cssi/SciSciGPT-SciSciNet huggingface dataset:
Social media experiences of adolescents and young adults with cerebral palsy who use augmentative and alternative communication

AbstractPurpose: This pilot study aimed to expand the current understanding of how adolescents and young adults with cerebral palsy (CP) and complex communication needs use social media.Method: An online focus group was used to investigate the social media experiences of seven individuals with CP who used Augmentative and Alternative Communication (AAC). Questions posed to the group related to social media: (a) advantages; (b) disadvantages; (c) barriers; (d) supports; and (e) recommendations.Result: Adolescents with CP who use AAC used a range of communication media to participate in daily interactions, including social media. An analysis of the focus group interaction revealed that the participants used social media to: bypass the constraints of face-to-face interactions; communicate for a number of reasons (e.g. maintain relationships, share experiences); and support independent leisure (e.g. playing games, looking at pictures/videos). Despite the advantages, the participants discussed barriers includi...
GW4064, an Agonist of Farnesoid X Receptor, Represses CYP3A4 Expression in Human Hepatocytes by Inducing Small Heterodimer Partner Expression

Farnesoid X receptor (FXR) functions as a regulator of bile acid and lipid homeostasis and is recognized as a promising therapeutic target for metabolic diseases. The biologic function of FXR is mediated in part by a small heterodimer partner (SHP); ligand-activated FXR enhances SHP expression, and SHP in turn represses the activity of multiple transcription factors. This study aimed to investigate the effect of FXR activation on expression of the major drug-metabolizing enzyme CYP3A4. The effects of 3-(2,6-dichlorophenyl)-4-(3′-carboxy-2-chlorostilben-4-yl)oxymethyl-5-isopropylisoxazole (GW4064), a synthetic agonist of FXR, on the expression and activity of CYP3A4 were examined in primary human hepatocytes by using quantitative real-time polymerase chain reaction and S9 phenotyping. In human hepatocytes, treatment of GW4064 (1 μM) for 48 hours resulted in a 75% decrease in CYP3A4 mRNA expression and a 25% decrease in CYP3A4 activity, accompanied by ∼3-fold increase in SHP mRNA expression. In HepG2 cells, SHP repressed transactivation of CYP3A4 promoter by pregnane X receptor (PXR), constitutive androstane receptor (CAR), and glucocorticoid receptor. Interestingly, GW4064 did not repress expression of CYP2B6, another target gene of PXR and CAR; GW4064 enhanced CYP2B6 promoter activity. In conclusion, GW4064 represses CYP3A4 expression in human hepatocytes, potentially through upregulation of SHP expression and subsequent repression of CYP3A4 promoter activity. Clinically significant drug-drug interaction involving FXR agonists and CYP3A4 substrates may occur.
Publications in academic medical centers: technology-facilitated culture clash.

Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed.
Observations on the Prevalence, Characteristics, and Effects of Self-Treatment.

Aims: When facing illness, a person may choose self-treatment as an alternative to hospital (and primary care)-based treatment. Despite its important role in healthcare, the study on self-treatment remains limited. The goal is to collectively report the observations in the literature on the prevalence, characteristics, and effects of self-treatment. Methods: Extensive literature search was conducted, and relevant information was extracted. Results: Published studies have reported that in some regions, the prevalence of self-treatment is high and varies across illness conditions and treatment approaches. Self-medication is the most popular self-treatment approach. Multiple regional, demographic, personal, cultural and religious factors have been implicated in the pursuit of self-treatment. In addition, accessibility of healthcare also plays a role. Self-treatment in general has a positive clinical and financial effect. However there have been concerns on abuse and possible negative effects. Conclusions: This article reviews observations made in recent studies on several important aspects of self-treatment. Comprehensive and systematic study is still lacking. Interventions are needed to solve several problems associated with self-treatment.
Contact force-displacement relationship for geotechnical granular medium under stress wave

In order to describe the force-displacement relationship of geotechnical granular medium under stress wave,an elastoplastic contact model of low velocity impact is derived according to the theories of contact mechanics and rigid dynamics,in which the local nonlinear dynamic interaction of granulae is considered and the coefficient of restitution is introduced.Then the rationalities of the contact model are verified by several examples.The results show that the complicated incremental formula and the problem of nonlinear dynamic contact have been avoided in the contact model;and the effects of many factors such as impact velocity,physico-mechanical property,geometrical characteristic and exterior physical condition of the granulae during contact are taken into account;therefore the contact model is convenient for engineering application.
Epizootiology of lyme borreliosis

