cssi/SciSciGPT-SciSciNet huggingface dataset:
Predictors of Developmental Task Attainment for Young Adults from Divorced Families

To determine which variables impact developmental task attainment for young adults from divorced families, respondents completed demographic questions, the young adult version of the Personal Authority in the Family System Questionnaire, and the three family relationship subscales of the Family Environment Scale. Of the factors assessed, results suggest that the quality of post-divorce family functioning is the most salient predictor of development for young adults from divorced families. Additionally, although conflict and cohesion have unique effects on task attainment for young adults, expressiveness appears to be the dimension of post divorce family functioning most related to young adult development.
Sparse Matrix-Matrix Multiplication on Multilevel Memory Architectures: Algorithms and Experiments

Architectures with multiple classes of memory media are becoming a common part of mainstream supercomputer deployments. So called multi-level memories offer differing characteristics for each memory component including variation in bandwidth, latency and capacity. This paper investigates the performance of sparse matrix multiplication kernels on two leading high-performance computing architectures -- Intel's Knights Landing processor and NVIDIA's Pascal GPU. We describe a data placement method and a chunking-based algorithm for our kernels that exploits the existence of the multiple memory spaces in each hardware platform. We evaluate the performance of these methods w.r.t. standard algorithms using the auto-caching mechanisms. Our results show that standard algorithms that exploit cache reuse performed as well as multi-memory-aware algorithms for architectures such as KNLs where the memory subsystems have similar latencies. However, for architectures such as GPUs where memory subsystems differ significantly in both bandwidth and latency, multi-memory-aware methods are crucial for good performance. In addition, our new approaches permit the user to run problems that require larger capacities than the fastest memory of each compute node without depending on the software-managed cache mechanisms.
Instrumented arthrodesis for non-traumatic craniocervical instability in very young children

Occipitocervical instrumentation is infrequently required for stabilization of the axial and subaxial cervical spine in very young children. However, when it is necessary, unique surgical considerations arise in children when compared with similar procedures in adults. The authors reviewed literature describing fusion of the occipitocervical junction (OCJ) in toddlers and share their experience with eight cases of young children (age less than or equal to 4 years) receiving occiput to axial or subaxial spine instrumentation and fixation. Diagnoses and indications included severe or secondary Chiari malformation, skeletal dysplastic syndromes, Klippel-Feil syndrome, Pierre Robin syndrome, Gordon syndrome, hemivertebra and atlantal occipitalization, basilar impression, and iatrogenic causes. All patients underwent occipital bone to cervical spine instrumentation and fixation at different levels. Constructs extended from the occiput to C2 and T1 utilizing various permutations of titanium rods, autologous rib autografts, Mersilene sutures, and combinations of autografts with bone matrix materials. All patients were placed in rigid cervical bracing or halo fixation postoperatively. No postoperative neurological deficits or intraoperative vascular injuries occurred. Instrumented arthrodesis can be a treatment option in very young children to address the non-traumatic craniocervical instability while reducing the need for prolonged external halo vest immobilization. Factors affecting fusion are addressed with respect to preoperative, intraoperative, and postoperative decision-making that may be unique to the toddler population.
Krümmungskreis im Scheitel der Parabel

Wir bringen die Parabel y = ax2 zum Schnitt mit einem Kreis, der die Scheiteltangente im Scheitel beruhrt. Der Kreis moge die Gleichung haben x 2 = y(2r−y). Die Koordinaten der Schnittpunkte erfullen beide Gleichungen; es ist also (Abb. 55) $$y = ay\left( {2r - y} \right)$$ Oder $$y\left( {2ar - ay - 1} \right) = 0$$ ; y = 0 entspricht dem Punkte 0, $$y = \frac{{2ar - 1}}{a} = 2r - \frac{1}{a} $$ den Punkten A und B.
High-Throughput Analysis of PPCPs, PCDD/Fs, and PCBs in Biological Matrices Using GC–MS/MS

Abstract There is an increasing demand for high-throughput analytical methods specifically designed for the quantitation of organic contaminants in biological matrices. This demand exists in the broad fields of environmental chemistry and toxicology as well as medicine, food safety, drug discovery, and criminal forensics. Analytical chemists seek to develop techniques to reduce or eliminate method bottlenecks, which will improve the flow of information and downstream decisions. Advances in analysis of organic contaminants in biological matrices require the development of a novel sample preparation technique as well as more detailed MS/MS optimization. These analytical methods improve the laboratory’s ability to provide routine analysis and scale up its capability for larger, time-sensitive projects, such as environmental disasters. In addition, these advances reduce labor, training, consumption of and exposure to hazardous organic solvents, and laboratory space, thus reducing the time and cost of analysis.
Genomic Signatures of Adaptation to a Precipitation Gradient in Nigerian Sorghum

