cssi/SciSciGPT-SciSciNet huggingface dataset:
Surgical Treatment of Carpal Tunnel Syndrome

This article describes the etiology, pathophysiology, surgical anatomy, and surgical techniques for the treatment of carpal tunnel syndrome. The authors discuss open release and endoscopic techniques. Clinical results and complications of surgical treatment are part of the discourse.
Can wisdom and psychosocial growth be learned in university courses

This study explored whether three-dimensional wisdom and psychosocial growth, defined as increases in psychological well-being (PWB), spirituality, and death acceptance, can be learned in universit...
Treatment of Malignant Melanoma with a Mouse Monoclonal IgG3 Antibody Detecting the Ganglioside GD3

Twelve patients with metastatic melanoma were treated with the IgG3 mouse monoclonal antibody R24 which detects the ganglioside GD3, prominent on the surface of melanoma cells and other cells of neuroectodermal origin. Side effects were mild and were readily controlled by antihistamines. Major tumor regression was observed in three patients.
Linking variation in intrinsic water‐use efficiency to isohydricity: a comparison at multiple spatiotemporal scales

Species-specific responses of plant intrinsic water-use efficiency (iWUE) to multiple environmental drivers associated with climate change, including soil moisture (θ), vapor pressure deficit (D), and atmospheric CO2 concentration (ca ), are poorly understood. We assessed how the iWUE and growth of several species of deciduous trees that span a gradient of isohydric to anisohydric water-use strategies respond to key environmental drivers (θ, D and ca ). iWUE was calculated for individual tree species using leaf-level gas exchange and tree-ring δ13 C in wood measurements, and for the whole forest using the eddy covariance method. The iWUE of the isohydric species was generally more sensitive to environmental change than the anisohydric species was, and increased significantly with rising D during the periods of water stress. At longer timescales, the influence of ca was pronounced for isohydric tulip poplar but not for others. Trees' physiological responses to changing environmental drivers can be interpreted differently depending on the observational scale. Care should be also taken in interpreting observed or modeled trends in iWUE that do not explicitly account for the influence of D.
Exercises in Programming Style

The first edition of Exercises in Programming Style was honored as an ACM Notable Book and praised as "The best programming book of the decade." This new edition retains the same presentation but has been upgraded to Python 3, and there is a new section on neural network styles. Using a simple computational task (term frequency) to illustrate different programming styles, Exercises in Programming Style helps readers understand the various ways of writing programs and designing systems. It is designed to be used in conjunction with code provided on an online repository. The book complements and explains the raw code in a way that is accessible to anyone who regularly practices the art of programming. The book can also be used in advanced programming courses in computer science and software engineering programs. The book contains 40 different styles for writing the term frequency task. The styles are grouped into ten categories: historical, basic, function composition, objects and object interactions, reflection and metaprogramming, adversity, data-centric, concurrency, interactivity, and neural networks. The author states the constraints in each style and explains the example programs. Each chapter first presents the constraints of the style, next shows an example program, and then gives a detailed explanation of the code. Most chapters also have sections focusing on the use of the style in systems design as well as sections describing the historical context in which the programming style emerged.
Affirmative action challenges keep on keeping on: responding to shifting federal and state policy

In response to disparities in postsecondary access, governments have enacted policies to facilitate the admission of traditionally underrepresented students. Known as affirmative action in the Unit...
Qualitative analyses of polishing and pre-coating FIB milled crystals for MicroED

Summary Microcrystal electron diffraction (MicroED) leverages the strong interaction between matter and electrons to determine protein structures from vanishingly small crystals. This strong interaction limits the thickness of crystals that can be investigated by MicroED, mainly due to absorption. Recent studies have demonstrated that focused ion beam (FIB) can thin even very large crystals into ideal sized lamellae however it is not clear how to best apply FIB-milling for MicroED. Here, The effects of polishing the lamellae, whereby the last few nanometers are milled away using a low-current gallium beam, are explored in both platinum pre-coated and uncoated samples. Our results suggest that pre-coating samples with a thin layer of platinum followed by polishing the crystal surfaces prior to data collection consistently led to superior results as indicated by higher signal/noise ratio, higher resolution and better refinement statistics. This study lays the foundation for routine and reproducible methodology for sample preparation in MicroED.
Surgical resection for diverticulitis using robotic natural orifice intracorporeal anastomosis and transrectal extraction approach: the NICE procedure