Borrelia burgdorferi is transmitted from animals to humans by ticks belonging primarily to the Ixodes ricinus complex. Transmission occurs during feeding, either by salivation, regurgitation, or by both processes. Two Eurasian (Ixodes ricinus and I. persulcatus) and three North American (I. dammini, I. scapularis and I. pacificus) species vector B. burgdorferi to humans. All ticks feed on three different host animals during their lives, and each species parasitizes a relatively large number of different host animals. For example, Ixodes ricinus is known to feed on more than 300 different kinds of mammals, birds, and reptiles. Borrelia burgdorferi has been isolated or detected in 24 different species of mammals or birds. Rodents belonging to the genera Peromyscus and Apodemus are important reservoirs in North America and Europe, respectively. Birds are a natural means of distributing infected ticks long distances during their migratory flights. Reptiles may not support the growth of borreliae. The B31 strain of B. burgdorferi is predominant in north-eastern United States. It is the only strain known to cause disease in humans, and the only one thus far isolated from rodents. In Europe, variants with distinctly different proteins from those found in the B31 strain also are infectious to humans, through they have not been identified with any specific clinical syndrome of Lyme borreliosis. Variants of the B31 strain have been isolated from lagomorphs in the United States.
Ca2+/calmodulin-dependent protein kinase II activation and regulation of adrenal glomerulosa Ca2+ signaling

We recently reported that elevations in the intracellular Ca2+ concentration ([Ca2+]i) enhance low-voltage-activated, T-type, Ca2+ channel activity via Ca2+/calmodulin-dependent protein kinase II (CaMKII). Here, we document CaMKII activity in bovine adrenal glomerulosa (AG) cells and assess the importance of CaMKII in depolarization-induced Ca2+ signaling. AG cell extracts exhibited kinase activity toward a CaMKII-selective peptide substrate that was dependent on both Ca2+ [half-maximal concentration for Ca2+ activation (K0.5) = 1.5 microM] and calmodulin (K0.5 = 46 nM) and was sensitive to a calmodulin antagonist and a CaMKII peptide inhibitor. On cell treatment with elevated extracellular potassium (10-60 mM) or angiotensin II, Ca(2+)-independent CaMKII activity increased to 133-205% of basal activity. Ca(2+)-independent kinase activity in agonist-stimulated extracts was inhibited by the CaMKII inhibitor peptide, 1(-)[N,O-bis(1,5- isoquinolinesulfonyl)-N-methyl-L-tyrosyl]-4-phenylpiperazine (KN-62), a cell-permeable inhibitor of CaMKII, reduced the agonist-induced stimulation of Ca(2+)-independent CaMKII activity. KN-62 also diminished depolarization-induced increases in [Ca2+]i without affecting the membrane potential. These observations suggest that CaMKII is activated in situ by aldosterone secretagogues and augments Ca2+ signaling through voltage-gated Ca2+ channels.
Operative laparoscopy for the treatment of ovarian remnant syndrome.

Objective To present the technique and assess the efficacy of operative laparoscopy to manage ovarian remnant syndrome. Design Observational with a follow-up of 6 to 32 months. Setting Private subspecialty practice with a large referral base. Patients Thirteen women, 9 with previous bilateral salpingo-oophorectomy and 4 with previous unilateral salpingo-oophorectomy and pain on the ipsilateral side. Interventions Multipuncture advanced operative laparoscopy. Main Outcome Measures Patient pain relief was assessed through return examinations, telephone interviews, or contact with referring physicians. Results Nine patients reported complete pain relief. One reported incomplete but satisfactory pain relief. Two required bowel resection by laparotomy to obtain pain relief, and one, despite subsequent laparotomy, had persistent pain. No intraoperative or postoperative complications were noted. Conclusion Laparoscopy can be effective in managing ovarian remnant syndrome when performed by an experienced laparoscopist.
Floral Morphology and Organogenesis in Tinantia pringlei , Along with a Review of Floral Developmental Variation in the Spiderwort Family, Commelinaceae

Floral organogenesis had previously been investigated thoroughly in 11 species from three of nine subtribes or their equivalent in the Commelinaceae. Here flower morphology and development is described from a member of a fourth subtribe, Tinantia pringlei from the Thyrsantheminae, and comparisons are made. Although the calyx is only weakly monosymmetric at maturity, development is of the monosymmetric-type known from or resembling that of the monosymmetric flowers of Cochliostema, Dichorisandra, and Plowmanianthus (subtribe Dichorisandrinae; tribe Tradescantieae) and Commelina (tribe Commelineae). Whereas the corolla also is weakly monosymmetric at maturity, development is of the polysymmetric-type known from the polysymmetric flowers of Callisia, Gibasis, and Tradescantia (subtribe Tradescantiinae). In the androecium, the long, inconspicuous blue stamens of the lower floral hemisphere emerge first during development, while the shorter, showy yellow, upper stamens emerge last. The overall pattern of stamen development is centripetal, thereby resembling that reported for the majority of confamilial taxa, and contrasting with the centrifugal pattern known from Callisia and Tradescantia. Relative to the majority of confamilial taxa investigated, the carpels emerge relatively late in development, resembling the timing known for the carpels of Callisia and Tradescantia. Overall, however, carpel emergence in Tinantia pringlei is unique in the comparatively small size of the remnant floral apical primordium on which the carpels emerge. Other variations in floral development are discussed and further such studies within the family are encouraged based on the potential for using such developmental variations in the assessment of morphological homologies and phylogenetic relationships within the Commelinaceae.
Neonatal Clinical Nurse Specialist in Improving Neonatal Care through Outreach to Referral Hospitals

