cssi/SciSciGPT-SciSciNet huggingface dataset:
SPEECH FLUENCY IN CROSSED APHASIA

Three strongly right-handed patients developed fluent aphasia after right hemisphere infarction documented by computerized tomography. For these patients and for other reported cases of crossed aphasia suitable for analysis, the correlation between fluency and infarct localization was similar to that of right-handed aphasies with left-sided lesions. Right hemisphere language representation in most crossed aphasies probably mirrors that normally present in the language-dominant left hemisphere. Two of these patients showed concomitant hemispatial inattention and visuoconstructive impairment. Right hemisphere language dominance therefore does not preclude ipsilateral specialization for visuospatial functions.
Function and assembly of DNA looping, clustering, and microtubule attachment complexes within a eukaryotic kinetochore.

The kinetochore is a complex protein–DNA assembly that provides the mechanical linkage between microtubules and the centromere DNA of each chromosome. Centromere DNA in all eukaryotes is wrapped ar...
"Communicating Organizational Change: A Case Study on Interface, Inc."

Because organizational change has become unavoidable and is essential to compete in today’s global marketplace, executives must be able to initiate and sustain change throughout their organizations. A necessary component of that endeavor is effective communication strategies (Fiol, Harris, & House, 1999). Literature suggests that while change can occur under crisis or non-crisis conditions, visionary and transformational leaders, as opposed to crisis-responsive leaders, are more likely to facilitate sustained change initiatives (Hunt, Boal, & Dodge, 1999). This paper seeks to demonstrate the role of transformational leadership in communicating organizational change in non-crisis circumstances through a longitudinal case study of Interface, Inc., a carpet tile manufacturing company who has implemented and sustained a complete transformation. Through executive leadership, Interface’s resolute commitment to becoming a fully sustainable organization has been fully ingrained in the company’s culture. By examin...
Connected Mothers: A Follow-Up Study of Incarcerated Women and Their Children

This study examines mothers who were incarcerated in the Minnesota Correctional Facility at Shakopee in 1985. It establishes that their commitment to parenthoodis deeply tenacious and that when followed up five years later most of these mothers had sustained continuous, primary parenting from within prison and reunification with their children when released from prison. This study establishes that frequent contact with their children in a nurturing, child-centered institution supports their ongoing custody of and future reunification with their children. It speaks to the willingness of families to step forward as caretakers for the children of incarcerated mothers. The study's findings also establish the unhappy fact that a third of the Shakopee mothers were unable to sustain continuous parenting in spite of their obvious love of their children, the involvement of caring kin, and the presence of generous prison visitation policies.
TRANSIENT RESPONSE ANALYSIS OF GIMBALLED TILTROTORS DURING ENGAGE AND DISENGAGE OPERATIONS

An analysis has been developed to predict transient aeroelastic response of gimballed tiltrotors during shipboard engage/disengage operations. Initially, a two degree of freedom rigid blade model was used to simulate the transient gimbal response. Results of this simulation indicated potential for gimbal restraint impacts in severe wind conditions. To investigate transient response of gimballed tiltrotors in more detail, the multi-blade gimballed rotor is modeled with slender elastic beams rigidly attached to a hub and undergoing flap bending, lag bending, elastic twist, and axial deflection. The gimbal restraint is simulated using a conditional rotational spring. The rotor equations of motion are formulated using Hamilton's principle and spatially discretized using the finite element method. The discretized rotor equations of motion are integrated in modal space for a specified rotor speed run-up or run-down profile. Blade element theory is used to calculate quasi-steady loads in linear and nonlinear regimes. Studies for a 1/5 size aeroelastically scaled tiltrotor model are conducted to validate the analysis and investigate transient response and loads of the gimballed rotor during engagement in varying conditions. Good correlation existed between the experimental data and the prediction of blade flap and lagmoments in hover condition. Blade bending moment and hub moment predictions indicated that gimbal restraint impacts can induce high transient loads on the rotor blades and hub. For ju =0.096 , the peak flap and lag bending moment at section 0.15R are 130% and 310% above loads for 1G hover condition. The peak hub moment when gimbal restraint impacts show six times static hub loads for 11 degrees gimbal tilt (gimbal restraint).
Weight Versus Toxicity: a Need for Revision of the Standard Method of Testing for Resistance of the Tobacco Budworm to Insecticides

Toxicity studies with methyl parathion and permethrin topically applied to several weight classes of the larvae of Heliothis virescens (F.) revealed that LD50 expressed as μg of toxicant per g of body weight was not constant among the weight classes treated for both insecticides. Specifically, an increase in susceptibility was noted near the larval weight of 30 mg, which also corresponds to the average larval weight at the third molt. Because an Insect’s body is undergoing rapid and dramatic changes in structure and enzyme activity during a molt, the weight range, selected as a standard for testing insects for resistance to insecticides, should exclude molting larvae. The accepted standard weight range for H. zea (Boddie) and H. virescens set by the Second Conference on Test Methods for Resistance in Insects of Agricultural Importance is 35 ± 5 mg. This weight range includes a significant number of larvae at or near molt. To avoid time of molt, acceptance of 20 ± 3 mg as a standard weight range for testing insecticide resistance in H. virescens is suggested.
Affordable Care Act Provision Had Similar, Positive Impacts For Young Adults With And Without Disabilities

