cssi/SciSciGPT-SciSciNet huggingface dataset:
Evolution, Current Structure, and Role of a Primary Care Clinical Pharmacy Service in an Integrated Managed Care Organization

The impact of the declining number of primary care physicians is exacerbated by a growing elderly population in need of chronic disease management. Primary care clinical pharmacy specialists, with their unique knowledge and skill set, are well suited to address this gap. At Kaiser Permanente of Colorado (KPCO), primary care clinical pharmacy specialists have a long history of integration with medical practices and are located in close proximity to physicians, nurses, and other members of the health care team. Since 1992, Primary Care Clinical Pharmacy Services (PCCPS) has expanded from 4 to 30 full-time equivalents (FTEs) to provide services in all KPCO medical office buildings. With this growth in size, PCCPS has evolved to play a vital role in working with primary care medical teams to ensure that drug therapy is effective, safe, and affordable. In addition, PCCPS specialists provide ambulatory teaching sites for pharmacy students and pharmacy residents. There is approximately 1 specialist FTE for every 13,000 adult KPCO members and every 9 clinical FTEs of internal medicine and family medicine physicians. All clinical pharmacy specialists in the pharmacy department are required to have a PharmD degree, to complete postgraduate year 2 residencies, and, as a condition of employment, to become board certified in an applicable specialty. The evolution, current structure, and role of PCCPS at KPCO, including factors facilitating successful integration within the medical team, are highlighted. Patient and nonpatient care responsibilities are described.
Novel Clostridium botulinum Toxin and Dual Use Research of Concern Issues

(See the major articles by Barash and Arnon on pages 183–91 and Dover et al on pages 192–202, and the editorial commentaries by Popoff on pages 168–9 and Relman on pages 170–2.)
Disulfide Bond Formation in the Herpes Simplex Virus 1 UL6 Protein Is Required for Portal Ring Formation and Genome Encapsidation

The herpes simplex virus 1 (HSV-1) UL6 portal protein forms a 12-subunit ring structure at a unique capsid vertex which functions as a conduit for the encapsidation of the viral genome. We have demonstrated previously that the leucine zipper region of UL6 is important for intersubunit interactions and stable ring formation (J. K. Nellissery, R. Szczepaniak, C. Lamberti, and S. K. Weller, J. Virol. 81:8868–8877, 2007). We now demonstrate that intersubunit disulfide bonds exist between monomeric subunits and contribute to portal ring formation and/or stability. Intersubunit disulfide bonds were detected in purified portal rings by SDS-PAGE under nonreducing conditions. Furthermore, the treatment of purified portal rings with dithiothreitol (DTT) resulted in the disruption of the rings, suggesting that disulfide bonds confer stability to this complex structure. The UL6 protein contains nine cysteines that were individually mutated to alanine. Two of these mutants, C166A and C254A, failed to complement a UL6 null mutant in a transient complementation assay. Furthermore, viral mutants bearing the C166A and C254A mutations failed to produce infectious progeny and were unable to cleave or package viral DNA. In cells infected with C166A or C254A, B capsids were produced which contained UL6 at reduced levels compared to those seen in wild-type capsids. In addition, C166A and C254A mutant proteins expressed in insect cells infected with recombinant baculovirus failed to form ring structures. Cysteines at positions 166 and 254 thus appear to be required for intersubunit disulfide bond formation. Taken together, these results indicate that disulfide bond formation is required for portal ring formation and/or stability and for the production of procapsids that are capable of encapsidation.
Seasonal cycles of abundance in zooplankton populations of Yaquina Bay, Oregon

Descriptions of the seasonal cycles of abundance of the dominant zooplankters of Yaquina Bay, Oregon, USA, are derived from a 7 year series of net samples taken at two downstream stations. The summer dominants are forms distributed to the north, along the American coast. Winter dominants have sonthern affinities. This cycle is associated with the annual cycle of coastal surface currents: from north to south in summar, reversed in winter. There are no persistent trends in the abundance data from year-to-year.
A three point algorithm for attitude and range determination using vision

In this paper we discuss the development of a vision-based algorithm to determine the relative position and orientation of an aircraft with respect to a ship which has three visible points with known separation distances. Results of both a simulation and processed aircraft video data are also presented. The potential application for the results presented is vision-based autonomous shipboard landing by an unmanned air vehicle.
Diabetic Day Setting Goals for a Child-Directed Ambulatory Program

The techniques of management by objective have been used to coordinate and evaluate the activities of a non-traditional program for the medical care and education of children with juvenile diabetes mellitus. "Diabetic Day" is an ambulatory child-directed clinic program in which health professionals work together to improve the child's ability to cope with diabetes.
Hemodynamic Basis of Mitral E Transmission in the Left Ventricular Cavity and Its Relation to the Left Ventricular Relaxation Process

