cssi/SciSciGPT-SciSciNet huggingface dataset:
Teaching drug utilization review skills via a simulated clinical decision making exercise

Abstract Background Drug utilization review (DUR) is a central role of the pharmacist, especially within the community pharmacy setting. Previous literature has shown risk of “alert fatigue”, supporting the necessity of pharmacists to utilize a step-wise approach in evaluation of drug therapy during the verification process. Many students are intimidated by this process, and may lack verification practice or experience until their first day as a licensed pharmacist. Educational Activity and Setting An innovative skills-based laboratory exercise was developed for third-year pharmacy students to develop DUR skills. Through simulation of patient prescriptions, profiles, and drug information resources, students were tasked with completing a DUR for each patient case. Students were expected evaluate the clinical significance of various drug-related problems, determine if they would or would not dispense the prescription, and were required to provide rationale for their decision. Findings This learning activity was well-received by the student population; however, students struggled with the volume of cases along with identifying a solution to the clinical scenario. On average, students required nine minutes per case, which is likely longer than community pharmacists can devote to a single DUR in practice. Discussion In response, to student challenges with the activity, the number of cases was condensed to highlight key concepts and cases that facilitated strong discussion. To improve students’ approach to the DUR process, faculty developed a vodcast to watch prior to the activity explaining a systematic approach to the DUR process as well as considerations a pharmacist should have. Summary Development and integration of an active-learning, simulated dispensing activity allowed students to gain valuable experience completing the DUR process, a foundational community pharmacy practice skill; however, repeated experience should be provided to ensure competency.
Using Oscillating Sounds to Manipulate Sleep Spindles.

Introduction EEG oscillations known as sleep spindles have been linked with various aspects of cognition, but the specific functions they signal remain controversial. Two types of EEG sleep spindles have been distinguished: slow spindles at 11-13.5 Hz and fast spindles at 13.5-16 Hz. Slow spindles exhibit a frontal scalp topography, whereas fast spindles exhibit a posterior scalp topography and have been preferentially linked with memory consolidation during sleep. To advance understanding beyond that provided from correlative studies of spindles, we aimed to develop a new method to systematically manipulate spindles. Aims and methods We presented repeating bursts of oscillating white noise to people during a 90-min afternoon nap. During stage 2 and slow-wave sleep, oscillations were embedded within contiguous 10-s stimulation intervals, each comprising 2 s of white noise amplitude modulated at 12 Hz (targeting slow spindles), 15 Hz (targeting fast spindles), or 50 Hz followed by 8 s of constant white noise. Results During oscillating stimulation compared to constant stimulation, parietal EEG recordings showed more slow spindles in the 12-Hz condition, more fast spindles in the 15-Hz condition, and no change in the 50-Hz control condition. These effects were topographically selective, and were absent in frontopolar EEG recordings, where slow spindle density was highest. Spindles during stimulation were similar to spontaneous spindles in standard physiological features, including duration and scalp distribution. Conclusions These results define a new method to selectively and noninvasively manipulate spindles through acoustic resonance, while also providing new evidence for functional distinctions between the 2 types of EEG spindles.
Internet inspirations: Library instruction with a virtual touch

Abstract This piece examines the use of websites prepared for specific library instructional sessions. This discussion has two main parts. First, the web page's construction process receives a detailed analysis in terms of various library resources, differing patron learning styles, the preinstructional interview, and the proper balance between traditional and virtual resources within this activity. Then, the section entitled “Combinations for the Instructional Website” discusses several different page types and their advantages for individual classes. The “Conclusion” reprises the earlier discussions, asks questions about the future of library instruction, and places the pages within that future context.
Robot-assisted Transplanted Ureteral Stricture Management.

Objective To assess the feasibility of robot-assisted transplanted ureteral reimplantation as a minimally invasive alternative to open surgery. Material and Methods Between August 2015 and March 2016, 5 patients presented with transplanted ureteral strictures after failure of a previous endoscopic management. All patients underwent robot-assisted ureteral reimplantation. Patients' demographics, perioperative outcomes, and complications are reported. Results All patients presented with deterioration of kidney function with or without recurrent urinary tract infection. Two patients had short strictures ( 1 cm), whereas 1 patient had a nitinol ureteral stent in situ. The location of the stricture varied among these patients with 3 distal and 1 proximal. Intraoperatively, 3 patients had a modified Lich-Gregoir reimplantation and 2 patients had a pyelovesicostomy. The mean operative time was 164 (±52) minutes. There were no intraoperative complications, conversion to open surgery, or significant blood loss necessitating blood transfusion. There were no urine leaks in the immediate or late postoperative period. One patient developed a Clavien grade IVa complication (sepsis). The median length of stay, the duration of catheterization, and the duration of stenting were 1 day (range 1-5 days), 7 days (range 6-14 days), and 39 days (range 25-51 days), respectively. After a median follow-up of 79 days (range 40-139 days), no strictures or delayed leakages were identified. Conclusion Robot-assisted transplanted ureteral reimplantation is technically feasible. With a larger number of cases and a longer follow-up, robot-assisted transplanted ureteral reimplantation may provide a new and effective, minimally invasive alternative for the treatment of this complex surgical problem.
Deciding The Undecidable A Few Things Post-Modernism Might Have to Offer Public Administration