Numerous studies have confirmed significant benefits of intracorporeal anastomosis (ICA) following colorectal procedures; however technical challenges have limited this approach following conventional laparoscopic surgery. The robotic Xi platform serves as an enabling technology and has resulted in a surge of reports for right-sided ICA, however, there are no reports involving more complex left-sided procedures such as diverticulitis. Furthermore, there are no reports of natural orifice-assisted techniques using robotic Xi in which the specimen can be removed and the anvil can be placed transrectally, thereby completely eliminating the need for an abdominal wall incision other than for port sites. We present a pilot study to investigate the safety, feasibility and short-term outcomes of robotic Natural orifice-assisted IntraCorporeal anastomosis with transrectal Extraction of specimen, called the robotic NICE procedure. Consecutive patients presenting for elective resection for diverticulitis with formation of a colorectal anastomosis were entered into an IRB database. All patients underwent the robotic NICE procedure. Demographic data, intraoperative data and outcomes data were assessed and analyzed. Ten patients (five males and five females) underwent resection. The mean age and BMI were 56 years (43–66) and 29 kg/m2 (21–35). All procedures were successfully completed including transrectal extraction of the specimen and formation of an ICA. The mean operative time was 198 min (146–338) and mean EBL was 35 ml (15–50). Mean time to first flatus was 16 h (10–22) and mean length of stay was 1.9 days (1.6–2.6). There were no intraoperative or postoperative complications. There was no unexpected ICU stay, reoperation or readmission. Colorectal left-sided resections such as for diverticulitis were safely accomplished using natural orifice-assisted extraction of the specimen as well as complete intracorporeal anastomosis in this pilot study. The NICE procedure resulted in early return of bowel function, short length of stay and low complication. The complete elimination of abdominal wall incision likely accounts for these findings and larger cohorts of patients are to be investigated to explore this promising approach afforded by robotic technology.
Effects of Bio-Impedance Sensor Placement Relative to the Arterial Sites for Capturing Hemodynamic Parameters

Accurate measurement of the heart pulse waveform based on blood volume changes inside the arteries is crucial for reliable estimation of hemodynamic parameters such as blood pressure and cardiac output. Placement of blood volume sensors such as bio-impedance sensors close to the arterial sites is essential for the accurate measurement of the pulse waveform. The effect of sensor location relative to the wrist arteries on the pulse waveform had not been studied previously on human subjects. In this paper, we explore the effect of arterial and off-arterial placement of the bio-impedance sensor on important pulse waveform features such as pulse transit time (PTT), which is the travel time of the arterial pressure pulse between two sensors, and diastolic peak error (DPE), a measure of pulse signal sharpness. Placing the current injection and voltage sensing electrodes of a bio-impedance sensor on the radial artery provide greater accuracy for such features. We find that arterial PTT has a significantly lower standard deviation compared to off-arterial PTT indicating better signal quality. Similarly, we observe that DPE is much smaller for arterial bio-impedance which confirms our expectations. Based on these features, the location of the artery can be determined using an array of sensors placed around the artery.
Aortic Valve Papillary Fibroelastoma: A Sea Anemone in the Heart, A Case Report

Cardiac papillary fibroelastomas are benign primary cardiac tumors usually arising from the normal components of the endocardium. Grossly they have a characteristic short pedicle and multiple papillary fronds similar to sea anemone. Clinically they have varying presentations ranging from asymptomatic to severe ischemic or embolic complications. We hereby present a case of a middle-aged man who presented with exertional dyspnea and palpitations and was discovered to have papillary fibroelastoma involving the aortic valve. The described case illustrates some of the presenting features, the workup and some of the management modalities that need to be implicated in cases of papillary fibroelastomas. Cardiol Res. 2019;10(6):378-381 doi: https://doi.org/10.14740/cr818
Abnormal Expression of the Plasma Cell Differentiation Factor X-Box Protein 1 (Xbp-1) in Waldenstrom’s Macroglobulinemia.

INTRODUCTION: Xbp-1 is a ubiquitously expressed basic leucine zipper protein which serves as key transcription factor for plasma cell differentiation and immunoglobulin production. XBP-1 mRNA undergoes splicing at an IRE-1a specific cleavage site to produce a spliced form (Xbp-1s) which due to a frame shift results in a more stable and potent transcription factor than the unspliced form (Xbp-1 us ). Previous observations demonstrated that Xbp-1 was highly expressed in multiple myeloma (MM), though its expression in other B-cell disorders including Waldenstrom’s macroglobulinemia (WM) remains to be clarified. METHODOLOGY: In this study, we investigated the different forms of Xbp-1 in CD19 + selected bone marrow (BM) cells from 61 patients with the consensus panel definition of WM using semi-quantitative PCR analysis. CD19 + selected BM cells from 6 healthy donors, and CD138 + selected BM cells from 4 MM patients were used as controls. All RT-PCR results were normalized to b-actin levels. Sequencing of Xbp-1 in CD19 + selected LPC was also performed for 20 WM patients. RESULTS: In 9/61 (15%) WM patients, Xbp-1 transcripts were undetectable. Among WM patients expressing Xbp-1, as well as all MM patients evaluated, higher levels of XBP-1us were observed in comparison to normal healthy donors (p=0.001). Decreased XBP-1s transcript levels were also observed among WM and MM patients versus healthy donors, but did not reach statistical significance. Sequence analysis of Xbp1 in CD19 + selected BM LPC demonstrated variants 10/20 WM patients in exon 1 that are currently under investigation. CONCLUSIONS: Abnormal expression of Xbp-1 is common in patients with WM, and includes loss of expression, and aberrations in splice patterns. The genetic basis for these findings is under investigation.
Community Characteristics, Victimization, and Psychological Adjustment Among School-Aged Adopted Children With Lesbian, Gay, and Heterosexual Parents

