early abstinence, and relapse is essential for optimal management of alcohol use disorder (AUD). In an effort to identify biological correlates of craving, we used proton magnetic resonance spectroscopy (1H-MRS) to investigate the correlation between craving and glutamate levels in the left dorsolateral prefrontal cortex (LDLPFC) of patients with AUD. Methods Participants underwent 1H-MRS of the LDLPFC with 2-dimensional J-resolved (2DJ) averaged PRESS. MRS data were processed with LCModel and cerebrospinal fluid (CSF)-corrected to generate metabolite concentrations. The Penn Alcohol Craving Scale (PACS) and the 30-day time line follow-back (TLFB 30) were used to quantify craving for alcohol and drinking patterns, respectively. Results There was a statistically significant positive correlation between CSF-corrected glutamate ([Glu]) levels and PACS scores (n = 14; p = 0.005). When PACS scores were dichotomized (< or ≥median = 16), [Glu] levels were significantly higher in the high- versus low-craving group (p = 0.007). In addition, there was a significant negative correlation between CSF-corrected N-acetyl aspartic acid ([NAA]) levels and mean number of drinks per drinking day in the past month (n = 13; TLFB 30; p = 0.012). When mean TLFB 30 was dichotomized (< or ≥median = 7.86), [NAA] levels were significantly lower in subjects that consumed more alcoholic beverages. There was no significant correlation between [Glu] and [NAA] levels with other measures of drinking behavior and or depression symptom severity. Conclusions While limited by small sample size, these data suggest that glutamate levels in LDLPFC are associated with alcohol craving intensity in patients with AUD. Further study with larger sample size is needed to replicate this finding and evaluate the merits of glutamate spectroscopy as a biological correlate of alcohol craving intensity and a guide to treatment interventions.
Sensitivity analysis of fly ash geopolymer cement slurries: Implications for oil and gas wells cementing applications

Abstract Geopolymers are a new class of binder materials suitable for applications in civil industry and Oil and Gas well cementing. Although these materials are widely applied in civil industry applications, they still need more research and development before they can be fully applied for Oil and Gas well cementing. Specifically, these materials have potential to reduce wellbore isolation problems reported by use of ordinary Portland cement (OPC). The study here first presents a comprehensive literature study of geopolymers and results of laboratory testing of class Fly ash geopolymer mixtures under various experimental conditions. We conducted a sensitivity analysis of various factors on specimen's strength as well as selection of plasticizer type and dosage, the effect of Sodium Hydroxide molarity, the effect of shear mixing and rate, mixing time, and effects of solid to liquid ratio. Study results show a strong impact of temperature and curing time on geopolymer mixture's strength whereas mixing condition were not found as a significant factor. Finally, this paper investigates the effect of drilling fluid's contamination on the performance of geopolymers when compared with ordinary Portland cement.
Relative Value of CD38 and ZAP-70 Versus Immunoglobulin Mutation Status in Predicting Early Disease Progression in Chronic Lymphocytic Leukemia.

Abstract We assessed the relative value of CD38 in predicting the need for early treatment in 307 patients with chronic lymphocytic leukemia (CLL) previously characterized for ZAP-70 and immunoglobulin heavy-chain-variable region gene (IgVH) mutational status (NEJM 2004, 351;9;893–901). Recursive partitioning by maximally selected chi-square analyses of flow cytometry and clinical data identified the optimal cut-off for designating a CLL sample as CD38+ was at 34%, which was highly similar to the conventional cut-off of 30%. Since these cut-offs identified highly similar cohorts of CD38+ CLL patients (e.g. 32.2% (99/307) vs. 35.5% (109/307)) we chose to use 30% as the cut-off for this analysis. We used the logrank test to compare CD38 expression-status to the time from diagnosis to therapy (TTT), initiated per established NCI-Working Group guidelines. Patients with CLL cells that were CD38-negative by this criterion had a median TTT of 7.8 years; whereas, patients with CD38+ CLL cells had a median TTT of 3.7 years (p We explored the TTT based only on flow cytometric parameters (CD38 and ZAP-70) and investigated whether addition of mutation status significantly altered our predictions. For most patients, the knowledge of CD38 and ZAP-70 provided a reliable means for predicting the TTT and the knowledge of the IgVH mutation status did not substantially alter the prediction. Only in 41 cases (14% of the total), where the CLL cells were CD38+ but negative for ZAP-70, was the prediction significantly improved by inclusion of IgVH mutation status. The median TTT of this group of 41 patients was 7.8 years. Addition of mutation status identified a subgroup of 20 patients with unmutated IgVH genes for whom median TTT was estimated at 4.6 years; 21 patients with mutated IgVH genes had a median TTT of 8.4 years. For patients with CLL cells that were CD38-negative and either negative or positive ZAP-70, stratification via IgVH mutation status did not identify subgroups within each of these categories that had significantly different median TTT. We conclude that knowledge of CD38 and ZAP-70, as assessed by the CRC, can reliably predict TTT in most patients with CLL. For the 14% of cases that are CD38+ but negative for ZAP-70, determining the IgVH mutation status may provide added value in predicting the time from diagnosis to initial therapy.
The Search for Resistance to Cassava Mosaic Geminiviruses: How Much We Have Accomplished, and What Lies Ahead