Mitral E-wave transit time to the left ventricular outflow tract was measured as an E-Er interval in 30 subjects undergoing cardiac catheterization. The E-Er interval (range 30 to 190 ms) correlated with left ventricular peak negative dP/dt (r = -0.62, p = 0.0003) and tau (r = 0.74, p <0.0001) but not with left ventricular minimum, pre-A-wave, or end-diastolic pressures. We conclude that the E-Er interval is an easily obtainable Doppler measurement that reflects the left ventricular relaxation process.
On variable overlapped windows and weighted orthonormal bases

A generalized lapped orthonormal transform (GLOT) formulation is presented for the analysis and synthesis of signals. This formulation is composed of a variable width window and a linear combination of weighted orthonormal functions. Tradeoffs in the specification of windows are examined. A sinusoidal example is considered, and a fast algorithm is provided for its evaluation. >
Smart data pricing: using economics to manage network congestion

Economic incentives that alleviate congestion for Internet customers can also improve business performance for network operators.
The relative effect of hospital and surgeon volume on failure to rescue among patients undergoing liver resection for cancer.

Background Although previous reports have focused on factors at the hospital level to explain variations in postoperative outcomes, less is known regarding the effect of provider-specific factors on postoperative outcomes such as failure-to-rescue (FTR) and postoperative mortality. The current study aimed to quantify the relative contributions of surgeon and hospital volume on the volume–outcomes relationship among a cohort of patients undergoing liver resection. Methods Patients undergoing liver surgery for cancer were identified using the Nationwide Inpatient Sample from 2001 and 2009. Multivariable logistic regression analysis was performed to identify factors associated with mortality and FTR. Point estimates were used to calculate the relative effects of hospital and surgeon volume on mortality and FTR. Results A total of 5,075 patients underwent liver surgery and met inclusion criteria. Median patient age was 62 years (interquartile range, 52–70) and 55.2% of patients were male. Mortality was lowest among patients treated at high-volume hospitals and among patients treated by high-volume surgeons (both P Conclusion The risk of complications, mortality, and FTR were less among both high-volume hospitals and high-volume surgeons, but the beneficial effect of volume on outcomes was attributable largely to surgeon volume.
Effects of fludrocortisone on water and sodium intake of C57BL/6 mice

Little is known about steroidal control of thirst- and salt-appetite behaviors of mice. The current study investigates effects of fludrocortisone acetate (FCA), a steroid with potent glucocorticoid and mineralocorticoid effects, on thirst- and salt-appetite responses of C57BL/6 mice. Treatment with FCA produced dose-dependent (5, 10, and 25 mg/kg) increases in both magnitude and duration of water and sodium intake. Chronic elevation of water and saline intake was achieved with daily injections of FCA. Daily injection of FCA, when only 0.9% saline was available, produced a remarkably rapid increase in saline intake. A single injection of FCA stimulated brisk diuresis and natriuresis in fluid-restricted animals. This work is the first to demonstrate copious water drinking by mice in response to FCA. The results are discussed in terms of the possibility that the renal effects of FCA promote increases in water and sodium turnover and thereby, increases in water and sodium ingestion.
Field verification and data analysis of high PV penetration impacts on distribution systems

This paper describes a methodology for field evaluation of large PV system impacts on distribution systems based on data collected from several phasor measurement devices deployed on two distribution feeders. The method utilizes a series of performance indicators and pattern trending approaches to process large amounts of granular data gathered from fielded data acquisition instruments (1 second GPS time-synchronized phasor measurements). A summary of key observations and findings from data analysis approach and field verified effects are provided in the paper to explain key operational concerns and future design challenges. The approach mainly focuses on analysis of voltage and current profiles of distribution feeders at primary feeder level (e.g. 12 kV) for various daily and seasonal conditions to identify and evaluate events with adverse power quality impacts. Event categories are proposed and used to classify types of events based on the level of severity in the range or rate of voltage or frequency variations. The proposed approach was proven to be very effective to investigate field issues and to capture events.
Cuff-associated errors of blood pressure recording in infants and toddlers.

As commercially available cuffs are unsatisfactory, systolic blood pressure (BP) was measured in 88 children aged < 4 years using a conventional Velcro self-adhesive cuff with inflatable bladder. Results were compared with the “separate bladder” method (where the inflatable bladder is wrapped around the arm and is held by a separate Velcro-band), the Pedisphyg cuff and, in 10 patients, with intra-arterial recording. The last 3 methods gave nearly identical results. In contrast, conventional cuffs with a 4 cm and a 5.5 cm wide bladder considerably over-estimated systolic BP, by 13.3 mm Hg (range -2 to 30) for bladder width 4 cm, and by 13.1 mm Hg (range 4 to 22) for bladder width 5.5 cm, respectively. The conventional bladder-cuff thus yields grossly inaccurate results in young children and should be replaced by an alternative method, e.g. the “separate bladder”.
Increase in Surface Expression of ICAM-1, VCAM-1 and E-Selectin in Human Cerebromicrovascular Endothelial Cells Subjected to Ischemia-Like Insults