Little research has examined victimization among school-aged children raised in lesbian/gay (LG) parent households and almost no work has attended to the school and community contexts that may impact their victimization risk. This study examined predictors of parent-reported child victimization and child adjustment, and parent responses to victimization, in 43 two-mother, 37 two-father, and 56 mother-father families, with adopted children (median age = 8.6 years). Predictors included parent (sexual orientation), school (climate, public versus private) and community (urbanicity, percentage voted Democrat) factors, with parent and child demographics included as controls. A total of 47% of parents reported one or more child victimization experiences in the past year; there were no differences by family type. An exploratory interaction between family type and urbanicity indicated that in large urban areas, children with LG parents were predicted to experience less victimization than children with heterosexual parents; in more rural regions, children with LG parents were predicted to experience more victimization than children with heterosexual parents. School climate was related to victimization: Parents who reported more negative school climate reported more child victimization. Children with higher levels of parent-reported victimization had higher levels of parent-reported internalizing and externalizing symptoms. In large urban areas, children with LG parents were predicted to have fewer internalizing symptoms than children with heterosexual parents; in more rural areas, children with LG parents were predicted to have more internalizing symptoms than children with heterosexual parents. Regarding parents' responses to victimization, LG parents were more likely to talk to school administrators, their children, and the bully, compared to heterosexual parents.
Nondestructive measurements of the mechanical and structural properties of nanostructured metalattices

Metalattices are artificial 3D solids, periodic on sub-100nm length scales, that enable the functional properties of materials to be tuned. However, because of their complex structure, predicting, ...
Targeted next generation sequencing (NGS) to classify melanocytic neoplasms.

This study piloted a pan-solid-tumor next generation sequence (NGS)-based laboratory developed test as a diagnostic aid in melanocytic tumors. 31 cases (4 "epithelioid" nevi, 5 blue nevi variants, 7 Spitz tumors [3 benign and 4 malignant] and 15 melanomas) were evaluated. All tumors [median diameter 7 mm (range 4-15 mm); median thickness 2.25 mm (range 0.25-12 mm)] yielded satisfactory results. The number of small nucleotide variants/tumor was significantly different between melanoma (median 18/tumor, range 4-71) and all other lesions (median 8/tumor, range 3-17) (P 1 pathogenic alteration. Developed NGS-based criteria correctly classified all malignant lesions in this series. 10/12 cases showed concordance with FISH; consensus diagnosis agreed with NGS classification in FISH-non-concordant cases. This pilot study suggests that NGS may be an effective diagnostic adjunct comparable to FISH, but further studies with larger numbers of cases are needed.
Impact of caregivers’ negative response to cancer on long-term survivors’ quality of life

Cancer survivors’ quality of life (QoL) is consistently shown to be positively impacted by social support from family and friends, including informal caregivers. In contrast, a loved one’s negative response to cancer can diminish survivors’ QoL, and these negative responses can be more impactful than supportive behaviors. Nonetheless, negative caregiver response has not been extensively researched, and few studies have explored the potential interaction of negative caregiver response and perceived social support on survivors’ QoL. Therefore, we examined direct effects of perceived negative caregiver response, and the potential moderating role of social support, on QoL in a population-based sample of cancer survivors (N = 7543) using generalized linear models. Findings indicate that survivors who rated their caregiver’s response to their cancer diagnosis more negatively reported worse physical and mental health, even up to 10 years after their initial cancer diagnosis. Perceived social support was not significantly associated with physical health, but it was positively associated with mental health. However, social support was not shown to moderate the relationship between negative caregiver response and mental health. Findings suggest that positive support from others within a survivor’s social network may not be enough to attenuate the negative effects of their primary caregiver’s unsupportive behaviors. Accordingly, cancer survivorship research and practice must consider the critical role that negative caregiver responses have on survivors’ QoL and develop strategies that focus on the survivor–caregiver dynamic.
Chapter 22 Of Mites and Men: What WWII Scabies Experiments Can Teach Us About New, Unregulated Human Subject Research

Human subject research in the United States has historically been governed by federal regulations attached to grant funding support. Through this regulatory reach, it has been possible to enforce standards of ethical treatment, built on the foundations of the Nuremberg Code, Declaration of Helsinki, and the Belmont Report, on the vast majority of research with human subjects in the United States. However, new research methods, such as citizen science, DIY biology, biohacking, and corporate research all pose challenges to the conventional approach, because they can be left ungoverned by these regulations. This requires us to think anew about how to ensure such research is conducted ethically. How can we think about ethical research in the absence of regulatorily required or universally shared norms?
Soaring Imaginations: The First Montgolfier Ballooning Spectacle at Versailles in Word and Image