Beginning in 2010 the Affordable Care Act (ACA) allowed young adults (ages 19–25) to remain on their parents’ private health insurance plans, even if they were not full-time students. This study investigated the impact of the ACA on health insurance coverage for young adults with disabilities, comparing their experience with that of young adults without disabilities and that of a group of older adults (ages 26–34) with disabilities. We analyzed the periods 2006–09 and 2011–14, which were before and after implementation of the dependent coverage provision in the ACA, respectively. Coverage gains for older adults with disabilities were entirely attributable to changes in public insurance. Gains for young adults overall were driven by changes in private insurance. Both young adults with and without disabilities experienced a 4-percentage-point increase in private health insurance coverage between the two time periods, so the gap in private coverage between the two groups did not change significantly over tim...
Analysis On Epidemiological Characteristics And Vaccine Efficacy Of Mumps In Chaohu City From 2005 To 2009

Objective To analyze the epidemiological characteristics of mumps in Chaohu from 2005 to 2009 and explore the vaccine efficacy(VE),and to provide scientific evidence for control of mumps.Methods Data of mumps cases from the internet-based reported system in Chaohu from 2005 to 2009 was analyzed by descriptive epidemiological method.Clustering cases between 2008 and 2009 were selected to analyze VE of mumps by epidemiological 1∶2 matched case-control study.Results In Chaohu,1620 cases of mumps were reported from 2005 to 2009,the annual average incidence was 7.52/lakh,and the incidence showed a ascending trend.The high peak incidence was from April to July.Cases age 10 to 14 and cases age 5 to 9 accounted for 43.83 % and 36.48% respectively,and cases were majoring in full-time middle or primary school students.Male/female ratio was 2.40:1.Among 95 cases and 190 controls,56.00% of them became ill after vaccination more than 5 years,and the interval between vaccination and Incidence time was more than 5 years in 58.33% cases age 5 to 9 and 77.78% cases age 10 to 14.The VE was 66%(the 95% confidential interval was 25%～85%).Conclusion The main reasons for mumps prevalence were the lower VE and vaccination rate.We should formulate the control program,conduct disease surveillance based on laboratory,implement reasonable,standard and scientific two-doses immunization programs,conduct supplementary immunization activity among children under 15 at suitable time to improve the immunity level of susceptible population and reduce the incidence.
RETracer: triaging crashes by reverse execution from partial memory dumps

Many software providers operate crash reporting services to automatically collect crashes from millions of customers and file bug reports. Precisely triaging crashes is necessary and important for software providers because the millions of crashes that may be reported every day are critical in identifying high impact bugs. However, the triaging accuracy of existing systems is limited, as they rely only on the syntactic information of the stack trace at the moment of a crash without analyzing program semantics. In this paper, we present RETracer, the first system to triage software crashes based on program semantics reconstructed from memory dumps. RETracer was designed to meet the requirements of large-scale crash reporting services. RETracer performs binary-level backward taint analysis without a recorded execution trace to understand how functions on the stack contribute to the crash. The main challenge is that the machine state at an earlier time cannot be recovered completely from a memory dump, since most instructions are information destroying. We have implemented RETracer for x86 and x86-64 native code, and compared it with the existing crash triaging tool used by Microsoft. We found that RETracer eliminates two thirds of triage errors based on a manual analysis of 140 bugs fixed in Microsoft Windows and Office. RETracer has been deployed as the main crash triaging system on Microsoft's crash reporting service.
Abstract C47: Gender and racial disparities in long-term survival of oral and oropharyngeal cancer in the United States

Purpose: Increased survivorship of head and neck cancer necessitates longer-term care for patients. However, no previous study from the United States has described head and neck survivorship beyond 15 years. The study aimed at describing 25-year survival of oral and oropharyngeal cancer; investigating the effect of race and gender on long-term survivorship. Methods: The Surveillance, Epidemiology and End Results (SEER) database was queried for clinically and pathologically-defined adult oral and oropharyngeal cancer cases with at least 25 years follow-up. Kaplan-Meier survival curves were produced and a long-rank test was used to identify differences. A cox proportional hazards model was created including race, gender and other significant covariates. Results: Of the 22,162 patients identified, 70.3% were males. Overall 10-year survival is 30.8% and survival declined through the follow up period, with only 8.9% alive at 25 years post-diagnosis. African American males show the poorest overall and disease specific survival rates (p Conclusion: Overall survival for patients with oral and oropharyngeal cancer is poor with African Americans and males demonstrating the worst survival over both short and long term follow-up. This illustrates the need for a cancer survival plan that incorporates the role of disparities in overall cancer outcomes. Citation Format: Nosayaba Osazuwa-Peters, Sean T. Massa, Kara M. Christopher, Ronald J. Walker, Mark A. Varvares. Gender and racial disparities in long-term survival of oral and oropharyngeal cancer in the United States. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C47.
Is Outpatient Arthroplasty as Safe as Fast-Track Inpatient Arthroplasty? A Propensity Score Matched Analysis