Secondary ischemic brain injury has been shown to develop as a consequence of inflammation and vasogenic brain edema. In this study we show that inflammatory cytokines and simulated in vitro ischemia stimulate the surface expression of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and endothelial-leukocyte adhesion molecule-1 (E-selectin) in human cerebromicrovascular endothelial cells (HCEC) in culture. The levels of all three adhesion molecules were dramatically (3 to 10-fold) up-regulated by 4-24 hour exposure to the inflammatory cytokines. IL-1 beta (10-200 u/ml) or TNF alpha (50 200 u/ml), and by a 4 hour exposure to "simulated" in vitro ischemia, as determined by immunocytochemistry and ELISA. Following 24 hours of subsequent reperfusion, the expression of ICAM-1 and VCAM-1 was maintained at ischemia-induced levels, whereas E-selectin was no longer detectable. Both the cytokine- and ischemia-induced up-regulation of adhesion molecules were completely abolished by the transcriptional inhibitor, actinomycin D (10 micrograms/ml), and inhibited by the cycloxygenase (COX) inhibitor, indomethacin (300 microM). These findings implicate HCEC in the processes of leukocyte adhesion and recruitment in the brain during stroke in vivo.
Regional variation in resistance artery diameter responses to alpha-adrenergic stimulation during pregnancy.

Whole animal pressor responses are blunted during pregnancy; yet, uterine arteries, paradoxically, become significantly more sensitive to the constrictor effects of phenylephrine (PE). The objectives herein were to investigate 1) the regional variation (uterine vs. mesenteric arteries) in dose-lumen diameter relationship to alpha-adrenergic stimulation during pregnancy, and 2) the selectivity of these sensitivity shifts for this pathway (PE vs. KCl). Lumen diameter was measured in isolated, pressurized (50 mmHg) arterial segments from age-matched virgin (nonpregnant; NP) and late pregnant (LP; days 19-20) Sprague-Dawley rats. Uterine arcuate vs. mesenteric arteries from NP rats were equally sensitive to either vasoconstrictor. Arcuate arteries from LP rats, however, were 4.5-fold more sensitive to PE (P or = 0.1 microM, even though initial diameter of arcuate arteries from LP rats was significantly larger (P < 0.001). Conversely, mesenteric arteries from LP rats were three-fold less sensitive to PE (P < 0.02), and the diameter curve displayed a corresponding parallel rightward shift. Pregnancy did not affect the sensitivity to KCl depolarization in either arcuate or mesenteric arteries. The percent reduction in lumen diameter to the maximum [KCl] was significantly decreased only in arcuate arteries from LP rats (P < 0.001). Thus, during pregnancy, divergent constrictor responses specific to alpha-adrenergic stimulation occur in resistance arteries from the uterine vs. splanchnic circulations. Consequently, concentrations of PE that are subthreshold in NP uterine arteries can elicit large changes in lumen diameter and thereby have a pronounced effect on uterine vascular resistance in the pregnant state.
Domestic Violence and the Need for an International Legal Response

In this Article I propose that an international instrument obliging States to take preventive, protective and punitive measures would prove effective in condemning and combating domestic violence world wide. Specifically, this article argues that i) domestic violence (hereinafter DV) is a universal problem that demands attention from the international community, ii) there is a ever growing trend internationally and in national forums to recognize the severity and prescribe legal measures to tackle the problem, and iii) An international instrument devoted exclusively to addressing the causes, consequences and remedial measures for situations involving DV is the right course at this time to address this silent epidemic.
Fluorescent studies on the potential existence of vascular metallic immune complexes.

Abstract Renal arteriolar thickening, which occurs in response to the presence of cadmium ions, was investigated by fluorescent microscopy. In an acridine orange-stained preparation of the rat kidney, positive fluorescence was observed in the media of renal arterioles following longterm implantation of cadmium wire into the cortex, but was absent in animals similarly treated with copper wire or plastic. The presence of lymphocytic foci around the thickened vessels in cadmium-containing kidneys, together with recent evidence pointing to an association of RNA with immune complex formation, would suggest that the vascular thickening in the presence of cadmium ions is attributable, at least in part, to the mural location of a metallicoriginated immune complex.
Myosin Heavy Chain Composition and Fiber Size of the Cricopharyngeus Muscle in Patients with Achalasia and Normal Subjects

Objectives:Cricopharyngeal achalasia (CA) can be defined as inadequate opening of the cricopharyngeus muscle (CPM) resulting in dysphagia. Myosin heavy chain (MHC) isoform fiber type composition and size are key determinants of muscle function. These parameters have not been described in CA. It is hypothesized that there is a difference between the MHC isoform composition of the CPM in patients with the clinical diagnosis of CA and that in normal subjects.Methods:Patients who had received prior botulinum were excluded. The MHC fiber type composition and size in patients and cadaveric controls were determined by adenosine triphosphatase staining and image analysis.Results:The CPMs of 12 CA patients (6 male, 6 female; mean age, 61 years) and 5 control cadaveric subjects (3 male, 2 female; mean age, 67 years) were analyzed. There were relatively fewer type I fibers (67%) in patients with CA than in controls (81%), but the difference was not significant (p = 18). Type I fibers were slightly smaller in CA pati...
Review of Raymundo Gómez González and Sergio Pagaza Castillo, El Aguila Mormón O El Anarquista Cristiano: Plotino Constantino Rhodakanaty