Despite its irritating apparent refusal to answer public administrators' need for help in understanding complex situations and making tough decisions, post-modem thought actually has some rather practical observations to offer. Using Robert Frosts poem, "Mending Wall," as a catalyst for reflection, this brief essay considers central post-modem questions like the power-knowledge nexus and the impossibility of closure, in order to suggest the possibility that just decisions might be grounded in a recognition of undecidability, that is, the openness that otherness constitutes.
Diagnosing subtle palatal anomalies: Validation of video-analysis and assessment protocol for diagnosing occult submucous cleft palate

Abstract Introduction Submucous cleft palate (SMCP) classically involves bifid uvula, zona pellucida, and notched hard palate. However, patients may present with more subtle anatomic abnormalities. The ability to detect these abnormalities is important for surgeons managing velopharyngeal dysfunction (VPD) or considering adenoidectomy. Objectives Validate an assessment protocol for diagnosis of occult submucous cleft palate (OSMCP) and identify physical examination features present in patients with OSMCP in the relaxed and activated palate positions. Methods Study participants included patients referred to a pediatric VPD clinic with concern for hypernasality or SMCP. Using an appropriately encrypted iPod touch, transoral video was obtained for each patient with the palate in the relaxed and activated positions. The videos were reviewed by two otolaryngologists in normal speed and slow-motion, as needed, and a questionnaire was completed by each reviewer pertaining to the anatomy and function of the palate. Results 47 patients, with an average age of 4.6 years, were included in the study over a one-year period. Four videos were unusable due to incomplete view of the palate. The most common palatal abnormality noted was OSMCP, diagnosed by each reviewer in 26/43 and 30/43 patients respectively. Using the assessment protocol, agreement on palatal diagnosis was 83.7% (kappa = 0.68), indicating substantial agreement, with the most prevalent anatomic features being vaulted palate elevation (96%) and visible notching of hard palate (75%). Conclusion The diagnosis of subtle palatal anomalies is difficult and can be subjective. Using the proposed video-analysis method and assessment protocol may improve reliability of diagnosis of OSMCP.
Medical Management of GERD

Nonsurgical approaches continue to be at the cornerstone for initial therapy of GERD. Ultimately, the most efficacious therapy depends on the etiology of GERD symptoms. Therapies range from acid suppression with proton pump inhibitors to baclofen for non-acid reflux to neuromodulators for functional heartburn. While PPI therapy is very safe, it is important to understand the reported potential pitfalls of long-term use. The prescriber must also understand the risks and benefits of GERD therapy in the pregnant or breastfeeding patient. This chapter presents an overview of the therapeutic options available to the managing provider.
Young adult's attachment style as a partial mediator between maternal functioning and young adult offsprings' functioning.

Abstract Background The quality of our early attachment relationships with primary caregivers is carried forward to new developmental domains, including interpersonal contexts in adulthood. One of the factors that can disrupt early attachment is maternal depression, which may be associated with less responsive care and may impede the development of a secure attachment. Moreover, this disruption in secure attachment may act as a mechanism by which offspring of depressed mothers are more likely to experience their own psychopathology. In this study we predicted that attachment anxiety and avoidance would mediate the relationship between maternal depression diagnosis and functional impairment predicting young adult offspring's functional impairment. Methods This study utilized longitudinal data from 98 families with clinically diagnosed depressed and well mothers, and two of their young adult children, an older and younger sibling (N = 123, Female = 75, Mage = 22.09, SD = 2.57). Mother's and young adult children's functioning was based on clinical ratings on the Global Assessment Scale. Attachment was based on the young adult's self-report on the Experiences in Close Relationships. Results Results indicate that maternal diagnosis and functional impairment predicted offspring's functional impairment. This relationship was partially mediated through offspring's attachment anxiety, but not attachment avoidance. Limitations The mediator and outcome variable were measured concurrently, thus causal implications are limited. Conclusions Our study provides critical evidence that early experiences with depressed mothers may have influence into young adulthood in typical and atypical domains of development. This work extends our understanding of the impact of early experiences in long-term development, and may have treatment implications for intervening on both maternal and romantic relationships to improve attachment.
Prenatal and postnatal contributions of the maternal microbiome on offspring programming