Abstract Background In the emerging fiscal climate of value-based decision-making and shared risk and remuneration, outpatient total joint arthroplasty is attractive provided the incidence of costly complications is comparable to contemporary "fast-track" inpatient pathways. Methods All patients undergoing total hip arthroplasty or total knee arthroplasty between 2011 and 2013 were selected from the American College of Surgeons–National Surgical Quality Improvement Program database. A propensity score was used to match 1476 fast-track (≤2 day length of stay) inpatients with 492 outpatients (3:1 ratio). Thirty-day complication, reoperation, and readmission rates were compared, both during and after hospitalization. Logistic regression was used to calculate propensity score adjusted odds ratios. Results After matching, outpatients had higher rates of medical complication (anytime, 10.0% vs 6.7%, P = .018; post discharge, 6.3% vs 1.1%, P P = .113; post discharge, 4.1% outpatients vs 0.1% inpatients, P P = .589). Conclusion Outpatients experience higher rates of post-discharge complications, which may countermand cost savings. Surgeons wishing to implement outpatient total joint arthroplasty clinical pathways must focus on preventing post-discharge medical complications to include blood management strategies.
Angiosperm Phylogeny and Diversification

The prerequisites for discussing angiosperm diversification are stated. Some distinctive features of angiosperms including double fertilization, endosperm, short life cycle, and herbaceous and annual habit are outlined. In monocots, diversification in Orchidaceae, the largest plant family, and Poaceae is outlined. In eudicots the core patterns of diversity in eudicots Malpighiaceae, Euphorbia Euphorbiaceae and the nitrogen-fixing clade, are discussed, and within the very speciose yet florally stereotyped asterids, Asteraceae are mentioned. The significance of increased venation density in angiosperms and of specialized plant/pollinator interactions in which a single pollinator pollinates many unrelated species of plants is emphasized.
Improved removal rates for retrievable inferior vena cava filters with the use of a 'filter registry'.

The American Association for the Surgery of Trauma challenged the trauma community to improve a 22 per cent average removal rate for retrievable inferior vena cava filters (r-IVCFs). Since 2006, we maintained a "filter registry" documenting all IVCFs placed in trauma patients. Our goal was to improve removal rates for r-IVCF. Patients receiving an IVCF before implementation of filter registry, 2003-2005, comprised the control group. Patients receiving an IVCF after implementation of filter registry, 2006-2009, comprised the study group. Data obtained included age, gender, Injury Severity Score (ISS), length of stay (LOS), mortality, filter inserted, placement indication, removal rates, and reasons why removal did not occur. Fisher exact test and chi square were used for nominal variables. Stepwise logistic regression analysis was used to define predictors of removing and not removing an IVCF. Three hundred seven patients received an IVCF, 142 preregistry and 165 postregistry. No significant difference existed between groups in age, gender, ISS, placement indication, or mortality. A significant difference existed between groups in LOS and presence of deep vein thrombosis (DVT) and pulmonary embolism. A total of 98.2 per cent of postregistry patients received a Gunther Tulip filter and all retrievals were performed by Interventional Radiology. Retrieval rates improved, 15.5 to 31.5 per cent post registry (P < 0.001). No differences existed in lost to follow-up (LTF) between groups. Univariate analysis identified age, IVC clot, DVT, and LTF as predictors for not removing a filter. Stepwise logistic regression revealed the filter registry independently predicts the removal of an r-IVCF. A filter registry is effective in improving rates of removal for r-IVCFs.
Verbalism and the Blind: A Critical Review of the Concept and the Literature:

The present paper presents current theorizing in psycholinguistics which points up the inadequacy of the notion that verbalisms (nonsensory based words) are meaningless and detrimental to conceptual thinking in the blind. The failure to acknowledge the word-word nature of meaning is cited as the significant flaw in the development of the verbalism construct. A review of the literature indicates some of the methodological problems in research on verbalism. Suggestions for future research on the phenomenon are presented.
Evaluation of a random displacement model for predicting particle escape from canopies using a simple eddy diffusivity model

There is a need for more practical tools for estimating spore escape from crop canopies, which is essential in forecasting the propagation of disease to other fields. In this paper, we evaluated whether a random displacement model (RDM) parameterized with an eddy diffusivity Kz(z) could be used to predict spore escape probability. The proposed RDM does not require detailed turbulence measurements for parameterization. Instead, it constructs profiles of velocity and eddy diffusivity from a simple set of parameters [canopy height, canopy density, vegetation length scale, and wind speed]. The RDM was validated using field measurements of spore concentration. On average, the model predictions matched the field measurements within 28% inside the canopy and 42% above it, comparable to LES results over the same canopy. Once validated, the RDM was used to explore particle escape across a range of canopy densities and particle settling velocities, in order to inform estimates of particle escape from crops of varying maturity or area density. Escape fraction as calculated by the RDM increased as canopy density decreased, as the ratio of particle settling velocity to turbulent shear velocity ratio decreased, and as the source height within the canopy increased.
Pacifism and Just War Theory after 9/11

