cssi/SciSciGPT-SciSciNet huggingface dataset:
Sleep in Extreme Environment

This chapter briefly describes sleep and its impact on health in certain extreme situations in the environment (e.g., space travel, polar regions, mountain climbers at high altitude, deep-sea divers in hyperbaric atmosphere, and extremely hot climates in the tropics). There are limited but adequate data in the literature to make some tentative conclusions about the adverse effects of microgravity on sleep obtained from many space and simulated missions. There are valid scientific data to show hypoxemia due to a low barometric pressure at high altitude, causing periodic breathing and sleep dysfunction in unacclimatized mountain climbers. There are very limited data available to make a firm conclusion about polar and tropical insomnia and other sleep dysfunction.
Strategies to Implement the Baldrige Criteria for Performance Excellence

Only a small number of U.S. businesses have adopted the Baldrige Performance Excellence Program. The purpose of this multiple case study was to explore strategies that executive business leaders use to implement the Baldrige Criteria for Performance Excellence. The study population consisted of six business executives and two organizations in the U.S. state of Texas, all with experience in implementing the Baldrige Criteria for Performance Excellence. The theory of high performance work systems provided the conceptual framework for the study. Data were gathered from interviews and record reviews that were conducted within the organizations. Inductive analysis was used to identify words, phrases, ideas, and actions that were consistent among participants and organizations as well as patterns and themes. Triangulation of sources between the interview and record review data was used for consistency. Three main themes emerged from data analysis: organizations embedded the Baldrige Criteria for Performance Excellence into native work models; they also used robust strategy deployment systems with accountability for action plans to spread the Baldrige Criteria for Performance Excellence; and, rather than specifically create goals to align with the Baldrige Criteria for Performance Excellence, they identified actions to reach organizational strategic goals that were molded using the Baldrige Criteria for Performance Excellence as a business model.
Utility of Appendiceal Calcifications Detected on Computed Tomography as a Predictor for an Underlying Appendiceal Epithelial Neoplasm.

Mucinous appendiceal neoplasms can contain radiopaque calcifications. Whether appendiceal radiographic calcifications indicate the presence of an appendiceal epithelial neoplasm is unknown. This study aimed to determine whether appendiceal calcifications detected by computed tomography (CT) correlate with the presence of appendiceal epithelial neoplasms. From prospective appendiceal and pathology databases, 332 cases of appendiceal neoplasm and 136 cases of control appendectomy were identified, respectively. Only cases with preoperative CT scans available for review were included in the study. Images were reviewed by two abdominal radiologists. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated, and the kappa statistic was used to determine agreement between the radiologists’ interpretations. Interobserver agreement between the radiologists was substantial, with a kappa of 0.74. Appendiceal mural calcifications were identified on CT scans in 106 appendiceal neoplasm cases (32%) and in 1 control case (1%) (P = 0.0001). In the appendiceal neoplasm subgroup, the presence of radiographic calcifications was associated with mucinous histology (35% vs 17%; P = 0.006; odds ratio [OR], 0.38; 95% confidence interval [CI], 0.18–0.78) and with well-differentiated histologic grade (40% vs 24%; P = 0.002; OR, 0.47; 95% CI, 0.29–0.76). The findings showed a sensitivity of 31.9% (95% CI, 26.9–37.2%), a specificity of 99.3% (95% CI, 96–100%), a PPV of 99.1% (95% CI, 94.9–100%), and an NPV of 37.4% (95% CI, 32.4–42.6%). This case–control study showed that appendiceal mural calcifications detected on CT are associated with underlying appendiceal epithelial neoplasms and that the identification of incidental mural appendiceal calcifications may have an impact on decisions regarding surgical intervention.
Utilizing biomarkers to forecast quantitative metabolite concentration profiles in human red blood cells

One of the major limitations in making experimental measurements of biological systems is the complexity of the network being investigated. Major efforts have been made to identify a subset of measurements (“biomarkers”) that can be used to provide information about the rest of the system. For red blood cells under cold storage conditions in a blood bank, a set of metabolite biomarkers have been identified that can reliably define the qualitative trend of cellular metabolism. Recently, it was shown that these biomarkers could also be used to train a model that quantitatively predicts the concentrations of other metabolites in the network over a 45 day time course. Here, we extend the utility of these methods by using a linear blackbox model to forecast future values of these concentrations. We show that 57 of the 70 metabolites measured in the red blood cell metabolic network (81%) can be accurately forecasted after 8 days of storage (5 time points) with a global median error of 18.36%. The ability to forecast metabolite profiles by only requiring a subset of measurements for the first few days of storage makes these methods immediately applicable in a clinical setting to assess the metabolic health of stored blood.
Hospital Discharge Summaries: Lessons in Improvement (P05.006)

