cssi/SciSciGPT-SciSciNet huggingface dataset:
An object-oriented fault-tolerance framework based on specialization techniques

Many fault-tolerant systems have been designed for specific fault tolerance requirements and application domains. The author develops a fault tolerance framework that can be easily customized for various system specifications and requirements. The framework is constructed in an object-oriented paradigm. An application program can be plugged in the framework and a desired configuration can be specified to obtain the desired level of fault-tolerance for the application. The framework can also be easily extended to accommodate a wider spectrum of fault assumptions and system models.
Crustacean Hyperglycemic Hormone Family: Old Paradigms and New Perspectives1

I present an overview of recent research on the isolation and characterization of members of the crustacean hyperglycemic hormone (CHH) neuropeptide family. Members of this arthropod-specific family include CHH, molt-inhibiting hormone (MIH), vitellogenesis-inhibiting hormone (VIH), and mandibular organ-inhibiting hormone (MOIH). There are two subfamilies of this neuropeptide group, based upon the presence or absence of a C-terminal CHH precursor-related peptide. There are also sequence motif differences between these subfamilies. Most of the peptides comprising this neuropeptide family are synthesized and released by the eyestalk X-organ/sinus gland complex. Recent experiments have demonstrated the presence of extra-eyestalk cells that produce CHH and the assignment of additional functions to this hormone family.
Development and Effectiveness of a National Board Certification for Occupational Therapists (NBCOT) Examination Preparatory Course

This study examined the effectiveness of the use of a test preparatory course to increase the first time passage rate on the National Board Certification for Occupational Therapist (NBCOT) examination. Means of the pre- and post-Occupational Therapy Knowledge Exam (OTKE) scores, as well as the change between pre- and post- intervention were calculated. The pre-OTKE mean score was 50.85, in comparison to, the post-OTKE mean score of 56.00 with a mean change in OTKE score of 5.15. The study results support the use of a mock examination in conjunction with other test preparatory techniques. Results of this study can serve as a baseline for the structured use of educational techniques to measure student improvement on first time passage rates for the NBCOT examination.
Three-dimensional simulations of supercritical black hole accretion discs - luminosities, photon trapping and variability

We present a set of four three-dimensional, general relativistic, radiation MHD simulations of black hole accretion at super-critical mass accretion rates, $\dot{M} > \dot{M}_{\rm Edd}$. We use these simulations to study how disk properties are modified when we vary the black hole mass, the black hole spin, or the mass accretion rate. In the case of a non-rotating black hole, we find that the total efficiency is of order $3\%\dot M c^2$, approximately a factor of two less than the efficiency of a standard thin accretion disk. The radiation flux in the funnel along the axis is highly super-Eddington, but only a small fraction of the energy released by accretion escapes in this region. The bulk of the $3\%\dot M c^2$ of energy emerges farther out in the disk, either in the form of photospheric emission or as a wind. In the case of a black hole with a spin parameter of 0.7, we find a larger efficiency of about $8\%\dot M c^2$. By comparing the relative importance of advective and diffusive radiation transport, we show that photon trapping is effective near the equatorial plane. However, near the disk surface, vertical transport of radiation by diffusion dominates. We compare the properties of our fiducial three-dimensional run with those of an equivalent two-dimensional axisymmetric model with a mean-field dynamo. The latter simulation runs nearly 100 times faster than the three-dimensional simulation, and gives very similar results for time-averaged properties of the accretion flow.
Glial cell line-derived neurotrophic factor promotes sleep in rats and rabbits

Various growth factors (e.g., growth hormone-releasing hormone, acidic fibroblast growth factor, nerve growth factor, brain-derived neurotrophic factor, and interleukin-1) are implicated in sleep r...
Blood transfusion is an independent predictor of mortality after blunt trauma.

Allogeneic blood transfusion is associated with increased morbidity and mortality. The authors evaluated the affect of blood transfusion, independent of injury severity on mortality. The authors co...
Laboratory Suggestion: A Simplified and Modified Methyl Green Pyronin Stain

The preparation and staining procedure of an improved methyl green pyronin stain is described. With no apparent loss in specificity, the stain has the advantage of simplicity, reliability, and reproducibility, and can be used quite effectively with tissues fixed with Zenker's solution. It is believed that the use of this modified stain may prove useful in the study of lymphoid proliferations and as an adjunct in the search and identification of Reed-Sternberg cells.
pH-Dependent Si-Fluorescein Hypochlorous Acid Fluorescent Probe: Spirocycle Ring-Opening and Excess Hypochlorous Acid-Induced Chlorination

We report the synthesis and characterization of a fluorescent probe (Hypo-SiF) designed for the detection of hypochlorous acid (HOCl) using a silicon analogue of fluorescein (SiF). The probe is regulated in an “off–on” fashion by a highly selective thioether spirocyclic nonfluorescent structure that opens to form a mixture of fluorescent products in the presence of HOCl. Over a range of pH values, the probe reacts with a stoichiometric amount of HOCl, resulting in a mixture of two pH-dependent fluorescent species, a SiF disulfide product and a SiF sulfonate product. The unique colorimetric properties of the individual SiF fluorophores were utilized to perform simultaneous detection of HOCl and pH. When an excess of HOCl is present, the SiF fluorophores become chlorinated, via an intermediate halohydrin, resulting in a more pH independent and red-shifted fluorophore.
Influence of ovarian hormones on strength loss in healthy and dystrophic female mice.