Abstract In the United States, the majority of babies are born at community hospitals that have a limited ability to care for premature or ill neonates. Regionalization was developed in the early 1970’s in an effort to improve the outcomes of these neonates and pregnant women. Hospitals were designated a level of care based on their resources and capability to care for the premature or ill neonates and pregnant women. The highest level of care is the regional center. A requirement of these centers is to provide outreach education and initiatives to the referral hospitals in their referral area. The perinatal/neonatal clinical nurse specialist working in regional centers is an ideal position to lead the hospital outreach initiative to improve the care of neonates and pregnant women in the referral area.
Integrating the Inner City: The Promise and Perils of Mixed-Income Public Housing Transformation, by Robert J. Chaskin and Mark L. Joseph

Most previous American public housing research has concentrated either on the history of public housing or on the consequences of demolishing projects and relocating residents. Robert Chaskin and M...
The positivity bias and prosocial deception on facebook

Can the positivity bias, observed across various Social Network Sites (SNSs), predict the use of prosocial lies in a SNS such as Facebook? The positivity bias may be a product of politeness norms (i.e., positive face concern) that have influenced communication phenomena before these sites existed. In addition, positive face concern may also be affected by unconscious cues or primes that promote prosocial behavior on Facebook. We conducted an online experiment using current Facebook users to examine how positive face concern and surveillance primes affect prosocial lying in public and private Facebook contexts. Although positive face concern and publicness predicted the use of prosocial lying, positive face concern was not affected by the publicness and surveillance primes did not affect positive face concern or the use of prosocial lies in our study. This hints towards the nuance of positive face concern and the potential limitations of surveillance primes on prosocial lying behavior. Participants post prosocial lies on Facebook if the truth would threaten another's positive face.Participants post prosocial lies on Facebook when posting publicly on the site.Surveillance primes did not predict the likelihood that users would post prosocial lies on Facebook.
Exploring rater cognition: A typology of raters in the context of music performance assessment

This manuscript sought to investigate rater cognition by exploring rater types based upon differential severity and leniency associated with rating scale items, rating scale category functioning, a...
Deaf and Hard of Hearing

Individuals with reduced hearing are a heterogeneous group. The hearing status (i.e., the extent to which one is able to hear, typically described as ranging from mild to profound hearing levels), the age at which reduced hearing is identified, the time of onset of reduced hearing (whether congenital or later in life), and the access to supports for communication (such as signed language and/or the introduction of technologies to improve hearing, such as hearing aids or cochlear implants) will all have a significant impact on the functioning of the individual who is Deaf or hard of hearing. Persons who self-identify as Deaf (emphasis on the “capital D”) perceive themselves as a part of a cultural and linguistic minority group, united by a shared visual language (e.g., in the USA, typically this is American Sign Language), as well as shared customs, norms, and cultural traditions. Others may perceive their reduced hearing as more burdensome, as it may reduce their social opportunities and lead to feelings of isolation. In working with patients with reduced hearing, it is important to seek to understand individuals’ own perceptions of their hearing status and to work to ensure good communication.
Facing Your Opponents Social Identification and Information Feedback in Contests

We experimentally investigate the effect of social identification and information feedback on individual behavior in contests. In all treatments we find significant over-expenditure of effort relative to the standard theoretical predictions. Identifying subjects through photo display decreases wasteful effort. Providing information feedback about others’ effort does not affect the aggregate effort, but it decreases the heterogeneity of effort and significantly affects the dynamics of individual behavior. We develop a behavioral model which incorporates a non-monetary utility of winning and relative payoff maximization. The model explains significant over-expenditure of effort. It also suggests that decrease in ‘social distance’ between group members through photo display promotes pro-social behavior and decreases over-expenditure of effort, while improved information feedback decreases the heterogeneity of effort.
Impact of body mass index and ethnicity on asparaginase toxicity in adult acute lymphoblastic leukemia patients.

