cssi/SciSciGPT-SciSciNet huggingface dataset:
Charged particle therapy versus photon therapy for paranasal sinus and nasal cavity malignant diseases: a systematic review and meta-analysis

Summary Background Malignant tumours arising within the nasal cavity and paranasal sinuses are rare and composed of several histological types, rendering controlled clinical trials to establish the best treatment impractical. We undertook a systematic review and meta-analysis to compare the clinical outcomes of patients treated with charged particle therapy with those of individuals receiving photon therapy. Methods We identified studies of nasal cavity and paranasal sinus tumours through searches of databases including Embase, Medline, Scopus, and the Cochrane Collaboration. We included treatment-naive cohorts (both primary and adjuvant radiation therapy) and those with recurrent disease. Primary outcomes of interest were overall survival, disease-free survival, and locoregional control, at 5 years and at longest follow-up. We used random-effect models to pool outcomes across studies and compared event rates of combined outcomes for charged particle therapy and photon therapy using an interaction test. Findings 43 cohorts from 41 non-comparative observational studies were included. Median follow-up for the charged particle therapy group was 38 months (range 5–73) and for the photon therapy group was 40 months (14–97). Pooled overall survival was significantly higher at 5 years for charged particle therapy than for photon therapy (relative risk 1·51, 95% CI 1·14–1·99; p=0·0038) and at longest follow-up (1·27, 1·01–1·59; p=0·037). At 5 years, disease-free survival was significantly higher for charged particle therapy than for photon therapy (1·93, 1·36–2·75, p=0·0003) but, at longest follow-up, this event rate did not differ between groups (1·51, 1·00–2·30; p=0·052). Locoregional control did not differ between treatment groups at 5 years (1·06, 0·68–1·67; p=0·79) but it was higher for charged particle therapy than for photon therapy at longest follow-up (1·18, 1·01–1·37; p=0·031). A subgroup analysis comparing proton beam therapy with intensity-modulated radiation therapy showed significantly higher disease-free survival at 5 years (relative risk 1·44, 95% CI 1·01–2·05; p=0·045) and locoregional control at longest follow-up (1·26, 1·05–1·51; p=0·011). Interpretation Compared with photon therapy, charged particle therapy could be associated with better outcomes for patients with malignant diseases of the nasal cavity and paranasal sinuses. Prospective studies emphasising collection of patient-reported and functional outcomes are strongly encouraged. Funding Mayo Foundation for Medical Education and Research.
Modelling potential dispersal corridors for cougars in midwestern North America using least-cost path methods

Since 1990, cougar (Puma concolor) presence in midwestern North America has been increasing, with >130 confirmed cougar occurrences (i.e., tracks, photos, carcasses) being verified by professional wildlife biologists during this time. Because many of these confirmed cougar occurrences (>30%) have been carcasses of juvenile males, it is likely that cougars are dispersing into the Midwest from established western populations. Although several wildlife biologists have acknowledged the possibility of cougar presence in the region, no research has been conducted regarding potential corridors that may facilitate dispersal. Therefore, our goal was to determine potential dispersal corridors for cougars in a 9-state portion of the Midwest using a habitat suitability model and least-cost path analysis. We modelled 2km wide dispersal corridors from established western cougar populations to (1) large areas (≥2500 km 2
A comment on "Economy-wide estimates of the implications of climate change: Human health" ☆

Abstract In a recent article in this journal, Francesco Bosello, Roberto Roson, and Richard Tol make the remarkable prediction that one degree of global warming will, on balance, save more than 800,000 lives annually by 2050. They introduce enormous, controversial monetary valuations of mortality and morbidity, varying with income; they then focus primarily on modeling the much smaller, indirect economic effects of the changes in health outcomes. Their calculations, large and small, are driven by the huge projected reduction in mortality — an estimate that Bosello et al. fail to substantiate. They rely on research that identifies a simple empirical relationship between temperature and mortality, but ignores the countervailing effect of human adaptation to gradual changes in average temperature. While focusing on small changes in average temperatures, they ignore the important health impacts of extreme weather events. They extrapolate the effects of small changes in average temperature far beyond the level that is apparently supported by their principal sources, and introduce arbitrary assumptions that may bias the result toward finding net health benefits from warming.
Energy scaling in silicon photonic data encoding

Analytical lower energy limits are established for optical interferometric modulation based on free-carrier plasma index change, then augmented with (1) optically-resonant modulation, or (2) resonantly (bound charge) mediated index change. When combined these suggest the possibility of single electron modulation, but saturation effects are significant.
Cutting edge: Pseudomonas aeruginosa abolishes established lung transplant tolerance by stimulating B7 expression on neutrophils.