ABSTRACTPurposeThe primary objective of this study was to determine whether strength loss and recovery after eccentric contractions are impaired in healthy and dystrophic female mice with low levels of ovarian hormones.MethodsFemale C57BL/6 (wild-type) or mdx mice were randomly assigned to ovarian-i
Direct Vasodilators and Sympatholytic Agents

Direct vasodilators and sympatholytic agents were some of the first antihypertensive medications discovered and utilized in the past century. However, side effect profiles and the advent of newer antihypertensive drug classes have reduced the use of these agents in recent decades. Outcome data and large randomized trials supporting the efficacy of these medications are limited; however, in general the blood pressure-lowering effect of these agents has repeatedly been shown to be comparable to other more contemporary drug classes. Nevertheless, a landmark hypertension trial found a negative outcome with a doxazosin-based regimen compared to a chlorthalidone-based regimen, leading to the removal of α-1 adrenergic receptor blockers as first-line monotherapy from the hypertension guidelines. In contemporary practice, direct vasodilators and sympatholytic agents, particularly hydralazine and clonidine, are often utilized in refractory hypertension. Hydralazine and minoxidil may also be useful alternatives for patients with renal dysfunction, and both hydralazine and methyldopa are considered first line for the treatment of hypertension in pregnancy. Hydralazine has also found widespread use for the treatment of systolic heart failure in combination with isosorbide dinitrate (ISDN). The data to support use of this combination in African Americans with heart failure are particularly robust. Hydralazine with ISDN may also serve as an alternative for patients with an intolerance to angiotensin antagonists. Given these niche indications, vasodilators and sympatholytics are still useful in clinical practice; therefore, it is prudent to understand the existing data regarding efficacy and the safe use of these medications.
Mechanical Property Evaluation of Electroplated High Aspect Ratio Microstructures

High aspect ratio microstructures (HARMs) with a height of hundreds of micrometers and a width of a few tens of micrometers present high promise in a number of challenging fields. At LSU, a number of applications are being developed in which nickel HARMs are electroplated on metal surfaces (mold insert fabrication for the LIGA process, HARMs on mechanical seal faces, HARMs on heat exchange surfaces, etc.). In some of these applications, the HARMs are subjected to high stresses and the mechanical properties are particularly important. These properties can be used to adjust processing parameters to optimize properties of the HARMS. This paper presents a method for measuring the strength properties of cantilevered nickel HARMs constructed by LIGA. Experimentally measured values are reported for modulus of rupture (1280 MPa), Young's modulus (153 GPa) and Knoop hardness (500 H k ) for HARMs with an overplated base. SEM micrographs clearly indicate that failure of the beams is brittle and most frequently occurs at the interface of the beam and overplated base.
Self-Assembly of Nanoparticle Amphiphiles with Adaptive Surface Chemistry

We investigate the self-assembly of amphiphilic nanoparticles (NPs) functionalized with mixed monolayers of hydrophobic and hydrophilic ligands in water. Unlike typical amphiphilic particles with “fixed” surface chemistries, the ligands used here are not bound irreversibly but can rearrange dynamically on the particles’ surface during their assembly from solution. Depending on the assembly conditions, these adaptive amphiphiles form compact micellar clusters or extended chain-like assemblies in aqueous solution. By controlling the amount of hydrophobic ligands on the particles’ surface, the average number of nearest neighbors—that is, the preferred coordination number—can be varied systematically from ∼1 (dimers) to ∼2 (linear chains) to ∼3 (extended clusters). To explain these experimental findings, we present an assembly mechanism in which hydrophobic ligands organize dynamically to form discrete patches between proximal NPs to minimize contact with their aqueous surroundings. Monte Carlo simulations in...
The Spatial Development Pattern of Hebei Coastal Cities Undertaking the Functions Expansion from Beijing as the Word City:A Case Study of Qinhuangdao

There have been few studies on the spatial development pattern of Hebei coastal port city undertaking the functions expansion from Beijing as the Word City. Based on the fact that World Cities take shape by spatial coupling between the Capital city and the port city according to international development perspective, this paper studied the strategic meeting point of Qinhuangdao City integrating into the Beijing World City functions expansion, calculated the degree of aggregation and diffusion from 2008 to 2012 for spatial analysis on the characteristics and trends of Qinhuangdao City. The results show that the modern international coastal city with the"second living room"is the major meeting point for Qinhuangdao undertaking the Beijing World City functions expansion. For the polycentric and networked spatial pattern is the best development pattern for Qinhuangdao to extend the functions and spillovers of Beijing World City. Consequently, the study suggested that the"Herringbone Axis"spatial structure of urban system should be established, in which the overall layout of"two axes, two wings and four poles"can further develop the polycentric and networked spatial pattern. Moreover, Qinhuangdao should organize the hub- networked undertaking platform to extend the functions and spillovers of Beijing World City by constructing the National "second living room",the international coastal tourist port and the capital of strategic emerging industries zone.
Accurate Measurement and Traceability Method of Electrical Energy for Charging and Discharging Devices of Electric Vehicles