The cassava mosaic disease (CMD), which occurs in all cassava growing regions of Africa and the Indian subcontinent, is caused by cassava mosaic geminiviruses (CMGs). CMGs are considered to be the most damaging vector-borne plant pathogens. So far, the most successful approach used to control these viruses has been the transfer of a polygenic recessive resistance locus, designated CMD1, from wild cassava to cassava cultivars. Further progress in harnessing natural resistance to contain CMGs has come from the discovery of the dominant monogenic resistance locus, CMD2, in some West African cassava cultivars. CMD2 has been combined with CMD1 through genetic crosses. Because of the limitations of the cassava breeding approach, especially with regard to time required to produce a variety and the loss of preferred agronomic attributes, efforts have been directed toward the deployment of genetic engineering approaches. Most of these approaches have been centered on RNA silencing strategies, developed mainly in the model plant Nicotiana benthamiana. Early RNA silencing platforms assessed for CMG resistance have been use of viral genes for co-suppression, antisense suppression or for hairpin RNAs-mediated gene silencing. Here, progress and challenges in the deployment of these approaches in the control of CMGs are discussed. Novel functional genomics approaches with potential to overcome some of the drawbacks of the current strategies are also discussed.
Distance Learning for Global Understanding

Distance Learning is a pragmatic catalyst for promoting global education. For professors who have been teaching for 15 years or more, it may seem as digital technology has transformed communication and educational strategies at rapid speed. The challenge is to develop an effective pedagogy for distance education to enhance global understanding. Three virtual global studies courses were examined using a case study qualitative research method. The objective was to isolate duplicable methods, events and activities in a course using distance technology that met specific learning objectives for global understanding. The essential research questions (RQs) were:
Two-Medium Treatment

In this chapter we examine the single-phase flow through solid matrices where the assumption of the local thermal equilibrium between the phases is not valid. When there is a significant heat generation occurring in any one of the phases (solid or fluid), i.e., when the primary heat transfer is by heat generation in a phase and the heat transfer through surfaces bounding the porous medium is less significant, then the local (finite and small) volumes of the solid and fluid phases will be far from the local thermal equilibrium. Also, when the temperature at the bounding surface changes significantly with respect to time, then in the presence of an interstitial flow and when solid and fluid phases have significantly different heat capacities and thermal conductivities, the local rate of change temperature for the two phases will not be equal.
Solar Irradiance Forecasting Using Deep Neural Networks

Predicting solar irradiance has been an important topic in renewable energy generation. Prediction improves the planning and operation of photovoltaic systems and yields many economic advantages for electric utilities. The irradiance can be predicted using statistical methods such as artificial neural networks (ANN), support vector machines (SVM), or autoregressive moving average (ARMA). However, they either lack accuracy because they cannot capture long-term dependency or cannot be used with big data because of the scalability. This paper presents a method to predict the solar irradiance using deep neural networks. Deep recurrent neural networks (DRNNs) add complexity to the model without specifying what form the variation should take and allow the extraction of high-level features. The DRNN is used to predict the irradiance. The data utilized in this study is real data obtained from natural resources in Canada. The simulation of this method will be compared to several common methods such as support vector regression and feedforward neural networks (FNN). The results show that deep learning neural networks can outperform all other methods, as the performance tests indicate.
Agricultural Intensification in the Titicaca Basin

For the past 100 years, anthropological theories of the evolution of complex society have been intimately linked to agricultural production. From the 19th century evolutionists and Marxists through V. G Childe, Julian Steward, and contemporary archaeological theory, agricultural production has figured consistently in our idea of what created the conditions for the emergence of sedentary populations, urban environments, and hierarchical political structures.
Data-Mining-Based Computer Vision Analytics for Automated Helicopter Flight State Inference

The National Transportation Safety Board recently emphasized the importance of flight data monitoring as a tool to improve the safety and performance of helicopter operations. However, due to the h...
29: Impact of HSV-1 induced VEGF-A on corneal lymphangiogenesis during the development of herpetic stromal keratitis