The mechanisms that link bacterial infection to solid organ rejection remain unclear. In this study, we show that following the establishment of lung allograft acceptance in mice, Pseudomonas aeruginosa airway infection induces a G-CSF–dependent neutrophilia that stimulates acute rejection. Graft-infiltrating neutrophils sharply upregulate the B7 molecules CD80 and CD86, but they do not express CD40 or MHC class II in response to P. aeruginosa infection. Neutrophil B7 promotes naive CD4 + T cell activation and intragraft IL-2 + , IFN-γ + , and IL-17 + T lymphocyte accumulation. Intravital two-photon microscopy reveals direct interactions between neutrophils and CD4 + T cells within pulmonary allografts. Importantly, lung rejection in P. aeruginosa -infected recipients is triggered by CD80/86 on neutrophils and can be prevented by B7 blockade without affecting clearance of this pathogen. These data show that neutrophils enhance T cell activation through B7 trans-costimulation and suggest that inhibiting neutrophil-mediated alloimmunity can be accomplished without compromising bacterial immune surveillance.
Peripheral Arterial Disease: Pathophysiology, Risk Factors, and Role of Antithrombotic Therapy

ABSTRACT Objective To provide an overview of the impact of peripheral arterial disease (PAD) and the steps that can be taken to reduce its burden through greater awareness of the disease, improved diagnosis, and better treatment, with emphasis on the use of antiplatelet agents. Data Sources Recent (1990-2003) published scientific literature, as identified by the author through Medline searches, using the terms peripheral arterial disease, atherothrombosis, pathophysiology, risk factors, treatment, clinical trials, and reviews on treatment. Study selection Recent systematic English-language review articles and reports of controlled randomized clinical trials were screened for inclusion. Data Synthesis PAD is a distinct atherothrombotic syndrome marked by stenosis and occlusion of peripheral arterial beds, typically those in the lower extremities. Symptoms range from intermittent claudication (IC) during exercise to peripheral limb ischemia requiring limb amputation. IC, the most common symptom, is experienced by 2% to 3% of men and 1% to 2% of women aged 60 years and older. Despite its recognition as a major atherothrombotic risk factor, PAD is not widely appreciated by clinicians, and most cases remain undiagnosed. Asymptomatic PAD, as indicated by a reduced ankle brachial systolic pressure index, should alert the health care provider to the presence of diffuse atherothrombotic disease and need for treatment. Risk factors for development and progression of PAD include smoking, hypertension, diabetes, hyperlipidemia, and physical inactivity. The aim of pharmacotherapy is to improve the symptoms of PAD (especially IC), defer onset of limb-threatening ischemia, and improve long-term survival. Successful treatment strategies include risk factor modification, particularly smoking cessation; initiation of regular exercise; control of hypertension, diabetes, and hyperlipidemia; and use of antiplatelet agents to reduce the risk of atherothrombotic events. Available data suggest that aspirin reduces morbidity and mortality in PAD, while clopidogrel reduces the risk of atherothrombotic events such as myocardial infarction and stroke in these patients. Conclusion Increased awareness among members of the health care community about the prevalence of PAD and benefits associated with risk-factor reduction and antiplatelet therapy could produce substantial decreases in the burden of this disease.
Parental allocation of food to nestling tree swallows: the influence of nestling behaviour, sex and paternity