The electric characteristics of the charging and discharging devices of the rapidly developing electric vehicle industry are nonlinear and impact-like.The traditional watt-hour meter can hardly meet the requirements of dynamically distorted load's accurate measurement,a drawback aggravated also by a lack of corresponding verification source method.So the improved ip-iq algorithm for specific integer harmonic wave,fundamental wave and harmonic voltage to process real-time frequency detection is proposed.The algorithms based on real-time fast Fourier transform(FFT) and quasi-synchronous sampling linear interpolation and nonlinear amplitude compensation are put forward.The broad range of impact loads measurement technique based on variable amplifying is proposed.The related devices are also developed to effectively solve the source tracing of the dynamically distorted load metering and detection of direct voltage during voltage discharging.The application effect proves the suggested electricity measurement method and devices can meet the demand of tracing the source of dynamically distorted load metering.
Pulmonary valvulotomy alone for pulmonary stenosis: results in children with and without muscular infundibular hypertrophy.

Pulmonary valvulotomy for valvular pulmonic stenosis has been performed in 78 children at the Children's Hospital of Pittsburgh. Although 27 patients had muscular hypertrophy of the infundibulum, a muscle resection was employed in only one child. Examinations 2 to 10 years after operation have not demonstrated electrocardiographic (ECG) or clinical evidence of persistent right ventricular hypertension, indicating resolution of the muscular outflow tract narrowing. Systolic right ventricular pressure averaged 30 mm Hg in 10 patients at postoperative catheterization: Six of these patients had peak right ventricular pressures greater than 100 mm Hg immediately after valvulotomy. The diameter of the infundibulum in systole was compared to valve ring diameter and expressed as a ratio (I/V). This correlated with the preoperative and intraoperative right ventricular pressures, but did not identify patients who might fail to resolve secondary muscular hypertrophy. A murmur of pulmonary regurgitation was present in 70% of the patients after operation, but was without clinical significance. In the absence of fixed infundibular obstruction or excessive right ventricular hypertension above 200 mm Hg, resection of infundibular hypertrophy is not recommended.
“Shows You Hate (But Watch Anyway)”: The Dark Side of Online Criticism

Falero discusses the darker side of online criticism, particularly the ways that Television Without Pity fostered and encouraged what has been called “anti-fan” behavior. The site’s motto, “spare the rod, spoil the network,” was taken up by many members. These very critical viewers were part of the emergence of “hate watching” a program, viewing for the purpose of harsh, unrelenting criticism. Falero discusses the ritual of “hate watching” and how the ensuing discussion online surprised many television industry insiders who explored the message boards looking for fans. Reality television programs in particular allowed for a complex critical environment, where members sometimes hurled personal insults at television program cast members and then had to deal with the fallout when some of them later joined the discussion.
Peter Strawson: Skepticism and Naturalism : Hume revisited

Skepticism, Naturalism and Transcendental Arguments Strawson's interest in Kant did not end with the publication of The Bounds of Sense in 1966. He continued to give regular graduate seminars on Kant for the following twenty years, and, in a series of articles, he both amended and developed the views he had established in that book. Kant had said that it was Hume who had awakened him from his “dogmatic slumber” and set him on the path to his critical philosophy. While Strawson continued to see Kant as the greatest of the moderns, he has also been prepared to see Hume as his hero on particular issues of continuing interest. He can view Hume as both a naturalist and a sceptic, with a tension between those two outlooks that in some ways is reminiscent of the tension he finds between Kant's empirical realism and his transcendental idealism. Strawson gave form to his reflections on Hume in the Woodbridge Lectures at Columbia University, subsequently published under the title Skepticism and Naturalism: Some Varieties (1985). As the theme of this work, Strawson appropriately takes a quotation from Gibbon: “The satirist may laugh, the philosopher may preach; but reason herself will respect the prejudices and habits, which have been consecrated by the experience of mankind”.
Controlled insertion of tin atoms into zeolite framework vacancies and consequences for glucose isomerization catalysis