Beginning with the first series of flights by the French Montgolfier brothers in 1783, hot air ballooning quickly metamorphosed from a dangerous scientific experiment with potential military uses into a widespread cultural craze with deep social implications. Using the lens of the idea of “wonder,” I examine the word-image interactions in a selection of engraved representations of the first Montgolfier demonstration for Louis XVI at Versailles. Such a collective close reading first exposes techniques that aim at encouraging admiration in readers for both the new technology and the French state that produced it. However, visual cues in the images indicate a persistent suggestion of doubt and uncertainty—and even fear—as they take readers “up and away” from the confines and comforts of everyday life. The word-image nexus surrounding this spectacle generates an altered textual world in which traditional social and sexual hierarchies lose stability and the future is full of possibility.
Adipocytes protect fibroblasts from radiation-induced damage by adiponectin secretion

Prostate and colon cancers are among the most common cancers diagnosed annually, and both often require treatment with radiation therapy. Advancement in radiation delivery techniques has led to highly accurate targeting of tumor and sparing of normal tissue; however, in the pelvic region it is anatomically difficult to avoid off-target radiation exposure to other organs. Chronically the effects of normal urogenital tissue exposure can lead to urinary frequency, urinary incontinence, proctitis, and erectile dysfunction. Most of these symptoms are caused by radiation-induced fibrosis and reduce the quality of life for cancer survivors. We have observed in animal models that the severity of radiation-induced fibrosis in normal tissue correlates to damaged fat reservoirs in the pelvic region. We hypothesize that adipocytes may secrete a factor that prevents the induction of radiation-associated fibrosis in normal tissues. In these studies we show that the adipokine, adiponectin, is secreted by primary mouse adipocytes and protects fibroblasts from radiation-induced cell death, myofibroblast formation, and senescence. Further, we demonstrated that adiponectin does not protect colorectal or prostate cancer cells from radiation-induced death. Thus, we propose that adiponectin, or its downstream pathway, would provide a novel target for adjuvant therapy when treating pelvic cancers with radiation therapy.
Intolerance of uncertainty as a factor linking obsessive-compulsive symptoms, health anxiety and concerns about the spread of the novel coronavirus (COVID-19) in the United States

Abstract The novel coronavirus disease (COVID-19) has had a significant impact on public health, economic activity, and mental health as it spread across the globe. Research from past pandemics links excessive anxiety about illness-related threats with symptoms of health anxiety and obsessive-compulsive disorder (OCD). In the present study, we investigated whether intolerance of uncertainty (IU), a psychological vulnerability factor involved in both OCD and health anxiety, accounts for a portion of the relationship between these symptoms and fear of COVID-19 during the early stages of the outbreak in the Unites States. We administered measures of concern about the spread of COVID-19 (Coronavirus Threat Scale; CTS), health anxiety, and OCD symptoms to a large sample of community adults in the United States (n = 738) recruited through Amazon MTurk. Results revealed that concern about COVID-19 was moderately and positively correlated with both OCD and health anxiety symptoms, as well as IU. Moreover, regression analyses found that IU partially accounted for the connections between concern about the spread of COVID-19 and OCD and health anxiety symptoms. These results highlight IU as a potential mechanism connecting OCD and health anxiety to anxiety about pandemic threats. Clinical implications, limitations, and future directions for research are discussed.
Alternating gemcitabine/nab-paclitaxel (GA) and 5-FU/leucovorin/irinotecan (FOLFIRI) as first-line treatment for de novo metastatic pancreatic cancer (MPC): Safety and effect.

4125Background: Both gemcitabine and 5FU-based chemotherapy have demonstrated efficacy in MPC. Alternating regimens may 1) reduce toxicity 2) slow resistant cancer biology emergence and 3) provide ...
Atypical Presentation of Reversible Cerebral Vasoconstriction Syndrome at Very Early Pregnancy (5019)

Objective: We report a rare case of reversible cerebral vasoconstriction syndrome (RCVS) with vertebral artery dissection and extra-cranial vasospasm occurring during very early pregnancy. Background: RCVS is well recognized clinical-radiological entity characterized by thunderclap headache with diffuse segmental constriction. Commonly seen in late pregnancy or postpartum period. RCVS in early period of organogenesis is rare. Design/Methods: A healthy 36-year-old right-handed African-American female presented with acute onset of nausea, vertigo, right-sided weakness. Head and neck CT angiogram (HN-CTA) demonstrated a left vertebral V4 segment dissection with stenosis. On exam, she had difficulty swallowing, hoarseness, right-eye ptosis, right-gaze nystagmus, dysmetria and 4/5 right-sided weakness. MRI showed left Posterior-inferior-Cerebellar Artery stroke. Over the next few days, she improved and was ambulatory. However, she continued to have headaches and nausea. On hospital day 17th she had acute mental status change with increased right sided weakness. Repeat HN-CTA showed extra-cranial large artery diffuse vasospasm. Non-contrast head showed no intracranial hemorrhage. Diagnostic cerebral angiography showed diffuse vasospasm of bilateral cervical and petrous segment of internal carotid arteries and V2 segment of bilateral vertebral arteries. Repeat MRI was unchanged. Patient improved significantly after 5 day treatment of calcium channel blocker. She was discharged to an acute rehab with dysarthria, dysmetria and mild right-sided paresis. Results: Two-month repeat neurological exam was normal and MR angiography showed near resolution of arterial vasospasm. In the rehab, she was found to be pregnant. Obstetric examination indicated that she was 5 weeks pregnant at the time of vasospasm. An association between RCVS and arterial dissection has emerged in recent years but the presentation in early pregnancy is extremely rare. Conclusions: Although, RCVS diagnosed in late pregnancy is well established, early trimester neural change with headache should raise concern for RCVS. This case also raises awareness about getting pregnancy tests in all childbearing women in all acute strokes. Disclosure: Dr. Naik has nothing to disclose. Dr. Govindan Kutty has nothing to disclose. Dr. Madireddy has nothing to disclose. Sahil Naik has nothing to disclose. Dr. Remmel has nothing to disclose. Dr. Liu has nothing to disclose.
Impaired glucose tolerance and indeterminate glycemia in cystic fibrosis