Evolution of plants under climatic gradients may lead to clinal adaptation. Understanding the genomic basis of clinal adaptation in crops species could facilitate breeding for climate resilience. We investigated signatures of clinal adaptation in the cereal crop sorghum (Sorghum bicolor L. [Moench]) to the precipitation gradient in West Africa using a panel (n = 607) of sorghum accessions from diverse agroclimatic zones of Nigeria. Significant correlations were observed between common-garden phenotypes of three putative climate-adaptive traits (flowering time, plant height, and panicle length) and climatic variables. The panel was characterized at >400,000 single nucleotide polymorphisms (SNPs) using genotyping-by-sequencing (GBS). Redundancy analysis indicated that a small proportion of SNP variation can be explained by climate (1%), space (1%), and climate collinear with space (3%). Discriminant analysis of principal components identified three genetic groups that are distributed differently along the precipitation gradient. Genome-wide association studies were conducted with phenotypes and three climatic variables (annual mean precipitation, precipitation in the driest quarter, and annual mean temperature). There was no overall enrichment of associations near a priori candidate genes implicated in flowering time, height, and inflorescence architecture in cereals, but several significant associations were found near a priori candidates including photoperiodic flowering regulators SbCN12 and Ma6. Together, the findings suggest that a small (3%) but significant proportion of nucleotide variation in Nigerian sorghum landraces reflects clinal adaptation along the West African precipitation gradient.
Electric Field Breakdown Versus Frequency Simulated Under Atmospheric Conditions For Large Gaps

Breakdown of air at atmospheric pressure in response to AC fields in gaps larger than 1 cm was simulated. Most previous literature concerning breakdown in this regime has focused on much smaller gaps1
Negotiation Lessons From Former Wiseguy, Michael Franzese:

Thirteen years after his release from a federal penitentiary and after successfully walking away from a life in the Mafia, former crime boss Michael Franzese sat down with interviewers to discuss n...
Obstructive sleep apnea: A better Dx model for primary care

This study identified a method that provides a truer assessment of disease probability than has been achieved with history and physical exam evaluation.
From Clusters to Content: Using Code Clustering for Course Improvement

Large undergraduate CS courses receive thousands of code submissions per term. To help make sense of the large quantities of submissions, projects have emerged to dynamically cluster student submissions by approach for writing scalable feedback, tailoring hints, and conducting research. However, relatively little attention has been paid to the value of these tools for informing revision to core course materials and delivery methods. In this work, we applied one such technology-Sense, the eponymous product of its company-to an online CS1 class delivered simultaneously for credit to on-campus students and for free to MOOC students. Using Sense, we clustered student submissions to around 70 problems used throughout the course. In this work, we discuss the value of such clustering, the surprising trends we discovered through this process, and the changes made or planned to the course based on the results. We also discuss broader ideas on injecting clustering results into course design.
FROM MULTIPLE MYELOMA TO MYOCARDITIS

There are rare reports in the literature of bortezomib induced cardiotoxicity. We report a presentation of fulminant myocarditis due to bortezomib. A 53 year old male with recent diagnosis of multiple myeloma, on lenalidomide, bortezomib, and dexamethasone, presents to the ER with chest pain. ECG
Scalable Rule Enforcement in SDN through Separate User Identifiers

Aggressive usage of wildcard rules has been shown to be crucial to scaling software defined networks to large, policy rich enterprise networks. However, the full potential of wildcard rules is only realized through effective aggregation of users. In this paper, we take the position that this aggregation is best achieved through the use of separate identifiers for policy enforcement and packet forwarding. We present two contributions. First, we present three arguments against the current practice that uses IP addresses to enforce policy: (i) aggregation for policy rules conflicts with aggregation for forwarding, (ii) using IP addresses cannot adequately represent the multiple logical groups which a single user belongs to, and (iii) using IP addresses requires management domains to expose their IP allocation scheme to others. Second, we present a novel architecture that uses separate identifiers and tables for policy enforcement and packet forwarding, enabling optimal aggregation of users for both purposes. We carefully designed our architecture so that it can be readily implemented using functionalities provided by commodity OpenFlow switches.
Association of Ustekinumab vs TNF Inhibitor Therapy With Risk of Atrial Fibrillation and Cardiovascular Events in Patients With Psoriasis or Psoriatic Arthritis.