Abstract The incorporation of tin heteroatoms within framework vacancy defects of dealuminated Beta zeolites via stannic chloride reflux in dichloromethane solvent (333 K) enables preparing Sn-Beta zeolites comprising a wide range of Sn content (Si/Sn = 30–144; 1.4–6.1 wt% Sn) and >4× higher framework Sn densities than reported (Si/Sn > 120) for reflux in isopropanol solvent (383 K). Silanol defects form hydrogen bonds with isopropanol but not with dichloromethane under reflux conditions, evident in the evolution of adsorbed isopropanol (∼5× per vacancy) but not dichloromethane during temperature programmed desorption of dealuminated zeolites saturated with either solvent at ambient, and in IR features for perturbed hydroxyl stretches (∼3350 cm−1) and C H stretches (∼2700–3000 cm−1) that were retained after dealuminated zeolites were saturated with isopropanol and evacuated at 383 K. Dichloromethane-assisted tin grafting provides a route to precisely control the density of framework Sn sites and residual vacancy defects in Sn-Beta, up to the point of grafting virtually every framework vacancy with Sn. Open Sn sites ((OSi)3 Sn (OH), ν(CD3C N): 2316 cm−1), quantified from IR spectra collected after CD3CN titration (303 K), are preferentially incorporated over closed Sn sites (Sn(OSi)4, ν(CD3C N): 2308 cm−1) at low Sn densities via grafting in dichloromethane solvent, suggesting that this preparation method can tune the open-to-closed framework Sn site ratio more systematically than hydrothermal synthesis methods. Open Sn sites are dominant active sites for aqueous-phase glucose-fructose isomerization; consequently, isomerization turnover rates (per total Sn) decrease systematically with increasing Sn content. Initial isomerization rates (per open Sn) are invariant (within ∼2×, 373 K) among twelve Sn-Beta samples of varying Sn content (Si/Sn = 30–144), the behavior expected of a single-site catalyst in which open framework Sn sites are the loci of catalytic reactivity. First-order isomerization rate constants are 15–50× lower (373 K) when open Sn sites are confined within high-defect than within low-defect Beta micropores, consistent with previous reports that aqueous-phase sugar isomerization cycles turn over at faster rates within hydrophobic, low-defect micropores. These findings clarify the consequences of liquid-phase reflux procedures on the coordination of tin heteroatoms incorporated within zeolite framework vacancies, and underscore the requirement to quantify putative active site structures in order to rigorously normalize measured rate data prior to kinetic or mechanistic interpretation.
EXPERIMENTAL PRODUCTION OF ENTEROTOXIN B IN FISH PROTEIN CONCENTRATE

Staphylococcus aureus S-6 grew and produced enterotoxin B in two samples of fish protein concentrate (FPC) and three FPC-supplemented foods (beef broth, corn flour, and wheat flour). Enterotoxin B yields increased as concentrations of FPC increased in FPC suspensions as well as FPC-supplemented foods. Toxin yields obtained from FPC-supplemented beef broths (100 to 160 μg/ml). were higher than from FPC-supplemented corn flour and wheat flour (15 to 45 μg/ml). Small inocula (103 cells/ml) and large inocula ( 107 cells/ml) gave equivalent growth and toxin production after 24 hr incubation.
Passing waves from atomistic to continuum

Abstract Progress in the development of coupled atomistic–continuum methods for simulations of critical dynamic material behavior has been hampered by a spurious wave reflection problem at the atomistic–continuum interface. This problem is mainly caused by the difference in material descriptions between the atomistic and continuum models, which results in a mismatch in phonon dispersion relations. In this work, we introduce a new method based on atomistic dynamics of lattice coupled with a concurrent atomistic–continuum method to enable a full phonon representation in the continuum description. This permits the passage of short-wavelength, high-frequency phonon waves from the atomistic to continuum regions. The benchmark examples presented in this work demonstrate that the new scheme enables the passage of all allowable phonons through the atomistic–continuum interface; it also preserves the wave coherency and energy conservation after phonons transport across multiple atomistic–continuum interfaces. This work is the first step towards developing a concurrent atomistic–continuum simulation tool for non-equilibrium phonon-mediated thermal transport in materials with microstructural complexity.
High School Internships: Utilizing a Community Cultural Wealth Framework to Support Career Preparation and College-Going Among Low-Income Students of Color

This article investigates the experience of 229 low-income students of color who participated in an innovative high school internship program between 2011 and 2015. Using mixed methods (interviews,...
Localizing Optic Disc in Retinal Image Automatically with Entropy Based Algorithm

Examining retinal image continuously plays an important role in determining human eye health; with any variation present in this image, it may be resulting from some disease. Therefore, there is a need for computer-aided scanning for retinal image to perform this task automatically and accurately. The fundamental step in this task is identification of the retina elements; optical disk localization is the most important one in this identification. Different optical disc localization algorithms have been suggested, such as an algorithm that would be proposed in this paper. The assumption is based on the fact that optical disc area has rich information, so its entropy value is more significant in this area. The suggested algorithm has recursive steps for testing the entropy of different patches in image; sliding window technique is used to get these patches in a specific way. The results of practical work were obtained using different common data set, which achieved good accuracy in trivial computation time. Finally, this paper consists of four sections: a section for introduction containing the related works, a section for methodology and material, a section for practical work with results, and a section for conclusion.
Jesus as Object: Christian Conversion as Interpreted through the Perspective of Fairbairn's Object Relations Theory:

This article uses Fairbairn's object relations theory as a framework for understanding the process of Christian conversion. The basic principles of Fairbairn's object relations theory and identity ...
Advancement of clinical pharmacy practice through intervention capture.