Much of the research regarding lymphangiogenesis and disease has focused on lymphedema and cancer biology. There is still much to be elucidated regarding the impact of lymphatic vessel development during microbial pathogenesis. One function of lymphatic vessels is to drain soluble antigen and antigen-presenting cells from the periphery to the draining lymph nodes, facilitating the mobilization of an adaptive immune response. However, the resulting immune response can lead to detrimental tissue pathology. This is extremely important during ocular disease, wherein transparency of the tissues anterior to the retina is required for normal vision. Herpes simplex virus type-1 (HSV-1) infection of the cornea can result in herpetic stromal keratitis (HSK), an immunopathologic condition characterized by opacity, edema, and neovascularization of the cornea. The impact of hemangiogenesis during an HSV-1 ocular infection has been well studied; however, the impact of lymphangiogenesis in the cornea has only recently been investigated. Previous studies indicate HSV-1 induces lymphangiogenesis via the expression of VEGF-A by infected cornea epithelial cells during acute infection. Furthermore, blood and lymphatic vessels were found throughout the corneas of latently infected animals (day 30 post-infection (pi)). The goal of the current study is to identify the growth factors and cells that contribute to the maintenance and further development of lymphatic vessels in the cornea following the resolution of infection. Results indicate there is a substantial increase in LYVE-1-postive lymphatic vessels by day 14 pi, when HSK develops. Preliminary analysis of 20 growth factors and cytokines revealed robust expression of IL-6, IL-1β, HGF, MMP9, and VEGF-A preceding day 14 pi. It is anticipated that results from this study may lead to new treatment strategies to attenuate the development of HSK.
Soviet Philosophical Anthropology and the Foundations of the Human Sciences

In Soviet Marxism, the methodological structure of the relationships among the various sciences has traditionally been conceived as hierarchically ordered, at the top of which stands dialectics, taken in the broad sense as including both dialectical and historical materialism. In fact, the claim is still being made that the fundamental methodological principles of all the sciences are provided by dialectical materialism. B. S. Ukraincev recently wrote that “dialectical materialism as a world view has universal methodological significance for science”, insofar as it “orients scientists in their choice of the theoretical and methodological assumptions of their research”.1 Historical materialism performs an analogous function, in a more specified sense, for the social sciences. B. M. Kedrov designates historical materialism as the “general method of the Marxist social sciences”,2 in which class he includes most of the sciences dealing with man or the products of human culture — history, economics, law, the history of literature and art, and others. However, he cannot claim that the social sciences are the only ones that deal with man, or that historical materialism provides the methodology for every science of man. Psychology, which in one of Kedrov’s classifications is listed as a social science, in another scheme is located at an intermediate point between the natural and the social sciences. And though human physiology and anthropology both deal directly with man, they are grouped by Kedrov with the natural sciences. If one turns to Marxist-Leninist philosophy, which is alleged to provide the basic principles and methods for the special sciences, a similar lack of clear-cut boundaries is found. One cannot say that dialectical materialism provides, in addition to certain principles relevant to all sciences, the philosophical orientation for the sciences of nature, while historical materialism does the same for the sciences of man. The difficulty is that fundamental theses relating to the nature of man and the mode of study of human phenomena are found in both dialectical and historical materialism. Human consciousness and knowledge are topics treated in dialectical materialism, while freedom, the person, the nature of man, practice, and others have usually been addressed in the context of historical materialism.
Dosimetric and geometric characteristics of a small animal image-guided irradiator using 3D dosimetry/optical CT scanner.

Purpose The precise dosimetric and geometric characteristics of small animal irradiators are essential to achieving reproducible dose delivery, especially in cases where image-guidance is utilized. Currently, radiochromic film is the established measurement tool used to evaluate beam characteristics for these systems. However, only 2D information can be acquired with film. This study characterized both the dosimetric and geometric properties of the small animal research radiation platform (SARRP, Xstrahl) for commissioning purposes using a 3D radiochromic dosimetry system with a submillimeter resolution optical computed tomography (OCT) scanner. Methods Like a modern clinical linear accelerator, the SARRP features both a beam delivery system and a cone beam computed tomography (CBCT) imaging system. Dosimetric and geometric characteristics of the SARRP were studied using EBT3 radiochromic film and 3D PRESAGE dosimeters. Dosimetric measurements included percent depth dose (PDD) curves and beam profiles. For geometric evaluation, the isocenter sizes of the treatment stage and gantry rotations as well as their coincidence were measured using star shot patterns. A commercial Epson Expression 11000XL flatbed scanner was used for readout of irradiated EBT3 films at 300 dpi resolution. Each irradiated PRESAGE dosimeter was scanned using a submillimeter resolution single laser beam OCT scanner. Acquired data were reconstructed with a resolution of 0.3 mm/pixel. Results PDD data measured from films and 3D dosimeters agree to within ±3% for depths up to 5 cm, for both 3 × 3 and 10 × 10 mm2 fixed collimation. Profiles were analyzed at 10, 20, and 30 mm depth for 3 × 3 mm2 and 10 × 10 mm2 fields. The FWHM measurements for both dosimeters agreed to within 0.01 mm, and the penumbras agreed to within 0.1 mm for 3 × 3 mm2 and 0.5 mm for 10 × 10 mm2 . Gantry and treatment stage isocenter sizes were determined to be 0.21 and 0.43 mm using EBT3 film, and 1.72 and 0.75 mm using PRESAGE dosimeters. Absolute isocenter shifts, evaluated with 3D phantoms, were 0.80 mm for the gantry rotation isocenter (treatment isocenter) with respect to the laser-defined setup isocenter, and 0.71 mm for the gantry rotation isocenter relative to treatment stage rotation isocenter (CBCT isocenter). The difference between CBCT isocenter and laser-defined setup isocenter was 0.68 mm. Conclusions This study demonstrated that 3D PRESAGE dosimeters can be used for verification of precise targeting for the SARRP. This 3D dosimetry system can be utilized to obtain information on both geometric and dosimetric properties, as well as acquire beam data parameters for the purpose of commissioning image-guided small animal irradiator systems.
Treatment effects: IV