Importance Accumulating evidence indicates that there is an increased risk of cardiovascular disease among patients with psoriatic disease. Although an emerging concern that the risk of atrial fibrillation (AF) may also be higher in this patient population adds to the growing support of initiating early interventions to control systemic inflammation, evidence on the comparative cardiovascular safety of current biologic treatments remains limited. Objective To evaluate the risk of AF and major adverse cardiovascular events (MACE) associated with use of ustekinumab vs tumor necrosis factor inhibitors (TNFi) in patients with psoriasis or psoriatic arthritis. Design, Setting, and Participants This cohort study included data from a nationwide sample of 78 162 commercially insured patients in 2 US commercial insurance databases (Optum and MarketScan) from September 25, 2009, through September 30, 2015. Patients were included if they were 18 years or older, had psoriasis or psoriatic arthritis, and initiated ustekinumab or a TNFi therapy. Exclusion criteria included history of AF or receipt of antiarrhythmic or anticoagulant therapy during the baseline period. Exposures Initiation of ustekinumab vs TNFi therapy. Main Outcomes and Measures Incident AF and MACE, including myocardial infarction, stroke, or coronary revascularization. Results A total of 60 028 patients with psoriasis or psoriatic arthritis (9071 ustekinumab initiators and 50 957 TNFi initiators) were included in the analyses. The mean (SD) age was 46 (13) years in Optum and 47 (13) in MarketScan, and 29 495 (49.1%) were male. Overall crude incidence rates (reported per 1000 person-years) for AF were 5.0 (95% CI, 3.8-6.5) for ustekinumab initiators and 4.7 (95% CI, 4.2-5.2) for TNFi initiators, and for MACE were 6.2 (95% CI, 4.9-7.8) for ustekinumab initiators and 6.1 (95% CI, 5.5-6.7) for TNFi initiators. The combined adjusted hazard ratio for incident AF among ustekinumab initiators was 1.08 (95% CI, 0.76-1.54) and for MACE among ustekinumab initiators was 1.10 (95% CI, 0.80-1.52) compared with TNFi initiators. Conclusions and Relevance No substantially different risk of incident AF or MACE after initiation of ustekinumab vs TNFi was observed in this study. This information may be helpful when weighing the risks and benefits of various systemic treatment strategies for psoriatic disease.
Claude McKay, The Workers' Dreadnought, and collaborative poetics

This paper considers the journalism and poetry Claude McKay produced for Sylvia Pankhurst's communist weekly Workers' Dreadnought in 1920 as a collaboratively produced body of work. This allowed Pa...
Stage-Specific and Selective Delivery of Caged Azidosugars into the Intracellular Parasite Toxoplasma gondii by Using an Esterase-Ester Pair Technique

Toxoplasma gondii is an obligate intracellular parasite that chronically infects up to a third of the human population. The parasites persist in the form of cysts in the central nervous system and serve as a reservoir for the reactivation of toxoplasmic encephalitis. The cyst wall is known to have abundant O-linked N-acetylgalactosamine glycans, but the existing metabolic labeling methods do not allow selective labeling of intracellular parasite glycoproteins without labeling of host glycans. In this study, we have integrated Cu(I)-catalyzed bioorthogonal click chemistry with a specific esterase-ester pair system in order to selectively deliver azidosugars to the intracellular parasites. We demonstrated that α-cyclopropyl modified GalNAz was cleaved by porcine liver esterase produced in the parasites but not in the host cells. Our proof-of-concept study demonstrates the feasibility and potential of this esterase-ester click chemistry approach for the selective delivery of small molecules in a stage-specific manner.IMPORTANCE Selective delivery of small molecules into intracellular parasites is particularly problematic due to the presence of multiple membranes and surrounding host cells. We have devised a method that can deliver caged molecules into an intracellular parasite, Toxoplasma gondii, that express an uncaging enzyme in a stage-specific manner without affecting host cell biology. This system provides a valuable tool for studying many intracellular parasites.
Data-driven spatial modeling of global long-term urban land development: The SELECT model

Abstract Built-up land/impervious surface expansion links urbanization and environmental change. To enable large-scale long-term spatially-explicit studies, we took a data-driven approach exploiting newly-available time series of fine-spatial-resolution remote sensing observations, and developed the Spatially-Explicit, Long-term, Empirical City developmenT (SELECT) model. Closely calibrated to observational data, SELECT functions at several spatial scales, with multiple design traits capturing local variations of urbanization, and ensuring performance for long-term extrapolations in scenario analyses (e.g. the Shared Socioeconomic Pathways). It showed low estimation residuals, explained high fractions of the response's variations, and scored well in all robustness and generalizability tests we ran. When compared with a typical spatial-interaction-based model for projecting global built-up land in 2030, SELECT allocated more new development to areas with similar characteristics to locations that exhibited expansive urban growth historically, while the example spatial-interaction-based model allocated more new development to areas with high amounts of existing built-up land.
The Immune System and Skin Cancer