Purpose The methods and processes utilized to deploy the Pharmacists Achieve Results with Medications Documentation (PhARMD) Project intervention template across the largest integrated healthcare system in the United States are described. Summary The PhARMD Project team at the Department of Veterans Affairs (VA) designed, developed, and deployed a standardized template within VA’s electronic health record (EHR) that allows the clinical pharmacy specialist (CPS) to efficiently document select interventions made during patient care encounters that specifically contribute to the overall care provided and patient outcomes. The template is completed by the CPSs as part of progress note documentation within the EHR. Using point-and-click functionality, a CPS selects the check boxes corresponding to specific interventions made during that patient care encounter. This improves workflow and negates the need to document interventions in a separate software system, streamlining documentation. The implementation and use of the PhARMD template at each VA facility are voluntary. From October 1, 2016, to September 30, 2017, 4,728 CPSs documented 3,805,323 interventions during 2,384,771 patient care encounters. These interventions were documented across 592,126 unique patients, with a mean of 6.4 interventions per patient during this period. Most interventions (95%) were performed by CPSs functioning as advanced practice providers and with autonomous prescriptive authority authorized under their scope of practice. Conclusion The PhARMD template demonstrated that the capture of clinical pharmacy interventions and outcomes can be achieved across a large integrated healthcare system by thousands of CPSs in numerous practice settings.
Risk Predictors for Postcontrast Acute Kidney Injury.

Abstract Objective To evaluate risk predictors of acute kidney injury (AKI) after contrast-media procedures in a broader cohort of patients than previously reported. Data Sources Comprehensive medical and pharmacy commercial claims data from 2012 to 2014. Data Collection and Extraction Methods Claims associated with contrast-media procedures for 2,737,020 persons between January 1, 2012 and November 30, 2014, were reviewed. Principal Findings The overall incidence of AKI after a contrast-media procedure was 0.85%. AKI occurred in 26% of cases that had two or more contrast procedures within 30 days, compared with 9% of non-AKI cases. Although the incidence of postcontrast AKI was low, 10% of patients who developed AKI had a recent previous episode of AKI. In cases when AKI had occurred within 180 days of contrast administration, the odds of subsequent kidney injury was 9.39. Conclusions Overall, there is a low risk (0.85%) of developing an AKI after a procedure with contrast-media consistent with several recent studies. However, in adults with a recent history of AKI, physicians must consider this history as a risk factor for subsequent AKI.
Doppler ambiguity resolving in TDMA automotive MIMO radar via digital multiple PRF

Multiple input multiple output (MIMO) radars require orthogonality between the transmitted signals, which can be achieved via time division multiple access (TDMA) scheme, where only a single transmitter operates at a predefined time slot. This scheme determines the pulse repetition frequency (PRF) per transmitter, which in turn limits the maximal unambiguous Doppler. When radars are designed to operate in an ambiguous Doppler regime, Doppler ambiguity is conventionally resolved via waveform diversity (e.g. multiple PRFs), which is practically challenging. This work proposes a method to resolve Doppler ambiguity by generating an additional PRF digitally, without waveform diversity. In the case where the transmitters are positioned linearly, the proposed method performs better for targets that lie in a limited field of view, compared to the array. The proposed method performance is evaluated via simulations, compared to the traditional processing method and tested using measurements, collected with an automotive radar in real-life scenarios.
The compliance coach: A bedside observer, auditor, and educator as part of an infection prevention department's team approach for improving central line care and reducing central line-associated bloodstream infection risk

A compliance coach who audits central line maintenance and provides feedback and education to bedside nurses through timely, nonpunitive conversation is an effective addition to busy infection prevention departments. Staff nurses and nurse managers reported receiving clearly communicated and actionable information from the coach and compliance improved over time in multiple areas of central line maintenance.
Prevention Management of Postoperative Nausea and Vomiting in Ambulatory Setting: How Well are We Identifying Patients with Motion Sickness?

Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) continue to be a serious problem in the ambulatory setting. These symptoms are among the most undesired complications following surgery and can adversely affect the quality of recovery for many patients. Previous research has concluded that the identification of risk factors for PONV/PDNV is a first step in developing effective prevention strategies. The purpose of this study was to examine the incidence of PONV/ PDNV in the ambulatory setting in female clients who were treated with transdermal scopolamine (TDS) for motion sickness as compared to those patients who were not treated with TDS. The study design was a two-group retrospective chart review. Of the group identified with a positive history and not treated with TDS, 54% (n=6) developed PONV /PDNV as compared to 26% (n=3) that were treated. This pilot study provided preliminary support that preoperative identification of PONV/PDNV risk factors and treatment with TDS reduces PONV/PDNV. Standardized, comprehensive risk factor identification in the preoperative period is indicated.
The Path of Knowledge: The Knowledge of Path

The philosophies of Parmenides, Socrates, Aristotle, the science of Einstein is discussed with respect to a division of the empirica l and abstracted as they refer to the universe and universals. Methodologies of the natural and anthropological sciences are contrasted in order to discuss validity in the representation of nature. A physical model for the evolution of knowledge is presented that distinguishes both the conceptual and physical in terms of path and memory, the immaterial and the material, human activity as it mirrors symbolism and need. The universe, as infinite in description only, is reduced to a form whose nature aligns more readily with modern anthropological conceptualizations and is alternate to the more tangible and empirical, yet abstracted, content of scientific theory.
Anterolateral Approach for a Cervical Nerve Root Compression Syndrome Due to an Ectatic Vertebral Artery.