With the publication of its first book, the Museum of Mormon History in Mexico is helping to initiate an era in which international Mormon history is produced and published in local languages by local people. Fernanco R. Gomez Paez, president of the museum, and Raymundo Gomez Gonzalez, director of the museum, coauthor of this book, and an engineer, founded this independent museum to house the historical materials gathered by their aunt, Conseulo Gomez Gonzalez, an influential early convert to Mormonism in Mexico. The publication of an intellectual biography of Plotino Constantino Rhodakanaty, the first member of the Church of Jesus Christ of Latter-day Saints in Central Mexico, marks the expansion of their efforts from historical preservation to the production of local Mormon history. The title translated as "Mormon Eagle or Christian Anarchist" juxtaposes Rhodakanaty's prominent place in Mormon history with his significant role in Mexican intellectual history.
Present Condition Analysis on Typical Demonstration Application of Large-Scale Energy Storage Technology and Its Enlightenment

As the supporting technology and the key impetus for structural adjustment of energy resources and energy conservation and emission reduction, large-scale energy storage technology presents wide application prospects in the fields of power generation, transmission and distribution, power demand side, auxiliary service and grid integration of renewable energy sources. Hundreds of multi-type energy storage demonstration projects with capacities in MWs have been carried out home and abroad, and the related scope includes renewable energy sources, distributed generation and microgrid, power transmission and distribution, auxiliary services etc.. Through analyzing the basic situation of the existed large-scale energy storage demonstration projects, the technology type of energy storage and the focused application scope in academic and engineering study are discussed. From the prospective of the demonstration functions, main techniques and the funding, the technology concerns and the demands of different application modes on the performances of energy storage technologies are summarized. The promotion effect of related policies on energy storage technology is analyzed. Meanwhile, based on the previous analysis, the direction of industrialization development of energy storage in China is given.
Treatment and Problems Encountered in Unit Debugging of 350 MW Supercritical Indirect Air Cooling Steam Turbine

The entire turbine start-up debugging,debugging of small turbine system is an important part of steam turbine generator unit commission. The research has a detailed introduction on the problems encountered in the commission process and debugging of small turbine system of the three 2 × 350 MW supercritical indirect air cooling steam turbine in A power plant. And it describes the process of treatment analysis and sums up the debugging experience and operational experience.
Predictors and Outcomes of School Attachment and School Involvement in a Sample of Girls in Residential Treatment

ABSTRACTResearchers examined associations between number of schools attended, school attachment and involvement and social support among 86 girls (mean age = 15 years) living in a residential treatment center. Associations among school attachment and school involvement and symptoms of depression were also explored. Results indicated no association between numbers of schools attended and school attachment, involvement, or social support. Classmate support and support from people in school in general were significant predictors of school attachment and involvement, although teacher support was not. School attachment and involvement were not related to students’ reported symptoms of depression. Implications for policy and practice are discussed.
Tumor Suppressor Gene Alterations in Bladder Carcinoma: Translational Correlates to Clinical Practice

The most common tumor suppressor genes involved in the prediction of bladder tumor progression are the Rb and the p53 genes. This article summarizes current data on the use of these markers in prognostic evaluation.
WE-AB-207B-09: Margin Reduction for Planning Target Volume (PTV) in Patients with Localized Prostate Cancer: Impact On Delivered Dose and Quality of Life

Purpose: To estimate the delivered (cumulative) dose to targets and organs at risk for localized prostate cancer patients treated with reduced PTV margins and to evaluate preliminary patient reported quality-of-life (QOL). Methods: Under an IRB-approved protocol, 20 prostate cancer patients (including 11 control patients) were treated with reduced planning margins (5 mm uniform with 4 mm at prostate/rectum interface). Control patients had standard margin (10/6 mm)-based treatments. A parameter-optimized Elastix algorithm along with energy-mass mapping was used to deform and resample dose of the day onto the planning CT for each fraction to estimate the delivered dose over all fractions. QOL data were collected via Expanded Prostate cancer Index Composite (EPIC-26) questionnaires at time points pre-treatment, post-treatment, and at 2, 6, 12, 18 month follow-ups. Standardized QOL scores [range: 0–100] were determined and baseline-corrected by subtracting pre-treatment QOL data. Mean QOL differences between the margin reduced group and control group (QOLmr-QOLcontrol) were calculated for first 18 months. Results: The difference between the cumulative mean dose (Dmean) and the planned mean dose (±SD) for PTV, prostate, bladder, and rectum were −2.2±1.0, 0.3±0.5, −0.7±2.6, and −2.1±1.3 Gy respectively for the margin-reduced group, and −0.8±2.0, 0.9±1.4, - 0.7±3.1 and −1.0±2.4 Gy for the control group. Difference between the two groups was statistically insignificant (p=0.1). Standardized and baseline corrected QOLmr-QOLcontrol for EPIC domains categorized as “Urinary Incontinence”, “Urinary Irritative/Obstructive”, “Bowel”, “Sexual”, and “Hormonal” were 0.6, 12.1, 9.1, 13.3, and −0.9 for the 18 months following radiation therapy (higher values better). Delivered dose to rectum showed a weak correlation to “Bowel” domain (Pearson's coefficient −0.24, p<0.001), while bladder dose did not correlate to Urinary Incontinence/Irritative/Obstructive QOL domains. Conclusion: The margin-reduced group exhibited clinically meaningful improvement of QOL without compromising the PTV dose. A larger number of patients and greater follow-up is needed to draw unequivocal conclusions. This work was supported in part by a research grant from Varian Medical Systems, Palo Alto, CA
Physical Activity Levels in a Community Lifestyle Intervention: A Randomized Trial.