Carcinogenesis involves multiple mechanisms that disturb genomic integrity and encourage abnormal proliferation. The immune system plays an integral rxole in maintaining homeostasis and these mechanisms may arrest or enhance dysplasia. There exists a large body of evidence from organ transplantation literature supporting the significance of the immune suppression in the development of skin cancer. Nonmelanoma skin cancers are the most frequent neoplasms after organ transplantation, with organ transplant recipients having a 65-fold increase in squamous cell carcinoma incidence and 10-fold increase in basai cell carcinoma incidence. Similarly, UV-radiation (UVR) induced immunosuppression is correlated with the development of cutaneous malignancies in a dose-dependent manner. This was flrst shown several decades ago by Margaret Kripke, when transplanted tumors were rejected in mice with competent immune systems, but grew unchecked in immunosuppressed specimens. After UV exposure, chromophores initiate a cascade that leads to immunosuppression via derangement of Langerhans cells' antigen-presenting capacity. UV-irradiated Langerhans cells present antigens to Th2 cells, but fail to stimulate Thl cells. A subset of T regulatory cells, speciflc for the antigen encountered after UVR, is also stimulated to proliferate. In general UV irradiation leads to a greater number of T regulatory cells and fewer effector T cells in the skin, shiftingthe balance from T-cell-mediated immunity to immunosuppression. These regulatory cells have the phenotype CD4+, CD25+, Foxp3+, CTLA-4+. These and many other changes in local immunity lead to a suppressed immune state, which allow for skin cancer development.
Anastomotic Technique and Preoperative Imaging in Microsurgical Lower-Extremity Reconstruction: A Single-Surgeon Experience

Background The need for preoperative imaging as well as anastomotic technique (ie, end-to-side [ETS] vs end-to-end [ETE]) are areas of controversy in microsurgical lower-extremity reconstruction. The objective of this study was to (1) investigate whether preoperative imaging is mandatory and (2) to elicit if the type of anastomosis impacts clinical outcomes. Methods A retrospective review of all patients who underwent microvascular lower-extremity reconstruction between 2007 and 2015 by a single surgeon was performed. Patients were categorized into groups based on anastomotic technique, that is, ETE versus ETS anastomosis. Patients in the ETE group were further subclassified into those who had preoperative imaging (computed tomography angiography [CTA]+) versus those who did not (CTA-). Parameters of interest included flap type, thrombosis rate, flap loss, length of stay (LOS), return to ambulation, and rate of secondary amputation. Two-sided statistical analysis was performed using Kruskal-Wallis rank-sum test and Fisher exact test. Results One hundred twenty-eight patients were analyzed: ETE (n = 40) and ETS (n = 88). Mean follow-up for both groups was 20 ± 19 months. Anterolateral thigh flaps were most commonly performed (71%). Overall flap loss rate was 3.1% without any significant differences noted with respect to thrombosis (arterial, P = 0.09; venous, P = 0.56), flap loss (P = 0.33), LOS (P = 0.28), amputation (P = 1.00), or return to ambulation (P = 0.77). Furthermore, the availability of preoperative imaging (CTA+: N = 11 vs CTA-: N = 29) did not impact rates of thrombosis (arterial, P = 0.29; venous, P = 0.31), flap loss (P = 1.00), LOS (P = 0.26), or return to mobility (P = 0.62). Conclusions In light of similar reconstructive outcomes, we prefer to preserve distal extremity perfusion via ETS anastomoses whenever possible. Furthermore, preoperative vascular imaging angiography might not be necessary in patients with palpable pedal pulses on preoperative examination. An actionable algorithm for determining ETS versus ETE anastomosis in lower-extremity reconstruction is presented.
Prostate field cancerization and exosomes: Association between CD9, early growth response 1 and fatty acid synthase

Intracapsular and well‑defined adenocarcinomas of the prostate are often surrounded by tissue areas that harbor molecular aberrations, including those of genetic, epigenetic and biochemical nature. This is known as field cancerization, or a field effect and denotes a state of pre‑malignancy. Such alterations in histologically normal tumor‑adjacent prostatic tissues have been recognized as clinically important and are potentially exploitable as biomarkers of disease and/or targets for preventative/therapeutic intervention. The authors have previously identified and validated two protein markers of field cancerization: The expressional upregulation of the transcription factor early growth response 1 (EGR‑1) and the lipogenic enzyme fatty acid synthase (FASN). However, the molecular etiology of prostate field cancerization, including EGR‑1 and FASN upregulation, remains largely unknown. It was thus hypothesized that extracellular vesicles, notably exosomes, released by tumor lesions may induce molecular alterations in the surrounding tissues, resulting in field cancerization, priming the tissue, and ultimately promoting multifocal tumorigenesis, which is often observed in prostate cancer. Towards testing this hypothesis, the current study, to the best of our knowledge, for the first time, presents correlative protein expression data, generated in disease‑free, tumor‑adjacent and cancerous human prostate tissues by quantitative immunofluorescence, between the exosomal marker CD9, and EGR‑1 and FASN. Despite the pilot character of the present study, and the static nature and heterogeneity of human tissues, the data suggest that CD9 expression itself is part of a field effect. In support of this hypothesis, the results suggest a possible contribution of exosomes to the induction of field cancerization in the prostate, particularly for EGR‑1. These findings were corroborated in established cell models of cancerous (LNCaP) and non‑cancerous (RWPE‑1) human prostate epithelial cells. The findings of this study warrant further investigation into the functional interface between exosomes and field cancerization, as a detailed understanding of this characterization may lead to the development of clinical applications related to diagnosis and/or prognosis and targeted intervention to prevent progression from pre‑malignancy to cancer.
We Don't Have to Lose STEM Students to Business

Most undergraduate students who leave STEM majors before graduation choose careers in business. This article argues that better integrating business opportunities and context into the STEM curriculum could advance STEM learning, motivate students to remain in STEM as majors, and cultivate a constructive relationship between business, science, and society.
Alzheimer's Disease and its Related Dementias among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review.

