cssi/SciSciGPT-SciSciNet huggingface dataset:
ON EXPERIMENTAL VERSUS THEORETICAL INCIPIENT BUCKLING OF NARROW GRAPHITE/EPOXY PLATES IN COMPRESSION

Most stiffeners in aerospace structures are composed of narrow plate elements with the unloaded edges usually being either simply-supported or free. This paper is concerned with the difficulties encountered in attempting to predict the incipient buckling strength for narrow (low width to thickness ratio) angle-plied graphite/ epoxy plates in compression. Numerous available test data was compared to analytical predictions. The tested plates were of two types: both unloaded edges supported by steel V-blocks (no-edge-free); one unloaded edge supported by a steel V-block and the other edge free (one-edge-free). Nondimensional plots for both types of tests are presented which can be used to predict incipient buckling strengths for plates with laminate configurations other than those tested. For completeness, nondimensional crippling plots are presented where the incipient (initial) buckling stress is employed in the nondimensional parameters. This approach is an interesting ramification of previously published crippling plots where the theoretical buckling stress was employed in the nondimensional parameters. Nomenclature length of plate width of plate elastic flexural stiffness of plate theoretical elastic buckling stress incipient buckling stress Southwell plot buckling stress postbuckling failure (crippling) stress ultimate compressive strength overall length of test specimen effective column length of test specimen L/X, where C is the end fixity coefficient and is equal to approximately 3.6 for fixed ended test specimens in testing machine theoretical elastic buckling load incipient buckling load postbuckling failure (crippling) load thickness of plate
Segments in the Classroom

This paper applies a well-known marketing concept: segmentation, to the college classroom. Segments are identified using personality traits, grade point average, course evaluation and points earned in the class. By developing appropriate teaching strategies for each segment better student performance and evaluations should result in the large enrollment classes where individualized instruction is impossible.
The Problem of Cell Development

The typical cell is one of the grand illusions of biology. Like the average man, it is much discussed but infrequently met.
The Economic Case for CSR

This paper makes an economic case for corporate social responsibility. We develop a formal model of CSR, comparing the provision of a social good by for- profit and non-profit organizations, and de...
Lifetime measurements in 131Xe and 129Xe

Abstract Using the centrifuge technique, nuclear resonance fluorescence was observed from the levels at 364 keV, 637 keV and 723 keV in 131 Xe and from the 411 keV level in 129 Xe. The following lifetimes were determined: τ 364 = 73 ± 6 psec, τ 637 = 6.0 ± 0.6 psec, τ 723 = 0.76 ± 0.13 psec and τ 411 = 72 ± 15 psec. The results are compared with predictions from a recent calculation by Paradellis and Hontzeas using the intermediate coupling model.
α1-Adrenergic Receptors Function Within Hetero-Oligomeric Complexes With Atypical Chemokine Receptor 3 and Chemokine (C-X-C motif) Receptor 4 in Vascular Smooth Muscle Cells.

BackgroundRecently, we provided evidence that α1‐adrenergic receptors (ARs) in vascular smooth muscle are regulated by chemokine (C‐X‐C motif) receptor (CXCR) 4 and atypical chemokine receptor 3 (A...
Early developmental morphology reflects independence from parents in social beetles

The variation in degree of offspring dependence in parents where parental care has evolved is striking, from feeding independence at birth to complete dependence on parents for all nutritional resources. This presents an evolutionary puzzle. Why lose the ability to feed as a contingency when parents may die or abandon broods? Comparisons of altricial and precocial vertebrates suggest that there may be life-history and developmental costs to early independence. The generality of this beyond vertebrates is unclear, but we can extend the comparison as invertebrate species also vary in the level of independence in early life-history stages. For example, larvae of several burying beetle species (Nicrophorus), a genus in which parents regurgitate pre-digested food to begging larvae, have lost the ability to self-feed thus creating complete parental dependency for first instars. Here, we ask whether variation in dependency amongst burying beetles is related to heterochrony in development of a more complex morphological structures. We show that the rate of development and allometry of mandibles of precocial larvae that can self-feed from birth are the same as those in altricial larvae that cannot survive without parenting. Instead, self-feeding is associated with shape variation in mandibles. In altricial species first instar larvae have smooth mandibles, whereas in precocial species mandibles are serrated. Later instars, which can self-feed in all species, have serrated mandibles. Serrations on teeth generally function to 9grip and rip9, whereas smooth blades function more to puncture, and broods of altricial but not precocial Nicrophorus larvae show evidence for siblicide. We therefore suggest that altricial first-instar mandibles function more as weapons than feeding tools when released from self-feeding. This study presents a novel coevolution between developmental timing and parenting potentially mediated by sibling competition.
Immunotherapy Approaches to Breast Cancer