Abstract Oral glucose tolerance testing (OGTT) is the primary method to screen for and diagnose and cystic fibrosis-related diabetes (CFRD). Diagnostic thresholds as currently defined are based on microvascular complications seen in type 2 diabetes. Abnormal glucose tolerance (AGT) refers to OGTT glucose elevations outside the normal range and encompasses both impaired and indeterminate glucose tolerance. Current guidelines define impaired glucose tolerance (IGT) as a 2-hour glucose of 140-199 mg/dL (7.8-11 mmol/L) and indeterminate glucose tolerance (INDET) as any mid-OGTT glucose ≥200 mg/dL (11.1 mmol/L) with a normal fasting and 2h glucose. There is growing evidence that AGT also has associations with CF-centered outcomes including pulmonary decline, hospitalizations, and weight loss. Here we aim to review the historical emergence of glucose tolerance testing, review relevance to risk stratification for CFRD, discuss alternate cutoffs for identifying AGT earlier, and highlight the need for larger, future studies to inform our understanding of the implications of IGT and INDET on CF health.
Phase 2 trial of hypoxia activated evofosfamide (TH302) for treatment of recurrent bevacizumab-refractory glioblastoma

Evofosfamide (Evo or TH302) is a hypoxia-activated prodrug which is reduced leading to the release of alkylating agent bromo-isophosphoramide mustard, which has shown safety and signals of efficacy in a prior phase 1 study in recurrent glioblastoma. We performed a dual center single-arm Phase II study to expand on the safety and efficacy of Evo plus bevacizumab in bevacizumab refractory glioblastoma. 33 patients with bevacizumab refractory GBM received Evo 670 mg/m2 in combination with Bevacizumab 10 mg/kg IV every 2 weeks. Assessments included adverse events, response, and survival. Median age of patients was 47 (range 19-76) and 24 (69%) were male. At the time of study entry, 9 (26%) had ongoing corticosteroid use. ECOG performance status was 0 or 1 in 83% of patients. Patients were mostly heavily pretreated with 77% have three or more prior regimens. A total of 12 patients (36%) suffered grade 3-4 drug associated adverse event (AE); no grade 5 AE were reported. Of the 33 evaluable patients, best response was PR in 3 (9%), SD in 14 (43%), and PD in 16 (48%) with responses confirmed by a second reviewer. Median time to progression of disease was 53 days (95% CI 42-113) and Median time to death was 129 days (95% CI 86-199 days). Progression free survival at 4 months (PFS-4) on Evo-Bev was 31%, which was a statistically significant improvement over the historical rate of 3%. The median overall survival of patients receiving Evo-Bevacizumab was 4.6 months (95% CI 2.9-6.6). The progression free survival of patients on Evo-Bevacizumab met the primary endpoint of progression free survival at 4 months of 31%, although the clinical significance of this may be limited. Given the patient population and Phase II design, these clinical outcomes will need further validation.
Repeal of state laws permitting denial of health claims resulting from alcohol impairment: Impact on treatment utilization.

Abstract Background Many states in the U.S. still have Alcohol Exclusion Laws (AELs), which allow insurance companies to deny health claims resulting from alcohol impairment. There are concerns that this form of structural stigmatization affects alcohol treatment-seeking behaviors. We examined the effects of AEL repeal on treatment admissions for alcohol use disorder (AUD). Methods Data on alcohol treatment admissions from 1992 to 2017 were obtained from the Treatment Episode Data Set. The state-level aggregate number of treatment admissions was derived, including healthcare professional referrals only, self-referrals only, and both self-referral and healthcare professional referrals. The number of treatment admissions by health insurance status (private, public, and uninsured) was also calculated. The study used a difference-in-differences (DID) quasi-experimental design. Results The DID analysis showed that the number of admissions for alcohol treatment from healthcare professional referrals increased 16% in the AEL repeal states compared to states with AELs or that never had AELs (IRR=1.16, 95% CI=1.07, 1.25). These results were consistent for analysis by payment sources. In particular, treatment admissions from healthcare professional referrals for patients covered by private insurance increased about 38% in states with AEL repeal (IRR=1.38, 95% CI=1.17, 1.64) compared to states without AEL repeal. However, the findings were no longer significant when the state-specific time trends were taken into account. Conclusions This study documented that AEL repeal may have had a significant impact on the number of treatment admissions for AUD. These findings suggest that AELs function as a barrier to treatment-seeking behavior.
Development and Evaluation of an Integrated Outpatient Infusion Care Model for the Treatment of Pediatric Headache