Background The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) aging population is rapidly growing and the burden of Alzheimer's disease and its related dementias (ADRD) will likely mirror this demographic growth. AANHPIs face significant barriers in obtaining timely ADRD diagnosis and services; yet little is known about ADRD in this population. Objective The study objective is to conduct a systematic review on the published literature on ADRD among AANHPIs to identify gaps and priorities to inform future research and action plans. Methods The systematic review was conducted following the PRISMA Protocol for Systematic Reviews. Co-author (TR), an experienced Medical Librarian, searched PubMed, EMBASE, PsycINFO, Cochrane Central of Clinical Trials, Ageline, and Web of Science for peer-reviewed articles describing ADRD among AANHPIs. The search was not limited by language or publication date. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus. Results The title/abstract and full texts of 1,447 unique articles were screened for inclusion, yielding 168 articles for analysis. Major research topics included prevalence, risk factors, comorbidities, interventions and outreach, knowledge and attitudes, caregiving, and detection tools. A limited number of studies reported on national data, on NHPI communities generally, and on efficacy of interventions targeting AANHPI communities. Conclusion To our knowledge, this is the first systematic review on ADRD among AANHPI populations. Our review provides a first step in mapping the extant literature on ADRD among this underserved and under-researched population and will serve as a guide for future research, policy, and intervention.
Access and Barriers to Take-Home Naloxone Use among Emergency Department Patients with Opioid Misuse in Baltimore, Maryland, USA.

The opioid epidemic has prompted the expansion of take-home naloxone (THN) distribution programs. The proportion of emergency department (ED) patients with opioid misuse who have access to a naloxo...
Cancer Progress and Priorities: Breast Cancer

Breast cancer is the most commonly diagnosed invasive cancer among women both globally and within the United States and the number one cause of cancer-related deaths among women globally ([1, 2][1]). Less than 1% of diagnosed breast cancers occur in men ([2][2]) and, therefore, male breast cancer is
Rural Resilience in Cancer Survivors: Conceptual Analysis of a Global Phenomenon

Aim: The aims of this analysis are to (1) identify the concept of rural resiliency in cancer survivors in the nursing literature and (2) propose a conceptual framework that may help nurses leverage rural resilience to improve survivorship care. Background: Rural cancer survivors demonstrate rural resiliency by utilizing aspects of rural culture to improve their psychosocial distress. However, resiliency in rural cancer survivors is poorly understood. Design: We used Walker & Avants’ concept analysis approach to direct article selection, review, and analysis. Review methods: We identified a definition, antecedents, consequences, attributes, empirical referents, and related terms, and provide model, contrary, and borderline case examples. Results: We identified 29 articles that met inclusion criteria. We propose a conceptual model of rural resiliency that is grounded in three domains of rural culture: spirituality, cultural norms, and social capital. Attributes of rural culture within these domains impact a cancer survivor’s psychosocial health, leading to either negative or positive psychosocial outcomes. Conclusion: A better understanding of how rural resiliency impacts cancer survivors can help clinicians and researchers provide culturally-targeted post-treatment interventions. Our proposed conceptual framework may guide nurse researchers to develop measurement tools that evaluate rural resilience and its impact on health outcomes. Keywords: rural, cancer survivor, resilience, concept analysis, conceptual frameworkDOI: https://doi.org/10.14574/ojrnhc.v21i1.676
Teaching labor in food studies: challenging consumer-based approaches to social change through student research community partnerships

In this article we explore the results of a research collaboration between an undergraduate class focused on labor in the food system and the nonprofit organization, Restaurant Opportunities Center...
Catheter-based Techniques for Terminal Cancer Pain: A Review of Nonneuraxial Interventions with Clinical Implications for End-of-Life Pain Management.