Activating the immune system to eradicate breast cancer has emerged as a promising treatment strategy, and immune checkpoint inhibition has demonstrated activity in both advanced and early stage disease. Here we review recent clinical trial results of immunotherapy approaches to treat breast cancer. A number of trials of immune checkpoint inhibitors, both as monotherapy and in combination with other therapies, have been reported. While response rates with monotherapy in the advanced stage setting are relatively low, the durability of responses observed is remarkable. While PD-L1 positivity enriches for responders, it is not a consistent predictor of response. Response appears to correlate more strongly with tumor-infiltrating lymphocyte (TIL) density. Immune checkpoint inhibition alone and in combination with chemotherapy appears well tolerated with manageable side effects. Treatment clearly benefits a subset of patients, and more precise biomarkers of response are needed.
Limits on Runaway Growth of Intermediate Mass Black Holes from Advanced LIGO

There is growing evidence that intermediate-mass black holes (IMBHs), defined here as having a mass in the range $M=500\ensuremath{-}{10}^{5}\text{ }\text{ }{M}_{\ensuremath{\bigodot}}$, are present in the dense centers of certain globular clusters (GCs). Gravitational waves from their mergers with other IMBHs or with stellar BHs in the cluster are mostly emitted in frequencies $\ensuremath{\lesssim}10\text{ }\text{ }\mathrm{Hz}$, which unfortunately is out of reach for current ground-based observatories such as advanced LIGO (aLIGO). Nevertheless, we show that aLIGO measurements can be used to efficiently probe one of the possible formation mechanisms of IMBHs in GCs, namely a runaway merger process of stellar seed BHs. In this case, aLIGO will be sensitive to the lower-mass rungs of the merger ladder, ranging from the seed BH mass to masses $\ensuremath{\gtrsim}50--300\text{ }\text{ }{M}_{\ensuremath{\bigodot}}$, where the background from standard mergers is expected to be very low. Assuming this generic IMBH formation scenario, we calculate the mass functions that correspond to the limiting cases of possible merger trees. Based on estimates for the number density of GCs and taking into account the instrumental sensitivity, we show that current observations do not effectively limit the occupation fraction ${f}_{\mathrm{occ}}$ of IMBHs formed by runaway mergers of stellar BHs in GCs. However, we find that if runaway mergers occur steadily throughout the lifetimes of GCs (as opposed to happening mainly early in their lifetimes), then a six-year run of aLIGO at design sensitivity will be able to probe down to ${f}_{\mathrm{occ}}\ensuremath{\lesssim}3%$ at a 99.9% confidence level, either finding evidence for this formation mechanism, or necessitating others if the fraction of GCs that harbor IMBHs is higher.
A Movable Medical Crisis

On January 14, 1983, a small aircraft landed in an old World War II naval airfield sixty miles from the Atlantic coastline in a southeastern state. Four passengers deplaned. One of them, a healthy young man in his thirties, walked briskly past the only three private planes parked in the field, entered a telephone booth and called a taxi. The escort assisted his three very sick companions — two men and one woman — into the cab and asked the driver in broken English to rush to the nearby Pilt Hospital Emergency Room.
Frequent Pattern Mining Algorithms: A Survey

This chapter will provide a detailed survey of frequent pattern mining algorithms. A wide variety of algorithms will be covered starting from Apriori. Many algorithms such as Eclat, TreeProjection, and FP-growth will be discussed. In addition a discussion of several maximal and closed frequent pattern mining algorithms will be provided. Thus, this chapter will provide one of most detailed surveys of frequent pattern mining algorithms available in the literature.
Special and Differential Treatment of Developing Countries

The intellectual keystone of the GATT-WTO multilateral trade system is that economic development is best achieved through non-discriminatory trade patterns, the progressive reduction of tariffs, and the elimination of nontariff barriers that block trade flows. Still, non-discrimination is not a shibboleth in the GATT-WTO system. To cite just one example, the scores of regional trade arrangements that have proliferated over the past decade honor the MFN obligation in the breach. And so it is with developing countries under GATT 1994 and the WTO MTAs. During the initial GATT-ITO negotiations in 1947 the view was accepted that the principle of equality of treatment among countries is inappropriate when countries are not economic equals. Within the GATT-WTO system, the concept of preferential treatment of developing countries (or special and differential treatment in GATT parlance) made its way into the permanent legal structure of GATT 1947 and its many subsidiary agreements. In a nutshell, the rules requiring MFN treatment of imported goods regardless of origin were altered in the case of imports from developing countries.1
Thymosin Beta 4 Promotes Endothelial Cell Migration and Angiogenesis

The basement membrane associated with endothelial cells is important in regulating the passage of macromolecules and cells in and out of the circulation, forming a barrier to the underlying stroma and maintaining the differentiated phenotype of the endothelial cells (Grant et al., 1990). During the formation of new blood vessels, the basement membrane is first degraded and then the endothelial cells migrate away from the vessel, proliferate at the site of migration initiation and subsequently a new basement membrane is synthesized when the vessel is formed. Normally the vasculature is fairly stable with minimal turnover. During tissue formation, in wound repair and in certain diseases, considerable increases in vessel formation occur (Folkman, 1992). Using in vitro and in vivo assays, a number of factors have been described that regulate this process. Many of these factors are either stored in the basement membrane or produced by cells in response to the basement membrane.
Computer applications for the classroom: a review