BACKGROUND: A behavioral lifestyle intervention program with goals of increasing physical activity (PA) and losing weight was shown to be efficacious for preventing type 2 diabetes and decreasing risk for cardiovascular disease in the U.S. Diabetes Prevention Program (DPP). Modified versions of the DPP lifestyle intervention are being translated into diverse community settings and have been successful in decreasing weight and improving metabolic markers. However, comprehensive evaluations of PA levels within these community translation intervention efforts are rare. PURPOSE: To evaluate the effectiveness of a DPP-based community lifestyle intervention for improving PA levels. METHODS: 223 overweight adults at-risk for type 2 diabetes and/or cardiovascular disease were randomized (immediate or 6-month delayed-start) to a 12-month DPP-based lifestyle intervention. Past-month PA level was assessed at baseline and post-intervention with the Modifiable Activity Questionnaire. Simple and mixed-effects regression models were used to determine changes in PA level between and within groups over time. RESULTS: The between-group mean difference for change in PA levels from baseline to 6 months indicated significantly greater improvement in the intervention compared to the delayed-start group [+6.72 (SE=3.01) MET-hrs/week; p=0.03]. Examining combined within-group change from baseline to post-intervention, mean PA levels significantly increased by +14.69 (SE=1.43) and +9.50 (SE= 1.40) MET-hrs/week at 6 and 12 months post-intervention, respectively. This PA change offset to approximately +10 MET-hrs/week at both 6 and 12 months after adjusting for baseline PA level and season (all; pCONCLUSIONS: This community-based lifestyle intervention significantly increased PA levels among overweight adults at risk for type 2 diabetes and cardiovascular disease, even after adjusting for key variables. CLINICALTRIALSGOV IDENTIFIER: NCT01050205. Language: en
Elimination of Carbon Contamination from Silicon Kerf Using a Furnace Aerosol Reactor Methodology

Approximately 40% of the refined silicon is lost as sawdust (kerf) during the cutting process while producing wafers. Attempts have been made to recycle this kerf, but abundant impurities such as carbon (∼13000 ppm) burden its recovery. Using conventional bulk heating methods to remove carbon requires long residence time and inevitably causes silicon oxidation. This makes the treated kerf unsuitable for further processing and reuse. A novel aerosol method that is effective for selective carbon removal from silicon kerf at low residence times is described. The design of the aerosol process is supported by thermogravimetric analysis of kerf that provides insights into kinetics of the carbon removal process. At 900 °C in an air atmosphere carbon was removed below detection levels at a residence time of 6 s. Under the same conditions in a nitrogen atmosphere, 90% elimination of carbon was measured. Minimal oxidation of the Si sample was observed under these conditions.
OnabotulinumtoxinA vs Sacral Neuromodulation on Refractory Urgency Urinary Incontinence in Women: A Randomized Clinical Trial.

Importance Women with refractory urgency urinary incontinence are treated with sacral neuromodulation and onabotulinumtoxinA with limited comparative information. Objective To assess whether onabotulinumtoxinA is superior to sacral neuromodulation in controlling refractory episodes of urgency urinary incontinence. Design, Setting, and Participants Multicenter open-label randomized trial (February 2012-January 2015) at 9 US medical centers involving 381 women with refractory urgency urinary incontinence. Interventions Cystoscopic intradetrusor injection of 200 U of onabotulinumtoxinA (n = 192) or sacral neuromodulation (n = 189). Main Outcomes and Measures Primary outcome, change from baseline mean number of daily urgency urinary incontinence episodes over 6 months, was measured with monthly 3-day diaries. Secondary outcomes included change from baseline in urinary symptom scores in the Overactive Bladder Questionnaire Short Form (SF); range, 0-100, higher scores indicating worse symptoms; Overactive Bladder Satisfaction questionnaire; range, 0-100; includes 5 subscales, higher scores indicating better satisfaction; and adverse events. Results Of the 364 women (mean [SD] age, 63.0 [11.6] years) in the intention-to-treat population, 190 women in the onabotulinumtoxinA group had a greater reduction in 6-month mean number of episodes of urgency incontinence per day than did the 174 in the sacral neuromodulation group (−3.9 vs −3.3 episodes per day; mean difference, 0.63; 95% CI, 0.13 to 1.14; P = .01). Participants treated with onabotulinumtoxinA showed greater improvement in the Overactive Bladder Questionnaire SF for symptom bother (−46.7 vs −38.6; mean difference, 8.1; 95% CI, 3.0 to 13.3; P = .002); treatment satisfaction (67.7 vs 59.8; mean difference, 7.8; 95% CI, 1.6 to 14.1; P = .01) and treatment endorsement (78.1 vs 67.6; mean difference; 10.4, 95% CI, 4.3 to 16.5; P P = .36), adverse effects (88.4 vs 85.1; mean difference, 3.3; 95% CI, −1.9 to 8.5; P = .22), and treatment preference (92.% vs 89%; risk difference, −3%; 95% CI, −16% to 10%; P = .49). Urinary tract infections were more frequent in the onabotulinumtoxinA group (35% vs 11%; risk difference, −23%; 95% CI, −33% to −13%; P Conclusions and Relevance Among women with refractory urgency urinary incontinence, treatment with onabotulinumtoxinA compared with sacral neuromodulation resulted in a small daily improvement in episodes that although statistically significant is of uncertain clinical importance. In addition, it resulted in a higher risk of urinary tract infections and need for transient self-catheterizations.
Development of a digital micro-manufacturing process for high frequency ultrasound transducers