Background Evidence suggests that a significant proportion of terminal cancer patients have uncontrolled or inadequately controlled pain when using the World Health Organization (WHO) analgesic ladder approach. The use of interventional techniques has proven to reduce pain that is refractory to conventional methods. However, despite the use of well-established techniques (e.g., intrathecal drug delivery, celiac plexus blocks, etc), nonneuraxial, catheter-based techniques remain underutilized. Objective The purpose of this narrative review is to examine the evidence for nonneuraxial, catheter-based techniques in treating terminal cancer pain, the barriers to implementation, and its role in bridging the gap between single shot techniques and surgically implanted devices. Study design This is a narrative review article summarizing case reports, case series, retrospective studies, prospective studies, and review articles published at any time frame on the use of nonneuraxial, catheter-based techniques for the treatment of cancer pain in the end-of-life setting. Setting The University of Texas MD Anderson Cancer Center. Methods A literature search was conducted from November 2020 to January 2021 using the PubMed database and keywords related to nonneuraxial catheters, terminal cancer pain, and hospice. All English-based literature published at any time frame involving human patients was included. Results The number of studies referencing the use of nonneuraxial, catheter-based techniques for the treatment of terminal cancer pain is limited (n = 25). All of these studies were small, single-center, nonrandomized, noncontrolled case series and case reports. A total of 63 patients were evaluated across all studies, with the largest study involving 12 patients. The most common medication used was monotherapy with bupivacaine or ropivacaine and the longest duration of continuous catheter usage was 217 days. Of the studies that reported outcomes, the majority reported a reduction in pain. Very few studies reported catheter-related adverse events and tunneling appeared to be an important factor in reducing complications. Limitations No studies were available comparing the use of nonneuraxial, catheter-based techniques to conventional systemic medical management. Further, the studies in this review were heterogenous and limited to a small sample sizes reported in case reports and case series only. Conclusion Nonneuraxial, catheter-based techniques have the potential to play a significant role in the treatment of terminal cancer pain. Despite limited data, initial findings indicate that nonneuraxial, catheter-based techniques have the potential to bridge the gap between single shot interventions and surgical implanted devices by providing an effective, continuous therapy, with a lower risk profile.
Re-thinking Stepfathers’ Contributions: Fathers, Stepfathers, and Child Wellbeing

Using data from a contemporary cohort of children, we revisit the question of whether children benefit from being close to and engaging in activities with a stepfather. We deploy the Fragile Famili...
Single Ophthalmology Program Trends in Resident Surgical and Research Productivity by Gender, Underrepresented Minority Status, and Welcoming a Child

Objective The aim of the study is to identify differences for cataract surgery, total procedural volume, and publication rates between residents by gender, underrepresented minority (URM) status, and welcoming a child during ophthalmology residency. Design This is a retrospective, cross-sectional study. Participants A total of 89 residents graduating from 2002 to 2020 at a single program were included. Methods A multiple linear regression model was created to determine factors predictive of the number of cataract surgeries performed as the primary surgeon, total procedural volume, number of publications, or first author publications. Independent variables included resident gender, URM status, PhD degree, welcoming a child during residency, and graduation year. Results Of the 89 graduating residents included in this study, identifying as female (45 women, 50.6%) and as URM (eight identifying as URM, 9.0%) was not associated with a difference in surgical or research volume. Female residents performed a mean (SD) of 240.1 (55.1) cataract surgeries while male residents performed 210.6 (46.1) cataract surgeries. Residents identifying as URM completed 228.1 (41.9), while non-URM residents completed 234.8 (51.9) cataract surgeries. Since 2008, eight female residents (22.2%) and two male residents (6.9%) added children to their families. Welcoming a child to the family was also not associated with decreased surgical or publication volume. Number of cataract surgeries, total procedures, and number of publications did increase over time (p Conclusion Surgical and research productivity has increased, and female residents and residents who identify as URM did not have fewer cataract surgeries or procedures. Welcoming a child also did not correlate with differences in surgical or procedural volume. Programs should continue to promote equitable surgery and procedural distributions as well as identify more targeted strategies to encourage and recruit underrepresented medical students into ophthalmology.
Transverse and Short Oblique Metacarpal Shaft Fractures

Transverse metacarpal shaft fractures often result from crush or high-velocity injuries and are accompanied by severe swelling and soft tissue damage even when the fracture is closed (Figs. 16-1 A and 16-2 A). Even though the fracture configuation is stable, satisfactory reduction may not be possible because of soft tissue swelling (Fig. 16-1 B). Open reduction (Figs. 16-1 C, D) may be necessary. The surgeon must decide whether the additional dissection necesary for plate fixation is justified by the considerably increased stability achieved at the fracture site (Figs. 16-1 E-G). With less dissection, a tension band wire with or without neutralizing Kirschner wires may be considered for stabilization of a transverse or short oblique metacarpal diaphyseal fracture (Figs. 16-2 A-C).
Vibrational levels in the N4++H charge transfer system

The energies of bound vibrational levels supported by the attractive potential well in the interaction of a neutral hydrogen atom and a multiply charged nitrogen atom are calculated in the diabatic representation. Their rates of depopulation through predissociation to other ion-ion channels are evaluated and compared with the rate of spontaneous emission.
Symmetry-related mutants in the quinone binding sites of the bacterial reaction center – the effects of changes in charge distribution