The events of September 11, 2001, challenge us to reassess our thinking about war and peace. Pacifists have to consider whether military force is a permissible option in response to catastrophic terrorist attack. And defenders of the just war ideal have to ask how terrorism and a war on terrorism fit within the purview of the traditional just war theory. Pacifists and just war theorists both condemn terrorism, since terrorists deliberately attack innocent persons. But pacifists and just war theorists differ in their understanding of how best to respond to the evil of terrorism.
Roads, exports and employment: Evidence from a developing country

Abstract Domestic road programs are often justified on the basis of their presumed positive effects on firms' exports and accordingly on firms' employment. In this paper we evaluate this policy claim for Peru, a developing country whose regions were exposed to an asymmetric infrastructure shock. In so doing, we take advantage of detailed geo-referenced data on firm-level trade for the period 2003–2010 as well as on recent and historical road infrastructure. In particular, to identify the impacts of interest, we first exploit the dimensions of this dataset to account for regional-sectoral and even firm-level confounding factors through extensive sets of fixed effects. In addition, we conduct placebo exercises and carry out instrumental variable estimations whereby we instrument recent changes in the road network with the pre-Columbian Inca road network. Estimates concur in suggesting that improvements in transport infrastructure had a significant positive impact on firms' exports and thereby on firms' job growth.
Progesterone receptor and prostaglandins mediate luteinizing hormone-induced changes in messenger RNAs for ADAMTS proteases in theca cells of bovine periovulatory follicles.

Little is known about the ADAMTS (a disintegrin and metalloproteinase with thrombospondin motifs) family of extracellular proteases in ovarian follicles of non-rodent species, particularly in theca cells. In the present study, temporal patterns of change in mRNA for four ADAMTS subtypes and the hormonal transcriptional regulation of two subtypes were investigated in theca cells during the periovulatory period in cattle. Follicles were obtained at 0 h post-gonadotropin-releasing hormone (GnRH; preovulatory) or at 6, 12, 18, or 24 h after injection of GnRH (periovulatory) to induce a luteinizing hormone (LH)/follicle-stimulating hormone surge. ADAMTS1, -2, -7, and -9 transcript abundance were then determined in isolated theca interna. ADAMTS1 and -9 mRNA levels were up-regulated at 24 h post-GnRH; ADAMTS2 mRNA was elevated at 12-24 h post-GnRH; and ADAMTS7 mRNA increased transiently at 12 h post-GnRH compared to other time points. Subsequent in vitro experiments using preovulatory theca interna (0 h post-GnRH) showed that treatment with LH can mimic the observed up-regulation in ADAMTS1 and -9 mRNA and provided evidence that progesterone/progesterone receptor and/or prostaglandins regulate ADAMTS1 and -9 mRNA in theca interna, downstream of the LH surge. Time- and subtype-specific changes in ADAMTS mRNA abundance in vivo, and their regulation in vitro by hormones, argue that ADAMTS family members produced by theca cells play important roles in follicle rupture and the accompanying tissue remodeling in cattle. This article is protected by copyright. All rights reserved
Shaping Brainstem Representation of Pitch-Relevant Information by Language Experience

Pitch is a robust perceptual attribute that plays an important role in speech, language, and music. We present compelling evidence supporting the notion that long-term language experience enhances the neural representation of behaviorally relevant attributes of pitch in the brainstem. Pitch relevant neural activity in the brainstem is crucially dependent on specific dimensions or features of pitch contours. By focusing on specific properties of the auditory signal, irrespective of a speech or nonspeech context, it is argued that the neural representation of acoustic–phonetic features relevant to speech perception is already emerging in the brainstem and, importantly, can be shaped by experience. Such effects of language experience on sensory processing are compatible with a more integrated approach to language and the brain. Long-term language experience appears to shape an adaptive, integrated, distributed pitch-processing network. A theoretical framework for a neural network is proposed involving coordination between local, feedforward and feedback components that can account for experience-induced enhancement of pitch representations at multiple locations of the distributed pitch processing network. Feedback, feedforward connections provide selective gating of inputs to both cortical and subcortical structures to enhance neural representation of behaviorally relevant attributes of the stimulus and instantiate local mechanisms that exhibit enhanced sensitivity to behaviorally relevant pitch attributes. The focus on pitch processing in tonal languages notwithstanding, the findings presented here should be contextualized within the broader framework of language experience shaping subcortical processing.
Covert Sensitization for the Treatment of Sexual Deviations

A detailed procedural description of Covert Sensitization applied to the treatment of various maladaptive sexual behaviors is presented. Empirical support for the technique is reported. Implications for the use of Covert Sensitization are also discussed.
An Upper Bound Suitable for Parallel Vector Processing for the Objective Function in a Class of Stochastic Optimization Problems