OBJECTIVE: To evaluate the efficacy of standardized templates for discharge summaries. BACKGROUND: A discharge summary serves as means of communication between the inpatient and outpatient healthcare provider after the hospitalization of a patient. The acute healthcare provider should compile a summary that is complete, concise, and error-free. It should reflect the assessment and care of the patient including diagnoses, details of diagnostic studies, treatments, outcome, and disposition. Multiple studies demonstrate that discharge summaries are frequently unavailable or missing pertinent information. We examined the effectiveness of using templates for composing discharge summaries. DESIGN/METHODS: 30 discharge summaries over a 3-month period were randomly selected and reviewed for completeness using a checklist of twenty-five general admission information components including but not limited to history of present illness, past medical history, medications, allergies, etc. Areas of deficiencies were noted. Templates outlining the required items of a discharge summary were devised and implemented. Another 30 discharge summaries over 3-month period thereafter were reviewed and analyzed. RESULTS: The rates of overall completeness were slightly improved after the implementation of the template (90% vs. 86.1%). The areas of review of systems, allergies, discharge medications, vital signs, and pertinent laboratory data had reductions in deficiency rates by 40%, 66.7%, 71.4%, 72.7%, and 90%, respectively. However, the areas of family history, disposition, and follow up instructions did not show significant improvement. CONCLUSIONS: The implementation of templates improved multiples areas of previous deficiencies within the summaries. Stricter adherence to including all components of a summary as outlined in the standardized templates should be routinely emphasized to promote more comprehensive, and therefore, higher quality discharge summaries. Disclosure: Dr. Valles has nothing to disclose. Dr. Patil has nothing to disclose. Dr. Molina has nothing to disclose. Dr. Li has nothing to disclose.
Reporting of Sepsis Cases for Performance Measurement Versus for Reimbursement in New York State.

Objectives:Under “Rory’s Regulations,” New York State Article 28 acute care hospitals were mandated to implement sepsis protocols and report patient-level data. This study sought to determine how well cases reported under state mandate align with discharge records in a statewide administrative datab
Effect of Combined Treatment With Folic Acid, Vitamin B6, and Vitamin B12 on Plasma Biomarkers of Inflammation and Endothelial Dysfunction in Women

Background The aim of this study was to determine whether reducing plasma homocysteine concentrations with long‐term, combined treatment with folic acid, vitamin B 6 , and vitamin B 12 alters plasma biomarkers of inflammation and endothelial dysfunction in women at increased risk of cardiovascular disease. Methods and Results We conducted a blood substudy of 300 treatment‐adherent participants (150 in the active treatment group, 150 in the placebo group) in the WAFACS (Women9s Antioxidant and Folic Acid Cardiovascular Study), a randomized, double‐blind, placebo‐controlled trial testing a daily combination of folic acid (2.5 mg), vitamin B 6 (50 mg), vitamin B 12 (1 mg), or matching placebo, in cardiovascular disease prevention among women at increased risk of cardiovascular disease. Plasma concentration of 3 biomarkers of inflammation (C‐reactive protein, interleukin‐6, and fibrinogen) and a biomarker of endothelial dysfunction (intercellular adhesion molecule 1) were measured at baseline and at the end of treatment and follow‐up. After 7.3 years of combined treatment with folic acid, vitamin B 6 , and vitamin B 12 , homocysteine concentrations were reduced by 18% in the active treatment group as compared with the placebo group ( P P =0.77), interleukin‐6 ( P =0.91), intercellular adhesion molecule 1 ( P =0.38), or fibrinogen ( P =0.68). Conclusions These findings indicate that long‐term, combined treatment with folic acid, vitamin B 6 , and vitamin B 12 lowers homocysteine concentrations, but does not alter major biomarkers of vascular inflammation, consistent with the lack of clinical cardiovascular disease benefit in the trial. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000541.
Is Technology the Cure for Soaring Demand and the High Costs of Healthcare

Do you remember the last time you visited your doctor or dentist? During that visit, you came into contact with modern medical technology. At the very minimum, a computer was used to store your personal data and, later, the results of the physical examination, your medical history, and symptoms in the form of an electronic medical record. If you made the appointment because of an injury or pain, additional technological tools were used to help your doctor or dentist make a diagnosis or an assessment of the extent of injury, perhaps blood was drawn for analysis or some type of imaging (e.g., X-Ray, MRI) was ordered. The results of these technologically enabled tests were eventually used to guide treatment.
Urological management of patients with von Hippel-Lindau's disease.

AbstractWe present our experience with 7 patients with von Hippel-Lindai’s disease. Five patients had bilateral renal tumors and 2 had pheochromocytomas. Staging is accomplished best with abdominal computerized tomography and renal angiography. Computerized tomography is the preferred method to follow the patients. Because of the tendency for these patients to have bilateral renal involvement, surgical efforts should be directed toward preserving renal parenchyma without compromising adequate tumor excision. Of the 7 patients 6 are alive 4 months to 8 years postoperatively. One patient had metastatic disease at autopsy. No patient required dialysis or renal transplantation. The relationship between the multifocal renal cysts and renal carcinomas in this disease remains unknown.
Some Cellular Correlates of Behavior Controlled by an Insect Central Ganglion