Conventional methods for fabricating ultrasound imaging transducers especially for high frequency (>20 MHz) range are expensive, time consuming and limited to relatively simple geometries. In this paper, the development of an additive digital micro-manufacturing method for piezomaterials and composites based on digital micromirror devices (DMD) to be used in HF ultrasound transducers is presented. Photocured piezoelectric materials with micro-scale features were fabricated. Different piezoelectric characteristics of the materials have been tested and compared with the bulk case. The Density of the fabricated samples was increased by applying hot uniaxial press and adding PZT composite sol-gel to the photocure solution. The dielectric constant (£ r ) and the tangent loss (tgθ) of the samples at 1 KHz were found to be around 610 and 0.025, respectively. The measured piezoelectric constant (d33) of the fabricated samples was around 156×1012 C/N, and the sound velocity about 1850 m/s. The polarization (Pr) and the coercive field (Ec) were 18 µC/cm² and 80 kV/cm, respectively.
Connecting Gender, Race, Class, and Immigration Status to Disease Management at the Workplace.

Objective Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual's life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management. Methods This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited (N = 31) and invited to discuss their experiences with hypertension and hypertension management within the context of their work environments. Results Being a woman worker within the hotel industry was perceived to negatively influence participants' experience with hypertension and hypertension management. In contrast, being a woman played a protective role outside the workplace. Being an immigrant played both a positive and a negative role in hypertension and its management. Being black and from a low socioeconomic class had only adverse influences on participants' experience with hypertension and its management. Conclusion Being a woman, black, lower class, and an immigrant simultaneously contribute to immigrant hotel housekeepers' health and their ability to effectively manage their hypertension. The connection between these four constructs (gender, race, class, and immigration status) and disease management must be considered during care provision. Hotel employers and policy stakeholders need to consider those constructs and how they impact workers' well-being. More studies are needed to identify what mitigates the associations between the intersectionality of these constructs and immigrant workers' health and disease management within their work environment.
Effect of incorporation of preoperative CT scan on bladder doses and irradiated volume in postprostatectomy radiation therapy (pPRT).

e561Background: pPRT increases local control, biochemical progression free survival, and even overall survival in patients with adverse features undergoing prostatectomy. The Radiation Therapy Oncology Group (RTOG) consensus definition of the clinical target volume (CTV) in 2010 was based on patterns of failure and anatomy without consideration of pre-operative imaging. This results in large volumes of bladder in the treatment field. Our study evaluates whether incorporation of pre-operative prostate volume can reduce the post-operative CTV and minimize dose to adjacent normal tissue. Methods: We reviewed records of all patients with available pre-operative pelvic CT scans treated at our institution with pPRT. The pre-operative CT scan was fused to the simulation CT. Post-operative CTV (CTV1) was delineated based on RTOG guidelines. A separate CTV (CTV2) was constructed, based on the intact prostate and proximal seminal vesicles. Plans were constructed for each CTV and doses to rectum, bladder, and penile...
Effects of hydrated lime on radionuclides stabilization of Hanford tank residual waste.

Abstract Chemical stabilization of tank residual waste is part of a Hanford Site tank closure strategy to reduce overall risk levels to human health and the environment. In this study, a set of column leaching experiments using tank C-104 residual waste were conducted to evaluate the leachability of uranium (U) and technetium (Tc) where grout and hydrated lime were applied as chemical stabilizing agents. The experiments were designed to simulate future scenarios where meteoric water infiltrates through the vadose zones into the interior of the tank filled with layers of grout or hydrated lime, and then contacts the residual waste. Effluent concentrations of U and Tc were monitored and compared among three different packing columns (waste only, waste + grout, and waste + grout + hydrated lime). Geochemical modeling of the effluent compositions was conducted to determine saturation indices of uranium solid phases that could control the solubility of uranium. The results indicate that addition of hydrated lime strongly stabilized the uranium through transforming uranium to a highly insoluble calcium uranate (CaUO4) or similar phase, whereas no significant stabilization effect of grout or hydrated lime was observed on Tc leachability. The result implies that hydrated lime could be a great candidate for stabilizing Hanford tank residual wastes where uranium is one of the main concerns.
Low dose anti-thymocyte globulin reduces chronic graft-versus-host disease incidence rates after matched unrelated donor transplantation.