The maternal microbiota is positioned to regulate the development of offspring immunity, metabolism, as well as brain function and behavior. The mechanisms by which maternal microbial signals drive these processes are beginning to be elucidated. In this review, we provide a brief overview on the importance of the microbiome in brain function and behavior, define the maternal vaginal and gut microbiota as distinct influences on offspring development, and outline current concepts in microbial origins of offspring health outcomes. We propose that the maternal microbiota influences prenatal and early postnatal offspring development and health outcomes through two overlapping processes. First, during pregnancy maternal gut microbiota provide metabolites and substrates essential for fetal growth through metabolic provisioning, driving expansion and maturation of central and peripheral immune cells, and formation of neural circuits. Second, vertical transmission of maternal microbiota during birth and in the early postnatal window elicits a potent immunostimulatory effect in offspring that induces metabolic and developmental transcriptional programs, primes the immune system for subsequent microbial exposure, and provides substrates for brain metabolism. Finally, we explore the possibility that environmental factors, such as malnutrition, stress and infection, may exert programmatic effects by disrupting the functional contributions of the maternal microbiome during prenatal and postnatal development to influence offspring outcomes across the lifespan.
Theory of Periodically Time-Varying Induced Exceptional Points of Degeneracy

We present the novel concept of exceptional points of degeneracy (EPDs), which denote a coalescence of multiple eigenmodes, that directly emerge in systems when a linear time-periodic (LTP) variation is applied. Though the presented theory is general, as an example we establish the general conditions that yield an EPD in a single LTP LC resonator with a capacitance that varies periodically in time. We show a potential application of the proposed LTP system in making sensors to exploit the ultra-sensitivity associated with operating at an EPD.
Transforming Communities: How People Like You Are Healing Their Neighborhoods

As readers of Religious Education seek to integrate belief and action in the face of today’s injustices, Sandhya Rani Jha provides a dose of realistic hope. Transforming Communities: How People Lik...
River plume source-front connectivity

Abstract River plume source-front connectivity, or the relationship between processes at the source, plume body and front, is investigated with numerical simulations of the Merrimack River plume using the Regional Ocean modeling System (ROMS). Source water, i.e. water discharged from the estuary during an ebb pulse, overtakes the front as it propagates offshore, resulting in the strong convergence that exists there. Model results show that much of the water released over an ebb pulse does not interact with the propagating tidal plume front, suggesting that the front decouples from the source and sustains itself as a distinct water mass. When a gate is closed at the estuary mouth during early ebb, the overall plume structure changes; gates closed late in ebb do not significantly effect the along- or cross-shore scale of the plume. The change in plume extent is only evident hours after the early-ebb gate closing, when source water is no longer supplied to the front. These experiments suggest that the growing distance between the highly energetic liftoff region and the radial expansion of the plume front results in a flattening of the surface gradient driving flow in the interior, diminishing source-front connectivity.
From Deterrence to Cooperative Security on the Korean Peninsula

The 2018 US-DPRK Singapore Summit introduced a new model to guide resolution of long-standing disputes on the Korean Peninsula: a “lasting and stable peace regime” could be created simultaneously w...
Spontaneous coronary artery dissection of the left anterior descending artery in a patient with COVID-19 infection.

A 48-year-old woman with a past medical history of migraines and hyperlipidemia presented due to severe retrosternal chest pain with no other associated signs or symptoms. The patient was hemodynamically stable and was found to have an elevated troponin with electrocardiogram showing no ischemic changes. Computed tomography of the coronary arteries showed a left dominant system with dissection extending from the mid-to-distal left anterior descending (LAD) artery. The patient was subsequently discharged on medical therapy but returned 3 days later due to worsening chest pain. Electrocardiogram revealed inferior and anteroseptal ST segment changes with peak troponin of 14.9 ng/ml (reference range <0.80 ng/ml). Coronavirus disease 2019 (COVID-19) nasopharyngeal swab was performed prior to urgent coronary angiogram. Coronary angiogram was performed with full personal protective equipment for respiratory and droplet precautions due to pending COVID-19 testing results. Angiogram revealed spontaneous coronary artery dissection (SCAD) extending from the ostium of the LAD to the distal vessel. COVID-19 testing returned positive while in intensive care unit. The patient was not a percutaneous coronary intervention candidate due to the extent of the dissection and was not a surgical candidate due to a lack of graftable target and medical management was continued. To our knowledge, this case is the first in which SCAD has been reported in the LAD in a patient with COVID-19 with no other symptoms of respiratory illness or symptoms classically associated with the novel coronavirus. SCAD should be considered on the differential as one of the various cardiac manifestations of COVID-19 infection.
Incidence and outcomes of immune checkpoint inhibitor-related myositis.

e15128Background: Data from immune checkpoint inhibitor (ICI) clinical trials show a higher incidence of ICI-related myositis with single agent ICI compared to combination therapy, but the true fre...
Reconfigurable Network-on-Chip Security Architecture