BACKGROUND AND IMPORTANCE Nerve root compression by an ectatic vertebral artery is a known but easily overlooked cause of cervical radiculopathy. Management options include nonoperative conservative therapies or surgical approaches designed to relieve the compression via anterior or posterior cervical approaches. CLINICAL PRESENTATION A 72-yr-old female presented with a 6-mo history of sharp, shooting pain in her right arm and shoulder and deltoid weakness. Imaging demonstrated a vertebral artery loop compressing the proximal right C5 nerve root. She previously underwent both nonoperative measures as well as posterior foraminotomy at this level with limited improvement in her pain. Therefore, we performed an anterolateral approach for vascular decompression of the C5 nerve root from the vertebral artery loop. Patient has been pain-free at 1 yr with full recovery of her deltoid weakness. CONCLUSION Vertebral artery loop formation is an uncommon cause of cervical radiculopathy, which can be readily treated by vascular decompression of the nerve root-vertebral artery loop complex. Although anomalous vertebral artery compression of a cervical nerve root is rare, it is increasingly being recognized as a readily treatable entity that can lead to lasting and full neurological recovery. We also include an operative video to illustrate the vascular decompression of an ectatic vertebral artery causing severe cervical radiculopathy.
The fight for clean air

Despite substantial improvements in recent years, air pollution continues to be a major contributor to the global burden of disease—especially in highly polluted countries. Estimates suggest that it contributes to as many as 4 million to 9 million human deaths per year globally. Beth Gardiner9s remarkable book, Choked, reports on air pollution9s pervasive and pernicious effects on the health and well-being of individuals, families, and nations throughout the world.
Decision Trees in Periodontal Surgery: Resective Versus Regenerative Periodontal Surgery

Traditionally, periodontal surgical procedures such as osseous resective surgery and open flap debridement have been used as a treatment modality in order to control the progression of periodontal disease. The advent of new tools such as microscopes, cone beam computed tomography, and new surgical techniques has fundamentally changed treatment philosophy and rationale from one of resective toward a regenerative approach. This chapter will focus on recent scientific literature, exploring and discussing the newest tools, techniques, and materials which has changed the way we treat periodontal disease today. Due to the sensitivity in case selection for utilization of these techniques, a decision tree for periodontal resective and regenerative therapy has been suggested based on recent literature.
Pregnancy and Kidney Disease

Abstract Chronic kidney disease (CKD) affects almost 4% of women of childbearing age. In women with early stage CKD (serum creatinine concentration [S[Cr]] less than 1.4 mg/dL) and well-controlled blood pressure, the likelihood of successful pregnancy is high and of pregnancy-associated deterioration in kidney function is low. Nevertheless, CKD is associated with several adverse maternal and neonatal outcomes, including preeclampsia, intrauterine growth restriction, and preterm delivery. Pregnancy in more advanced CKD (S[Cr] > 2.0 mg/dL) can result in an accelerated and often irreversible decline in renal function. CKD can present de novo during pregnancy. Management and outcomes must be individualized based on the severity, etiology, and gestational age at presentation. Medical management of kidney disease and its complications during pregnancy is affected by the impact of therapy on the developing fetus. This chapter reviews the evaluation and management of pregnant women with CKD.
Allometry, Scaling and Ontogeny of Form-An Introduction to the Symposium.

Until recently, the study of allometry has been mostly descriptive, and consisted of a diversity of methods for fitting regressions to bivariate or multivariate morphometric data. During the past decade, researchers have been developing methods to extract biological information from allometric data that could be used to deduce the underlying mechanisms that gave rise to the allometry. In addition, an increasing effort has gone into understanding the kinetics of growth and the regulatory mechanisms that control growth of the body and its component parts. The study of allometry and scaling has now become an exceptionally diverse field, with different investigators applying state of the art methods and concepts in evolution, developmental biology, cell biology, and genetics. Diversity has caused divergence, and we felt that although there is general agreement about the new goals for the study of allometry (understanding underlying mechanisms and how those evolve to produce different morphologies), progress is hindered by lack of coordination among the different approaches. We felt the time was right to bring these diverse practitioners together in a symposium to discuss their most recent work in the hope of forging new functional, conceptual, and collaborative connections among established and novice practitioners.
Mobile Neurofeedback for Pain Management in Veterans with TBI and PTSD.