We consider the two-stage stochastic programming problem with recourse, and with a discretely distributed random variable with a finite number of realizations. When the number of realizations is large, the solution of these problems is difficult because the computation of values and subgradients of the expected recourse function is difficult. In this paper, we describe an algorithm that designs an upper bound to the expected recourse function. The computation of the values and subgradients of this upper bound is much faster than the computation of those of the expected recourse function, and is well-suited for parallel vector processors.
Lumbar Spine Trabecular Bone Score (TBS) Reflects Diminished Bone Quality in Patients With Diabetes Mellitus and Oral Glucocorticoid Therapy

Trabecular bone score (TBS) is a texture parameter that measures the grayscale variation within dual-energy X-ray absorptiometry (DXA) images, and has been shown to significantly correlate with the 3-dimensional bone microarchitecture. The objective of this study was to determine whether TBS is a better clinical tool than traditionally used bone mineral density (BMD) to detect the skeletal deterioration seen in patients with diabetes (DM), patients undergoing oral glucocorticoid (GC) therapy, and patients who are both diabetic and taking steroids (GC + DM). We performed retrospective, cross-sectional study using DXA images of patients who visited UTHealth Department of Internal Medicine DXA clinic in Houston, TX, from May 30, 2014 to May 30, 2016. A total of 477 men and women, who were 55 years or older, were included in the study. Lumbar spine (LS) BMD and TBS were collected. Electronic medical records were reviewed to collect clinical information for each patient. When both men and women were analyzed as a single group, LS-BMD was significantly higher in the diabetic group than in the control group (1.14 vs 1.10, p = 0.038), whereas mean TBS of L1-L4 was significantly lower in the diabetic group (1.21 vs 1.26, p = 0.004). LS-TBS was also significantly lower in diabetic women than in nondiabetic women (1.20 vs 1.26, p = 0.002). Receiver operating characteristic curves and areas under the curve indicated that LS-TBS provided better ability than LS-BMD to discriminate between control subjects and those in the DM, GC, or GC + DM groups (areas under the curve between 0.645 and 0.697, p < 0.010 for all). LS-TBS is a BMD-independent parameter that is capable of capturing a larger portion of bone quality deterioration undetected by BMD alone in patients with DM and undergoing oral GC therapy.
The Role of Palliative Medicine in Assessing Hereditary Cancer Risk.

Background:Hereditary cancer assessment and communication about family history risks can be critical for surviving relatives. Palliative care (PC) is often the last set of providers before death.Me...
Sickle Cell and Preeclampsia

General principles and perioperative management of sickle-cell disease and preeclampsia are reviewed.
The Science of Climate Change

This chapter provides a review of some of the concepts behind the phrase “climate change.” Recognizing the limitations of the definition and estimation of climate, climate change is typically associated with the notion of global warming. This has become shorthand for the recent and future changes in the climate that are resulting in higher average temperatures worldwide. Examples are provided regarding the difficulty in measuring and identifying the effects of climate despite the scientific nature of the findings. Even when humans are taken out of the picture, it can be difficult to know exactly what happened in a particular environment and determine how these changes may have necessarily impacted the ecological context. Archaeological reconstructions can provide important information on the interactions between the natural and cultural environment in the past. This collaborative work has important implications for understanding the role of humans in climate change events. Because of the long periods of time that archaeologists work with, long chronological sequences of climate data can be used to reconstruct human activities before, during, and after the events, such as long droughts, volcanic eruptions, or periods of cold and dry weather. These all had an impact on human groups who experienced them. Reconstructing past climates to look at changes over long periods of time is challenging, but there are ways of using proxy data. While there are challenges with all current and past estimates of climate change, careful and critical analysis of the past climate change offers a better way of understanding its current trends.
Topics in Mathematical Analysis of Viscoelastic Flow

The article reviews topics of current interest in the mathematical study of viscoelastic flows. Emphasis is placed on situations far from the Newtonian limit. Specifically, we discuss the asymptotics of the high Weissenberg number limit, flow instabilities, and the breakup of liquid jets.
A Novel Technique to Perform Microvascular Anastomosis Revisions without Clamps

Background For surgeons learning microsurgery, uneven spacing between sutures while performing microvascular arterial anastomoses is one of the most common technical errors made that can lead to leakage. Based on the previous surgical experience and training of these surgeons, the first option chosen to prevent bleeding is to place a vascular clamp proximal to the anastomosis and an additional suture at the site of the leak. Because this technique may have technical and thrombosis concerns, our study proposes an alternative technique of performing post-anastomotic revisions without the use of clamps. Methods Our technique involves placing a cotton-tipped applicator under the artery and lifting it to partially occlude flow within the vessel as an additional suture is placed at the leakage site to complete the revision. One-hundred eighty-four microvascular anastomoses were performed on the femoral arteries of 92 Sprague-Dawley rats, and of the 184 anastomoses, 147 had a leak and required a post-anastomotic revision. All revisions were completed using our technique, and no clamps were used during any of the revisions. Results Of the 147 post-anastomotic revisions completed using our technique, 141 (95.9%) were patent 2 hours post-revision. The mean operating time for the revisions was 5:03 minutes (range, 1:44–6:30 minutes). Conclusion Our technique of partially occluding an artery with a cotton-tipped applicator while performing a post-anastomotic revision is a safe and effective alternative to using vascular clamps. Our technique may also reduce technical errors and have a low risk of causing thrombosis when completing post-anastomotic revisions.
An appraisal of emergency medicine clinical practice guidelines: Do we agree?