A major problem in neurobiology is to relate the wealth of functional information about single neurons to the factors that determine the behavior of the whole animal. In considering this question one is immediately struck by two apparently paradoxical observations. The first concerns the large number of functional similarities found in neurons throughout the animal kingdom. Many of the physical and chemical parameters associated with propagation and transmission in neurons are common to nerve cells of an annelid worm, a lobster, a squid, or the cerebral cortex of man (Bullock and Horridge, 1965). In contrast to this commonality of certain properties in units of the nervous system, one is faced with the enormous variety of animal behavior. How does behavioral variability result from neural systems built with basically similar units?
Market Structure, Industry Concentration, and Barriers to Entry

In economics, we normally classify markets into four market structures: perfect competition, monopoly, monopolistic competition, and oligopoly. In this chapter, we are interested in understanding why real markets are structured so differently. For example, most agricultural commodities approximate competitive markets, as they have many producers of homogeneous or nearly homogeneous goods. In contrast, the market of computer operating systems is nearly monopolized by Microsoft. In 2009, Microsoft Windows had a market share of approximately 92%, while its nearest competitor, Mac, had a market share of just over 5%.
Educational and Scholarly Opportunities for Medical Students and Residents in Professional Ophthalmology Organizations

This study examines educational and scholarly opportunities offered by professional US ophthalmology organizations that may enrich the training experience of medical students and residents.
Surface acetone reactions on ZnxZryOz: A DRIFTS-MS study

Abstract We report a systematic DRIFTS-MS study of surface acetone aldolization and self-deoxygenation reactions on ZrO2 and Zn1Zr10Oz, using temperature programmed surface reactions of both acetone reactant and possible intermediate compounds including diacetone alcohol, mesityl oxide, phorone, and isophorone. DRIFTS was used to monitor the evolution of surface species while MS was used to track corresponding gas phase products, in an attempt to identify the distinct reaction pathways observed on the two catalysts as well as the role zinc plays in the corresponding reaction pathways. It is found that aldol condensation (or aldolization) of acetone occurs readily at low temperature (298 K), forming mainly acetone dimers (i.e., diacetone alcohol, DAA/mesityl oxide, MSO) on both ZrO2 and Zn1Zr10Oz with the latter being more active. At elevated temperatures, secondary MSO reactions are diverted, mainly caused by the different Lewis basicity on the two catalysts. Over ZrO2, MSO reacts with activated acetone (acetone enolate) to form a surface 4,4-dimethyl-2,6-heptadione (phorone-C), which is further converted into a stable isophorone intermediate. At temperatures above 473 K, polymerization/oligomerization of isophorone along with basic hydroxyl promoted decomposition reactions occur, leading to the formation of heavier carbonaceous surface species and gas-phase side products (methane and CO2). The addition of zinc balances the surface acid-base properties on ZnxZryOz (i.e., Zn1Zr10Oz) via not only enhancing the surface Lewis basicity but passivating the strong acidity. This balance, especially the enhanced surface Lewis basicity largely promotes the α-H abstraction of MSO to form MSO enolate on the Zn1Zr10Oz, which thus favors the aldolization of MSO enolate and acetone, a reaction tends to form 2,6-dimethyl-2,5-heptadien-4-one (phorone-A). Phorone-A then readily decomposes to produce isobutene as a major product at temperature as low as 373 K. Note that, despite the facile formation of isobutene at low temperatures, a high temperature (673 K) is still necessary to release the strongly adsorbed formate/carbonate/acetate species via CO2 formation.
Two names of stability: Spherical aromatic or superatomic intermetalloid cluster [Pd3Sn8Bi6]4−

Abstract Amidst the general bonding patterns designed to explain stability aromaticity has leading role. Going far away beyond classic notion of organic chemistry aromaticity was proven to be a useful tool to decipher stability of many clusters, all-metal compounds and solid states. Here we present chemical bonding model for recently synthesized highly aesthetic intermetalloid cluster [Pd3Sn8Bi6]4−. We found pattern based on spherical aromaticity consistent with Hirsch 2(n + 1)2 rule and responsible for bonding of Pd3 internal triangle to the external Sn-Bi cage. Spherical aromatic clusters are also referred as superatoms and due to their persistency are of primary interest for material science and nanotechnology. We also included brief guidelines how to decipher bonding pattern in complicated cases like [Pd3Sn8Bi6]4− into SI.
OR14I1 is a receptor for the human cytomegalovirus pentameric complex and defines viral epithelial cell tropism.

A human cytomegalovirus (HCMV) pentameric glycoprotein complex (PC), gH–gL–UL128–UL130–UL131A, is necessary for viral infection of clinically relevant cell types, including epithelial cells, which are important for interhost transmission and disease. We performed genome-wide CRISPR/Cas9 screens of different cell types in parallel to identify host genes specifically required for HCMV infection of epithelial cells. This effort identified a multipass membrane protein, OR14I1, as a receptor for HCMV infection. This olfactory receptor family member is required for HCMV attachment, entry, and infection of epithelial cells and is dependent on the presence of viral PC. OR14I1 is required for AKT activation and mediates endocytosis entry of HCMV. We further found that HCMV infection of epithelial cells is blocked by a synthetic OR14I1 peptide and inhibitors of adenylate cyclase and protein kinase A (PKA) signaling. Identification of OR14I1 as a PC-dependent HCMV host receptor associated with epithelial tropism and the role of the adenylate cyclase/PKA/AKT–mediated signaling pathway in HCMV infection reveal previously unappreciated targets for the development of vaccines and antiviral therapies.
Fluorescent dye adsorption in aqueous suspension to produce tagged cellulose nanofibers for visualization on paper