Abstract Background Care for pediatric patients with headache often occurs in high-cost settings such as emergency departments (ED) and inpatient settings. Outpatient infusion centers have the potential to reduce care costs for pediatric headache management. Methods In this quality improvement study, we describe our experience creating the capacity to support an integrated outpatient pediatric headache infusion care model through an infusion center. We compare costs of receiving headache treatment in this model compared to the emergency and inpatient settings. Since dihydroergotamine (DHE) is a costly infusion, encounters at which DHE was administered were analyzed separately. We track the number of ED visits and inpatient admissions for headache using run charts. As a balancing measure, we compare treatment efficacy between the infusion care model and the inpatient setting. Results The mean percentage increase in cost of receiving headache treatment in the inpatient setting with DHE was 61% (CI: 30-99%) and without DHE was 582% (CI: 299-1068%) compared to receiving equivalent treatments in the infusion center. The mean percentage increase in cost of receiving headache treatment in the ED was 30% (CI: -15-100%) compared to equivalent treatment in the infusion center. After the intervention, ED visits and inpatient admissions for headache decreased. The mean change in head pain was similar across care settings. Conclusions Our findings demonstrate that developing an integrated ambulatory care model with infusion capacity for refractory pediatric headache is feasible and our early outcomes suggest this may have a favorable impact on the overall value of care for this population.
Anterior cingulate cortex surface area relates to behavioral inhibition in adolescents with and without heavy prenatal alcohol exposure

Prenatal alcohol exposure is associated with behavioral disinhibition, yet the brain structure correlates of this deficit have not been determined with sufficient detail. We examined the hypothesis that the structure of the anterior cingulate cortex (ACC) relates to inhibition performance in youth with histories of heavy prenatal alcohol exposure (AE, n = 32) and non-exposed controls (CON, n = 21). Adolescents (12-17 years) underwent structural magnetic resonance imaging yielding measures of gray matter volume, surface area, and thickness across four ACC subregions. A subset of subjects were administered the NEPSY-II Inhibition subtest. MANCOVA was utilized to test for group differences in ACC and inhibition performance and multiple linear regression was used to probe ACC-inhibition relationships. ACC surface area was significantly smaller in AE, though this effect was primarily driven by reduced right caudal ACC (rcACC). AE also performed significantly worse on inhibition speed but not on inhibition accuracy. Regression analyses with the rcACC revealed a significant group × ACC interaction. A smaller rcACC surface area was associated with slower inhibition completion time for AE but was not significantly associated with inhibition in CON. After accounting for processing speed, smaller rcACC surface area was associated with worse (i.e., slower) inhibition regardless of group. Examining processing speed independently, a decrease in rcACC surface area was associated with faster processing speed for CON but not significantly associated with processing speed in AE. Results support the theory that caudal ACC may monitor reaction time in addition to inhibition and highlight the possibility of delayed ACC neurodevelopment in prenatal alcohol exposure.
Using Video Self-Modeling to Increase Compliance to Classroom Requests in Students with Autism Spectrum Disorder

ABSTRACTVideo self-modeling (VSM) is a resource-efficient intervention that has been used to address some of the social and behavioral challenges experienced by children with autism spectrum disord...
Updates with Equality: Beyond the Herbrand Universe Assumption

Model-based update semantics appear promising as a definition for the meaning of updates to logical databases and knowledge bases. The proposals for these semantics to date, however, do not fully support updates involving equality; for example, given a knowledge base containing ‘Destination(Galileo)=Venus’, inserting the new fact ‘Destination(Galileo)=Jupiter’ will produce inconsistency. This paper extends model-based update semantics to support updates involving equality, by permitting changes in both universe composition and in function interpretations in the models being updated. We present both a semantics based on the traditional measures of distance between models, and a new measure that evaluates the similarity between pairs of models on the basis of the presence and/or absence of homomorphisms between them.
Introduction to Software Engineering

In the early years of computing, when the new technology was restricted to college campuses and government sponsored labs, software development was often limited to the practice of computer programming, and consisted of writing specific software solutions to unique scientific queries. Today, though, with the use of computers in nearly every imaginable field, simply attempting to program a solution is not enough. Instead, processes borrowed from the field of engineering were applied to the building of software systems to create the field of software engineering.
From Grimm to Glory: Simulated Oral Argument as a Component of Legal Education's Signature Pedagogy