To probe the structural elements that contribute to the functional asymmetries of the two ubiquinone10 binding pockets in the reaction center of Rhodobacter capsulatus, we targeted the L212Glu–L213Asp (near QB) and the M246Ala-M247Ala (near QA) pairs of symmetry-related residues for site-specific mutagenesis. We have constructed site-specific mutants that eliminate the sequence differences at these positions (L212Glu–L213Asp→Ala-Ala or M246Ala–M247Ala→Glu-Asp), and have reversed that asymmetry by constructing a quadruple-mutant strain, ‘RQ’ (L212Glu–L213Asp-M246Ala–M247Ala→Ala-Ala-Gl u-Asp). The mutations were designed to change the charge distribution in the quinone-binding region of the reaction center; none of the strains is capable of photosynthetic growth. In photocompetent phenotypic revertants of the RQ strain, second-site mutations which affect QB function are coupled to mutations in the QA site which restore an Ala or substitute a Tyr at the M247 site; one strain carries an additional Met→Leu substitution at M260 near QA. All of the RQ revertants retain the engineered M246Ala→Glu mutation in the QA site as well as the L212Ala–L213Ala mutations in the QB site. Kinetic characterization of the RQ revertants will give us an idea of what structural and functional elements are important for restoring efficiency to electron and proton transfer pathways in the RQ RC, which is far from native. To date, these preliminary results underscore the importance of an asymmetric distribution of polar amino acids in the quinone binding pockets and its influence on the functional properties of the reaction center.
The Effect of CAREX on muscle activation during a point-to-point reaching task

Exoskeletons have been used successfully for functional training of human motions. Our designs of the Cable-driven Arm Exoskeleton (CAREX) are targeted to improve arm function in patients with stroke. In this study, we focus on how muscle activation patterns of subjects change during movements with and without CAREX. Our goal was to evaluate whether CAREX distorts the natural pattern of EMG activity in healthy human subjects during arm movements. Eight healthy subjects performed point-to-point reaching tasks under two conditions: (a) with or without CAREX, and (b) with or without a 5 lb weight attached to their wrist. The EMG signals of 10 muscles were recorded and processed. The results showed that (i) EMG pattern of the subjects while wearing CAREX and while not wearing CAREX showed a high correlation, suggesting little alteration to normal EMG patterns while wearing CAREX; (ii) The subjects showed significantly lower muscle activation when they wore CAREX; (iii) The high correlation and the lower activation were observed in both the no weight condition and the 5 lb weight condition. Overall, the results suggest that CAREX can help subjects reduce the magnitude of muscle activation while preserving normal muscle activation patterns.
Anomalous results from PO applied to reflector antennas: the importance of near field computations

In the design of reflector antennas the physical optics (PO) analysis technique is the most popular numerical technique. Powerful computer codes are available for the analysis of single or multi reflector antenna systems. Additionally, ever-increasingly demand on the antenna performance necessitates the computation of antenna far field patterns under various situations. For example, in using multi-reflector antennas such as Gregorian or Cassegrain, it may become necessary to determine the total fields including the feed radiation pattern, subreflector scattered pattern and the main reflector scattered pattern. In these situations, the common practice is to sum up various scattered fields and the incident field contributions to obtain the desired total field. It is the purpose of this paper to demonstrate that the typical approach based on the far field pattern of the feed would result in an erroneous result and special care must be exercised to obtain the correct result. This is demonstrated through a detailed investigation of a representative test case.
Principles and Practices of Immunoassays, 2nd ed. Christopher Price and David Newman. New York: Stockton Press, 1997, 750 pp. $140.00. ISBN 1–56159-175–0.

In the 6 years since the publication of the first edition there have been significant advances in immunoassay. The second edition brings this volume up to the current state-of-the-art. The editors have kept to their successful formula of putting together a collection of papers by active participants in the development of immunoassays. Except for a couple of chapters, the material has been significantly revised and expanded. The number of chapters has increased by 3 to a total of 25. The book focuses on the components and methodologies of immunoassays with specific application to the clinical laboratory. However, this is not a laboratory manual, but rather more of a source manual. Each chapter is heavily referenced, with the majority of the references published within the last 10 years. Upon first opening the book, I was delighted to see three pages of abbreviations prior to the first chapter, a welcome addition. The first third of the book concerns itself with the production and characterization of antibodies for use in immunoassays. Included here are chapters on the utilization of surface plasmon resonance …
Evidence-Base for Fever Interventions Following Stroke

The febrile response is an important and adaptive host defense. In the context of brain injury, however, fever is thought to induce secondary brain injury and be associated with worse outcomes and higher mortality rates. For many years, researchers and clinicians have identified fever as a critical concern in the management of patients after stroke. Recent work has focused on care processes in fever management of the stroke patient. Most studies have focused solely on frequency of temperature measurement or antipyretic administration rather than examining the full scope of possible intervention. Fever is an adaptive response of the host to a perceived threat and is frequently encountered by healthcare professionals. Instead of being an adaptive response, in the presence of an acute neurological insult such as stroke, fever has been associated with worsened outcomes, such as larger infarct volume, higher rates of mortality, and greater disability and dependence.1–6 The underlying mechanism for the secondary injury related to fever is the heightened inflammatory response induced by the elevation in temperature. This makes the blood–brain barrier more permeable to immune cells, leading to cerebral edema and neuronal death. Additionally, fever increases the production of free radicals, promoting glutamate release and resulting in excitotoxicity.6,7 Fever is seen in between 40% and 60% of patients after stroke.8,9 The American Heart Association (AHA) stroke guidelines state that maintenance of normothermia (T 99.6°F should be managed aggressively” as a Class I recommendation (p. 2926).11 Similarly, the European Stroke Initiative recommends treating temperature >37.5°C.12 Nurses frequently must manage fever, and their decision-making is relevant …
Retardation of fetal brain cell growth during maternal starvation: circulating factors versus altered cellular response.