Cellulose nanofibers (CNFs) have great potential to be a layer in packaging materials because of their good barrier properties. When paper is coated with CNFs, they are difficult to distinguish from the base sheet. This issue creates challenges when trying to determine where CNFs migrate relative to the paper fibers during coating and drying. A three-dimensional analysis is possible by using confocal laser scanning microscopy (CLSM) if CNFs can be tagged with fluorescently active groups. In this study, CNFs were fluorescently tagged through adsorption of fluorescent dyes such as fluorescein isothiocyanate (FITC) and thioflavin by mixing with CNFs in their native suspension followed by purification. The adsorbed dye remained attached during typical coating procedures, low pH values, and high ionic strengths, but not for high pH and in contact with acetone. CNFs were also covalently tagged with FITC following methods reported in the literature as a comparison to already established methods for tagging cellulose nanocrystals. Images of never dried samples indicated that covalently tagging CNFs altered the state of the fines dispersion, while dye adsorption did not. Coatings of the adsorbed dye tagged CNFs on paper were successfully imaged by CLSM since the concentration of dye in the water phase was low enough to provide a good contrast between regions of CNFs and paper. With this method, the location and potential migration of CNFs coated on paper were successfully determined for the first time to the best of our knowledge. CNF based coatings with solids larger than 2.8% were found to have a distinct layer of CNFs at the paper surface with little CNFs penetrating into the paper structure, but lower solids result in significant penetration into the paper.
Association of sex, age and education level with patient reported outcomes in atrial fibrillation

In atrial fibrillation (AF), there are known sex and sociodemographic disparities in clinical outcomes such as stroke. We investigate whether disparities also exist with respect to patient-reported outcomes. We explored the association of sex, age, and education level with patient-reported outcomes (AF-related quality of life, symptom severity, and emotional and functional status). The PaTH AF cohort study recruited participants (N = 953) with an AF diagnosis and age ≥ 18 years across 4 academic medical centers. We performed longitudinal multiple regression with random effects to determine if individual characteristics were associated with patient-reported outcomes. Women reported poorer functional status (β − 2.23, 95% CI: -3.52, − 0.94) and AF-related quality of life (β − 4.12, 95% CI: -8.10, − 0.14), and higher symptoms of anxiety (β 2.08, 95% CI: 0.76, 3.40), depression (β 1.44, 95% CI: 0.25, 2.63), and AF (β 0.29, 95% CI: 0.08, 0.50). Individuals < 60 years were significantly (p < 0.05) more likely to report higher symptoms of depression, anxiety, and AF, and poorer AF-related quality of life. Lack of college education was associated with reporting higher symptoms of AF (β 0.42, 95% CI: 0.17, 0.68), anxiety (β 1.86, 95% CI: 0.26, 3.45), and depression (β 1.11, 95% CI: 0.15, 2.38), and lower AF-related quality of life (β − 4.41, 95% CI: -8.25, − 0.57) and functional status. Women, younger adults, and individuals with lower levels of education reported comparatively poor patient-reported outcomes. These findings highlight the importance of understanding why individuals experience AF differently based on certain characteristics.
“Japanese Buddhism”: Constructions and Deconstructions

This essay provides a critical analysis of the concept “Japanese Buddhism.” “Japanese Buddhism” is an inherently ambiguous phrase, and this allows it to conceal a host of problematic theoretical commitments. On the one hand, the phrase is relatively bland—a mere locative identifying the various forms of Buddhism found in Japan. On the other, however, it can be used with a different kind of adjectival intent, identifying a unique kind of Buddhism, a Buddhism that is Japanese. In contrast, the expression “Buddhisms of Japan” is explicitly employed as an alternative to “Japanese Buddhism.” These usages are intentional—not simply a matter of stylistics, but serving meta-theoretical ends. In fact, it is in this realm of meta-theory that the following critique of three prominent approaches to the study of the thought and practice of the Buddhisms of Japan—one theoretical and two disciplinary—is leveraged. The distinction between theoretical and disciplinary creates something of an unbalanced structure in the following, since the theoretical issue—the tendency to essentialize “Japanese Buddhism” in one way or another—is common to both of the disciplinary approaches examined here, that is, comparative philosophy and comparative religion. It is necessary to subvert the very idea that there is any one correct way to represent Japanese Buddhism against which other representations may be judged. Such a project is necessarily doomed to failure. This is clear once we shift our understanding of the referent of the phrase “Japanese Buddhism.” Rather than having any fixed referent, whether as a Platonic ideal form, a natural kind, or a class noun, it is a social construction, one that operates within a sociology or economy of knowledge. To presume that “Japanese Buddhism” has a fixed referent, an ahistorical essence or a transhistorical identity, that can be represented, conceals the role of selection underlying the referent. In other words, “Japanese Buddhism” is not something discovered but, rather, something made, an artifact of both popular and academic discourse. Such a claim, of course, does not imply that there are not indefinitely many things that can be pointed to stipulatively as instances of Japanese Buddhism. Indeed, the constructed nature of the concept is indicated by this overwhelming number of possible stipulative referents and the plurality of ways in which they can be grouped and categorized.
Attention-Deficit Hyperactivity Disorder, Disruptive Behaviors, and Drug Shortage.