For most educators, especially those who teach computing or other technical subjects, changes to existing software applications are a common occurrence. However, for educators who are just entering the workforce or being encouraged to update their teaching activities to include new applications, the task of finding an appropriate application for a subject or grade level can be daunting. Educators are constantly exposed to new technologies and updates to applications already in use in their classrooms. This paper offers a review and discussion of options that may help with the selection problem. The discussion is not intended to be exhaustive but rather to provide a starting point in the discussion of applications currently being used by educators today. Every application can look 'cool' or 'fun' at a conference; however, knowing the concepts it supports and whether it will work with one's current hardware and software resources is critical in making new adoption decisions. As an aid to this, the discussion in this paper offers several conceptual distinctions that may be useful, as well as information about the platforms that best support the different applications.
Description of a method for localizing swarming mosquitoes and other insects in 3D space with visualizations

Male mosquitoes swarm to find mates, but the characteristics of these swarms have not yet been quantitatively analyzed in the field. This paper describes a simple method used recently to localize individual Anopheles gambiae in a swarm via stereoscopic image analysis of video footage swarms recorded in Doneguebougou, Mali. The methods described here represent a streamlining of simple triangulation for insect localization in the hope that other researchers will be able to apply the method for studying fundamental questions about flying insects or other taxa.
Automatic Formal Verification of Digital Components of IoTs Using CBMC

These days, internet of things (IoT) are being widely used in many safety-critical domains, like healthcare and transportation. Thus, their functional correctness is very important. However, simulation based analysis is based on sampling methods and thus their results are not complete and cannot be termed as accurate. Formal verification has been recently proposed to verify the digital components of IoT devices and thus overcome the incompleteness issues of simulation. However, formal verification process requires manual development of a formal model of the given circuit and its desired properties. Moreover, the verification of the relationship between the formally specified model and its properties sometimes also requires manual interventions. These manual efforts can be quite cumbersome while verifying large systems and thus make formal verification of IoT devices somewhat infeasible for industrial usage. To overcome these limitations, we present a tool chain to automatically formally verify digital components of IoT devices, which are usually expressed in the Verilog language. The proposed methodology primarily leverages upon the strong verification support for the C language. The idea is to convert the given Verilog code and its properties to C language and use bounded model checking to verify the obtained C code. The formally verified C code is then converted back to Verilog to facilitate circuit design steps i.e., synthesis, timing analysis etc., and thus continue with the regular digital system design flow. For illustration, we present the verification of several widely used components of IoT devices, including an ALU and a 64-bit processor, which are fairly complex and to the best of our knowledge have never been formally verified automatically before.
Utilization Patterns of Single Fraction Radiation Therapy for Multiple Myeloma.

Abstract Background Patients with multiple myeloma (MM) are living longer than ever before thanks to new therapies. As a consequence, radiation therapy (RT) is increasingly important in the management of bone lesions from MM. Current American Society for Radiation Oncology guidelines recommend greater usage of 8 Gy in 1 fraction for treatment of these lesions. The objective of this study is to analyze utilization of 8 Gy in 1 fraction for treatment of MM bone lesions in the United States utilizing the National Cancer Data Base (NCDB). Materials and Methods The NCDB was used to identify patients with MM treated with palliative RT for painful bony lesions in the period between 2004 and 2014. Utilization rate of RT in this patient population as well as single-fraction (SFRT) versus multiple-fraction RT (MFRT) was compared according to demographic, socioeconomic, and logistic details. Results A total of 95,190 patients met our inclusion criteria. Of these, 10,261 (10.8%) patients received RT, and a total of 243 (2.4%) of these patients received SFRT over the 10-year period. There was an 11.73% annual increase (P = .0001) in SFRT utilization from 2004 to 2014. Older age, black race, longer distance from the treatment facility, lower degree of education, treatment at an academic or integrated healthcare network, worse comorbidities, and more recent diagnoses were all associated with increased usage of SFRT. Conclusion SFRT for the management of MM painful bony metastases remains underutilized. Trends show that radiation oncologists do not appear to be changing their approach to treating this disease.
Substituting open educational resources for commercial curriculum materials: effects on student mathematics achievement in elementary schools

Open Educational Resources (OER) have the potential to replace commercial learning materials in education. An empirical examination of this potential was conducted, comparing the end-of-year mathem...
Testicular activity and epididymal sperm collection from American black bears in November

Prolonged reproductive behavior of American black bears (Ursus americanus) has been reported in the southeastern United States compared with other regions, but functional spermatogenesis or potential fertility has not previously been described for these bears. Additionally, methods for gamete collection are only in early stages of development for ursids. Testicles were collected from 29 post-pubertal legally hunter-killed black bears in eastern North Carolina, USA, in November 2016. Active spermatogenesis was identified in 48.3% (14/29) of bears via histology. Epididymal sperm collection was attempted via mincing (n = 29), vas deferens flush (n = 24), and percutaneous aspiration (n = 5). Epididymal mincing identified sperm in 78.6%, and vas flush in 53.8%, of bears with spermatogenesis on histology. Percutaneous aspiration was unsuccessful. These findings provide evidence that male bears may maintain reproductive capabilities into the late autumn in this region, and that under the conditions of this study, sperm can be collected via epididymal mincing or vas deferens flush, but not percutaneous aspiration.
Quantitative spleen and liver volume changes predict survival of patients with primary sclerosing cholangitis