Growth of the Internet-of-things has led to complex system-on-chips (SoCs) being used in the edge devices in IoT applications. The increased complexity is demanding designers to consider several critical factors, such as dynamic requirement changes, long application life, mass production, and tight time-to-market deadlines. These requirements lead to more complex security concerns. SoC manufacturers outsource some of the intellectual property cores integrated on the SoC to untrusted third-party vendors. The untrusted intellectual properties can contain malicious implants, which can launch attacks using the resources provided by the on-chip interconnection network, commonly known as the network-on-chip (NoC). Existing efforts on securing NoC have considered lightweight encryption, authentication, and other attack detection mechanisms such as denial-of-service and buffer overflows. Unfortunately, these approaches focus on designing statically optimized security solutions. As a result, they are not suitable for many IoT systems with long application life and dynamic requirement changes. There is a critical need to design reconfigurable security architectures that can be dynamically tuned based on changing requirements. In this article, we propose a tier-based reconfigurable security architecture that can adapt to different use-case scenarios. We explore how to design an efficient reconfigurable architecture that can support three popular NoC security mechanisms (encryption, authentication, and denial-of-service attack detection and localization) and implement suitable dynamic reconfiguration techniques. We evaluate our proposed framework by running standard benchmarks enabling different tiers of security and provide a comprehensive analysis of how different levels of security can affect application performance, energy efficiency, and area overhead.
Demographic and Clinical Variables Associated With 30-day Re-Intubation Following Surgical Aortic Valve Replacement.

BACKGROUND A retrospective study was performed to evaluate factors associated with 30-d re-intubation following surgical aortic valve repair. We hypothesized a significant increase in the odds of re-intubation among patients with preoperative comorbidities. METHODS The American College of Surgery National Surgical Quality Improvement Program database from 2007 to 2016 was used to evaluate demographic and clinical factors associated with 30-d re-intubation following surgical aortic valve repair. Multivariable logistic regression was used to report factors associated with 30-d re-intubation while controlling for various patient characteristics. RESULTS The study population consisted of 5,766 adult subjects who underwent surgical aortic valve repair, of whom 258 (4.47%) were re-intubated within 30 d of surgery. The mean ± SD age was 69 ± 12.98 y, and 3,668 (63.6%) were male. The prevalence of diabetes mellitus, shortness of breath, poor functional status, COPD, congestive heart failure, hypertension, and bleeding disorder was higher among subjects who were re-intubated compared to those who were not (P < .05). Age, severe COPD, congestive heart failure, and bleeding disorder were associated with this outcome. CONCLUSIONS Age, COPD, congestive heart failure, and bleeding disorder were associated with 30-d re-intubation in this surgical cohort. If surgical aortic valve repair is deemed non-emergent, patients should be optimized preoperatively and receive careful postoperative planning to reduce the risk of postoperative complications.
Network Modeling of Assisted Living Facility Residents’ Attendance at Programmed Group Activities: Proximity and Social Contextual Correlates of Attendance

BACKGROUND AND OBJECTIVES Social engagement, including participation in group activities, supports older adults' mental and physical health. However, many residents of assisted living facilities do not participate in their facility's programmed group activities. Explaining residents' attendance at group activities is complex; attendance is associated with a confluence of individual-level and contextual factors. The aim of this study was to assess the effects of multilevel factors on attendance, including residents' proximity to activity location and the potential for one resident's attendance to depend on other residents' attendance. RESEARCH DESIGN AND METHODS We used bipartite exponential random graph models to examine the attendance of 35 residents at 563 programmed group activities. We simultaneously modeled the effects of the geospatial distance from a resident's apartment to the activity and the tendency for residents to attend activities with similar groups of other residents (i.e., shared attendance) on the likelihood of attendance, while controlling for individual-level factors (demographic and health indicators) and activity popularity. RESULTS Greater distance was associated with a reduced likelihood of attendance (p < .001) and residents tended to attend activities with similar subsets of other residents (p < .001). DISCUSSION AND IMPLICATIONS Findings suggest that greater distance to group activities may be a barrier to attendance. Implications include facility design, placement of activities and apartments, and mobility-related strategies to increase activity participation. It is also important to recognize that participation in activities is dependent on social context. We recommend that proximity to activities and social contextual factors be considered in future examinations of attendance at group activities.
Stigmatisierung und Verfolgung ‚asozialer‘ Frauen im nationalsozialistischen Österreich:

Gegenstand des Buches ist die Geschichte der Verfolgung von als ‚asozial‘ bezeichneten Frauen wahrend des Nationalsozialismus in und aus Osterreich. Neben einer ausfuhrlichen Diskussion des Begriffs ‚asozial‘ und den verfolgungsrelevanten behordlichen Gesetzen und Verordnungen enthalt das Buch diverse Fallstudien und Einzelschicksale, anhand derer die Lebens- und Leidensbedingungen der Frauen vor, wahrend und nach dem Konzentrationslager skizziert werden. Der Schwerpunkt des Buches liegt in der Sichtbarmachung systematischer Verfolgung sowie der Ursachenforschung und Begrundung von Unterschieden im behordlichen Verhalten. Zuletzt widmen sich die Autor_innen der fortgesetzten Diskriminierung und Stigmatisierung von als ‚asozial‘ verfolgten Frauen im Osterreich der Nachkriegszeit.
Joint Source and Sensor Localization by Angles of Arrival