CASE Kyle is a 10-year-old boy with Down syndrome and intellectual disability who is being followed up by a developmental behavioral pediatrician for attention-deficit hyperactivity disorder (ADHD) and anxiety. Kyle was initially taking a long-acting liquid formulation of methylphenidate for ADHD and fluoxetine for anxiety. Several months ago, the liquid formulation was on back order, and the methylphenidate formulation was changed to an equal dose of a long-acting capsule. Kyle is not able to swallow pills; therefore, the contents of the capsule were sprinkled onto 1 bite of yogurt each morning. Over the course of the next month, Kyle's behaviors became increasingly difficult. He was not able to tolerate loud or crowded places, and despite a visual schedule and warnings, he would become aggressive toward adults when directed to transition away from preferred activities. Fluoxetine was increased from 0.4 to 0.6 mg/kg/day at that time.One month later, his parents reported that although there may have been slight improvement in Kyle's irritability since the increase in fluoxetine, they felt he was nonetheless more aggressive and less cooperative than his previous baseline. Kyle was returned to the long-acting liquid formulation of methylphenidate at that time, and a follow-up was scheduled 2 weeks later.On return to clinic, his parents reported that Kyle's behaviors had continued to become increasingly difficult. He was described as uncooperative and aggressive at home and school. Kyle was easily upset any time he was not given his way, his behavior was corrected, or he felt that he was not the center of attention. When upset, he would yell, bite, kick, spit, or throw his body to the ground and refuse to move. At 110 pounds, Kyle's parents were no longer able to physically move his body when he dropped to the ground. This was a safety concern for his parents because he had displayed this behavior in the parking lot of a busy shopping area. Because of Kyle's aggressive and unpredictable behavior, parents no longer felt comfortable taking him to public places. Family members who had previously been comfortable staying with Kyle while his parents were out for short periods would no longer stay with him. Overall, the behaviors resulted in parents being unable to go to dinner as a couple or provide individual attention to their other children. The parents described the family as "on edge." How would you approach Kyle's management?
Measuring common knowledge: latent semantic analysis, linguistic synchrony, and common knowledge in international relations:

Common knowledge, also called intersubjectivity, is a core theme in the study of international cooperation and diplomacy. Yet International Relations (IR) lacks a method to systematically measure t...
Representation of equatorial waves by a single scalar field and the effect of the horizontal component of the Earth's rotation

A new representation for equatorial waves in terms of a single scalar field is used to demonstrate the influence of the (usually neglected) horizontal component of the earth's rotation vector $\boldsymbol{\vec\Omega}$ on the dispersion of the waves. It is shown that, in the case of constant Brunt-Vaisala frequency $N$, the dispersion relation is unaltered when the horizontal component of $\boldsymbol{\vec\Omega}$ is included.
Fragmentation or Diversification? Ethnoracial Change and the Social and Economic Heterogeneity of Places

Our study investigates the diversification and fragmentation theses, fueled by claims that greater diversity is reshaping the social fabric of American life and that the United States is an increasingly fragmented nation. We take a multidimensional view of heterogeneity that considers whether growing ethnoracial diversity within U.S. communities (i.e., incorporated and unincorporated places) has resulted in the consolidation or differentiation of demographic, sociocultural, and economic distinctions between 1980 and 2010. As communities have become more ethnoracially diverse, they have become more heterogeneous in language and nativity-two characteristics tied closely to Latino and Asian population growth. However, ethnoracial diversity within communities is only weakly associated with household, age, educational, occupational, or income heterogeneity despite large racial/ethnic differences in these characteristics nationally. This trend does not apply to all forms of ethnoracial diversity equally: Hispanic and especially Asian population growth is more likely to generate community sociodemographic and economic heterogeneity than is black population growth. Consistent with the fragmentation hypothesis, we also find that broader geographic context matters, with more ethnoracially diverse metropolitan and micropolitan areas experiencing reduced social and economic heterogeneity inside their constituent places. We conclude by discussing the social implications of these patterns for intergroup relations, spatial exclusion, and ethnoracial inequality.
Transcranial Direct Current Stimulation Over the Prefrontal Cortex in Depression Modulates Cortical Excitability in Emotion Regulation Regions as Measured by Concurrent Functional Magnetic Resonance Imaging: An Exploratory Study