The past two years have been a period of landmark transformation in legal education. With the issuance of the Carnegie and Best Practices in Legal Education reports, law schools and law professors have re-begun the essential process of analyzing and transforming legal pedagogy. This widespread re-examination of the law school curriculum has yielded two important changes in legal education: first, law schools - including those in the top tier - have begun radically to amend their curricular goals and structures; and, second, legal scholars have begun to turn their attention to the theory and implementation of better legal education. As Carnegie and Best Practices note, this nascent metamorphosis in scholarly thought about legal education has the potential to transform both the law school and the law practice experience, as well-grounded pedagogy will remove the barriers to learning that some law students have historically experienced while better preparing them to practice law.This article represents one of the first concrete responses to Carnegie and Best Practices. In proposing that law professors regularly use oral argument exercises to supplement traditional Socratic dialogue, it meets head on the concerns expressed by Best Practices and Carnegie that over-reliance on the Langdell method neither mimics law practice nor nurtures student learning. It also responds directly to the suggestion in both reports that simulation exercises may yield better legal analysis and knowledge. Finally, this article advances a novel theory directly related to the objectives and conclusions of the Reports; namely, that for experienced advocates and law students alike, practice oral argument may be a starting point, rather than a mere end point, for teaching, learning, and executing the fundamentals of legal analysis. In the style of the transcribed classroom conversations of the Carnegie Report, it discusses and demonstrates by example a simulation exercise designed for professors to use in introducing this teaching methodology. The exercise, based on seven fairy tales used as precedent cases, provides a familiar, non-threatening technique for students to learn about rule synthesis, weight of authority, analogy and distinction, and theme through oral argument.
Secure link state routing for mobile ad hoc networks

Secure operation of the routing protocol is one of the major challenges to be met for the proliferation of the mobile ad hoc networking (MANET) paradigm. Nevertheless, security enhancements have been proposed mostly for reactive MANET protocols. The proposed secure link state routing protocol (SLSP) provides secure proactive topology discovery, which can be beneficial to network operation in a number of ways. SLSP can be employed as a stand-alone protocol, or fit naturally into a hybrid routing framework, when combined with a reactive protocol. SLSP is robust against individual attackers, is capable of adjusting its scope between local and network-wide topology discovery, and is capable of operating in networks of frequently changing topology and membership.
A unitarity bound on the evolution of nonstationary states

A version of an equation derived by Ersak is studied to obtain rigorous bounds on the rate of change of the integrity of a normalized state.
Normalized Landslide Index Method for susceptibility map development in El Salvador

El Salvador and Central America in general are highly prone to landsliding. In November 1998, Hurricane Mitch killed 240 people, displaced about 85,000 people, caused more than $600 million in economic losses, and damaged about 60 % of the nation’s roads (Rose et al. in Natural hazards in El Salvador. Geologic Society of America of special paper 375, Boulder, 2004). An understanding of susceptibility of locations to landsliding is critical for development and mitigation planning. This work presents the development of the Normalized Landslide Index Method which is a derivative of the bivariate statistical methods commonly used in landslide susceptibility assessment. The resultant map was amended through a tangential analysis, also commonly used in landslide susceptibility mapping, the Analytical Hierarchy Process (AHP), which reduces multi-criteria analysis to pair-wise comparisons. The assimilation of results from the AHP analysis into the statistically derived susceptibility map skewed the original results by emphasizing the extremes already found. It was determined that addition of AHP results did not increase the value of the derived susceptibility map. Finally, a physically based a priori approach to landslide susceptibility mapping, developed by El Salvador National Service of Territorial Studies, was compared to the statistically derived map developed herein. It was found that the a priori approach was not sufficiently discriminant to be useful for planners and regulators, as very large areas were designated high susceptibility that included areas with low slope angles. The development of the normalized landslide index is a significant improvement to the class of bivariate statistical strategies to assess regional landslide susceptibility.
Space radiation interaction mechanisms in materials

Models of charged-particle impact under conditions typical of the space environment are reported, with a focus on impact excitation and nuclear reactions, especially for heavy ions. Impact excitation is studied by using a global model for electronic excitation based on formal relations through the classical dielectric function to derive an approximation related to the local plasma (electron density distribution) within the atoms and molecules; and corrections to the model resulting from the nonfluid nature of this plasma are discussed. Nuclear reactions are studied by reducing quantum-mechanical treatment of this general N-body problem to an equivalent two-body problem that is solvable, and by comparing the results with experimental data. The equations for heavy-charged-particle transport are derived and solution techniques demonstrated. Finally, these methods of analysis are applied to study the change in the electrical properties of a GaAs semiconductor for photovoltaic applications; proton damage to GaAs crystals is found to arise from stable replacement defects and to be nonannealable, in contrast to electron-induced damage.
Association of chronotropic incompetence with echocardiographic ischemia and prognosis