BACKGROUND Clinical practice guidelines (CPGs) have been published by the American College of Emergency Physicians (ACEP) since 1990 to advance evidence-based emergency care. ACEP clinical policies have drawn anecdotal criticism for bias, yet the overall quality of these guidelines has not previously been quantified. We sought to examine ACEP clinical policies using a recognised, validated appraisal instrument: Appraisal of Guidelines for Research & Evaluation (AGREE II). METHODS Systematic assessment of current ACEP clinical policies was conducted using the AGREE II instrument, which contains 23 appraisal items (scored on a 1-7 scale) in six domains and two overall assessments. Each policy was independently appraised by five trained appraisers. Primary outcomes were AGREE II ratings for each item, domain and "Overall Assessment," and scores were reported as standardised percentages from all five appraisers. Secondary analyses examined associations between AGREE II ratings and policy publication date, strength of underlying evidence and strength of recommendations. Additional analysis examined relationships between domain and "Overall Assessment" ratings. RESULTS Twenty guidelines published from April 2007 to November 2017 were included. Of the six domains, "Scope and Purpose" scored highest (mean 90%) and "Applicability" scored lowest (mean 35%). The four remaining domains ("Stakeholder Involvement," "Rigor of Development," "Clarity of Presentation" and "Editorial Independence") had mean scores of 53%-78%. The mean "Overall Assessment" rating was 69% and was not associated with policy publication date, strength of underlying evidence or strength of recommendations. We found positive associations between "Overall Assessment" ratings and two domains: "Rigor of Development" (r = 0.70) and "Clarity of Presentation" (r = 0.70). CONCLUSIONS Based on validated AGREE II criteria, ACEP clinical policies can be most improved by addressing their application in practice. ACEP clinical policies' overall quality did not improve over the assessed time period and is not explained by the quality of underlying evidence.
Increased sequence hydrophobicity reduces conformational specificity: A mutational case study of the Arc repressor protein

The amino-acid sequences of soluble, globular proteins must have hydrophobic residues to form a stable core, but excess sequence hydrophobicity can lead to loss of native state conformational specificity and aggregation. Previous studies of polar-to-hydrophobic mutations in the β-sheet of the Arc repressor dimer showed that a single substitution at position 11 (N11L) leads to population of an alternate dimeric fold in which the β-sheet is replaced by helix. Two additional hydrophobic mutations at positions 9 and 13 (Q9V and R13V) lead to population of a differently folded octamer along with both dimeric folds. Here we conduct a comprehensive study of the sequence determinants of this progressive loss of fold specificity. We find that the alternate dimer-fold specifically results from the N11L substitution and is not promoted by other hydrophobic substitutions in the β-sheet. We also find that three highly hydrophobic substitutions at positions 9, 11, and 13 are necessary and sufficient for oligomer formation, but the oligomer size depends on the identity of the hydrophobic residue in question. The hydrophobic substitutions increase thermal stability, illustrating how increased hydrophobicity can increase folding stability even as it degrades conformational specificity. The oligomeric variants are predicted to be aggregation-prone but may be hindered from doing so by proline residues that flank the β-sheet region. Loss of conformational specificity due to increased hydrophobicity can manifest itself at any level of structure, depending upon the specific mutations and the context in which they occur.
Pearls & Oy-sters: Hydroxychloroquine-induced toxic myopathy mimics Pompe disease: Critical role of genetic test

Chloroquine and hydroxychloroquine, commonly used for rheumatologic conditions, are rare yet very important causes of toxic myopathy with vacuolar changes on muscle biopsy.
USA aid policy and induced abortion in sub-Saharan Africa: an analysis of the Mexico City Policy.