Abstract Background A well-established impaired top-down network for effortful emotion regulation (ER) in major depressive disorder (MDD) includes the dorsal and ventromedial prefrontal cortex (PFC) and the amygdala. Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation method that has been used successfully to induce mood changes in MDD. Despite reliable findings, little is known regarding the precise effects of tDCS on cortical excitability in vivo in depression and how such changes relate to ER. Here, we addressed this question by combining—for the first time in a psychiatric sample—tDCS with functional magnetic resonance imaging in a single-blind randomized design. Methods We applied anodal tDCS over the left PFC (area F3 per the 10/20 system) together with cathodal tDCS over the right PFC (F4) or sham tDCS during functional magnetic resonance imaging in patients with moderate to severe MDD (n = 20) and gender- and age-matched control subjects (n = 20). Participants performed 2 runs of an ER task prior to tDCS and 2 runs of the task during tDCS, which was administered at 1.5 mA with 5-cm × 5-cm electrodes. Results Whole-brain, region of interest, and connectivity analyses revealed an impaired ER network in patients with MDD prior to stimulation. Active anodal tDCS over the left (with concurrent cathodal stimulation of the right) PFC during reappraisal of negative stimuli upregulated activity in ventromedial PFC, which was predictive of gains in reappraisal performance during stimulation for the patients with MDD. Conclusions The results of this study offer insights into the mechanisms of action of tDCS and support its potential as a treatment for depression.
Association of ABO blood group with survival following pancreatoduodenectomy for pancreatic ductal adenocarcinoma.

Abstract Background Existing research suggests patients with blood group O are less likely to develop pancreatic ductal adenocarcinoma (PDAC) compared to those with non-O blood groups, and that survival from PDAC may be affected by ABO blood type. This study assessed survival outcomes in PDAC patients who underwent pancreatoduodenectomy (PD) in one health system. Methods From 2010 to 2017, demographic, operative, chemotherapy and survival data for patients undergoing PD at Emory Healthcare were reviewed. Patients with blood type AB were excluded due to small sample size. The relationship between ABO blood group and survival was analyzed using Kaplan–Meier survival curves and multivariate cox proportional regression analysis. Results Of 449 PDAC patients assessed, 204 (45.4%), 60 (13.4%) and 185 (41.2%) were blood groups A, B and O, respectively. Patients were well matched in clinicopathologic characteristics. Median survival did not differ by blood group (p = 0.82), and this relationship remained insignificant on cox regression analysis (p = 0.15). On multivariate analysis, lymph node positivity (p Conclusion In contrast to recent reports, this larger study found that blood group did not impact overall survival among patients undergoing PD for PDAC.
Clinician Recognition of the Acute Respiratory Distress Syndrome: Risk Factors for Under-Recognition and Trends Over Time.

OBJECTIVES The acute respiratory distress syndrome is common in critically ill patients. Recognition is crucial because acute respiratory distress syndrome is associated with a high mortality rate, and low tidal volume ventilation improves mortality. However, acute respiratory distress syndrome often goes unrecognized. Risk factors for under-recognition and trends over time have not been fully described. DESIGN Retrospective chart review of patients with acute respiratory distress syndrome from a prospective cohort study of critically ill patients. For each patient's ICU stay, we searched the chart for terms that indicated that acute respiratory distress syndrome was diagnosed, in the differential diagnosis, or treated with low tidal volume ventilation. SETTING ICUs at a tertiary hospital at the University of California, San Francisco between 2008 and 2016. PATIENTS Critically ill patients with acute respiratory distress syndrome. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Acute respiratory distress syndrome was recognized in 70% of patients, and recognition increased from 60% in 2008-2009 to 92% in 2016 (p = 0.004). Use of tidal volumes less than 6.5 mL/kg also increased (p < 0.001) from 20% to 92%. Increased acute respiratory distress syndrome severity (p = 0.01) and vasopressor use (p = 0.04) were associated with greater recognition. Clinician diagnosis of acute respiratory distress syndrome and inclusion of acute respiratory distress syndrome in the differential diagnosis were associated with tidal volumes less than 6.5 mL/kg (51% use of tidal volume ≤ 6.5 mL/kg if acute respiratory distress syndrome recognized vs 15% if not recognized; p = 0.002). Diagnosing acute respiratory distress syndrome was associated with lower tidal volume in multivariate analysis. CONCLUSIONS Although acute respiratory distress syndrome recognition and low tidal volume ventilation use have increased over time, they remain less than universal. Clinician recognition of acute respiratory distress syndrome is associated with both systemic and respiratory severity of illness and is also associated with use of low tidal volume ventilation.
Teaching in an Orientation and Mobility Program for Chinese Special Educators.

Since China has a favored-nation status, there has been an increase in the exchange of information between the United States and China over the past few years. Through the joint efforts of these tw...
Comparative Genomics of Spruce and Other Gymnosperms

In contrast to flowering plants, the genomes of gymnosperms are still poorly understood. Current knowledge on the genomic architecture, gene space, and macrostructure of gymnosperm genomes mainly comes from Pinaceae species, in which spruce species (genera with most sequenced genomes to date) had played a significant role. Whereas the accumulation of nuclear genomes’ sequence information has followed a slow pace, the sequencing of chloroplast genomes skyrocketed in the last 10 years, with many spruce species sequenced so far. From the comparison of nuclear, mitochondrial, and chloroplast genomes, we can conclude that they all differ in their genomic macrostructure and rates of sequence evolution. The high structural conservation among species, genera, and families is characteristic of nuclear genomes, whereas chloroplast and mitochondrial genomes show less conserved structures due to genomic arrangements. Finally, Picea species follow trends observed in other gymnosperms and angiosperms, in which rates of sequence evolution are the highest in nuclear DNA, followed by chloroplast and then mitochondrial DNA.
Secondary Data Usage in Direct-to-Consumer Genetic Testing: To What Extent Are Customers Aware and Concerned?