Maternal starvation inhibits fetal brain development during late gestation in the rat. To determine whether intrinsic or extrinsic factors might be the principal contributor to altered growth, brain cells from 20 day fetuses were cultured in a 96 well plate with MEM and 10% adult rat serum. Tissue growth was monitored by spectrophotometric measurement of the mitochondrial reduction of a chromagen 3-(4,5 dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide (MTT). After 1, 4 or 6 days incubation, MTT activity in non confluent cultures was shown to be directly related to tissue mass. When fetal brain cell cultures were incubated with 1% and 10% concentrations of adult rat serum, an 11-fold increase in MTT activity paralleled a 15-fold increase in tritiated thymidine incorporation. The impact of maternal starvation on fetal brain cell growth was examined by measuring MTT activity in fetal brain cells from fed and starved mothers. When cultures were incubated for 6 days with graded concentrations of fed adult serum (1.25–10%), the MTT response was slightly but consistently lower in cells from starved when compared with cells from fed mothers. By contrast, a marked difference in MTT activity which was paralleled by a lower DNA content became apparent when fetal rat brain cells were incubated with starved adult serum. Fetal serum and adult male serum were found to support growth equally well, while incubation of fetal brain cells with maternal sera resulted in lower MIT values than with the corresponding fetal sera. When cells were incubated with fetal sera pooled from starved mothers, MTT activity was decreased by 42 to 45%. A relative decrease in MTT activity was also apparent when cells were exposed to sera from starved mothers. Graded concentrations of starved fetal serum (2.5–10%) produced an increase in MTT activity that was consistently lower than similar concentrations of fed fetal serum, a finding suggesting a decrease in growth factors. Mixing fasted with fed serum did not correct the diminished growth, and indicated that an inhibitor might also be functioning to restrict growth. These findings therefore suggest that the principal determinants of diminished fetal brain growth during maternal starvation are not only intrinsic to the cells but are importantly related to the altered extrinsic factors in the fetal circulation.
The Group Inverse of a Triangular Matrix

Block conditions are given for the group inverse of a triangular matrix over a field to exist. These involve the zero-nonzero Schur complement. Applications are given to idempotent matrices.
Metachromatic activity of heparin and heparin fragments

Heparin of an average molecular weight of 13,000 was fractionated on the basis of size into five fractions of different weight-average molecular weight ranging from 8500 to 20,000. The heparin was also degraded using microbial heparinase resulting in products ranging from a disaccharide of molecular weight 500 to an oligosaccharide of molecular weight 3100. These products were also size fractionated. The individual heparin fractions and products were tested for metachromatic activity with Azure A. The metachromatic activity of the heparin fractions was independent of molecular weight, while the metachromatic activity of the products was dependent on molecular weight. Metachromatic activity was found in a fragment as small as a tetrasaccharide. Anticoagulant activity was found in fragments of tetrasaccharide or larger by a Factor Xa clotting assay and in fragments of hexasaccharide or larger by a Factor Xa amidolytic chromogenic assay.
Comparing the long-term outcome of immediate postoperative facial nerve dysfunction and vocal fold immobility after parotid and thyroid surgery.

Summary Hypothesis: The long-term recovery rate of immediate postoperative facial nerve dysfunction with an electrophysiologically and anatomically intact facial nerve is higher than the long-term recovery rate of immediate postoperative vocal fold immobility with an electrophysiologically and anatomically intact recurrent laryngeal nerve. Methods: A retrospective review of parotid and thyroid surgery with electrophysiologic monitoring of the facial and recurrent laryngeal nerves, respectively. Results: Forty-five consecutive patients had electrophysiologic and anatomic integrity of the facial nerve at the conclusion of the parotidectomy. Eight of 45 (18%) patients developed a postoperative facial nerve dysfunction. All eight patients with facial nerve dysfunction had complete return of facial nerve function within 3 months. A total of 102 consecutive patients underwent dissection of the recurrent laryngeal nerve during thyroid surgery. Seven of 102 (7%) had immediate unilateral vocal fold dysfunction. All 102 had electrophysiologic and anatomic integrity of the recurrent laryngeal nerve at the conclusion of the procedure. Two of 102 (2%) have clinically complete permanent vocal fold dysfunction. Five of seven (71%) with immediate complete vocal fold immobility had complete return of mobility. Conclusions: A higher immediate postoperative rate of transient facial nerve dysfunction is reported compared with vocal fold immobility in parotid and thyroid surgery, respectively ( P