Objective Chronic pain is common in military veterans with traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Neurofeedback, or electroencephalograph (EEG) biofeedback, has been associated with lower pain but requires frequent travel to a clinic. The current study examined feasibility and explored effectiveness of neurofeedback delivered with a portable EEG headset linked to an application on a mobile device. Design Open-label, single-arm clinical trial. Setting Home, outside of clinic. Subjects N = 41 veterans with chronic pain, TBI, and PTSD. Method Veterans were instructed to perform "mobile neurofeedback" on their own for three months. Clinical research staff conducted two home visits and two phone calls to provide technical assistance and troubleshoot difficulties. Results N = 36 veterans returned for follow-up at three months (88% retention). During this time, subjects completed a mean of 33.09 neurofeedback sessions (10 minutes each). Analyses revealed that veterans reported lower pain intensity, pain interference, depression, PTSD symptoms, anger, sleep disturbance, and suicidal ideation after the three-month intervention compared with baseline. Comparing pain ratings before and after individual neurofeedback sessions, veterans reported reduced pain intensity 67% of the time immediately following mobile neurofeedback. There were no serious adverse events reported. Conclusions This preliminary study found that veterans with chronic pain, TBI, and PTSD were able to use neurofeedback with mobile devices independently after modest training and support. While a double-blind randomized controlled trial is needed for confirmation, the results show promise of a portable, technology-based neuromodulatory approach for pain management with minimal side effects.
Measurable Outcomes for Transition: The Nurses’ Role

This chapter highlights the importance of the role of the nurse in monitoring and tracking transition-related outcomes both pre- and post-transfer of care. Nurses play a vital role in educating adolescents and young adults (AYA) about their healthcare condition, including how to manage their condition for optimal outcomes. Additionally, nurses prepare youth for transition supporting them pre- and post-transition. Important outcomes to monitor include self-management and treatment adherence, healthcare planning, disease specific outcomes, healthcare utilization, and quality of life (QOL). Nurses, prior to transfer, have essential roles in preparing AYA for self-management of their healthcare needs. Nurses can help AYA develop the knowledge and skills needed for self-management, while monitoring and tracking treatment adherence. Additionally, nurses are ideally suited to assist AYA and their families with planning for the transition while monitoring readiness for the transfer of care. Disease specific outcomes and healthcare utilization are important to monitor both before transfer (as baseline data) and after transfer to determine the success of the transition. Finally, measuring and tracking QOL is essential. In summary, nurses can assist in tracking and monitoring outcome measures to evaluate the extent to which the healthcare transition has achieved expected outcomes.
Data-Enhanced Hierarchical Control to Improve Distribution Voltage with Extremely High PV Penetration

Dynamic, scalable, and interoperable control paradigms are required to enable efficient, secure, reliable, and resilient distribution grid operations with widespread grid integration of renewable energy resources. This paper presents our recent research on developing a novel, holistic, data-enhanced hierarchical control architecture that addresses the formidable challenges faced by emerging distribution grids with increasing penetrations of distributed energy resources. The proposed architecture integrates centralized monitoring and control with distributed grid-edge control and thus effectively deals with multi-spatiotemporal dynamics existing in the grid. Simulation results are provided to demonstrate the effectiveness of the proposed control architecture.
CHAPTER 6 – Rewrite Systems

Publisher Summary This chapter focuses on rewrite systems, which are directed equations used to compute by repeatedly replacing sub-terms of a given formula with equal terms until the simplest form possible is obtained. As a formalism, rewrite systems have the full power of Turing machines and may be thought of as nondeterministic Markov algorithms over terms rather than strings. The theory of rewriting is in essence a theory of normal forms. To some extent, it is an outgrowth of the study of A. Church's Lambda Calculus and H. B. Curry's Combinatory Logic. The chapter discusses the syntax and semantics of equations from the algebraic, logical, and operational points of view. To use a rewrite system as a decision procedure, it must be convergent. The chapter describes this fundamental concept as an abstract property of binary relations. To use a rewrite system for computation or as a decision procedure for validity of identities, the termination property is crucial. The chapter presents the basic methods for proving termination. The chapter discusses the question of satisfiability of equations and the convergence property applied to rewriting.
Individual Variation of Human Cortical Structure Is Established in the First Year of Life

Abstract Background Individual differences in cortical gray matter (GM) structure are associated with cognitive function and psychiatric disorders with developmental origins. Identifying when individual differences in cortical structure are established in childhood is critical for understanding the timing of abnormal cortical development associated with neuropsychiatric disorders. Methods We studied the development of cortical GM and white matter volume, cortical thickness, and surface area using structural magnetic resonance imaging in two unique cohorts of singleton (121 male and 131 female) and twin (99 male and 83 female) children imaged longitudinally from birth to 6 years. Results Cortical GM volume increases rapidly in the first year of life, with more gradual growth thereafter. Between ages 1 and 6 years, total surface area expands 29%, while average cortical thickness decreases about 3.5%. In both cohorts, a large portion of individual variation in cortical GM volume (81%–87%) and total surface area (73%–83%) at age 6 years is present by age 1 year. Regional heterogeneity of cortical thickness observed at age 6 is largely in place at age 1. Conclusions These findings indicate that individual differences in cortical GM structure are largely established by the end of the first year of life, following a period of rapid postnatal GM growth. This suggests that alterations in GM structure associated with psychiatric disorders with developmental origins may largely arise in the first year of life and that interventions to normalize or mitigate abnormal GM development may need to be targeted to very early childhood.
A Review of past and Current Pharmacological Intervention in the Treatment of Emotionally Disturbed Children and Adolescents

Increasingly, seriously handicapped students are returning to the schools and the use of psychotropic medications is on the rise with these and other emotionally disturbed children and adolescents....
Kikuchi Disease: A Case Report.