Joint source and sensor localization (JSSL) attempts to simultaneously locate the multiple sources and sensors by exploiting the measurements between them. The research of JSSL has been based on time of arrival (TOA) measurements that require synchronization of the sources and sensors. This paper explores the use of angle of arrival (AOA) observations instead for the JSSL problem that does not require synchronization. The investigation and development presented are valid for localization in a $d\geq 2$ dimensional space. We first look into the feasibility and the fundamental properties of JSSL using AOA in terms of localization ambiguity, the minimal source and sensor case and the Cramer-Rao lower bound (CRLB). By representing the AOA as the direction vector of arrival (DVOA), we next devise the rank property of DVOA matrix for the JSSL problem. The rank property leads us to develop the algorithms for the refinement of AOA observations, the estimation of TOAs between the sources and sensors and the closed-form solution of their positions. The optimality of the closed-form solution in reaching the global minimum of the cost function based on DVOA is established. Simulations confirm the theoretical developments, and support the performance of the proposed JSSL solution in reaching the CRLB accuracy under Gaussian noise when the number of sources and sensors is sufficient.
Investigating implicit biases around race and gender in Canadian counterterrorism

A growing body of research on terrorism and countering violent extremism (CVE) has increasingly questioned the lack of attention to—and myths around—women involved in extremist and political violen...
A simplified thermal approximation method to include the effects of Marangoni convection in the melt pools of processes that involve moving point heat sources

Processes that use moving point heat sources to temporarily create localized melt pools (metal additive manufacture and fusion welding) have a flow phenomenon due to the surface tension gradient. S...
The problem of play in children’s museums

Play is central to the purpose of most American children’s museums and often highlighted as an attribute that makes them distinct from other types of museums and informal learning institutions. How...
Two- and three-dimensional size-dependent couple stress response using a displacement-based variational method

Abstract Based upon the principle of minimum total potential energy for consistent couple stress theory, a Ritz variational approach is developed using tensor product B-splines for both two- and three-dimensional elastostatic analysis. The underlying theory is size-dependent due to incorporation of the energy conjugate skew-symmetric couple-stress and mean curvature tensors, in addition to the force-stress and strain conjugate pair of classical theory. The use of B-splines as the basis functions can assure the required C 1 continuity of the displacement field, while also permitting higher order representations. Both displacements and rotations are essential boundary conditions in this theory. Displacements can be enforced in the usual way, but rotations require special treatment to maintain symmetry and positive definiteness of the stiffness matrix for well-posed elastostatic problems . Several computational examples are considered to validate the formulation, illustrate convergence characteristics, and investigate mechanical behavior under consistent couple stress theory. All previous numerical analysis of consistent couple stress theory has been limited to plane strain problems . Thus, the extension here to three-dimensions is of great importance, especially because the behavior in several cases shows significant deviation from the plane strain solutions. Consequently, the variational formulations and computational methodology presented in this paper can play a critical role in assessing the predictive capability of consistent couple stress theory and in understanding size-dependent elastic response .
Glycolytic Metabolism, Brain Resilience, and Alzheimer's Disease.

Alzheimer's disease (AD) is the most common form of age-related dementia. Despite decades of research, the etiology and pathogenesis of AD are not well understood. Brain glucose hypometabolism has long been recognized as a prominent anomaly that occurs in the preclinical stage of AD. Recent studies suggest that glycolytic metabolism, the cytoplasmic pathway of the breakdown of glucose, may play a critical role in the development of AD. Glycolysis is essential for a variety of neural activities in the brain, including energy production, synaptic transmission, and redox homeostasis. Decreased glycolytic flux has been shown to correlate with the severity of amyloid and tau pathology in both preclinical and clinical AD patients. Moreover, increased glucose accumulation found in the brains of AD patients supports the hypothesis that glycolytic deficit may be a contributor to the development of this phenotype. Brain hyperglycemia also provides a plausible explanation for the well-documented link between AD and diabetes. Humans possess three primary variants of the apolipoprotein E (ApoE) gene - ApoE∗ϵ2, ApoE∗ϵ3, and ApoE∗ϵ4 - that confer differential susceptibility to AD. Recent findings indicate that neuronal glycolysis is significantly affected by human ApoE isoforms and glycolytic robustness may serve as a major mechanism that renders an ApoE2-bearing brain more resistant against the neurodegenerative risks for AD. In addition to AD, glycolytic dysfunction has been observed in other neurodegenerative diseases, including Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis, strengthening the concept of glycolytic dysfunction as a common pathway leading to neurodegeneration. Taken together, these advances highlight a promising translational opportunity that involves targeting glycolysis to bolster brain metabolic resilience and by such to alter the course of brain aging or disease development to prevent or reduce the risks for not only AD but also other neurodegenerative diseases.
Directed forgetting in associative memory: Dissociating item and associative impairment.