Parents are expected to invest more in young that provide the greatest fitness returns. The cues that parents use to allocate resources between their offspring have received much recent attention. In birds, parents may use begging intensity, position in the nest or nestling size as cues to provision the most competitive young or those most likely to survive. It may also benefit parents to invest in young differentially by sex or relatedness if the fitness returns of sons and daughters differ or broods are sired by multiple males. We examined the allocation of food to tree swallow, Tachycineta bicolor, nestlings in relation to their begging behaviour, size, sex and paternity. Provisioning by parents was not related to nestling size, sex or paternity. The begging behaviour of nestlings did not differ with respect to sex or paternity. Both parents were more likely to feed nestlings that begged first or were closer to the nest entrance, suggesting that parents allocate food resources in response to cues that nestlings control. As a consequence, brood reduction was facilitated by biased provisioning within the brood in addition to the nestling size hierarchies created by hatching asynchrony.  2003 Published by Elsevier Ltd on behalf of The Association for the Study of Animal Behaviour.
Characterization of extracellular peroxidases produced by acetate-buffered cultures of the lignin-degrading basidiomycete Phanerochaete chrysosporium

Growth of Phanerochaete chrysosporium in a nitrogen-limited medium buffered with sodium acetate, instead of the commonly used 2,2-dimethylsuccinate (DMS), resulted in quantitative and qualitative differences in the production of various extracellular lignin peroxidases (LIPs) and manganese-dependent peroxidases (MNPs) involved in lignin degration. The results indicate that production of LIPs and MNPs can be selectively enhanced by manipulation of culture conditions. Partial N-terminal analyses of the major LIPs and MNPs have made it possible to assign a specific protein to the specific genes and cDNAs that have been reported recently. The LIPs and MNPs differed widely in their ability to decolorize various dyes that are known to be degraded by the lignin degrading enzyme system of P. chrysosporium.
Time Optimal Attitude Control of Asymmetric Rigid Spacecraft

Time optimal rest-to-rest reorientation of a rigid spacecraft with an arbitrary initial attitude and distinct principal moments of inertia is discussed. The effect of the gyroscopic coupling terms in Euler's equations on the control switch times is shown. A method for recursively generating coefficients for a truncated Taylor series solution of Euler's equations and the differential equations for the Euler parameter state transition matrix is shown. These solutions are used to solve for the optimal control switch times.
Shoulder muscle firing patterns during the windmill softball pitch

The purpose of this study was to describe the activity of eight shoulder muscles during the windmill fast-pitch softball throw. Ten collegiate female pitchers were analyzed with intramuscular electromyography, high-speed cinematography, and motion analysis. The supraspinatus muscle fired maximally during arm elevation from the 6 to 3 o'clock position phase, centralizing the humeral head within the glenoid. The posterior deltoid and teres minor muscles acted maximally from the 3 to 12 o'clock position phase to continue arm elevation and externally rotate the humerus. The pectoralis major muscle accelerated the arm from the 12 o'clock position to ball release phase. The serratus anterior muscle characteristically acted to position the scapula for optimal glenohumeral congruency, and the subscapularis muscle functioned as an internal rotator and to protect the anterior capsule. Although the windmill softball pitch is overtly different from the baseball pitch, several surprising similarities were revealed. The serratus anterior and pectoralis major muscles work in synchrony and seem to have similar functions in both pitches. Although the infraspinatus and teres minor muscles are both posterior cuff muscles, they are characteristically uncoupled during the 6 to 3 o'clock position phase, with the infraspinatus muscle acting more independently below 90 degrees. Subscapularis muscle activity seems important in dynamic anterior glenohumeral stabilization and as an internal rotator in both the baseball and softball throws.
Risk Factors for Chronic Exertional Compartment Syndrome in a Physically Active Military Population

Background:Chronic exertional compartment syndrome (CECS) is a common source of lower extremity pain in physically active military service members. While anatomic risk factors of CECS have been proposed, there is no existing study that evaluates the correlation of demographic and occupational risk factors and the overall incidence rate of CECS in an active military population.Hypothesis:Young, enlisted service members in the United States (US) ground military forces would demonstrate higher incidence rates of CECS in the study population because of greater exposure to at-risk dismounted activity on the battlefield and in training.Study Design:Cohort study (prevalence); Level of evidence, 2.Methods:A retrospective study of all US active military service members with diagnosed nontraumatic exertional compartment syndrome of the lower extremity (code 729.72 in the International Classification of Diseases, 9th Edition) between 2006 and 2011 was performed using the Defense Medical Epidemiology Database. Demogr...
Symptom-Related Self-Care of Mexican Americans With Type 2 Diabetes: Preliminary Findings of the Starr County Diabetes Education Study:

Starr Country Texas, a Texas-Mexico border community, was the site of a study involving culturally-appropriate education and group support for Mexican Americans with type 2 diabetes. Data were collected from 63 subjects on frequency of diabetes-related symptoms during the previous month and on self-care symptom treatments. On average, subjects were 57-year-old females, diagnosed with diabetes for 10 years, and exhibiting HbA1clevels of 12.5%. Almost 50% experienced excessive urination, excessive thirst, shakiness/nervousness, and numbness and/or tingling in their extremities. More than 50% of those who experienced symptoms did not view them as serious. Only one subject checked blood sugar levels when symptoms occurred. Significantly higher mean glycosylated hemoglobin levels were found for individuals who experienced dizziness and/or chest pain compared with those who did not. A variety of self-care treatments were employed, including over-the-counter medications and home remedies.
Exact results for soft supersymmetry-breaking parameters in supersymmetric gauge theories

We obtain exact relations (valid to all orders in the coupling constant) for the running gaugino mass in supersymmetric gauge theories, treating the soft supersymmetry-breaking effects in the linear approximation. If a supersymmetry-breaking squark (selectron) mass term is introduced, our relation connects the renormalization group equation for this term with that for the gaugino mass. Exact relations for the threshold effects in the gaugino masses are derived. The key ingredients of our analysis are the use of the Wilsonian action and holomorphy of this action with respect to relevant parameters. {copyright} {ital 1997} {ital The American Physical Society}
The n-n S-wave scattering length from the neutron spectra of the reaction π− +d → 2n+γ☆

Abstract We present a measurement of the neutron-neutron S-wave scattering length, ann, from an analysis of the neutron energy and angular spectra for the reaction d(π−, γ)2n. This reaction provides the unique advantage that while all three final-state particles are experimentally detectable, only the neutrons are strongly interacting. The data are analyzed using the treatment of this reaction given by Bander, taking the effects of experimental resolution into account with Monte Carlo techniques. Two independent analyses of 4200 events yield ann = −16.7 ±1.3 fm assuming rnn = 2.65 fm. This value is in good agreement with calculations of ann which assume charge symmetry of the nuclear components of p-p and n-n interactions.
Immigration quotas and immigrant selection

Several factors influenced the composition of migrants in the early 20th century, including World War I, the Literacy Act of 1917, and the implementation of strict immigration quotas. This paper examines whether the United States' first immigration quota, established under the Emergency Immigration Act of 1921, affected migrant selection. The Emergency Immigration Act of 1921 severely capped the number of admittable migrants by nationality. Canadian migrants, or any migrants who resided in Canada for five consecutive years, were unrestricted by the quota and could freely migrate to the U.S. Using transcribed ship records from states bordering Canada (specifically New York, Alaska, and Washington), I compare the skills of restricted migrants to the skills of unrestricted Canadian migrants, before and after establishment of the 1921 quota. Difference-in-differences estimates indicate that the quota resulted in migrants of higher skill.
Characterization of the blunt leaf apex (bla) trait in cucumber

Additional index words. Cucumis sativus , leaf morphological mutations Abstract. A further characterization of the cucumber ( Cucumis sativus L.) mutant 'Wis- consin SMR-18' bla (blunt leaf apex) revealed a new character associated with the previously described leaf phenotype. The attachment of the blade to the petiole of bla plants is flat across, as opposed to the cordate or indented attachment in the wild-type 'Wisconsin SMR-18' plants. The new character (truncate leaf base) was easier to score and becomes distinctive earlier in development than previously described leaf apex characters. It was expressed consistently in homozygous bla plants. Segregation analysis of 1159 F 2 seedlings arising from self-pollinated 'Wisconsin SMR-18' x 'Wisconsin SMR-18' bla F 1 plants suggested that the leaf base and leaf apex character were controlled by a single locus or two tightly linked ones with a maximum distance between the two of 0.03 cM. In a field study of growth and fitness characteristics, the two genotypes did not differ significantly for flower or fruit count. The similar flowering and fruiting characteristics, along with the reliable early occurring truncate character, likely will make the two genotypes useful for pollination and gene movement studies.
The Effect of Peer Tutors on Motor Performance in Integrated Physical Education Classes