Abstract Background Kikuchi disease, also known as Kikuchi–Fujimoto disease, is a rare, benign cause of cervical lymphadenitis. It is characterized by painful cervical lymphadenopathy with fevers, leukopenia, and an elevated erythrocyte sedimentation rate. It is diagnosed by obtaining a biopsy specimen from a lymph node that shows characteristic histopathologic findings. Case Report We highlight a 42-year-old Japanese man who presented with persistent fevers and cervical lymphadenopathy who was misdiagnosed at multiple urgent care facilities and emergency departments. He was eventually diagnosed with Kikuchi disease after a biopsy specimen was obtained from a lymph node 1 month after his symptoms began. He was treated with hydroxychloroquine and prednisone with resolution of his symptoms. Why Should An Emergency Physician Be Aware of This? Although Kikuchi disease has been previously described in various specialty medical journals, the published literature on Kikuchi disease in emergency medicine is relatively scarce. Given that cervical lymphadenopathy is a common presentation to emergency departments, it is important for emergency physicians to be cognizant of Kikuchi disease in the differential diagnosis of cervical lymphadenopathy to prevent misdiagnoses and unnecessary treatments.
Impact of collaborative clinician visits on postdischarge total cost of care in a polypharmacy population.

Purpose To evaluate the impact of a collaborative intervention by pharmacists and primary care clinicians on total cost of care, including costs of inpatient readmissions, emergency department visits, and outpatient care, at 30, 60, and 180 days after hospital discharge in a population of patients at high risk for readmission due to polypharmacy. Methods A retrospective study of cost outcomes in a cohort of adult patients discharged from a single institution from July 1, 2013 to March 25, 2016, was conducted. All patients had at least 10 medications listed on their discharge list, including at least 1 drug frequently associated with adverse events leading to hospital readmission. About half of the cohort (n = 496) attended a postdischarge visit involving both a pharmacist and a primary care clinician (a physician, physician assistant, or licensed nurse practitioner); this was designated the pharmacist/clinician collaborative (PCC) group. The remainder of the cohort (n = 500) attended a visit without pharmacist involvement; this was designated as the usual care (UC) group. Costs were compared using a quantile regression to assess the potential heterogeneous impacts of the PCC intervention across different parts of the cost distribution. All outcomes were adjusted for differences in baseline characteristics. Results At 30 days post index discharge, there was a significant decrease in total costs in the 10th and 90th cost quantiles in the PCC cohort vs the UC cohort, without a statistically significant decrease in the 25th, 50th or 75th quantiles. The difference was significant in the 75th and 90th quantiles at 60 days and in the 25th, 50th, and 75th quantiles at 180 days. There was a nonsignificant cost reduction in all other quantiles. Conclusion Medically complex patients had a significantly lower total cost of care in approximately half of the adjusted cost quantiles at 30, 60, and 180 days after hospital discharge when they had a PCC visit. PCC visits can improve patient clinical outcomes while improving cost metrics.
Residual stress reduction in dissimilar metals weld

Abstract Conventional methods such as post-weld heat treatment is not capable to reduce residual stress (RS) in dissimilar metals weld (DMW) to the same extent as in similar weld due to mismatch between thermal expansion coefficient of base metals. The objective of this study to understand the effects of a modern in situ technique, called CO2 rapid cooling, on mechanism of RS redistributions in both similar and dissimilar metals welds. More focus of this investigation is given to the DMW. A thermo-mechanical numerical model is developed to investigate the effectiveness of various CO2 rapid cooling parameters such as power, radius, off-center, and location of the CO2 nozzle on RS distribution. The model is tested and validated with experimental data obtained from neutron diffraction measurement. Overall, this study shows that the CO2 cooling application can produce a significant RS reduction in similar weld as well as DMW. It shows that smaller CO2 nozzle can lead to lower RS magnitude considerably; however, it is not always capable to produce favorable RS distribution. In addition, since the RS distribution is asymmetric in a DMW, the implementation of CO2 cooling technique to mitigate RS need not be symmetric or uniform with respect to the weld center line. Based on the results, further recommendations to minimize RS in welded parts are provided.
Delayed Large Local Reactions to mRNA Covid-19 Vaccines in Blacks, Indigenous Persons, and People of Color.

Local Covid-19 Vaccine Reactions in Non-White Persons Previous reports document a small risk of delayed large local reactions to Covid-19 vaccines; however, clinical photos most often show White pe...