e18051 Background: Adolescent young adults (age 15-39 years) with acute lymphoblastic leukemia (ALL) and relapsed adult ALL patients receiving asparaginase (ASP) containing regimens (ASP+) have fav...
Us vs. Them – Voter Turnout, Partisanship, and Emotional Responses to Presidential Candidates, 1980-2012

While numerous studies have examined how emotions mediate different aspects of citizens’ political attitudes, information-seeking and knowledge, few have focused on how campaigns might motivate or depress political behavior such as voter turnout. We use measures of positive and negative emotions from the American National Election Studies (ANES) for presidential elections between 1980 and 2012 to examine whether emotional affect toward presidential candidates increases over time, whether Republican identifiers report stronger emotional affect than Democratic identifiers, and whether emotional affect is associated with self-reported voter turnout. Our evidence indicates that emotional affect is associated with higher turnout but fails to support our expectations regarding changes over time in affective reactions to candidates and partisan differences in affective reactions.
Winter Pea: Promising New Crop for Washington's Dryland Wheat-Fallow Region

A 2-year tillage-based winter wheat (Triticum aestivum L.)-summer fallow (WW-SF) rotation has been practiced by the vast majority of famers in the low-precipitation (< 300 mm annual) rainfed cropping region of east-central Washington and north-central Oregon for 140 years. Until recently, alternative crops (i.e., those other than WW) so far tested have not been as economically viable or stable as WW-SF. A 6-year field study was conducted near Ritzville, WA (292 mm avg. annual precipitation) to determine the yield and rotation benefits of winter pea (Pisum sativum L.) (WP). Two 3-year rotations were evaluated: WP-spring wheat (SW)-SF versus WW-SW-SF. Winter pea yields averaged 2443 kg/ha versus 4878 kg/ha for WW. No fertilizer was applied to WP whereas 56 kg N and 11 kg S/ha were applied to WW. Winter pea used significantly less soil water than WW. Over the winter months, a lesser percentage of precipitation was stored in the soil following WP compared to WW because: (i) very little WP residue remained on the soil surface after harvest compared to WW, and (ii) the drier the soil, the more precipitation is stored in the soil over winter. However, soil water content in the spring was still greater following WP versus WW. Soil residual N in the spring (7 months after the harvest of WP and WW) was greater in WP plots despite not applying fertilizer to produce WP. Spring wheat grown after both WP and WW received the identical quantity of N, P, and S fertilizer each year. Average yield of SW was 2298 and 2011 kg/ha following WP and WW, respectively (P< 0.01). Adjusted gross economic returns for these two rotation systems were similar. Based partially on the results of this study, numerous farmers in the dry WW-SF region have shown keen interest in WP and acreage planted WP in east-central Washington has grown exponentially since 2013. This paper provides the first report of the potential for WP in the typical WW-SF region of the inland Pacific Northwest (PNW).
Transorbital endoscopic approach for exposure of the sylvian fissure, middle cerebral artery and crural cistern: an anatomical study

The availability of minimal access instrumentation and endoscopic visualization has revolutionized the field of minimally invasive skull base surgery. The transorbital endoscopic approach using an eyelid incision has been proposed as a new minimally invasive technique for the treatment of skull base pathology, mostly extradural tumors. Our study aims to evaluate the anatomical aspects and potential role of the transorbital endoscopic approach for exposure of the sylvian fissure, middle cerebral artery and crural cistern. An anatomical dissection was performed in four freshly injected cadaver heads (8 orbits) using 0- and 30-degree endoscopes. First, an endoscopic endonasal medial orbital decompression was done to facilitate medial retraction of the orbit. An endoscopic transorbital approach through an eyelid incision, with drilling of the posterior wall of the orbit and lesser sphenoidal wing, was then performed to expose the sylvian fissure and crural cisterns. A stepwise anatomical description of the approach and visualized anatomy is detailed. A superior eyelid incision followed by orbital retraction provided a surgical window of approximately 1.2 cm (range 1.0–1.5 cm) for endoscopic transorbital dissection. The superior (SOF) and inferior (IOF) orbital fissures represent the medial limits of the approach and are identified in the initial part of the procedure. Drilling of the orbital roof (lateral and superior to the SOF), greater sphenoidal wing (lateral to the SOF and IOF) and lesser sphenoidal wing exposed the anterior and middle fossa dura. A square-shaped dural opening provided visualization of the posterior orbital gyri, sylvian fissure and temporal pole. Intradural dissection allowed exposure of the sphenoidal portion of the sylvian fissure, M1, MCA bifurcation and M2 branches and lenticulostriate perforators. Dissection of the medial aspect of the sylvian and carotid cisterns with a 30-degree endoscope allowed exposure of the mesial temporal lobe and crural cistern. The transorbital endoscopic approach allows successful exposure of the sphenoidal portion of the sylvian fissure and M1 and M2 segments of the middle cerebral artery. Angled endoscopes may provide visualization of the mesial temporal lobe and crural cistern. Although our anatomical study demonstrates the feasibility of intradural dissection and closure via an endoscopic transorbital approach, further studies are necessary to evaluate its role in the clinical scenario.
Exploring the microstructural evolution of Hf-Ti: From nanometallic multilayers to nanostructures