In this chapter we continue the discussion of treatment effects but replace ignorable treatment strategies in favor of instrumental variables and exclusion restrictions. Intuitively, instrumental variables are a standard econometric response to omitted, correlated variables so why not employ them to identify and estimate treatment effects. That is, we look for instruments that are highly related to the selection or treatment choice but unrelated to outcome. This is a bit more subtle than standard linear IV because of the counterfactual issue. The key is that exclusion restrictions allow identification of the counterfactuals as an individual’s probability
Lipid Incorporation During Experimental Decay of Arthropods

Laboratory decay experiments were carried out on shrimps, scorpions and cockroaches to monitor changes in the chitin-protein of the arthropod cuticle and associated lipids. The cockroach and scorpion exoskeleton remained largely unaltered morphologically, but the shrimp experienced rapid decomposition within a month that progressed through the 44 week duration of the experiment as revealed by electron microscopy. Mass spectrometry and 13C NMR spectroscopy revealed the association of an n-alkyl component with labile lipids, such as fatty acids with up to 24 carbon atoms, which were incorporated into the decaying macromolecule. The scorpion and cockroach cuticle did not reveal the incorporation of additional lipids indicating that decay is important in initiating in situ lipid association. This experiment provides evidence that lipids can become associated with carbohydrate and proteinaceous macromolecules during the very early stages of decay representing the first stage of the transformation process that contributes to the aliphatic rich composition ubiquitous in organic fossils and in kerogens.
Integrals and Asymptotic Expansions

In assessing the content of Ramanujan’s first letter to him, Hardy [9, p. 9] judged that “on the whole, the integral formulae seemed the least imprsessive.” Later he added that Ramanujan’s definite integral formulae “are still interesting and will repay a careful analysis” [9, p. 186]. Indeed, a dismissal of Ramanujan’s contributions to intergration would have beed decidedly premature. First, we might recall that this first letter contained several remarkable formulas on series and continued fractions. In evaluating infinite series and deriving series identities, Ramanujan had no peers, except for possibly Euler and Jacobi. Ramanujan’s work on continued fraction expansions of analytic functions ranks as one of his most brilliant achievements. Thus, if Ramanujan’s contributions to integrals dim slightly in comparison, it is only because the glitter of diamonds surpasses that of rubies. Indeed, there are many elegant and important integrals that bear Ramanujan’s name (See for example, Entry 22.)
Progress in Nitrogenase-Related Research

This session of the Congress comprises the latest results and thoughts with respect to the structure and function of nitrogenase and its components. Major success stories in the last five years have included the solution of the structures of the Fe protein (Georgiadis et al, 1992) and MoFe protein (Kim, Rees, 1992; Bolin et al, 1993; Peters et al., 1997). However, the three-dimensional structures of the MoFe protein have given rise to a major controversy, namely, the structure of the P cluster. Two related structures, both composed of two (whole or partial) [4Fe-4S] cubes with four terminal Cys-Fe bonds and two cysteinyl bridges, have been proposed. The first model has a disulfide bond as the third bridge between the cubes, whereas the second model, which comprises a [8Fe-7S] cluster, has a hexacoordinate S (i. e., one S atom common to both partial cubes) forming the third bridge. The second model is now preferred and the structural differences have been rationalized by different redox states having different structural P-cluster forms with the first structure solved on crystals in two (or more) states. The structure and composition of FeMo-cofactor have not been items of dispute. It is bound to the alpha-subunit by only alpha-Cys-275 and alpha-His-442, although many putative hydrogen-bonding interactions exist. Many of these interactions were predicted through mutagenesis studies, which predated the structure determination (Brigle et al, 1985; Dean et al., 1990; Scott et al., 1990; Kent et al., 1990).
Right ventricular-pulmonary artery coupling in patients undergoing transcatheter aortic valve replacement: is it relevant?

Transcatheter aortic valve replacement (TAVR) is now the preferred treatment strategy for patients with symptomatic aortic stenosis who are either high-risk, in-operable or intermediate-risk patients (1-3). The role of TAVR in low-risk patients is still not well established, and current evidence is limited to retrospective studies (4). However, several trials are underway which will hopefully address this knowledge gap (5-8). Undoubtedly, TAVR has transformed the landscape of management in AS patients, and its role is expected to expand in the years ahead. As matter of fact, some believe that the risk stratification should be altered to “high-risk TAVR patients” especially if low-risk trial shows positive outcomes.
Spatiality of Corruption in the Middle East and North Africa