We report three item-method directed forgetting (DF) studies to evaluate whether DF impairs primarily item memory, or whether it also impairs associative memory. The current studies used a modified associative recognition paradigm that allowed disentangling item impairment from associative impairment in DF. Participants studied scene-object pairings, followed by DF cues (item-method), and at test were presented with a previously studied scene along with three objects, one of which was studied with that scene (target), whereas the remaining two objects were studied with different scenes (lures). Experiment 1 used an associative encoding orienting task, and DF impairment was observed only when the forget targets were paired with forget lures within the test display; however, DF was eliminated when the forget targets were paired with remember lures, possibly due to a recall-to-reject strategy. Experiment 2 used an object-focused orienting task that downplayed the encoding of associative information. The results revealed the opposite of Experiment 1, with significant DF when the forget targets were paired with remember lures, and no DF when the lures and the target came from the same memory instruction. Experiment 3 used the same orienting task as Experiment 1, but testing used a sequential procedure, where item recognition was assessed first, followed by associative recognition test. Conditionalizing associative recognition on item recognition outcomes confirmed that DF impairment of associative memory can be obtained despite retained memory for forget-cued objects. Overall, the results provide strong support for the impairment of associative memory by DF. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Primary Care’s Effects on Costs in the US Veterans Health Administration, 2016–2019: an Observational Cohort Study

Enhancing primary care is a promising strategy for improving the efficiency of health care. Previous studies of primary care’s effects on health expenditures have mostly relied on ecological analyses comparing region-wide expenditures rather than spending for individual patients. To compare overall medical expenditures for individual patients enrolled vs. those not enrolled in primary care in the Veterans Health Administration (VHA). Cohort study with stratification for clinical risk and multivariable linear regression models adjusted for clinical and demographic confounders of expenditures. In total, 6,009,973 VHA patients in fiscal year (FY) 2019—5,410,034 enrolled with a primary care provider (PCP) and 599,939 without a PCP—and similar numbers in FYs 2016–2018. Total annual cost per patient to the VHA (including VHA payments to non-VHA providers) stratified by a composite health risk score previously shown to predict VHA expenditures, and multivariate models additionally adjusted for VHA regional differences, patients’ demographic characteristics, non-VHA insurance coverage, and driving time to the nearest VHA facility. Sensitivity analyses explored different modeling strategies and risk adjusters, as well as the inclusion of expenditures by the Medicare program that covers virtually all elderly VHA patients for care not paid for by the VHA. Within each health-risk decile, non-PCP patients had higher outpatient, inpatient, and total costs than those with a PCP. After adjustment for health risk and other factors, lack of a PCP was associated 27.4% higher VHA expenditures, $3274 per patient annually (p < .0001). Sensitivity analyses using different risk adjusters and including Medicare’s spending for VHA patients yielded similar results. In the VHA system, primary care is associated with substantial cost savings. Investments in primary care in other settings might also be cost-effective.
Big Data, Big Questions| A Dozen Ways to Get Lost in Translation: Inherent Challenges in Large Scale Data Sets

As noted by the late Susan Leigh Star, technoscientific research always involves simplification and standardization. In recent years, the collection and analysis of large-scale data sets (LSDS) have become the norm. These are often convenience samples analyzed by data mining techniques. Moreover, these data are often used as the basis for public and private policy and action. At the same time, the term “large-scale” suggests completeness, while ease of collection and analysis suggest that little else need be done. Both tend to crowd out other interpretations; hence understanding their limits should be of the utmost concern. This article discusses a number of the issues of concern that arise out of the necessary but potentially problematic simplifications/standardizations found in LSDS.
Drug Therapy for Hypercholesterolemia and Dyslipidemia

The initial and primary treatment of abnormal lipid levels in children is to change diet and activity levels. Pharmacological treatment of lipid disorders is used according to guidelines published in 2011. In adults treatment cutpoints and goals for therapy are adjusted based on high risk populations and in the presence of other cardiovascular (CV) risk factors. Pediatric lipid guidelines also reflect this type of thinking, although the data on which treatment cutpoints are based is less robust than adults. Atherosclerosis is known to begin in childhood; however, extensive outcome data are lacking in pediatrics and parental and/or patient preference are usually included in the decision-making process.
Isolation and characterization of the sulfated neolactotetraosylceramide from hog gastric mucosa.