Abstract Microstructural changes in nanocrystalline materials are driven by their high grain boundary density and greater mobility at elevated temperatures. For instance, segregation, precipitation, and grain growth become active as the temperature increases. The potential of nanometallic multilayers as a route to synthesize nanostructures is explored examining the microstructural evolution of Hf-Ti nanometallic multilayers through differential scanning calorimetry and characterization at different temperatures. Thermodynamic and kinetic calculations were performed to understand the observed transitions. This study presents a guide to microstructural changes in nanometallic multilayers which can be used to develop new nanocrystalline systems.
Clinical features, onsite evaluation, and follow-up results in patients with suspicious for adenocarcinoma on EUS-guided FNA of pancreas.

Background Occasionally, an interpretation of suspicious for adenocarcinoma is made for endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) of pancreas. In this study, we aimed to assess onsite evaluation and follow-up results for FNAs with suspicious for adenocarcinoma (FNA-SUS) in order to identify likely factors that are associated with this interpretation. Design A total of 53 pancreatic FNA-SUS cases and 149 pancreatic FNAs with an interpretation of adenocarcinoma (FNA-ADC) were included in current study. Clinical characteristics, onsite evaluation results, and follow-up results were collected and analyzed. Results Compared with FNA-ADC category, FNA-SUS category was associated with increased cystic/ill-defined lesions on imaging, increased frequency of inadequate materials (onsite evaluation), increased total smear/slide number, and increased number of cases with limited materials on permanent slides/sections. For follow-up resections, 21% of FNA-SUS cases (7 of 34) showed benign, dysplastic changes or neuroendocrine tumors and 79% (27 of 34) showed adenocarcinoma with increased frequency of well-differentiated type. In contrast, all FNA-ADC cases showed adenocarcinoma. The average age of those 7 FNA-SUS cases with non-adenocarcinoma on follow-up was significantly younger than that of 27 cases with adenocarcinoma. FNA-SUS cases with adenocarcinoma on follow-up showed even greater frequency of inadequate materials during onsite evaluation and more increased total smear slide number than FNA-ADC cases. Conclusion Our data demonstrated several clinicopathologic factors that are likely associated with a suspicious cytology. In younger patients with suspicious cytology and non-mass forming lesion, surgical management should be taken with caution as a considerable percentage of patients showed only benign or low-grade dysplastic changes.
Evaluation and comparison of an adaptive method technique for improved performance of linear Fresnel secondary designs

Abstract As a line-focus concentrating solar power (CSP) technology, linear Fresnel collectors have the potential to become a low-cost solution for electricity production and a variety of thermal energy applications. However, this technology often suffers from relatively low performance. A secondary reflector is a key component used to improve optical performance of a linear Fresnel collector. The shape of a secondary reflector is particularly critical in determining solar power captured by the absorber tube(s), and thus, the collector’s optical performance. However, to the authors’ knowledge, no well-established process existed to derive the optimal secondary shape prior to the development of a new adaptive method to optimize the secondary reflector shape. The new adaptive method does not assume any pre-defined analytical form; rather, it constitutes an optimum shape through an adaptive process by maximizing the energy collection onto the absorber tube. In this paper, the adaptive method is compared with popular secondary-reflector designs with respect to a collector’s optical performance under various scenarios. For the first time, a comprehensive, in-depth comparison was conducted on all popular secondary designs for CSP applications. It is shown that the adaptive design exhibits the best optical performance.
Assessment for Learning in Immersive Environments

Immersive Environments (IEs) hold many promises for learning. They represent an active approach to learning and are intended to facilitate better, deeper learning of competencies relevant for success in today’s complex, interconnected world. To harness the power of these environments for educational purposes (i.e., to support learning), we need valid assessments of the targeted competencies. In this chapter we focus on how to design and develop such valid assessments, particularly those providing an ongoing, unobtrusive collection and analysis of data as students interact within IEs. The accumulated evidence on learning thus provides increasingly reliable and valid inferences about what students know and can do across multiple contexts. This type of assessment is called “stealth assessment” and is applied toward the real-time measurement and support of learning in IEs—of cognitive and non-cognitive variables. The steps toward building a stealth assessment in an IE are presented through a worked example in this chapter, and we conclude with a discussion about future stealth assessment research, to move this work into classrooms for adaptivity and personalization.
Case 34: The Butterfly Needle (Abbott)