Summary Background The Mexico City Policy, first announced by US President Ronald Reagan and since lifted and reinstated by presidents along partisan lines, prohibits US foreign assistance to any organisation that performs or provides counselling on abortion. Many organisations affected by this policy are also providers of modern contraception. If the policy reduces these organisations' ability to supply modern contraceptives, it could have the unintended consequence of increasing abortion rates. Methods We empirically examined patterns of modern contraception use, pregnancies, and abortion among women in 26 countries in sub-Saharan Africa in response to the reinstatement and subsequent repeal of the Mexico City Policy across three presidential administrations (William Clinton, George W Bush, and Barack Obama). We combine individual-level data on pregnancies and abortions from 743 691 women, country-year data on modern contraception use, and annual data on development assistance for family planning and reproductive health in a difference-in-difference framework to examine relative changes in use of modern contraception, pregnancy, and abortion in response to the policy. Findings We found that when the Mexico City Policy was in effect (2001–08), abortion rates rose among women in countries highly exposed to the policy by 4·8 abortions per 10 000 woman-years (95% CI 1·5 to 8·1, p=0·0041) relative to women in low-exposure countries and relative to periods when the policy was rescinded in 1995–2000 and 2009–14, a rise of approximately 40%. We found a symmetric reduction in use of modern contraception by 3·15 percentage points (relative decrease of 13·5%; 95% CI −4·9 to −1·4; p=0·0006) and increase in pregnancies by 3·2 percentage points (relative increase of 12%; 95% CI 1·6 to 4·8; p Interpretation Our findings suggest that curbing US assistance to family planning organisations, especially those that consider abortion as a method of family planning, increases abortion prevalence in sub-Saharan African countries most affected by the policy. Funding The William and Flora Hewlett Foundation, the Doris Duke Charitable Foundation, the David and Lucile Packard Foundation, and the Stanford Earth Dean's Fellowship.
Information Theory in Econometrics

Applied econometrics deals mostly with the problem of estimating a given model against observed data. Usually the model is given in a parametric form e.g., a Cobb-Douglas production function and the estimation method is e.g., one of maximum likelihood or ordinary least squares. The observed data are also assumed to be generated by a given distribution e.g., normal and the samples are assumed to be statistically independent. In this specific framework one may raise some basic issues. First of all, how does one select the model: Let M = {Mk | k ∈ K} be the whole class of models out of which a specific choice Mk has to be made. How does one choose such a model Mk? The current econometric practice is to adopt an ad hoc approach e.g., choose a Cobb-Douglas function because it is very convenient. In time series autoregressive models how many lags there should be? Again apply an ad hoc procedure of one or two lags in order to avoid the problems of multicollinearity. Secondly, the sample data are assumed to come from a specific distribution Fj(x|θ) where θ is a vector of unknown parameters. How does one select the specific distribution Fj(•) out of the whole class F = {Fj | j ∈ J} of possibilities? Thirdly, the assumption of θ being a vector of unknown constants may appear to be very rigid in many applied situations e.g., time series models and random coefficient models. Bayesians would invoke the assumption of a prior distribution for θ and modify the estimation problem accordingly.
The Chicago sound show at the smart museum of art, the University of Chicago

The Chicago Sound Show mounted by the Smart Museum of Art at the University of Chicago invited a number of local artists to produce site-specific sound installations that revealed both the possibil...
106. UTILITY OF A QUALITY DASHBOARD ESTABLISHED BY A RESIDENT QUALITY COUNCIL

Quality Improvement (QI) science focuses on how healthcare is delivered (process measures) and the results (outcome measures). Although instruction in QI methodology is recognized as an important part of a resident's education, maintaining resident engagement is a challenge. A Resident Quality Council (RQC) was established to (1) create and maintain a resident-generated and relevant quality dashboard, (2) enhance resident awareness of in-hospital QI initiatives, and (3) increase QI scholarly activity among residents. A RQC was established in 2017 consisting of five resident champions and three chief residents, mentored by program leadership, a Chief Quality Officer, and QI staff. To increase resident engagement a continuously updated resident-inspired dashboard, which highlighted both quality and operational standards, was created. Metrics were chosen based on resident feedback. Over 18 months, a lecture series was introduced into the residency curriculum which highlighted various QI initiatives with a special focus on process and outcome measures related to the dashboard. At the start of the 2019-2020 academic year, the RQC surveyed residents in regards to their level of QI engagement and the utility of the dashboard as part of the residency curriculum. The most relevant metrics, as reported, included asthma guidelines, length of stay, and number of safety events. There was a reported increase in understanding of a dashboard's utility from 15.8% to 78.3% (N = 23). 78% reported continued interest in the maintenance of a dashboard with resident-pertinent metrics and acknowledged that the dashboard contributed to their understanding of the significance of QI science. Lastly, 87% felt the knowledge presented to them through the dashboard directly resulted in their increased interest in in-hospital QI initiatives and their desire to partake in QI scholarly work. Establishment of an RQC has proven beneficial in promoting QI interest amongst residents. Resident-pertinent dashboard metrics have kept housestaff engaged and interested in expanding their QI fund of knowledge through QI-driven scholarly projects.
Standardizing a Method to Safely Perform Kangaroo Care for Neonates While on High-Frequency Jet Ventilation