Abstract Objectives. This study sought to examine the prognostic importance of chronotropic incompetence among patients referred for stress echocardiography. Background. Although chronotropic incompetence has been shown to be predictive of an adverse prognosis, it is not clear if this association is independent of exercise-induced myocardial ischemia. Methods. Consecutive patients (146 men and 85 women; mean age 57 years) who were not taking beta-adrenergic blocking agents and were referred for symptom-limited exercise echocardiography were followed for a mean of 41 months. Chronotropic incompetence was assessed in two ways: (1) failure to achieve 85% of the age-predicted maximum heart rate and (2) a low chronotropic index, a heart rate response measure that accounts for effects of age, resting heart rate and physical fitness. Results. The primary end point, a composite of death, nonfatal myocardial infarction, unstable angina and late (>3 months after the exercise test) myocardial revascularization, occurred in 41 patients. Failure to achieve 85% of the age-predicted maximum heart rate was predictive of events (relative risk [RR] 2.47, 95% confidence interval [CI] 1.28 to 4.79, p = 0.007); similarly, a low chronotropic index was predictive (RR 2.44, 95% CI 1.31 to 4.55, p = 0.005). Even after adjusting for myocardial ischemia and other possible confounders, failure to achieve 85% of age-predicted maximum heart rate was predictive (adjusted RR 2.20, 95% CI 1.11 to 4.37, p = 0.02). A low chronotropic index also remained predictive (adjusted RR 1.85, 95% CI 0.98 to 3.47, p = 0.06). Conclusions. Chronotropic incompetence is predictive of an adverse cardiovascular prognosis even after adjusting for echocardiographic myocardial ischemia.
Pitting Susceptibility and Semiconducting Properties of Passive Films of 18Cr-18Mn-2Mo-0.9N High Nitrogen Austenitic Stainless Steel

The effects of pH value and chloride ions concentration of the solution on pitting susceptibility and semiconducting properties of passive films formed on 18Cr-18Mn-2Mo-0.9N high nitrogen austenitic stainless steel (HNSS) were investigated using potentiodynamic polarization and capacitance measurement methods, respectively. The anodic polarization curves show that HNSS exhibits excellent pitting corrosion resistance in the solution with different pH values and chloride ions concentration, and the pitting corrosion resistance of HNSS decreases a little with decreasing the pH value or increasing the chloride ions concentration of the solution. The passive films formed on HNSS in the solution with pH values ranging from 1 to 9 or chloride ions concentration from 3.5 wt% to 20 wt% NaCl behave as n-type semiconductors. With increasing the pH value or decreasing the chloride ions concentration, the shallow donor and deeper donor densities decrease and the flat bland potential decreases, and the thickness of space charge layer increases. The deeper donor increases and then the second positive slope of straight linear region disappears with decreasing the pH value or increasing the chloride ions concentration of the solution, which can be attributed to the formation of Cr6+ is depressed.
Growth of Nosema algerae in pig kidney cell cultures.

SYNOPSIS. Nosema algerae, a microsporidan parasite of mosquitoes, can infect pig kidney cell cultures. Spores germinated in the culture medium, infected the cells within 30 min of germination, multiplied, and produced spores. The early developmental stages in the N. algerae life cycle are described.
O-017 Does intraprocedural rupture of anterior communicating artery aneurysms matter? A retrospective comparison of endovascular and microsurgical approaches

Purpose Intraprocedural rupture is a dangerous complication of endovascular treatment. Small ruptured, 3–4 mm aneurysms of the anterior communicating artery (AcoA) are at increased risk for re-rupture during endovascular occlusion. Given this risk, microsurgical management may confer improved outcomes. Methods We performed a retrospective review of 409 AcoA aneurysms treated in 409 consecutive patients at Emory University over a 10-year period. Patient demographics, aneurysmal rupture, size, therapeutic approach (microsurgical or endovascular), patient outcomes, intraprocedural rupture and rerupture were reviewed. Aneurysm retreatments were noted, but excluded. Results Rupture rates were examined by size for all patients and subgroups as well as dichotomized to evaluate for size ranges associated with increased rupture rates. The highest risk of rupture was noted in aneurysms 4 mm compared to 8.2% (9/110) in 4 mm aneurysms, the endovascular rupture rate was 2.7% (5/182) while the microsurgical rate was 12.8% (15/117), p=0.0013. There was no statistically significant difference in Modified Rankin Scores between ruptured or non-ruptured aneurysms of any size once Age, Hunt and Hess and modified Fisher Grades were included in the model. Rupture rates tended to be higher in the microsurgical cases (10% vs 5%; p=0.078) but not statistically significant. In small aneurysms, endovascular rupture rate was higher (12.5% vs 4%, p=0.16). In larger aneurysms, microsurgery tended to have higher ruptures (13% vs 3%, p=0.0013). However, despite the intra-procedural rupture, the dichotomized mRS did not demonstrate statistically significant differences between endovascular and microsurgical therapy overall (p=0.23), in aneurysms 4 mm (p=0.37). Conclusions Microsurgical treatment of small ACOM aneurysms ≤4 mm appears to confer a lower intraprocedural re-rupture rate than endovascular management, but may have a higher procedural rupture rate in larger aneurysms. In this retrospective data set, there was no statistically significant difference in outcomes irrespective of the treatment modality and aneurysm size. Aneurysms ≤4 mm trend toward having a higher rate of rupture with endovascular techniques, while aneurysms >4 mm tend to have a higher rate of intraprocedural rupture during microsurgery. However, despite the ruptures, there is no statistically significant difference in outcomes.
Public Administration Singapore-Style

Public Administration Singapore-Style Jon S. T. Quah Bingley: Emerald Group Publishing, 2010 311 pp., ISBN: 978-1-84950-924-4 Public administration around the globe is in trouble, serious trouble i...