A 3-year-old boy (34 lb) is scheduled for an urgent manipulation of a fractured forearm. He has just come from a birthday party and has eaten cake and other sweets within the last hour. His medical history is unremarkable. The patient has no known drug allergies, and the family history is negative for anesthesia-related problems. An intravenous (IV) (25-gauge) Butterfly needle is established in the back of the hand with the help of lidocaine/prilocaine (EMLA cream). Monitoring equipment is placed on the child (electrocardiogram [ECG], pulse oximeter, a nerve stimulator, noninvasive blood pressure [BP], and precordial stethoscope). General anesthesia is induced with propofol (35 mg) followed by succinylcholine (20 mg) using the Butterfly needle to good effect. The patient’s trachea is easily intubated, and general anesthesia is initially maintained with isoflurane 1–3 % with 70 % nitrous oxide in oxygen. After 10 min, with the patient breathing spontaneously, meperidine, 10 mg, is injected again through the Butterfly needle. A few seconds later, the pulse oximeter alarms and the ECG shows a bradycardia of 40 beats per minute (bpm). You are puzzled because meperidine, being an atropine derivative, should produce a tachycardia, not a bradycardia.
Knowledge level engineering: ontological analysis

Knowledge engineering suffers from a lack of formal tools for understanding domains of interest. Current practice relies on an intuitive, informal approach for collecting expert knowledge and formulating it into a representation scheme adequate for symbolic processing. Implicit in this process, the knowledge engineer formulates a model of the domain, and creates formal data structures (knowledge base) and procedures (inference engine) to solve the task at hand. Newell (1982) has proposed that there should be a knowledge level analysis to aid the development of AI systems in general and knowledge-based expert systems in particular. This paper describes a methodology, called ontological analysis, which provides this level of analysis. The methodology consists of an analysis tool and its principles of use that result in a formal specification of the knowledge elements in a task domain.
The Apotheosis of Siti Khotijah: Islam and Muslims in a Balinese Galactic Polity

This article seeks to describe the way in which Gusti Ayu Made Rai, an eighteenth-century Balinese princess from Badung became Raden Ayu Siti Khotijah, one Indonesia’s few widely recognized female Muslim saints. In so doing I develop an alternative reading of the dynamics of the history of religion in Bali, countering the common view that it is a static monolithically Hindu tradition. Rather than turning inward as the surrounding areas embraced Islam, Balinese kingdoms sought to include Muslims and elements of Islam in scared narratives and geographies. Two distinct theoretical approaches are used in this analysis: the structural approach to indigenous Southeast Asian states pioneered by Robert Heine-Geldern in the early decades of the twentieth century and the performative approach to ritual studies developed by Victor Turner in the 1970s.
Idiopathic thyroid storm mimicking SIRS in a patient with hypothyroidism- a diagnostic dilemma.

Thyroid storm, defined as an endocrine emergency in 1926, remains a challenge for physicians in the 21st century. The mortality rate of untreated thyroid storm is very high. Hence, if a thyroid sto...
Family System Play Therapy: An Integrative Approach

Although the roots of family therapy are firmly embedded in a family systems approach to treating child-focused problems, recent research suggests that the treatment of young children is relatively...
Automated pharmaceutical assistance systems. I. Clinical pharmacokinetics. II. Drug interference with laboratory tests results.

The function of the clinical pharmacokinetic service (CPS) in University Hospital is described. A methodological procedure was developed for routine interpretation of specified drug serum levels. Work lists that identify analytical procedures to be included for clinical pharmacokinetic evaluation are prepared daily. The results of all analyses of serum drug levels are evaluated by a pharmacist who is trained in clinical pharmacokinetics. Patient variables that influence serum levels of drugs are mathematically manipulated by program logic. Projections of expected drug levels as a result of dosing regimens are made and compared to measured laboratory results. Iterative programming that modifies projections on the basis of actual measurements is employed to determine individual drug dosing regimens the provide therapeutic/nontoxic serum levels of drugs. The drug/test interference system, which accesses the CPS data base, provides information concerning the potential physiologic, therapeutic, or toxic effect of drugs on biochemical substances. The system allows display of data concerning each drug before it is administered. Information concerning the date and time of initiation and termination of drug therapy allows for a warning comment to be attached automatically to the appropriate laboratory test result if interference is indicated.
Effects of bromocriptine treatment on the expression of sexual behavior in male sheep (Ovis aries)