AbstractAnti-thymocyte globulin (ATG) is often added to hematopoietic stem cell transplant conditioning regimens to prevent graft rejection and reduce graft-versus-host disease (GVHD). Doses used in retrospective and prospective clinical trials have ranged from 2.5 to 20 mg/kg with rates of grade II–IV acute GVHD and chronic GVHD up to 40 and 60%, respectively. We retrospectively compared outcomes in recipients of matched unrelated donor (MUD) grafts given low dose rabbit ATG IV 3 mg/kg (n = 52) versus recipients of matched related donor (MRD) grafts (n = 48) without ATG. One year cumulative incidence of chronic GVHD was 25.2% in the MUD group versus 33.3% in the MRD group (p = .5). One-year cumulative incidence of extensive chronic GVHD was 9.6% in the MUD group versus 26.6% in the MRD group (p = .042). Our analysis supports the use of low dose ATG in MUD transplantation as an effective therapy to prevent chronic GVHD.
Pooled population resequencing of clam shrimp (Eulimnadia texana) from different vernal pools reveals signatures of local adaptation

Vernal pool clam shrimp (Eulimnadia texana) are a promising model due to ease of culturing, short generation time, modest genome size, and obligate desiccated diapaused eggs. We collected Illumina data (Poolseq) from eleven pooled wild vernal pool clam shrimp populations. We hypothesized that restricted gene flow between vernal pools, separated by distances of 0.36 to 253 km, in concert with Poolseq data from each population, could be used to identify genes important in local adaptation. We adapted Bayenv2 to genome-wide Poolseq data and detected thirteen genomic regions showing a strong excess of population subdivision relative to a genome-wide background. We identified a set of regions that appear to be significantly diverged in allele frequency, above what is expected based on the relationships amongst the populations. Regions identified as significant were on average 9.5 kb in size and harbored 3.8 genes. We attempted to identify correlations between allele frequencies at each genomic region and environmental variables that may influence local adaptation in the sequences populations, but found that there were too many confounding environmental variables to draw strong conclusions. One such genomic region harbored an ortholog of Drosophila melanogaster CG10413, a gene predicted to have sodium/potassium/chloride activity. Finally, we demonstrate that the identified regions could not have been found with less powerful statistics, i.e. FST, or with a less contiguous genome assembly.
Boosting ice hockey in China: political economy, mega-events and community

With Beijing winning the bid to host the 2022 Winter Olympics, China has been actively boosting winter sports in the domestic market. This article briefly reviews the history of China’s ice hockey ...
Drug persistence – From antibiotics to cancer therapies

Drug-insensitive tumor subpopulations remain a significant barrier to effective cancer treatment. Recent works suggest that within isogenic drug-sensitive cancer populations, subsets of cells can enter a 'persister' state allowing them to survive prolonged drug treatment. Such persisters are well-described in antibiotic-treated bacterial populations. In this review, we compare mechanisms of drug persistence in bacteria and cancer. Both bacterial and cancer persisters are associated with slow-growing phenotypes, are metabolically distinct from non-persisters, and depend on the activation of specific regulatory programs. Moreover, evidence suggests that bacterial and cancer persisters are an important reservoir for the emergence of drug-resistant mutants. The emerging parallels between persistence in bacteria and cancer can guide efforts to untangle mechanistic links between growth, metabolism, and cellular regulation, and reveal exploitable therapeutic vulnerabilities.
Living a Life Full of Pain: Older Pain Clinic Patients' Experience of Living With Chronic Low Back Pain

Chronic low back pain (CLBP) is older adults' most common pain complaint and is associated with many physical and psychosocial consequences, which have been quantitatively examined. However, little research has qualitatively examined the experience itself of CLBP in later life. Study objective was to understand older adults' lived CLBP experience. Guided by van Manen's phenomenological method, 21 pain clinic patients aged 66 to 83 completed semistructured interviews. Under the main theme "living a life full of pain," results are reflected in four existential subthemes: (a) Corporeality: The pain is relentless and constantly monitored, (b) Temporality: To live with pain is to live by pacing day and night, (c) Relationality: Pain creates limits that can be tested or obeyed, and (d) Spatiality: Manipulating the space around me to accommodate the pain. Findings improve understanding of the patient experience of late life CLBP and highlights the importance of empathy and patient-centeredness when treating older adults.
Planning Healthy Communities: Abating Preventable Chronic Diseases