This chapter is a summary of corruption in the Middle East and North Africa (MENA) region. It situates corruption in its historical and spatial context, noting the role of the “resource curse” in driving it. The empirical analysis explores the varying levels of severity, maps corruption scores, bribery rates, and includes a correlation analysis. It then turns to a case study of Turkey. The next section addresses corruption in the Arab world, followed by a case study of Saudi Arabia. It then offers case studies of Israel and Iran. The conclusion reiterates the major findings, notes the most modernized Middle Eastern states tend to have the lowest levels of corruption, criticizes anti-corruption campaigns as hollow rhetoric, and offers steps to mitigate corruption in the future.
Turn-Taking Predictions across Languages and Genres Using an LSTM Recurrent Neural Network

Going beyond turn-taking models built to solve specific tasks, such as predicting if a user will hold his/her turn after a pause, there is growing interest in more general models for turn taking that subsume many such tasks, and very good results have recently been obtained [1]. Here we present an improved recurrent network model that outperforms [1] and does so without requiring lexical annotation. Further, we show that this model can be trained for different languages with no modifications, providing good results in turn-taking prediction for English, Spanish, Japanese, Mandarin and French. We also show that our model performs well across genres, including task-oriented dialog and general conversation.
A Surgeon's View of the Influence of Anesthetic Procedures on Surgical Sequelae

The vast majority of operations in western countries can be conducted safely. For anesthetic procedures or other therapeutic techniques to make a major impact on patient outcome, they must be applied with benefit to seriously ill patients—those with burns, major injury, sepsis or debilitating disease which limits physiologic reserve. The response to injury and infection can be considered a neuroendocrine reflex response involving afferent signals, efferent signals, and central controllers. Several techniques to modulate these signals have been described. The application of these techniques to the care of the critically ill could modulate the response to injury and favorably affect patient outcome.
Instructional Design and Delivery for Mastery Learning

Instructional design and delivery to reach mastery learning goals in the health professions is a key responsibility of education leaders. This work requires thoughtful planning and execution, focus on learner improvement, and development and use of assessment programs that permit formative and summative decisions about learner achievement. This chapter begins with framing remarks that set the stage for five subsequent sections about mastery learning instructional design and delivery: (a) psychological foundations, (b) instructional design, (c) instructional delivery, (d) four health professions education examples, and (e) conclusions. The intent is to describe current evidence-based mastery learning instruction best practices informed by theory and experience.
The effects of six weeks of balance and strength training on measures of dynamic balance of older adults.

Purpose: Reliable tools on measuring outcomes of service-learning (SL) are scarce. This study aimed to develop and test a service-learning assessment tool to measure students’ perceived self-efficacy on program planning related competencies (SL-SEPP) and an overall SL impact scale. Methods: Students in a core Master of Public Health (MPH) course on program planning participated in the study (n=44). Course-based SL projects were incorporated into the learning process. Data from the baseline survey were used to assess the reliability of the 12-item SL-SEPP, and data from the posttest survey were used to assess the 5-item overall SL impact scale at the end of the course. Results: Data showed satisfactory reliability scores, with Cronbach alpha of .87 for the SL-SEPP and .84 for the overall impact scale. Even with this relatively small sample size, preliminary analyses showed that the SL-SEPP was sensitive to detect meaningful changes of self-efficacy scores after the course. Conclusion: This study provides needed pilot data supporting the reliabilities of the SL-SEPP tool. The study has implications for researchers and educators to apply or adapt this tool to assess student self-efficacy outcomes on program planning competencies.
High Efficiency Narrow Gap and Tandem Junction Devices: Final Technical Report, 1 May 2002--31 October 2004

The work described in this report uses a modified pulsed plasma-enhanced chemical vapor deposition (PECVD) technique that has been successfully developed to fabricate state-of-the-art nc-Si materials and devices. Specifically, we have achieved the following benchmarks: nc SiH device with an efficiency of 8% achieved at a deposition rate of {approx}1 A/s; nc SiH device with an efficiency of 7% achieved at a deposition rate of {approx}5 A/s; large-area technology developed using pulsed PECVD with uniformity of +/-5% over 25 cm x 35 cm; devices have been fabricated in the large-area system (part of Phase 3); an innovative stable four-terminal (4-T) tandem-junction device of h> 9% fabricated. (Note that the 4-T device was fabricated with existing technology base and with further development can reach stabilized h of 12%); and with improvement in Voc {approx} 650 mV, from the current value of 480 mV can lead to stable 4-T device with h>16%. Toward this objective, modified pulsed PECVD was developed where layer- by-layer modification of nc-SiH has been achieved. (Note that due to budget cuts at NREL, this project was curtailed by about one year.)
Logistical Considerations and Clinical Outcomes Associated With Converting Operating Rooms Into an Intensive Care Unit During the Coronavirus Disease 2019 Pandemic in a New York City Hospital.