AIM To assess the value of quantitative spleen and liver volume changes in predicting the survival of patients with primary sclerosing cholangitis (PSC). MATERIALS AND METHODS This institutional review board-approved single-centre study included 89 PSC patients with baseline and follow-up liver imaging studies and laboratory data between 2000 and 2018. Change in spleen, total and lobar liver volumes, and lobar-to-total liver volume ratio was compared between patients with and without adverse outcome (liver transplantation, transplant waiting list, and death). Receiver operating characteristic (ROC) and Kaplan–Meier analysis were performed to identify the volumetric threshold for prediction of outcome and show how these thresholds predict survival, respectively. A p-value of RESULTS The present cohort included 53 men (60%), with mean age of 42 years at baseline. The only volumetric parameters with significant differences in change between patients with and without adverse outcome were spleen volume (p CONCLUSION Spleen volume change and L/T change might be useful biomarkers for prediction of transplant-free survival in patients with PSC.
Failure to restore the calcar and locking screw cross-threading predicts varus collapse in proximal humerus fracture fixation.

Background Varus collapse is a common failure mode of proximal humerus fracture (PHF) fixation. The purpose of this study was to analyze predictors of varus collapse of PHF after open reduction, internal fixation (ORIF). Methods All patients who underwent ORIF of a PHF from January 2008 to July 2018 were identified. Known predictors of fixation failure were assessed, including calcar distance, calcar ratio, and calcar restoration. Additionally, the presence of cross-threaded screws was determined. The primary outcome analyzed was varus collapse of the fracture defined as a change in neck shaft angulation to less than 120°. Results There were 112 patients identified who underwent ORIF of a PHF that met inclusion criteria. The population was 75.0% female (84/112), average age was 62.5 ± 10.4 years (range 40.0-87.9), and average body mass index was 28.0 ± 5.5 (17.5-46.4). There were 17 with varus collapse. In 11 of the 17 patients (64.7%), there was screw cross-threading (vs. 31/95 [32.6%] in those that did not collapse); P = .012. In addition, 8 of the 17 (47.1%) did not have restoration of the calcar (vs. 16/95 [16.8%]; P = .005). Conclusion This study identifies 2 surgeon-controlled variables that can contribute to varus collapse after ORIF of PHFs. Cross-threading of locking screws and failure to restore the medial calcar can be a function of implant design, surgeon technical skill, and/or bone quality.
Impact of ocean acidification on growth, onset of competence, and perception of cues for metamorphosis in larvae of the slippershell snail, Crepidula fornicata

Ocean pH has been declining since the start of the Industrial Revolution, and is predicted to continue declining for at least another 200 years. Although the chemical cues that induce larval metamorphosis in marine invertebrates in part determine the distribution and persistence of many coastal marine communities, few studies have examined the effects of ocean acidification on the timing of metamorphic competence or the ability of larval invertebrates to metamorphose in response to environmental cues. Working with larvae of the marine gastropod Crepidula fornicata, we examined the impacts of sudden, short-term (2 h), and prolonged (several weeks) exposure to reduced pH as low as 7.5 on larval survival and growth, the onset of metamorphic competence, and the ability of larvae to perceive inductive cues and metamorphose in their presence. Unexpectedly, although larvae reared at pH 7.5 grew more slowly and took longer to become competent to metamorphose, exposure to acidified conditions did not appreciably impair larval cue perception for metamorphosis.
Multidecadal shifts in forest plant diversity and community composition across glacial landforms in northern lower Michigan, USA

Understanding how plant community assemblage is affected by spatial and temporal patterns is crucial to understanding forest ecosystem responses to disturbance, including future climate change. In ...
Juvenile polyposis syndrome

Juvenile polyposis syndrome (JPS) patients can have a significantly high burden of polyposis. Patient who undergoes prophylactic colectomy for polyps not amenable to endoscopic treatments requires close clinical surveillance to negate risk of malignancy from interval polyposis.
An Unexpected Outcome: Students’ Focus on Order in the Multiplication Principle

The multiplication principle (MP) is a fundamental aspect of combinatorial enumeration. In an effort to better understand students’ reasoning about the MP, we had two undergraduate students reinvent a statement of the MP in a teaching experiment. In this paper, we adopt an actor-oriented perspective (Lobato, Educational Researcher, 32(1), 17–20, 2003, Educational Psychologist, 47(3), 1–16 2012) and draw on Lockwood’s, Journal of Mathematical Behavior, 32, 251–265 (2013) model of students’ combinatorial thinking to trace the students’ development of a certain conception about order – that a statement of the MP should allow for any ordering of the stages of a counting process. Notably, this conception differs from how order is treated in textbook statements of the MP. We report on how this conception persisted for the students, and we explain how the researchers (interviewers) and students managed to proceed through the teaching experiment while maintaining different conceptions of order. The students’ reasoning about order sheds light on ways in which students may think about order and highlights potential subtleties about multiplication in counting that deserve attention.
Relationships between hamstring morphological characteristics and postural balance in elderly men.