Abstract A sulfated neolactotetraosylceramide has been isolated from the lipid extract of hog gastric mucosa. Isolation procedure involved extraction of lipids with 0.4 M sodium acetate in methanol/chloroform/water, alkaline methanolysis, column fractionation on DEAE-Sephadex, separation of the acetylated acidic glycolipids on silicic acid column, and thin layer chromatography. By partial acid hydrolysis, sequential hydrolysis with specific glycosidases, periodate oxidation, and methylation analysis of the native and desulfated compound, the structure of this glycolipid is proposed to be: Galbeta1 leads to 4GlcNAc(6 comes from SO3)beta1 leads to 3Galbeta1 leads to 4Glc1 leads to 1 ceramide.
Portfolio Decision Quality

The decision quality framework has been useful for integrating decision analytic techniques into decision processes in a way that adds value. This framework extends to the specific context of portfolio decisions, where decision quality is determined at both the project level and the portfolio level, as well as in the interaction between these two levels. A common heuristic says that the perfect amount of decision quality is the level at which the additional cost of improving an aspect of the decision is equal to the additional value of that improvement. A review of several models that simulate portfolio decision-making approaches illustrates how this value added depends on characteristics of the portfolio decisions, as does the cost of the approaches.
Mössbauer spectroscopy of ferromagnetic oxygen-rich dicalcium cuprate Ca 2 CuO 3+δ

Stoichiometric Ca2CuO3 qualifies as a low-dimensional antiferromagnet. Nonetheless, oxygenated sintered samples of high-purity Ca2CuO3+δ, δ≅ 0.17, exhibited remarkable spontaneous ferromagnetic hysteresis at ambient conditions [1–3]. In this work, Mossbauer fitting of spectroscopic data on Ca2Cu0.985 57Fe0.015 O3+δ revealed large magnetic hyperfine fields at two sites, indicative of FeIII charge state, combined with fairly large electric quadrupole interaction parameters, as well as two central quadrupole-split doublets. One sextet, having B=49 T, corresponds to the tetragonal copper ferrite spinel. The other sextet, with unusual B=42 T and greater relative intensity variability following annealing in vacuum and post-oxygenation treatments, allows us to assign it to 57Fe substitution in dicalcium cuprate grain surfaces. This also supports the tentative interpretation in [1] for the ferromagnetism in pristine phase as excess holes-driven double exchange. One of the central doublets, with δEQ= 0.3 mm/s, is assigned to in-grain substitution in dicalcium cuprate, while a small-intensity doublet, having δEQ= 2.2 mm/s and CS= 0.6 mm/s, is assigned to 57Fe x II Cu1-xO.
Intrajejunal administration of an elemental diet at neutral pH avoids pancreatic stimulation: Studies in dog and man*

Summary o 1. An elemental diet (Vivonex 100) stimulates pancreatic secretion when instilled into the stomach of dogs. 2. When Vivonex 100 at near neutral pH is perfused through a Thirty-Vella loop, pancreatic secretion is not stimulated significantly. 3. A mixture of essential and nonessential amino acids and a mixture of phenylalanine, leucine, and tryptophan (which are the strongest stimulators of pancreatic secretion in the dog), when perfused through a Thirty-Vella loop at neutral pH and in the concentration present in Vivonex 100, cause minimal stimulation of pancreatic secretion. 4. When the same amino acid mixtures acidified to a pH of 3.5 are perfused through a Thirty-Vella loop, strong pancreatic stimulation occurs. 5. Perfusion of hypertonic glucose solution (22.6 per cent) in a Thirty-Vella loop inhibits protein and bicarbonate output from the pancreas. 6. When 22.6 per cent glucose solution is introduced into the stomach, pancreatic secretion is stimulated. 7. When amino acid mixtures in the concentration present in Vivonex 100 are instilled into the stomach, strong stimulation of pancreatic secretion results. 8. The foregoing information emphasizes the importance of bypassing the stomach and minimizing acid secretion to keep the pancreas at rest. 9. Measurements of net absorption from the Thirty-Vella loop suggest that sodium chloride enhances glucose absorption. 10. Hypertonic glucose appears to inhibit amino acid absorption from a jejunal loop. 11. Separation of the amino acids and the glucose for intrajejunal feedings may improve the absorption of amino acids. This may be of particular importance in feeding elemental diets to patients with the short bowel syndrome.
Field Sampling with a FP‐XRF: A Real‐World Lab Experience

Abstract A field sampling laboratory experiment was developed so students would gain experience sampling on a field site and have an introduction to XRF spectrometry. The experiment used a rented field portable XRF instrument (FP‐XRF) to quantify the lead in soil samples collected adjacent to an urban highway and explored aspects of the USEPA Method 6200. Rainy weather conditions eliminated the possibility to record spectra in the field, so sample preparation procedures were modified to model the typical in situ and intrusive mode of spectral investigations stated in the method. The lead content in the soil samples collected at 15 ft from the highway were determined to be greater than 2000 ppm. The soil lead content decreases as the distance perpendicular to the highway increases. The site background sample collected from 300 ft away is nearly equal to the instrumental lead detection limit of 20 ppm. The experiment demonstrated the need to collect replicate spectral data for in situ sampling and that samp...
Cell biology of vascular hypertrophy in systemic hypertension