BACKGROUND: Covid-19 emerged as a public health crisis that disrupted normal patterns of health care in the New York City metropolitan area. In preparation for a large influx of critically ill patients, operating rooms (ORs) at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center (NYP-Columbia) were converted into a novel intensive care unit area, the ORICU. METHODS: 23 ORs were converted into an 82-bed ORICU. Adaptations to the OR environment permitted the delivery of standard critical care therapies. Non-intensive-care-trained staff were educated on the basics of critical care and deployed in a hybrid staffing model. Anesthesia machines were repurposed as critical care ventilators, with accommodations to ensure reliable function and patient safety. To compare ORICU survivorship to outcomes in more traditional environments, we performed Kaplan-Meier survival analysis of all patients cared for in the ORICU, censoring data at the time of ORICU closure. We hypothesized that age, gender, and obesity may have influenced the risk of death. Thus, we estimated hazard ratios for death using Cox proportional hazard regression models with age, gender, and body mass index (BMI) as covariables and, separately, using older age (65 years and older) adjusted for gender and BMI. RESULTS: The ORICU cared for 133 patients from March 24 - May 14, 2020. Patients were transferred to the ORICU from other ICUs, inpatient wards, the Emergency Department, and other institutions. Patients remained in the ORICU until either transfer to another unit or death. As the hospital patient load decreased, patients were transferred out of the ORICU. This process was completed on May 14, 2020. At time of data censoring, 55 (41.4%) of patients had died. The estimated probability of survival 30 days after admission was 0.61 (95% CI 0.52 - 0.69). Age was significantly associated with increased risk of mortality (HR = 1.05, 95% CI 1.03 - 1.08, p < 0.001 for a 1 year increase in age). Patients who were 65 years or older were an estimated 3.17 times more likely to die than younger patients (95% CI 1.78 - 5.63, p < 0.001) when adjusting for gender and BMI. CONCLUSIONS: A large number of critically ill Covid-19 patients were cared for in the ORICU, which substantially increased ICU capacity at NYP-Columbia. The estimated ORICU survival rate at 30 days was comparable to other reported rates, suggesting this was an effective approach to manage the influx of critically ill Covid-19 patients during a time of crisis.
Utility of Endotracheal Tube Cuff Pressure Monitoring in Mechanically Ventilated (MV) Children in Preventing Post-extubation Stridor (PES).

Objective To study if protocolized monitoring of endotracheal tube (ETT) cuff pressure every 6 hours is better than adjusting endotracheal tube cuff inflation by the only bedside clinical assessment. Materials and methods This was a single-center prospective randomized controlled study done between July 1, 2017 and March 31, 2019. Children between 1 month and 18 years, intubated with cuffed ETT by our trained doctors were included. After obtaining consent, patients were randomized into two groups, standard group (SG) and cuff pressure monitoring group (MG). Sample size was calculated with 80 patients in each group with a power of 80%, significance level (alpha 0.05 and beta 0.2). In the SG, ETT cuff inflation was adjusted by clinical assessment (bedside minimal leak technique and monitoring the percentage of leak displayed on ventilator display) at 6 hours interval. In the MG, cuff pressures were monitored by the device every 6 hours to maintain between 20 and 25 mm Hg. Results Out of 543 mechanically ventilated children during the study period, 266 were eligible and randomized for study. During the study, 89 patients died and 17 were left against medical advice, leaving 80 patients in each group. Incidence of post-extubation stridor (PES), re-intubation rate, ventilator-associated pneumonia (VAP) rate, ventilator days, and length of pediatric intensive care unit (PICU) stay were analyzed and found no advantage of protocolized monitoring of cuff pressures in the reduction of any of the above variables. Conclusion Our findings if confirmed by large multicentric studies can bring an end to routine ETT cuff pressure measurements and emphasize more on clinical assessment. Clinical trial registry (CTRI/2019/05/019098).Indian Journal of Critical Care Medicine (2021): 10.5005/jp-journals-10071-23737. How to cite this article Shaikh F, Janaapureddy YR, Mohanty S, Reddy PK, Sachane K, Dekate PS, et al. Utility of Endotracheal Tube Cuff Pressure Monitoring in Mechanically Ventilated (MV) Children in Preventing Post-extubation Stridor (PES). Indian J Crit Care Med 2021;25(2):181-184.
Structure Optimization of UHV RIP Oil-SF6 bushings Based on Improved Equal Margin Design Method and Back-Propagation Neural Network

Equal margin design method based on the classic analytic formula is widely used in development of extra-high voltage bushing products, and its effectiveness and practicality have been fully validated. However, model and temperature factors have significant impact on internal E-field distribution of UHVAC and UHVDC bushing condenser, which traditional analytic formula is difficult to evaluate quantitatively, so it’s necessary to improve traditional equal margin design method. Firstly, basic principles of equal margin design method and its software package were briefly described, and the laws of model and temperature factors influencing on condenser E-field were investigated on FEM (finite element method) computing platform. Based on these, mathematical model of improved equal margin design method for bushing condenser was established, and flow chart of optimization process combining FEM electro-thermal coupling calculation with genetic algorithm was presented. The improved method was applied to design of UHV RIP oil-gas prototype to realize uniform axial E-field distribution along bushing condenser and equal partial discharge margin between adjacent foils. Bushing condenser was fabricated according to above optimized design structure, and has passed all type tests. In the paper, the FEM electro-thermal coupling calculation method was applied to the inner insulation optimization design to make bushing condenser’s design more suitable. The paper can provide some theoretical guidelines for research and development of other bushings in UHV level.
Patient Portal Reminders for Pediatric Influenza Vaccinations: A Randomized Clinical Trial.