Objectives The link between hamstring morphology and postural balance performance in older adults is not well understood. This study aimed to examine the relationships between hamstring morphological characteristics of muscle size (cross-sectional area [CSA]) and quality (echo intensity [EI]) and postural balance with the eyes open and closed in elderly men. Methods Nineteen healthy elderly men (age= 73±4 years) participated in this study. Muscle CSA and EI were determined from ultrasound scans of the hamstrings. Postural balance was assessed with the eyes open and closed using a commercially designed balance testing device, which provides a measurement of static stability based on the sway index. Results The sway index with eyes closed was significantly related to muscle EI (r=0.474; P=0.040) but not CSA (r=0.021; P=0.932). The sway index with eyes open was not related to muscle CSA (r= -0.036; P=0.883) or EI (r=-0.079; P=0.747). Conclusions The significant relationship observed between the sway index with eyes closed and muscle EI suggests that hamstring muscle quality may be a characteristic relevant to postural balance in the absence of visual feedback. These findings may provide important insight regarding the morphological mechanisms involved in maintaining balance and in the development of proper training programs aimed at improving postural stability in older individuals.
Abstract P4-08-03: Tumor suppressors p53 and ARF control ADAR1-driven tumorigenicity in triple negative breast cancer

Research Overview and Objective Triple-negative breast cancer (TNBC) accounts for one-fifth of the breast cancer patient population. The heterogeneous nature of TNBC and lack of options for targeted therapy make its treatment a constant challenge. The co-deficiency of tumor suppressors p53 and ARF is a significant genetic signature enriched in TNBC, but it is not yet clear how TNBC is regulated by this genetic alteration. Methods To answer this question, we established p53/ARF-defective murine embryonic fibroblast (MEF) to study the molecular and phenotypic consequences in vitro. Moreover, transgenic mice were generated to investigate the effect of p53/ARF deficiency on mammary tumor development in vivo. Results Increased transformation capability was observed in p53/ARF-defective cells, and formation of aggressive mammary tumors was also seen in p53−/−ARF−/− mice. RNA-editing enzyme ADAR1 was identified as a potential mediator for the elevated oncogenic potential. Interestingly, we found that the overexpression of ADAR1 is also prevalent in human TNBC cell lines and patient specimen. Using short hairpin RNA (shRNA) to reduce ADAR1 expression abrogated the oncogenic potential of human TNBC cell lines, while non-TNBC cells are less susceptible. Different levels of RNA editing of known ADAR1 targets were detected in shRNA-treated human TNBC cell lines, suggesting that ADAR1-mediated RNA editing contributes to TNBC pathogenesis. Implication/Discussion These results indicate critical roles played by the tumor suppressors p53 and ARF in the pathogenesis of TNBC, partially through affecting ADAR1-mediated RNA editing. Further understanding of this pathway could shed light on potential vulnerabilities of TNBC and inform the development of personalized therapies based on patients’ genetic signiatures. Citation Format: Che-Pei Kung, Catherine E Kuzmicki, Emily A Bross, Sua Ryu, Eric Freeman, Thwisha Sabloak, Emily R Bramel, Leonard B Maggi Jr, Jason D Weber. Tumor suppressors p53 and ARF control ADAR1-driven tumorigenicity in triple negative breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-08-03.
Evolvable Hardware for Security through Diverse Variants

Evolvable hardware is attractive as a design strategy to hardware engineers, but suffers due to its lack of scalability to larger hardware systems. This work examines how hardware designers can make use of evolvable hardware to improve the security of their systems, and to create hardware systems that are better resistant to reverse engineering.
Leader Goal Orientation and Ethical Leadership: A Socio-Cognitive Approach of the Impact of Leader Goal-Oriented Behavior on Employee Unethical Behavior

Ethical leadership is an important construct in the literature on behavioral ethics in organizations, given its link with employee attitudes and behaviors. What remains unclear, however, is what leader characteristics are associated directly with ethical leader perceptions and indirectly with employee unethical behavior. In this paper, we use a socio-cognitive lens to integrate goal orientation theory with the literature on ethical behavior in organizations. Specifically, we propose that certain patterns of managers’ goal-oriented behavior provide signals and cues to employees about their managers’ ethical leadership, which then relates to employee displays of more unethical behavior. Using a sample of 265 manager–employee dyads, our findings largely support our claims. We found that leader performance-avoid goal orientation was negatively related to perceptions of ethical leadership and positively related to employee unethical behavior. Moderated mediation tests indicated that the positive indirect effect of leader performance-avoid goal orientation on employee unethical behavior through perceptions of ethical leadership was attenuated by higher levels of leader learning goal orientation. Taken together, these findings suggest that when leaders emphasize avoiding failure while downplaying the importance of personal learning and development, employees perceive them as less ethical and are more willing to engage in ethical misconduct. We discuss implications of our findings for both theory and practice.
Clinical Integration of Point-of-care Ultrasound by Emergency Medicine Residents: A Single-center Mixed-methods Study.