Introduction Customer data from direct-to-consumer genetic testing (DTC GT) are often used for secondary purposes beyond providing the customer with test results. Objective The goals of this study were to determine customer knowledge of secondary uses of data, to understand their perception of risks associated with these uses, and to determine the extent of customer concerns about privacy. Methods Twenty DTC GT customers were interviewed about their experiences. The semi-structured interviews were transcribed, coded, and analyzed for common themes. Results Most participants were aware of some secondary uses of data. All participants felt that data usage for research was acceptable, but acceptability for non-research purposes varied across participants. The majority of participants were aware of the existence of a privacy policy, but few read the majority of the privacy statement. When previously unconsidered uses of data were discussed, some participants expressed concern over privacy protections for their data. Conclusion When exposed to new information on secondary uses of data, customers express concerns and a desire to improve consent with transparency, more opt-out options, improved readability, and more information on future uses and potential risks from direct-to-consumer companies. Effective ways to improve readership about the secondary use, risk of use, and protection of customer data should be investigated and the findings implemented by DTC companies to protect public trust in these practices.
Hedge Fund Replication: A Model Combination Approach

Recent years have seen increased demand from institutional investors for passive replication products that track the performance of hedge fund strategies using liquid investable assets such as futures contracts. In practice, linear replication methods suffer from poor tracking performance and high turnover. We propose a model combination approach to index replication that pools information from a diverse set of pre-specified factor models. Compared with existing methods, the pooled clone strategies yield consistently lower tracking errors, generate less severe portfolio drawdowns, and require substantially smaller trading volume. The pooled hedge fund clones also provide economic benefits in a portfolio allocation context.
High temperature extinction of premixed flames

The far field of a stretched premixed flame with A→B⇄C kinetics is studied. Each of the reaction rates are assumed to be proportional to the mass fraction of the reactants and have a temperature dependence that is continuous, positive, and vanishes at both infinite and zero absolute temperature. Arrhenius reaction rate functions are examples that satisfy these requirements. Bounds are uncovered for the amount of blowing from behind the flame that plane premixed flames can withstand for all Lewis numbers when the intermediate species are lighter than the deficient reactant. When the intermediate products are heavier than the deficient reactant, bounds on the blowing are found when the Lewis number of the deficient reactant is less than one.
Gumbel's Extreme Value I Distribution: A New Look

Many basic hydrologic textbooks, following Gumbel’s original work, advocate use of frequency factors dependent on an integer m for estimation of event levels using the Extreme Value I distribution. Although Gumbel recommended use of m = n, the sample size, it is shown that this choice results in poor estimates, which are much improved by use of m = ∞\N. This is equivalent to use of the population values. Thus, use of m-dependent tables of frequency factors is misleading and should be avoided. It is also shown that a biased variance estimate (n divisor) yields slightly better estimates of extremes, both in terms of variability and bias, than does the unbiased (n-1 divisor) estimate usually advocated. Finally, modest improvements in estimates, most significant for large return periods and small sample sample sizes, are shown to result from use of maximum likelihood parameter estimators in favor of the best moment estimators.
Heredity, stress and blood pressure, a family set method—III: Family aggregation of hypertension☆

Abstract This third article, in a series of five, examines the role of family aggregation of hypertension. A family set sample composed of index, sib, first cousin and unrelated persons, for both black and white families, is used for this analysis. Results indicate that diastolic and systolic hypertension aggregate in family sets, but only weakly. Comparison of the observed proportions of diastolic and systolic hypertension among the relatives of hypertensive index cases with the expected proportions fails to support a dominant or recessive genetic model; a threshold model fits diastolic pressure better than systolic, which shows a poor fit, but even here discrepancies in siblings exist. Neither differences in residential environments nor race appear significant in this analysis. Results suggest that prior studies may have overestimated the genetic contribution to blood pressure, possibly by confounding of age and temporal changes.
The Wealth-Consumption Ratio: A Litmus Test for Consumption-based Asset Pricing Models

The volatility of the price-dividend ratio on stocks, the predictability of stock returns, and the lack of predictability in dividend growth are commonly interpreted as evidence of substantial time-variation in risk premia. We construct the wealth-consumption ratio for the U.S., the price-dividend ratio on total wealth. We show that it is at least five times less volatile than the price-dividend ratio on stocks. The wealth-consumption ratio encodes information about conditional market prices of risk, and hence about asset prices. Matching its properties is a litmus test for consumption-based asset pricing models. Models that match the predictability of equity returns impute too much predictability to total wealth returns and hence too much volatility to the wealth-consumption ratio, because they rely on time variation in the risk premium on total wealth. The smoothness of the wealth-consumption ratio suggests that there may be less time-variation in market prices of risk than commonly inferred from equity prices alone.
Clinically Diagnosed Acute Diverticulitis in Outpatients: Misdiagnosis in Patients with Irritable Bowel Syndrome