Twenty-three rams were treated twice daily with subcutaneous injections of bromocriptine or vehicle over 30 d during two seasons, spring and fall. Sexual behavior was observed and quantified to determine the effects of bromocriptine-induced hypoprolactinemia on mount attempt (MA), mount (M), and ejaculation (E) frequency of the rams upon exposure to estrous ewes. Behavioral responses and serum prolactin (PRL) concentrations were determined on a weekly basis before, during, and after the treatment period in each season. Treatment with bromocriptine caused a significant decrease in serum concentrations of PRL during both seasons (P < .01). Post-treatment period concentrations of PRL returned to pretreatment levels during the spring, whereas during the fall, post-treatment period PRL concentrations remained low (P < .05). The frequency of MA and M was lower during bromocriptine treatment relative to control rams in the spring (P < .05). The frequency of MA and M returned to pretreatment values after bromocriptine treatment was withdrawn. Ejaculation frequency tended to decrease during and after bromocriptine treatment relative to controls (P < .09). There was no effect of bromocriptine treatment on frequency of MA and M during the fall. During the fall, the frequency of E tended to decrease in bromocriptine-treated rams (P < .1). These data indicate that bromocriptine-induced hypoprolactinemia is associated with a significant diminution in expression of sexual behavior in rams. It is suggested that PRL modulates the intensity of expression of sexual behavior in rams, and this effect may be season-dependent.
Mitochondrial Electron Transfer Cascade Enzyme Activity Assessment in Cultured Neurons and Select Brain Regions

Measurement of the electron transfer cascade (ETC) enzyme activities and their kinetic profiles is important in assessing mitochondrial function in the nervous system in health and disease or following exposure to toxic agents. The optimization of enzymatic assays for brain tissues and neurons is critical to the development of high-throughput assay formats. This article describes a step-by-step protocol for reliable and reproducible assessment of ETC enzyme kinetics (Complex I-IV) for mitochondria from small quantities of tissue from different brain regions, such as the hippocampus, cerebellum, and frontal cortex, or from neurons in culture. Methods for differential and density gradient centrifugation are detailed for isolating cell body and synaptic mitochondria from brain, as well as measurement of ETC activities in microwell plate or single-cuvette format using spectrophotometric methods. Easy-to follow assay layouts and useful tips are presented, allowing the user to perform these assays in under 3 hr. © 2019 by John Wiley & Sons, Inc.
Bronchoscopic features, associations, and outcomes of organizing pneumonia following allogeneic hematopoietic stem cell transplantation.

Organizing pneumonia (OP) is a poorly understood complication of hematopoietic stem cell transplant (HSCT). We identified 15 patients diagnosed with OP following HSCT and described their clinical course. CT chest findings were remarkable for multifocal infiltrates that were predominantly consolidating or ground glass opacities. Bronchoalveolar lavage (BAL) was performed on 14 patients with five having lymphocytosis (> 25% lymphocytes), three with eosinophilia (> 5% eosinophils), three with neutrophilia (> 30% neutrophils), and three with normal cell counts. Flow cytometry was analyzed on BAL fluid in 13 patients with 11 having a CD4/CD8 of < 0.9. Initial treatment with 0.3–1.0 mg/kg prednisone resulted in improvement in symptoms, in radiographic findings, and in pulmonary function testing for the majority of patients. Six patients had recurrence of OP after completing treatment. Eleven patients had evidence of extra-pulmonary graft-versus-host disease prior to diagnosis of OP, and seven patients were diagnosed with an upper respiratory tract infection (URI) within 8 weeks of OP diagnosis. Most patients respond well to prednisone with significant improvement in pulmonary function, but risk of recurrence is high after cessation of steroid treatment. Risk factors for the development of OP may include prior URI.
Sensitivity of dryland plant allometry to climate

Patterns of plant biomass partitioning are fundamental to estimates of primary productivity and ecosystem process rates. Allometric relationships between above‐ground plant biomass and non‐destructive measures of plant size, such as cover, volume or stem density are widely used in plant ecology. Such size‐biomass allometry is often assumed to be invariant for a given plant species, plant functional group or ecosystem type. Allometric adjustment may be an important component of the short‐ or long‐term response of plants to abiotic conditions. We used 18 years of size‐biomass data describing of 85 plant species to investigate the sensitivity of allometry to precipitation, temperature or drought across two seasons and four ecosystems in central New Mexico, USA. Size‐biomass allometry varied with climate in 65%–70% of plant species. Closely related plant species had similar sensitivities of allometry to natural spatiotemporal variation in precipitation, temperature or drought. Annuals were less sensitive than perennials, and forbs were less sensitive than grasses or shrubs. However, the differences associated with plant life history or functional group were not independent of plant evolutionary history, as supported by the application of phylogenetically independent contrasts. Our results demonstrate that many plant species adjust patterns in the partitioning of above‐ground biomass under different climates and highlight the importance of long‐term data for understanding functional differences among plant species. A free Plain Language Summary can be found within the Supporting Information of this article.
Multi-morbidity and Highly Effective Contraception in Reproductive-Age Women in the US Intermountain West: a Retrospective Cohort Study