While creating healthy communities through built environment interventions became an objective of international health organizations, such as the World Health Organization since the mid-twentieth century, abating preventable chronic diseases continues to be a global concern. Consequently, there are few examples of mainstream application of local policy to include health priorities explicitly into community planning. This chapter discusses the case of Atlanta, Georgia, as a demonstration for prioritizing health and utilizing a health impact assessment in the region’s long-term comprehensive plan. PLAN 2040 envelopes key elements of the built environment (e.g., land use, transportation, access to health) known to impact population health. Further, the Atlanta Regional Commission incorporated economic development and sustainability principles to positively influence these factors as social determinants of health outcomes. The chapter introduces foundational definitions and philosophical frameworks to illuminate the legal basis for health inclusive community planning in Atlanta and discusses relevant frameworks for future application.
Aquic conditions for Soil Taxonomy: concepts, soil morphology and micromorphology

Abstract Vepraskas, M.J., Wilding, L.P. and Drees, L.R. 1994. Aquic conditions for Soil Taxonomy: concepts, soil morphology and micromorphology. In: A.J. Ringrose-Voase and G.S. Humphreys (Editors), Soil Micromorphology: Studies in Management and Genesis. Proc. IX Int. Working Meeting on Soil Micromorphology, Townsville, Australia, July 1992. Developments in Soil Science 22, Elsevier, Amsterdam, pp. 117–131.
Studies on 38 Patients with Pheochromocytoma in Whom Catecholamines Were Determined

The value of our plasma and tumor catecholamine studies in a large series of patients with pheochromocytoma deserves special attention and merits this separate chapter. Relatively few studies of plasma catecholamines in patients with pheochromocytoma have been reported and we wish to emphasize the remarkable diagnostic value and accuracy of plasma catecholamine determinations in detecting patients with this tumor. In addition, correlative studies between blood pressure and plasma and tumor catecholamines may improve our understanding of the patterns of hypertension encountered, and may also shed light on secretion characteristics of these neoplasms.
Probabilistic Aggregation of Uncertain Geological Resources

Commodities such as oil and gas occur in isolated reservoirs or accumulations, more generically called basic units here. To understand a study area’s economic potential and to craft plans for exploration and development, resource analysts often aggregate (sum, accumulate) basic unit magnitudes in distinct spatial subsets of the study area and then appraise the total area’s potential by summing these intermediate sums. In a probabilistic approach, magnitudes are modeled as random variables. Some have asked, “Do different methods of partitioning basic units into subsets lead to different probability distributions for the sum of all basic unit magnitudes?” Any method of aggregation of basic unit magnitudes which obeys the rules of probability leads to the same probability distribution of the sum of all unit magnitudes as that computed by direct summation of all basic unit magnitudes. A Monte Carlo simulation of a synthetic example in which the magnitude of resource in each unit is marginally lognormal and pairwise correlations among basic unit magnitudes are specified illustrates key features of probabilistic aggregation. The joint distribution of certain pairs of aggregates are closely approximated by a bivariate lognormal distribution.
The Economic Feasibility of Municipal Water Softening in California

The disadvantages of hard waters are too well recognized to need discussion here. The desirability of soft water likewise needs no comment. In the light of present day technic any water can be softened. The consideration is not one of technic, merely one of cost. In this paper we consider the economy of water softening only from the standpoint of the domestic consumer. While in this connection there may be a number of distinct considerations involved, most of them are appeals to the esthetic; pleasantness, the effect on hair and skin, the effect on laundry, and similar conditions. These are real, but nevertheless, intangible, in that they cannot be evaluated in monetary terms. Hard water does affect soap consumption and there we have an item that we can deal with in economic terms. Laundries have long since recognized this fact and have effected considerable savings by developing soft water supplies either natural or treated. For them it has been demonstrated to be economically feasible.
Multiscale effects of heating and cooling on genes and gene networks

Most organisms must cope with temperature changes. This involves genes and gene networks both as subjects and agents of cellular protection, creating difficulties in understanding. Here, we study how heating and cooling affect expression of single genes and synthetic gene circuits in Saccharomyces cerevisiae . We discovered that nonoptimal temperatures induce a cell fate choice between stress resistance and growth arrest. This creates dramatic gene expression bimodality in isogenic cell populations, as arrest abolishes gene expression. Multiscale models incorporating population dynamics, temperature-dependent growth rates, and Arrhenius scaling of reaction rates captured the effects of cooling, but not those of heating in resistant cells. Molecular-dynamics simulations revealed how heating alters the conformational dynamics of the TetR repressor, fully explaining the experimental observations. Overall, nonoptimal temperatures induce a cell fate decision and corrupt gene and gene network function in computationally predictable ways, which may aid future applications of engineered microbes in nonstandard temperatures.
State-Trajectory Control With Single-Cycle Response for Point-of-Load Converters

A popular variable-frequency control used for point-of-load (POL) converter application is the constant on-time (COT) control. COT control is able to improve light-load efficiency and reduce the amount of output capacitors with high-bandwidth designs, but the transient response of COT control is limited by the fixed on-time nature of the control. In this paper, a state-trajectory-based control with single-cycle transient response is proposed for POL converters. With the proposed control, the converter will follow the natural state trajectory of the converter for the duration of the detected load step-up transient, which can ensure a very fast transient response. Experimental results are presented to not only demonstrate the proposed idea but also the control's ability to further reduce the amount of output capacitors and save board footprint.