Background Point-of-care ultrasound (POCUS) competence consists of image acquisition, image interpretation, and clinical integration. Limited data exist on POCUS usage patterns and clinical integration by emergency medicine (EM) residents. We sought to determine actual POCUS usage and clinical integration patterns by EM residents and to explore residents' perspectives on POCUS clinical integration. Methods We conducted an explanatory sequential mixed-methods study at a 4-year EM residency program. In phase 1, EM ultrasound (US) attendings observed PGY-4 EM residents' clinical integration of POCUS in real time while on shift in the emergency department (ED). EM US attendings evaluated residents on their intent to perform POCUS, actual POCUS usage, and competence per patient encounter. We used logistic regression to analyze these parameters. In phase 2, we conducted semi-structured interviews with the observed PGY-4 residents regarding POCUS usage and clinical integration in the ED. We analyzed qualitative data for themes. Results Emergency medicine US attendings observed 10 PGY-4 EM residents during 254 high-acuity patient encounters from December 2018 to March 2019. EM US attendings considered POCUS indicated for 26% (66/254) of patients, possibly indicated for 12% (30/254) and not indicated for 62% (158/254). Of the 66 patients for whom EM US attendings considered POCUS indicated, PGY-4s intended to perform POCUS for patient management 61% (40/66) of the time. PGY-4s subsequently incorporated POCUS into patient management 73% (48/66) of the time. EM US attendings considered PGY-4s entrustable to perform POCUS independently 81% (206/254) of the time. We did not find a statistically significant association between shift volume, shift type, or POCUS application, and resident intent to perform POCUS nor competence. Interviews identified three factors that influence PGY-4's POCUS clinical integration: motivations to use POCUS, barriers to utilization, and POCUS educational methods. Conclusions This mixed-methods study identified a significant gap in POCUS utilization and clinical integration by PGY-4 EM residents for clinically indicated cases identified by EM US attendings. As clinical integration is a cornerstone of POCUS competence, it is important to ensure that EM resident POCUS curricula emphasize training on clinical utilization and indications for POCUS while on shift in the ED.
Addressing the Gap in Education for Cleft Palate: A Module Training Series for Craniofacial Assessment and Treatment

Purpose A shortage of speech-language pathologists (SLPs) with expertise in cleft lip and palate (CLP) care exists in the United States and worldwide. Limited educational and clinical preparation c...
Antibiotic Treatment Pipeline for Clostridioides difficile Infection (CDI): A Wide Array of Narrow-Spectrum Agents

Clostridioides difficile infection (CDI) represents a major burden on the U.S. healthcare system. Despite the U.S. Food and Drug Administration (FDA) approval of fidaxomicin in 2011, observed rates of clinical cure and CDI recurrence suggest there is room to improve. As a result, there are many antibiotic treatments in the developmental pipeline for CDI. The purpose of this focused review is to summarize these antibiotic therapies in all stages of development. Here, we discuss 10 antibiotics in development, including three that have completed phase II trials, five in phase II trials, and two still undergoing preclinical trials. The antibiotic treatment pipeline for CDI contains a plethora of narrow-spectrum agents with unique mechanisms of action and potent activity against C. difficile. Only ridinilazole, LFF571, and ramoplanin have completed phase II trials, and ridinilazole is the only antibiotic to begin recruitment for a phase III trial. While the future of CDI treatment appears bright, the healthcare community will have to await the results from phase III trials.
A Novel 2-D Current Signal-Based Residual Learning With Optimized Softmax to Identify Faults in Ball Screw Actuators

Ball screw electro-mechanical actuators are commonly found in high precision motion control applications including aerospace systems as well as automated setups for industries. These actuators perform flight / application critical job and ball screw drives are responsible to provide precise linear motion while carrying thrust loading. A failure in ball screw drive may disturb positioning accuracy of overall system. At present, few techniques are available to monitor electro-mechanical actuators for aerospace and industrial systems. This paper provides a deep learning based intelligent technique to monitor condition of ball screw actuators. The proposed scheme utilizes modified residual learning scheme to extract features from two-dimensional transformed motor current signals. The current signal data was collected under different load domains in terms of magnitude and direction reversal. A 2D-Remanant-CNN (2D-Rem-CNN) model was developed for features extraction with proposed optimized softmax for classification of mechanical faults. The proposed technique was validated against different ball screw fault cases. The testing results prove the superiority of 2D-Rem-CNN model against different state of the art techniques. The proposed framework was also tested for system's stability under different load domains.
A Note on Singularity Formation for a Nonlocal Transport Equation (Research)

The α-patch model is used to study aspects of fluid equations. We show that solutions of this model form singularities in finite time and give a characterization of the solution profile at the singular time.
Multiple new species of Ophiocordyceps fungus on ants