The effect of untrained and trained peer tutors on the motor performance of students with developmental disabilities in integrated physical education classes was studied. This study used a single-subject delayed multiple baseline design across six participants (5 boys and 1 girl, ages 9 to 11) with developmental disabilities. Six typically developing peers served as peer tutors. The ability to perform critical elements of fundamental motor skills was the dependent variable. Students were assigned to one of two protocols. Protocol 1 consisted of three conditions: baseline, assistance by an untrained peer tutor, and assistance by a trained peer tutor. Protocol 1 revealed that trained peer tutors were effective at assisting participants to improve their motor performance while untrained peer tutors were not. Protocol 2, which consisted only of a baseline and trained, peer tutoring, was used to replicate and provide additional support for the effect of trained peer tutors. Results revealed that trained peer t...
Communication and Renegotiation

In a bilateral monopoly, we are looking at the seller's incentives to propose an improved widget design under two different negotiation rules. With Renegotiation, the players negotiate a price after a design has been agreed upon, and with Commitment, they negotiate the price beforehand. The comparison depends on two effects. (1) Bargaining power: Since communication reveals information about his preferences, a seller with little bargaining power may prefer to remain quiet in anticipation of ex post negotiation. (2) Incentive transfer: If the gains from adjustment are large, ex post negotiation gives the seller a chance to share the gains. On balance, Renegotiation is better when adjustments are rare but large, while Commitment is better when adjustments are frequent but small. The comparison might help explain why some contracts have more features left incomplete and throw some light on the nature of the employment relationship.
Three Giant Steps Backward for the First Amendment

Three of the First Amendment cases that the Supreme Court decided during its 2009 term – Holder v. Humanitarian Law Project, United States v. Stevens, and Citizens United v. F.E.C. – constitute setbacks for the principle of freedom of speech. In the latter two cases the Supreme Court ruled that the laws in question violate the First Amendment, creating the impression that Freedom of Speech is on the move. However, careful examination of the Court’s opinions reveals that the movement is retrograde. The decisions of the Supreme Court in these cases all take us back – back to before 1937 when the Supreme Court recognized the right of the individual to act nonviolently in concert with disfavored organizations, before 1925 when Holmes and Brandeis introduced realist analysis into First Amendment law, and before 1907 when this country agreed to prohibit corporations from contributing money to political candidates. The Supreme Court seeks to return to the “good old days” when political activism (no matter how peaceful) could be prosecuted, longstanding traditions (no matter how unjust) were honored, and large corporations (no matter how much they may drown out the voices of ordinary citizens) were permitted to dominate the political process and purchase influence with public officials.
International Media Concentration

Around the world, media ownership and concentration is an issue of considerable public interest. When the FCC in America tried to change the rules, it got over a million letters, both from the activist left and the activist right. Noted academics weighed in. Lawrence Lessig argued that 'within a few years, we will live in a world where just three companies control more than 85 percent of the media.' Contrast this with Adam Thierer (President of the libertarian Progress and Freedom Foundation): 'To the extent that there was ever a 'Golden Age' of media in America, we are living in it today. The media sky has never been brighter and getting brighter with each passing year. And this is most definitely not a case of looking for silver linings around the clouds; there are no clouds.' Both sides in this debate see themselves as protecting democracy, either from heavy-handed megalomaniacal proprietors, or from flat-footed government bureaucrats. And they sneer at their opponents as, respectively, lackeys of big media companies, or as luddites with tenure. Are the cassandras or the polyannas correct? This would seem to be an empirical question with an empirical answer.
Enzymes in Poly(ADP-Ribose) Metabolism