Recent data demonstrate that in addition to its conduit function, the blood vessel is an active synthetic and secretory organ containing several autocrine and paracrine systems that are involved with the local regulation of its own function (i.e., structure and growth). The endothelium secretes vasorelaxant and vasoconstrictive substances, growth factors and inflammatory mediators that exert paracrine influences on vascular myocyte function. The vascular myocyte also expresses autocrine substances that influence its own function. The autocrine systems include angiotensin, prostaglandins, platelet-derived growth factor, insulin-like growth factor and heparin. These local factors exert modulatory influences on myocyte contractility and growth. These autocrine and paracrine systems serve as an adaptive mechanism by which the vasculature autoregulates its structural and functional state. We speculate that an alteration in this delicate balance of these local factors, due to genetic or acquired abnormalities, can result in increased vascular tone and vessel hypertrophy and thereby contribute to the pathogenesis of hypertension.
Gray-Image Encryption Using Multiplex Encoding Method

This paper proposes encoding the way and dealing with gray-image of multiplex double random phase technique. The true image is stored in a multiplex encoding that is so-called encodegram, and then it can be reconstructed by using proper random phase masks and correct retrieval protocol. It can then increase security and robustness of the true hidden image, and interrupt unauthorized receivers. Finally, we will verify this method encrypted in the image with experimental simulation.
Metaphorical views of interaction in families of origin and future families

(1989). Metaphorical views of interaction in families of origin and future families. Journal of Applied Communication Research: Vol. 17, Applying Communication Theory to Family Process, pp. 52-70.
Attitude Motion in an Eccentric Orbit.

Abstract : Both analytical and numerical techniques are used to study the oscillations and regions of stability of a gravity-gradient satellite in an eccentric orbit. A stroboscopic study of the results of a digital simulation of the equations of attitude motion yields stable regions that are considerably larger than those reported previously. The analytic study is conducted via a perturbational technique, and the results show good agreement with the numerical results in magnitude but not in phase. (Author)
Charge-transfer and the hydrogen bond: Spectroscopic and structural implications from electronic structure calculations

The absolutely localized molecular orbital (ALMO) model is a fully variational approach which permits polarization of molecules interacting in a cluster while prohibiting charge-transfer (or dative interactions) between individual molecules. The ALMO model can be applied within any density functional theory calculation – the B3LYP functional is employed in this work. ALMO DFT calculations of observables such as optimized geometry, vibrational frequencies and their intensities, and vertical detachment energies are performed for the water dimer, the chloride–water complex and the cyanide–water complex. The vibrational spectra are obtained both within the harmonic approximation and by quasiclassical trajectory simulations. By comparing these ALMO DFT calculations with full DFT calculations using precisely the same functional and basis, the role of charge-transfer on observables in these model hydrogen bonding systems can be assessed. The results can be further interpreted using ALMO-based energy decomposition analysis, which help to reveal the origin of sensitivity or insensitivity of observables to dative interactions. Analysis of the results also suggests that the B3LYP functional, while qualitatively adequate, appears to somewhat overestimate charge-transfer effects.
The scope of the cognitive sciences: Reply to 6 reviews of The MIT Encyclopedia of the Cognitive Sciences

Although there have been several reviews of the The MIT Encyclopedia of the Cognitive Sciences, the six reviews in this issue of Artificial Intelligence represent an unusual opportunity to see in one collection how scholars from a wide range of perspectives evaluate MITECS. I found it very useful to consider the reviews side by side and am grateful to the reviewers for providing a number of new insights into the nature of the cognitive sciences. It is also gratifying to see such generally positive assessments from five of the six reviewers (Carr, Dorr, Husbands, Okamato and Peterson) and it is intriguing to consider the more negative comments by Lakoff. In this essay, rather than consider in detail the many points raised by the reviews, I examine more globally how a project like MITECS might be evaluated and how it seemed to fare in light of these reviews. There are four primary ways in which an attempt to provide a comprehensive portrait of the cognitive sciences might be evaluated: (1) Does it give a correct picture of the phenomena of interest to cognitive scientists? (2) Even if it covers the right phenomena does it also cover the most important approaches to those phenomena? (3) Even if covers the right phenomena and the right approaches does it do so in a way that clearly accurately represents the relevant literatures? (4) Even if each of the articles succeeds on all accounts individually, do they as a collection link together in ways that give readers a sense of the cognitive sciences overall? The six reviews of MITECS touch on each of these four kinds of potential problems; but clearly with different emphases. Moreover, in at least some cases, it is not clear which of these criticisms is really intended. Rob Wilson’s comment provides a very useful description of how MITECS emerged as a project and how that process might be expected to relate to some of the concerns raised by reviewers. It shows how the evolution of