Abstract In tropical forests, one of the most common relationships between parasites and insects is that between the fungus Ophiocordyceps (Ophiocordycipitaceae, Hypocreales, Ascomycota) and ants, especially within the tribe Camponotini. These fungi have the ability to penetrate the exoskeleton of the ant and to manipulate the behavior of the host, making it leave the nest and ascend understorey shrubs, to die biting onto the vegetation: hence, the term zombie-ant fungi to describe this behavioral changes on the host. It is posited that this behavioral change aids spore dispersal and thus increases the chances of infection. Despite their undoubted importance for ecosystem functioning, these fungal pathogens are still poorly documented, especially regarding their diversity, ecology and evolutionary relationships. Here, we describe multiple new and host-specific species of the genus Ophiocordyceps on Camponotus and Polyrhachis ants from the central Amazonian region of Brazil, USA, Australia and Japan, which can readily be separated using classic taxonomic criteria, in particular ascospore morphology.
Generational Empathy: An Approach for Addressing Generational Differences.

Generational differences result in conscious and unconscious biases that affect day-to-day interactions among professionals in the field of pediatrics. From the millennial trainee to the baby boomer seasoned clinician educator, including the three authors of this article, who span three generations, all are guilty to some extent. Pediatricians are not alone. In fact, some of them may even be in “exalted” company: > “They [Young People] have exalted notions because they have not been humbled by life or learned its necessary limitations; moreover, their hopeful disposition makes them think themselves equal to great things, and that means having exalted notions. They would always rather do noble deeds than useful ones. Their lives are regulated more by moral feeling than by reasoning. All their mistakes are in the direction of doing things excessively and vehemently.” > > Aristotle1 Every day, multidisciplinary teams of pediatric health care professionals converge in a clinical setting, hoping to create a psychologically healthy workplace where all generations feel included and valued in patient care discussions. Nonetheless, although health care team members in the field of pediatrics intentionally work to remedy the generational differences that arise between parents and their children, generational comparisons persist. We all are products of our own generational upbringings and the events that shaped our own lives, which, in turn, lead to perceptions about other generations that may or may not be true. We then may treat others … Address correspondence to Christian D. Pulcini, MD, MPH, MEd, Department of Surgery and Pediatrics, The Robert Larner College of Medicine, The University of Vermont and The University of Vermont Children’s Hospital, 111 Colchester Avenue, Burlington, Vermont 05401. E-mail: christian.pulcini{at}uvm.edu
How Far to Go in Reforming Taxation of Wealth: Revenue and Tax Avoidance

The article describes the revenue estimates of incremental versus fundamental reform options for taxation of individual wealth, and explains how tax avoidance assumptions underlie the larger estimates for fundamental reform.
Reply to “Why Should We Monitor (1-3)-β-d-Glucan Levels during Invasive Candidiasis? Just Ask Your Ophthalmologist!”

The incidence of ocular involvement in patients with candidemia, especially endophthalmitis, is relatively low. Patients who have a longer duration of candidemia have higher risk of developing ocular candidiasis ([1][1]). The current Infectious Diseases Society of America clinical practice
Redistributing Income under Proportional Representation

Although majoritarian decision rules are the norm in legislatures, relatively few democracies use simple majority rule at the electoral stage, adopting instead some form of multiparty proportional representation. Moreover, aggregate data suggest that average income tax rates are higher, and distributions of posttax income flatter, in countries with proportional representation than in those with majority rule. While there are other differences between these countries, this paper explores how variations in the political system per se influence equilibrium redistributive tax rates and income distributions. A three-party proportional representation model is developed in which taxes are determined through legislative bargaining among successful electoral parties, and the economic decision for individuals is occupational choice. Political-economic equilibria for this model and for a two-party, winner-take-all, majoritarian system are derived and compared.
Circulating Hydrogen Sulfide (H2S) and Nitric Oxide (NO) Levels Are Significantly Reduced in HIV Patients Concomitant with Increased Oxidative Stress Biomarkers

Human immunodeficiency virus (HIV) attacks the immune system and weakens the ability to fight infections/disease. Furthermore, HIV infection confers approximately two-fold higher risk of cardiac events compared with the general population. The pathological mechanisms responsible for the increased incidence of cardiovascular disease in HIV patients are largely unknown. We hypothesized that increased oxidative stress and attenuated circulating levels of the cardioprotective gaseous signaling molecules, nitric oxide (NO), and hydrogen sulfide (H2S) were involved in the cardiovascular pathobiology observed in HIV patients. Plasma samples from both HIV patients and age–matched normal subjects were used for all assays. Oxidative stress was determined by analyzing the levels of advanced oxidation protein products (AOPP) and H2O2. Antioxidant levels were determined by measuring the levels of trolox equivalent capacity. ADMA, hs-CRP, and IL-6 were determined by using ELISA. The levels of H2S (free H2S and sulfane sulfur) and NO2 (nitrite) were determined in the plasma samples by using gas chromatography and HPLC, respectively. In the present study we observed a marked induction in the levels of oxidative stress and decreased antioxidant status in the plasma of HIV patients as compared with the controls. Circulating levels of the cardiovascular disease biomarkers: ADMA, hs-CRP (high-sensitivity C-reactive protein), and IL-6 were significantly increased in the circulatory system of HIV patients. The levels of both nitrite and H2S/sulfane sulfur were significantly reduced in the plasma of HIV patients as compared with normal subjects. Our data demonstrate significant increases in circulating biomarkers of oxidative stress and cardiovascular (CV) in conjunction with decreased bioavailability of H2S and NO in HIV patients. Diminished levels of these two cardioprotective gaseous signaling molecules may be involved in the pathogenesis of CV disease in the setting of HIV.
Immobilization of molecular catalysts on solid supports via atomic layer deposition for chemical synthesis in sustainable solvents