Studies over many years have revealed the central importance of poly(ADP-ribose) metabolism in the maintenance of genomic integrity. While the involvement of poly(ADP-ribose) polymerase-1 (PARP-1) in this metabolism has been long known, more recent studies have demonstrated the contribution of many different genes coding for PARPs to promoting cellular recovery from genotoxic stress, eliminating badly damaged cells from the organism, and ensuring accurate transmission of genetic information during cell division. Additionally, emerging information suggests the involvement of ADP-ribose polymer metabolism in the regulation of intracellular trafficking, memory formation and other cellular functions. This chapter reviews the chemistry of ADP-ribose polymer metabolism and the enzymes that catalyze the synthesis and turnover of poly(ADP-ribose).
S01-1 Addressing challenges in the role of work on health

The nature of work has, and continues to undergo radical transformation, with significant changes in work organisation, especially through ‘fissuring’ of business models, increased globalisation, including expansion of international supply chains and large scale immigration, and the blurring of lines between what constitutes work and non-work exposures. The conceptual model of occupational health that was developed in the ‘OSHA’ era is largely inadequate for addressing these changes. The major elements of these changes, and their implications for preventing work-related injury and illness are discussed. Informing this discussion is the rapidly expanding disparities in both wealth and health, typically associated race, gender, nativity, education and other elements of SES. Although highly intertwined with these factors, the role of work in creating the associated health and wealth disparities is rarely explicitly discussed. An alternative model of worker health and health disparities, describing the interaction of social determinants of health and work-related risks is proposed, and used to generate discussion about future directions for occupational health research and prevention activities.
From ‘bisexual’ to ‘queer’: the radical sexuality of Paul Goodman

This article explores the nature of Paul Goodman’s sexuality within his historical context, arguing that his radical queerness influenced his social and political radicalism in important ways. His unrepentant homosexuality allowed him to identify as a social rebel, and it also broadened his understanding of the human condition. His visibility as a self-identified ‘queer’ provided a model for the early 1970s American gay liberation movement. Goodman’s conservative attitudes about gender, however, also encouraged the sexism found in many 1960s American social movements.
BRAF V600E mutation independently predicts central compartment lymph node metastasis in patients with papillary thyroid cancer.

Purpose This study was designed to examine whether available preoperative clinical parameters, including B-type Raf kinase (BRAF) V600E mutation status, can identify patients at risk for central compartment lymph node metastasis (CLNM).
Complementary and Integrative Medicine in Hematologic Malignancies: Questions and Challenges

Hematologic malignancies represent 9.7% of all cancers, making them the fourth most common type of cancer in the United States. The aggressive and complex treatments administered in hematologic malignancies result in a high burden of psychological needs. Complementary and integrative medicine (CIM) is becoming one of the options that patients use to address their distress during and after cancer treatments. It is not clear whether appropriate CIM can relieve distress in patients affected by these malignancies. This review covers the potential benefits of CIM as relates to nutrition, nutritional supplements, exercise, circadian rhythm, methods for reducing distress during bone marrow aspiration, massage therapy, and acupuncture, in treating patients with hematological malignancies. This review may provide a framework to enhance patient-doctor dialogue regarding CIM use in hematologic malignancies.
Fractional models simulating non-Fickian behavior in four-stage single-well push-pull tests.

Four-stage single-well push-pull (SWPP) tracer tests, including injection, chasing, resting and pumping, were conducted in a fractured aquifer at Newark basin. An anomalous transport phenomenon observed in the SWPP tests is the linear decline of breakthrough curves (BTCs) at late time with slope of -1.8 in log-log plots. A time-dependent fractional model is developed to interpret the anomalous transport behavior. This model considers a time-dependent power-law memory function and a time-dependent fractional advection-dispersion operator. The fractional advection-dispersion equations (fADE) are solved in a radial coordinate system using the implicit Euler method. A semi-analytical solution of the first-order rate-limited mobile-immobile model (FORMIM) is derived for comparison. It is found that both the non-local transport in time and space can produce the long-tailed BTC. A smaller time-fractional or space-fractional index leads to a lower peak concentration and a larger late-time slope. The mass distribution of the fractional-in-space (FS) model exhibits power-law decline at the leading plume edge. Early breakthrough during pumping is not observed because the mobile mass at the start of pumping is nonzero and more concentrated near the wellbore. The capacity ratio is an important factor that affects the peak concentration. A larger capacity ratio leads to greater peak concentration. A smaller time-fractional index in the injection, chasing or resting stage will move the BTC downward and the slope of the late time BTC is determined by the space-fractional index over all stages and the time-fractional index in the pumping stage. The capability of the existing models to recover the BTC of the SWPP test is discussed and some guidelines for how to choose the appropriate model to interpret the SWPP test data are proposed.
Emerging Technology for Modernizing Pharmaceutical Production: Continuous Manufacturing