Physicians often diagnose diverticulitis and prescribe antibiotics in outpatients with abdominal pain and tenderness without other evidence. We investigated the misattribution of irritable bowel syndrome (IBS) symptoms to diverticulitis in outpatients. In patients diagnosed with diverticulitis and dispensed antibiotics in an integrated healthcare system, we retrospectively compared 15,846 outpatients managed without computed tomography (CT) versus 3750 emergency department/inpatients who had CT. We assessed demographics and past history, including 17 symptom-based somatic and 11 mental disorders and three somatic–mental comorbidity pairs (dyads) coded over 3 years and seven drug classes dispensed over 1 year before diagnosis. Univariate analysis showed small intergroup demographic differences. Outpatients had increases in prior diverticulitis, including outpatient-managed episodes, total somatic diagnoses (p < .0001), eight somatic and three mental disorders (p ≤ .015), all three dyads (p ≤ .05), and dispensing of three drug classes (p ≤ .016). IBS had been diagnosed in 2399 (15.1 %) outpatients versus 361 (9.6 %) emergency department/inpatients (p < .0001), the greatest increase in any comorbidity. Emergency department/inpatients had no somatic comorbidity more often but more alcohol dependence, non-dependent drug abuse, and opioid dispensing (p ≤ .05). Regression analysis revealed outpatient care was independently positively associated with younger age, non-Hispanic white race/ethnicity, less Charlson comorbidity, diverticulitis history, IBS, chest pain, dyspepsia, fibromyalgia, low back pain, migraine, acute reaction to stress, and antispasmodic and anxiolytic dispensing and negatively associated with non-dependent drug abuse and opioid dispensing (p ≤ .0226). Multiple types of indirect and concordant evidence suggest misattribution of IBS pain to diverticulitis and unnecessary antibiotic therapy in outpatients.
Tracking Mental Well-Being: Balancing Rich Sensing and Patient Needs

Serious mental illnesses are among the most pressing public healthcare concerns. Continuous and unobtrusive sensing of social and physical functioning has tremendous potential to support lifelong health management by acting as an early warning system to detect changes in mental well-being, delivering context-aware micro-interventions to patients when and where they need them and significantly accelerating patients' understanding of their illness.
Two Biblical Models of Conversion: An Example of Puritan Hermeneutics

Puritan religious experience centered around conversion, the soul's new birth in faith. Entry into the realm of the Spirit, the path to salvation, involved a protracted emotional confrontation with grace borne in God's Word. The injunction to begin life anew in grace is as old as John 3:3, which declares that one “cannot see the kingdom of God” without being “born again” but does not associate the event with any particular psychological experience; what one undergoes in becoming a child of the Spirit the gospel does not relate. Into this gap of possibility Puritan preachers insinuated their vision of holy passions; well known as physicians of the soul, they pieced together a compelling model of how the Spirit moves a human being as it translates individuals from the estate of damnation to that of grace.
Rapid extraction and solubilization of potato starch with Dimethylsulfoxide

Dimethyl sulfoxide (DMSO) solubilization of starch from lyophilized potato tissue is equally quantitative and more convenient than solubilization in dilute alkali, especially when analysis of a large number of samples is necessary. Starch extraction with DMSO decreases the handling time of each sample by eliminating sonication, filtration, and centrifugation steps required by the NaOH solubilization technique.
A review of `contact recording' technologies

Different approaches toward contact recording are reviewed from the point of view of tribology and their placement on the Stribeck diagram. The various approaches are evaluated critically, and the most practical implementations of these approaches are discussed. It is concluded that a partial air bearing/partial contact approach is the most feasible implementation to succeed.
Use and abuse of internal evaluation

Although there are many advantages of internal evaluation, there are also disadvantages, the most serious of which is potential misuse by managers who want evaluations to appear to objectively support decisions that have already been made.
Elicitation of primary anti-Sendai virus cytotoxic T lymphocytes with purified viral glycoproteins

The requirement of integration of viral proteins into cell surface membranes of host cells for elicitation of anti-Sendai virus (SV) cytotoxic T lymphocytes (CTL) has been investigated. The purified hemagglutinin-neuraminidase (HN) and fusion (F) glycoproteins of SV incorporated into phospholipid vesicles was used to analyze this question. Phospholipid vesicles possessing an active HN and F glycoprotein were capable of eliciting both anti-SV CTL and antibodies. However, the incorporation of an inactive F glycoprotein into HN-containing vesicles or its absence from such vesicles resulted in stimulation of only anti-SV antibodies and not anti-SV CTL.
Mind the Child: Using Interactive Technology to Improve Child Involvement in Decision Making About Life-Limiting Illness

The approach to advance care planning and, as part of this process, the development of advance care directives has been an important topic of discussion and debate in the care of adults at the end ...