Homogeneous molecular catalysts are valued for their reaction specificity but face challenges in manufacturing scale-up due to complexities in final product separation, catalyst recovery, and instability in the presence of water. Heterogenizing these molecular catalysts, by attachment to a solid support, could transform the practical utility of molecular catalysts, simplify catalyst separation and recovery, and prevent catalyst decomposition by impeding bimolecular catalyst interactions. Previous strategies to heterogenize molecular catalysts via ligand-first binding to supports have suffered from reduced catalytic activity and leaching (loss) of catalyst, especially in environmentally friendly solvents like water. Herein, we describe an approach in which molecular catalysts are first attached to a metal oxide support through acidic ligands and then “encapsulated” with a metal oxide layer via atomic layer deposition (ALD) to prevent molecular detachment from the surface. For this initial report, which is based upon the well-studied Suzuki carbon–carbon cross-coupling reaction, we demonstrate the ability to achieve catalytic performance using a non-noble metal molecular catalyst in high aqueous content solvents. The catalyst chosen exhibits limited catalytic reactivity under homogeneous conditions due to extremely short catalyst lifetimes, but when heterogenized and immobilized with an optimal ALD layer thickness product yields >90% can be obtained in primarily aqueous solutions. Catalyst characterization before and after ALD application and catalytic reaction is achieved with infrared, electron paramagnetic resonance, and X-ray spectroscopies.
Data modeling in the understanding database course: adding UML and XML modeling to the traditional course content

The purpose of this paper is to propose that following the teaching of entity-relationship modeling in the traditional way, visual CASE tools be used to introduce students to data modeling in object-oriented applications and XML schemas. The intent is to better align database courses with the teaching of object-oriented and network-based programming.
Hypothalamic-pituitary-adrenal axis modulation of GABAergic neuroactive steroids influences ethanol sensitivity and drinking behavior.

Activation of the hypothalamic-pituitary-adrenal (HPA) axis leads to elevations in γ-aminobutyric acid (GABA)-ergic neuroactive steroids that enhance GABA neurotransmission and restore homeostasis following stress. This regulation of the HPA axis maintains healthy brain function and protects against neuropsychiatrie disease. Ethanol sensitivity is influenced by elevations in neuroactive steroids that enhance the GABAergic effects of ethanol, and mayprevent excessive drinking in rodents and humans. Low ethanol sensitivity is associated with greater alcohol consumption and increased risk ofalcoholism. Indeed, ethanol-dependent rats show blunted neurosteroid responses to ethanol admin­istration that may contribute to ethanol tolerance and the propensity to drink greater amounts of ethanol. The review presents evidence to support the hypothesis that neurosteroids contribute to ethanol actions and prevent excessive drinking, while the lack of neurosteroid responses to ethanol may underlie innate or chronic tolerance and increased risk of excessive drinking. Neurosteroids may have therapeutic use in alcohol withdrawal or for relapse prevention.
Spin optodynamics analog of cavity optomechanics

The dynamics of a large quantum spin coupled parametrically to an optical resonator is treated in analogy with the motion of a cantilever in cavity optomechanics. Distinct spin optodynamic phenomena are predicted, such as cavity-spin bistability, optodynamic spin-precession frequency shifts, coherent amplification and damping of spin, and the spin optodynamic squeezing of light.
Role of arachidonic acid metabolites in acid-pepsin injury to rabbit esophagus

The role of cyclooxygenase and lipoxygenase metabolites of arachidonic acid in experimental esophageal were lumenally perfused for 1 h with acidified saline (pH 2.0) with or without pepsin followed by a second hour with acidified saline. Separate groups of pepsin-perfused animals were pretreated with indomethacin, a cyclooxygenase inhibitor, or BW755C, a lipoxygenase-cyclooxygenase inhibitor. Esophageal injury was graded grossly. H+ and hemoglobin fluxes were determined. Acidified saline caused no significant damage. Pepsin induced moderate injury. Indomethacin decreased pepsin-induced H+ flux by 55% without affecting the other indices. BW755C, by all measurements, dramatically increased pepsin-induced injury. In separate experiments, cyclooxygenase activity was decreased by indomethacin and BW755C by 62% and 49%, respectively. Lipoxygenase activity was decreased 74% by BW755C and was not significantly affected by indomethacin. These results suggest that esophageal cytoprotection is mediated by endogenous lipoxygenase metabolites.