Abstract Over the past decade, there has been progress in the adoption of systematic science and risk approaches for pharmaceutical development, which emphasize product and process understanding, as well as control strategy. Nevertheless, available product quality data show that pharmaceutical manufacturing and its regulation, in general, are being confronted with new and increasingly complex challenges, such as unacceptably high occurrence of product recalls and drug shortages. The adoption of emerging technology is one of the key mechanisms for addressing these challenges. Continuous pharmaceutical manufacturing is an emerging technology that offers potential flexibility, quality, and economic advantages over batch processing, both in process development and manufacturing. Over the past decade, there have been significant advancements in science and engineering to support the implementation of continuous pharmaceutical manufacturing. These investments, along with the adoption of the quality-by-design paradigm for pharmaceutical development and the advancement of process analytical technology for designing, analyzing, and controlling manufacturing, have furthered the scientific and regulatory readiness for continuous manufacturing. Building on this progress, research efforts should continue in several key areas to address the remaining implementation challenges.
Effect of Alpha Tocopheryl Succinate on Cell Differentiation and Adenylate Cyclase System

Increased daily dietary intake of alpha tocopherol (vitamin E) at levels higher than Recommended Dietary Allowance (RDA) reduces the risk of animal cancer induced by tumor initiators and promoters (1–7). Two human epidemiological studies (8–9) have supported the hypothesis that there may be an inverse relationship between the vitamin E level and risk of some cancer. Additional human studies are needed to substantiate this hypothesis. Except for its function as an antioxidant (10–13), the mechanisms of its action remain largely unknown. This may have been due to the fact that the tissue culture models, which are commonly used for mechanistic studies, could not be utilized, because both alpha tocopherol and alpha tocopheryl acetate were inactive in this experimental system. Some of the earlier effects of water soluble alpha tocopherol preparations on neuroblastoma and glioma cells (14) may have been at least in part due to toxicity of solvents (15).
Effect of structural damping on the tuning between piezoelectric wafer active sensors and Lamb waves

Piezoelectric wafer active sensors have been widely used for Lamb-wave generation and acquisition. For selective preferential excitation of a certain Lamb-wave mode and rejection of other modes, th...
Optimizing Content Delivery in Wireless Networks

Wireless networks all over the world are being upgraded to support 2.5 and 3G mobile data services. GPRS and UMTS networks in Europe, and CDMA 1xRTT and CDMA 2000 networks in the USA and Asia are currently being deployed and tested to provide Wireless data services that enable ubiquitous mobile access to IP-based applications. During recent years a lot of attention has been paid to improving the physical and the MAC Wireless layers. Thus, advances in coding mechanisms, FEC, and scheduling algorithms have been critical for the success of these technologies. However, despite of the advances in layer-2 techniques and the momentum behind these networks, surprisingly little attention has been paid to evaluating how efficient content delivery can be achieved over cellular networks and how the different protocol stacks interact with the Wireless bearer.
Introduction to Multiple-Wavelength Spectrophotometric Measurements in Analytical and Clinical Chemistry

Spectrophotometry continues to be very important in analytical chemistry and is the single most important detection system in the clinical laboratory. Even recent clinical laboratory advances in high-pressure liquid chromatography and enzyme-linked immunochemistry depend on spectrophotometric measurements. Although measurements made at a single wavelength are most common, multiple-wavelength analyses are growing in importance and add to the capabilities of the modern laboratory. Multiple wavelength spectrophotometry has been used to measure multiple components in a complex mixture, to correct for interferences, and to increase sensitivity. Examples of these applications will be discussed individually with special reference to their relevance in clinical chemistry. These general principles will serve as an introduction to the three following contributions which describe commercial applications of multiple-wavelength spectrophotometry in the clinical chemistry laboratory. This chapter is not intended to be an exhaustive review, but to provide the reader with general insight into clinical chemistry applications and a bibliography to guide further study. Two recent reviews(1,2) are suggested for additional background.
Dexmedetomidine for Sedation of Neonates with HIE Undergoing Therapeutic Hypothermia: A Single-Center Experience