OBJECTIVES In a large health system, we evaluated the effectiveness of electronic health record patient portal reminders in increasing pediatric influenza vaccination rates. METHODS We conducted an intention-to-treat randomized clinical trial of 22 046 children from 6 months to RESULTS First-dose influenza vaccination rates were 56.9% in the control group, 58.0% in the loss-frame reminders group (P = .07), and 58.0% in the gain-frame group (P = .47). Rates were 58.3% in the precommitment group versus 57.0% in the control group (P = .11). Adjusted risk ratios for first vaccination were 1.02 (95% confidence interval [CI]: 1.00–1.04) for loss-frame reminders, 1.01 (95% CI: 0.98–1.05) for gain-frame reminders, and 1.02 (95% CI: 1.00–1.04) for precommitment messages versus controls. Second-dose vaccination rates were 44.1% in the control group and 55.0% in the reminder group, with an adjusted risk ratio of 1.25 (95% CI: 1.07–1.45). CONCLUSIONS Patient portal reminders for influenza vaccines in children, whether framed as gains or losses, did not increase first-dose influenza vaccination rates but were highly effective for the second dose of the vaccine.
Self-Examination of Music Methods Teaching in a Reggio Emilia-Inspired Learning Community:

Music teacher educators have taken different approaches to enrich teaching-specific reflective practice through peer collaboration. In this study, three music teacher educators examined their exper...
Symbol Digit Modalities Test and Academic Outcomes in Pediatric MS: Preliminary Findings (P1.356)

Objective: To determine whether standard measures of cognition (i.e., neuropsychological tests) are related to functional outcomes of academic achievement in a pilot sample of children and adolescents with multiple sclerosis (MS). Background: Cognitive impairment is a major cause of disability in children with MS, with frequency ranging from 30% to 50%. Functional decrements have also been noted. However, to our knowledge, no study has examined the concordance of performance on standard neuropsychological measures and functional outcomes, e.g., academic achievement, in children with MS. Design/Methods: 7 participants were tested: all were female, mean age 16.14 (±3.31), mean EDSS 0.29 (±0.45), currently on disease modifying therapy, off steroids and relapse free at time of testing. The Symbol Digit Modalities Test (SDMT) and Woodcock Johnson-III Test of Achievement (WJ-III; verbal and math subtests) were administered. Normative scores were calculated for each test. Impairment was considered as z = −1.5 (SDMT), and below grade equivalent (WJ-III). Results: Overall, SDMT performance did not correspond well with WJ-III performance within our sample. Only one subject was impaired on SDMT. 6 participants had intact SDMT performance, 5 of whom were impaired in at least one academic area (reading, writing, math): 4 were below grade level on both math and verbal skills and one was below grade level on math skills only. Of the 5 subjects with academic impairment, none were below grade level on verbal skills alone. Conclusions: The SDMT, though a widely used screening measure for detection of cognitive impairment in pediatric MS, failed to correspond to declines in academic achievement in this pilot sample. Future work in larger samples is needed to determine whether standard neuropsychological tests adequately capture/predict decrements in academic achievement in children with multiple sclerosis. Study Supported by: National Multiple Sclerosis Society (PP3442) Disclosure: Dr. Vargas has nothing to disclose. Dr. Street has nothing to disclose. Dr. Tosto has nothing to disclose. Dr. Leavitt has nothing to disclose. Dr. Sumowski has nothing to disclose.
Perspective, Space, and Camera Obscura in the Renaissance

Contemporary digital media are correlated to spatial GPS (Global Positioning Satellite) coordinates. Spatial information is itself knit together according to absolute coordinates, which may be viewed in conformity with the principles of projective geometry. Such a mode of viewing—relatively recent—has now become completely natural to most electronics users. It is natural to assume that such digital technologies, whose algorithms include projective geometrical processing according to a mobile viewpoint, are descended from the history of western art in the Renaissance. But that genealogy is much contested.
High Resolution Single Cell Maps Reveals Distinct Cell Organization and Function Across Different Regions of the Human Intestine

The colon is a complex organ that promotes digestion, extracts nutrients, participates in immune surveillance, maintains critical symbiotic relationships with microbiota, and affects overall health. To better understand its organization, functions, and its regulation at a single cell level, we performed CODEX multiplexed imaging, as well as single nuclear RNA and open chromatin assays across eight different intestinal sites of four donors. Through systematic analyses we find cell compositions differ dramatically across regions of the intestine, demonstrate the complexity of epithelial subtypes, and find that the same cell types are organized into distinct neighborhoods and communities highlighting distinct immunological niches present in the intestine. We also map gene regulatory differences in these cells suggestive of a regulatory differentiation cascade, and associate intestinal disease heritability with specific cell types. These results describe the complexity of the cell composition, regulation, and organization for this organ, and serve as an important reference map for understanding human biology and disease.
Abstract 12083: Lymphatic Vasculature Mediates Cardiac Progenitor Cell Trafficking After Myocardial Infarction