Background: Kangaroo care (KC) is the valuable practice of holding a naked diaper-clad infant on the bare chest of a parent. High frequency jet ventilation (HFJV) is lung protective ventilation that is designed to minimize volume-induced injury to immature surfactant deficient alveoli. This type of ventilation requires one ventilator to deliver the Jet breaths and another ventilator to deliver the PEEP. Therefore, there are 2 circuits that are tethered to the already small endotracheal tube (usually 2.5 mm – 3.0 mm). This type of ventilation complicates the KC process because of the risk of an unplanned extubation (UE). Therefore, NICU’s Tiny Baby Workgroup composed of Physicians, Respiratory Therapists, Nurses and APP’s carefully developed a standardized method to provide KC to this population to reduce the risk of UEs. Methods: This is a Quality Improvement Observational Cohort Study, Retrospective Chart Review in which all premature infants (born 23.0-29.6 weeks gestation admitted to UK-KCH NICU who received HFJV from October 2017 to February 2019 were included. Comparison of neonates who received KC while on HFJV (Jet/KC) to those who did not receive KC while on HFJV (Jet/Non-KC). UE rates during KC on Jet-KC neonates was compared to UE due to other causes (poor ETT securement, repositioning, nursing care, emesis, agitation/spontaneous movement) in Jet/non-KC group. Chi-squared or Fisher’s exact tests were used to compare categorical variables. Results: Data was collected for a total of 34 extremely premature infants placed on HFJV between October 2017 and February 2019. Three neonates were excluded due to insufficient clinical information. Out of 61 neonates on HFJV, 20 neonates received KC (Jet/KC group), of which 4 had UEs during KC. There were 41 neonates in the Jet/non-KC group, of which 14 had UE due to other causes as mentioned in the Methods Section. There was no significant difference in the incidence of UE between the 2 groups (P = .56) using Chi Square analysis as a measure of association. Gestational age in weeks (24.9 ± 1.46 vs 25.7 ± 1.52, Mean ± SD, P = .06) and birth weight in grams (742.8 ± 225.14 vs 812.9 ± 234.27 Mean ± SD, P = .27) were comparable in Jet/KC and Jet/Non-KC groups respectively. Conclusions: This observational cohort study demonstrates that KC can be safely used with HFJV without significant risk of UE. KC while on HFJV did not result in an increase in UE in extreme prematurity compared to other causes.
Mobile phone use while driving: Development and validation of knowledge, attitude, and practice survey instruments.

Abstract Introduction: Instruments that assess the knowledge, attitude, and practice (KAP) of mobile phone use serve as a primary assessment tool on which mobile phone distracted driving interventions can be designed. The objective of this study is to develop and validate KAP-modeled survey instruments that measure the knowledge of mobile phone hazards while driving (KMPHD), the attitude of drivers towards mobile phone use while driving (AMPUD), and the practice of mobile phone use while driving (PMPUD). Method: This study was a cross-sectional analytical survey conducted in Ibadan, Nigeria. Three instruments were designed to measure KMPHD, AMPUD, and PMPUD. Content validity, item analysis, exploratory factor analysis were conducted, and items were excluded based on the collective results of the analysis. The domains of the constructs and the reliability of the instruments are reported. A confirmatory factor analysis was used to assess the regression weights of each item and the model fit. Results: From an original list of 13, 12, and 10 items in the KMPHD, AMPUD, and PMPUD instruments, a final list of 7, 5, and 7 items were generated in each survey instrument, respectively. Two domains of the knowledge of hazards and practice of mobile phone use were obtained, and attitude to phone use while driving was a single domain. The reliabilities (Cronbach alpha) of the KMPHD (0.881), AMPUD (0.954), and PMPUD (0.920) were sufficiently high. Also, all items in the three instruments had moderate-to-high regression coefficients, and the model fits of the instruments were good. Conclusions: This study provides KAP-modeled survey instruments that can be used to assess a population-based knowledge, attitude, and practice of mobile phone use while driving. Practical Applications: This survey instrument can be used in assessing baseline knowledge, attitude, and practice of phone use while driving and determine the focus and effectiveness of mobile phone-induced distracted driving interventions.
Self-healing elastomers based on conjugated diolefins: a review

The formation of microcracks is a common problem in elastomeric materials. The propagation of microcracks to bigger cracks results in the failure of the elastomeric material, which needs to be replaced by a new material, thus creating a huge elastomer waste. The introduction of self-healing property into the elastomeric material is an important way to repair microcracks and to stop the crack propagation process. This review summarizes the progress in self-healing elastomers (polybutadiene rubber, styrene–butadiene rubber, polyisoprene rubber, butyl rubber, nitrile butadiene rubber, chloroprene rubber, and silicon rubber) based on conjugated diolefins. The use of various self-healing mechanisms and their effect on the self-healing property as well as reprocessability has been discussed. The challenges and future research opportunities are highlighted.
Joint Representation of Color and Form in Convolutional Neural Networks: A Stimulus-rich Network Perspective

To interact with real-world objects, any effective visual system must jointly code the unique features defining each object. Despite decades of neuroscience research, we still lack a firm grasp on how the primate brain binds visual features. Here we apply a novel network-based stimulus-rich representational similarity approach to study color and form binding in five convolutional neural networks (CNNs) with varying architecture, depth, and presence/absence of recurrent processing. All CNNs showed near-orthogonal color and form processing in early layers, but increasingly interactive feature coding in higher layers, with this effect being much stronger for networks trained for object classification than untrained networks. These results characterize for the first time how multiple basic visual features are coded together in CNNs. The approach developed here can be easily implemented to characterize whether a similar coding scheme may serve as a viable solution to the binding problem in the primate brain.