Women with chronic health conditions benefit from reproductive planning and access to highly effective contraception. To determine the prevalence of and relationship between chronic health conditions and use of highly effective contraception among reproductive-age women. Retrospective cohort study using electronic health records. We identified all women 16–49 years who accessed care in the two largest health systems in the US Intermountain West between January 2010 and December 2014. We employed administrative codes to identify highly effective contraception and flag chronic health conditions listed in the US Medical Eligibility Criteria for Contraceptive Use (US MEC) and known to increase risk of adverse pregnancy outcomes. We described use of highly effective contraception by demographics and chronic conditions. We used multinomial logistic regression to relate demographic and disease status to contraceptive use. Of 741,612 women assessed, 32.4% had at least one chronic health condition and 7.3% had two or more chronic conditions. Overall, 7.6% of women with a chronic health condition used highly effective contraception vs. 5.1% of women without a chronic condition. Women with chronic conditions were more likely to rely on public health insurance. The proportion of women using long-acting reversible contraception did not increase with chronic condition number (5.8% with 1 condition vs. 3.2% with 5 or more). In regression models adjusted for age, race, ethnicity, and payer, women with chronic conditions were more likely than those without chronic conditions to use highly effective contraception (aRR 1.4; 95% CI 1.4–1.5). Public insurance coverage was associated with both use of long-acting reversible contraception (aRR 2.2; 95% CI 2.1–2.3) and permanent contraception (aRR 2.9; 95% CI 2.7–3.1). Nearly a third of reproductive-age women in a regional health system have one or more chronic health condition. Public insurance increases the likelihood that women with a chronic health condition use highly effective contraception.
The US Government and the Advertising, Radio, Newspaper, and Magazine Industries Confront the War

The entire advertising community, along with the radio, newspaper, and magazine industries, were committed to providing Americans on the home front with timely and accurate information about the perils the nation faced after Pearl Harbor and until the end of hostilities in August 1945. However, they also confronted serious issues of “censorship” because the US Government issued a series of “voluntary” guidelines regarding what could and should not be conveyed to the American public. The newspaper and magazine industries were concerned about any erosion in their prized First Amendment protection; however, radio was excluded from First Amendment protection because of the terms and conditions of the Communications Act of 1934; and advertisements would not receive First Amendment protection until after the end of World War II. Yet it was clear that advertising, radio, newspapers, and magazines essentially complied with the “voluntary suggestions” from various government agencies and departments during this period of great uncertainty. This chapter outlines the “voluntary” guidelines; and how these media industries complied with and contributed to the war effort.
Rising Temperatures, Human Health, and the Role of Adaptation

There is near consensus in the scientific community that humans will experience higher future temperatures due to the ongoing accumulation of greenhouse gases in the atmosphere. The human response to this climatic change, particularly if accompanied by a surge in extreme heat events, is a key topic being addressed by scientists across many disciplines. In this article, we review recent (2012–2015) research on human health impacts of observed and projected increases in summer temperature. We find that studies based on projected changes in climate indicate substantial increases in heat-related mortality and morbidity in the future, while observational studies based on historical climate and health records show a decrease in negative impacts during recent warming. The discrepancy between the two groups of studies generally involves how well and how quickly humans can adapt to changes in climate via physiological, behavioral, infrastructural, and/or technological adaptation, and how such adaptation is quantified.
Arguing by Analogy in Law: A Case-Based Model

In this chapter we focus on arguing by analogy in law, the way in which attorneys argue in favor of deciding a problem situation by analogizing it to precedent cases. We describe a 3-ply, turn-taking structure of analogical legal arguments in which analogous precedents are cited in points and responded to by distinguishing and citing counter-examples. After working through a brief example, we examine the traditional theoretical account of legal analogical reasoning and two criticisms of the traditional account, that it does not explain: (1) what similarities and differences are important, or (2) how competing analogies are resolved. We present a more complete account of arguing by analogy in law and show how the model is implemented in HYPO, a computer program that makes case-based, analogical arguments in the domain of trade secret law. We describe how HYPO uses “dimensions” and “claimlattice” mechanisms to perform indexing and dynamic relevancy assessment of precedent cases, compares and contrasts cases to come up with the best precedents pro and con a decision and makes a skeletal argument with points and responses that pose and distinguish analogous precedents. We show how the HYPO approach addresses the criticisms of the traditional model and compare it to the approaches of other AI research on analogical reasoning.