Myocardial infarction (MI) and post-MI heart failure are major causes of morbidity and mortality. Cardiac progenitor cells (CPC) regenerate injured myocardium, due to their ability to migrate and engraft in the wounded area. Yet, the mechanisms governing CPC trafficking in the diseased myocardium are largely unknown. We examined a hitherto unaddressed role of cardiac lymphatic microvessels (LMV) in CPC mobilization to the site of infarction. We detected that in acute and chronic MI, mouse CPC accumulated in the infarct border zone in proximity of LMV and traversed their wall. We showed that human CPC actively intravasated into the lumen of three-dimensional LMV formed by human lymphatic endothelial cells (LEC) in vitro. The binding of CPC to LEC was hindered in the presence of N-cadherin inhibitory peptide or E-selectin neutralizing antibody. CPC displayed unique pattern of interactions with LEC. Specifically, the propensity of CPC to adhere to LEC at basal conditions and after pre-stimulation with an inflammatory mediator TNFα was higher comparing to human cardiac microvascular endothelial cells (CMEC). Trans-migration of CPC through LEC but not CMEC monolayer was enhanced following treatment with TNFα. Interference with the SDF-1/CXCR4 pathway diminished CPC intravasation via LEC but did not affect the CPC ability to traverse CMEC. Intriguingly, we found that the bioactive lipid S1P, secreted by endothelial cells, had a significant impact on CPC migration. S1P binds to 5 different S1P receptors (S1P1-5). We established that the expression of S1P3 was enriched in CPC. Although exposure to S1P mitigated CPC motility, an S1P3-selective agonist evoked strong chemotaxis of CPC, whereas down-regulation of S1P3 blocked CPC translocation. Accordingly, CPC activation with S1P3 agonist reduced their contacts with the extracellular matrix, while S1P ligand induced the organization of adhesion complexes containing β1-integrin subunit. The direct role of S1P3 in CPC trafficking in vivo is supported by our observations that S1P3 expression was increased in the cardiac cells associated with LMV after MI. In conclusion, we provide evidence that specific interactions with LMV may promote CPC trafficking in the infarcted heart facilitating myocardial repair.
Individuals and Individuation in the Disputatio

In the opening three sections of the Disputatio Leibniz examines the “state of the question” and makes it clear that he intends to argue for a principle of individuation that is internal to, or constitutive of, individual entities. He makes an important distinction between the logical and metaphysical senses of ‘individual’. Leibniz does not provide his reader with much information on how he might have understood this distinction. The bulk of this chapter is devoted to setting out a plausible interpretation of the distinction, based on general features of Aristotelian philosophy, with which Leibniz was familiar. Doing so provides an adequate basis for interpreting the basic features of individuals and their individuation that occupied Leibniz in his earliest philosophy — and that persist in his mature philosophy.
Bacillus subtilis Glutamine Synthetase DEPENDENCE OF γ-GLUTAMYLTRANSFERASE ACTIVITY ON IONIC STRENGTH AND SPECIFIC MONOVALENT CATIONS

Abstract Bacillus subtilis glutamine synthetase requires high ionic strength for optimal γ-glutamyltransferase activity; 0.4 m K2SO4 added directly to the assay enhances catalytic activity more than 12-fold. Specific monovalent cations modify this enhanced activity, with potassium salts favoring activation more than sodium salts, and rubidium salts intermediate between the two. Lithium antagonizes the stimulatory effects of high ionic strength. In contrast, the biosynthetic activity of glutamine synthetase is inhibited by salts added directly to the assay, the relative inhibition being greatest with potassium salts, least with lithium, and intermediate with sodium. Incubation of glutamine synthetase in buffer with high salt concentrations prior to assay stimulates the transferase activity also, but has no effect on the biosynthetic activity. This latter stimulation of activity is independent of the monovalent cation in the preliminary incubation, but is blocked by Mn2+, and to a lesser extent by Mg2+, when these divalent cations are included in the preliminary incubation buffer. When the enzyme is studied under optimal conditions of preliminary incubation and assay, the Mn2+ and ADP substrate saturation curves are sigmoid, but those of arsenate, glutamine, and hydroxylamine are hyperbolic. The transferase activity is subject to feedback inhibition by tryptophan, AMP, glycine, and alanine. The enzyme in the high salt buffer has altered sulfhydryl reactivity and increased fluorescence with the hydrophobic probe, N-phenyl-N-methyl-2-aminonaphthalene-6-sulfonate, in comparison to enzyme in the low salt buffer. No differences, however, between the high and low salt preparations could be detected in sedimentation velocity and light-scattering experiments. After 17 hours, some dissociation of the enzyme centrifuged in the high salt buffer is demonstrated in sedimentation equilibrium studies; this dissociation was not seen in comparable studies without added salt. Assay in high salt concentrations raises the apparent affinity of the enzyme for the substrates of the transferase assay; such changes may explain partially the marked increase in the transferase activity associated with the high salt environment.