Hypoxic-ischemic encephalopathy (HIE) is a significant cause of morbidity and mortality in neonates. Therapeutic hypothermia reduces the risk of death or disability. Providing optimal sedation while neonates are undergoing therapeutic hypothermia is likely beneficial but may present therapeutic challenges. There are limited data describing the use of dexmedetomidine for sedation in patients undergoing therapeutic hypothermia. The objective of this study is to evaluate the efficacy and short-term safety of dexmedetomidine infusion for sedation in term neonates undergoing therapeutic hypothermia for HIE.
UAV Based Wireless Charging of Sensor Networks Without Prior Knowledge

Unmanned Aerial Vehicles (UAVs) can charge Wireless Rechargeable Sensor Networks (WRSNs) in remote or hard to access locations. However, the charging efficiency is heavily affected by the distance between the wireless transmitter and receiver. This efficiency impacts the possible power level increase of each charged node. Most charging algorithms require full knowledge of sensor nodes' power levels to identify the nodes to charge. Collecting this power information adds overhead to the network and limits scalability. We propose and implement Charging with Power Transfer Efficiency Compensation (CPTEC), an algorithm that charges a WRSN without the need for a priori knowledge of the nodes' power levels. We show that CPTEC compensates for efficiency drops, due to landing alignments, making it practical for real-world power transfer scenarios. Our results show that CPTEC is able to perform with a median at ≈ 72% of the optimal performance of a full knowledge algorithm that assumes maximum power transfer efficiency, while other work drops to ≈ 22%. Under constant maximum efficiency CPTEC performs ≈ 90% of the optimal full knowledge case.
Three Hfq-dependent small RNAs regulate flagellar motility in the fire blight pathogen Erwinia amylovora

Erwinia amylovora, the causative agent of fire blight disease of apple and pear trees, causes disease on flowers by invading natural openings at the base of the floral cup. To reach these openings, the bacteria use flagellar motility to swim from stigma tips to the hypanthium and through nectar. We have previously shown that the Hfq-dependent sRNAs ArcZ, OmrAB and RmaA regulate swimming motility in E. amylovora. Here, we tested these three sRNAs to determine at what regulatory level they exert their effects and to what extent they can complement each other. We found that ArcZ and OmrAB repress the flagellar master regulator flhD post-transcriptionally. We also found that ArcZ and RmaA positively regulate flhD at the transcriptional level. The role of ArcZ as an activator of flagellar motility appears to be unique to E. amylovora and may have recently evolved. Our results suggest that the Hfq-dependent sRNAs ArcZ, OmrAB and RmaA play an integral role in regulation of flagellar motility by acting primarily on the master regulator, FlhD, but also through additional factors.
Signal Enhancement in MEM Resonant Sensors Using Parametric Suppression

We use parametric suppression for signal amplifi-cation in a phase-modulated microelectromechanical (MEM) charge detector. Simultaneously driving and parametrically pumping a MEM resonator with the appropriate relative phase increases the phase slope near the resonant frequency. We use this to increase the sensitivity of a MEM electrometer more than tenfold.
Case Report of Intractable Vomiting and Abdominal Pain Related to Heavy Daily Cannabis Use.

Case A highly anxious and dehydrated adolescent came to a local emergency department with complaints of intractable emesis, weight loss, and abdominal pain. He stated that bathing and "guzzling water" ameliorated symptoms. He admitted to using marijuana socially. Efforts at palliation with benzodiazepines, atypical antipsychotics, and antiemetic medications were unable to soothe the patient. After thorough initial diagnostics and physical exam failed to elucidate etiology, the patient was referred to an inpatient psychiatric facility for further evaluation of potential psychosomatic or affective causes. During psychiatric evaluation and upon obtaining additional information from family and reviewing the work done by primary care providers, the patient was questioned stringently about his marijuana use patterns. Questioning revealed that the patient had previous chemical dependency treatment, legal charges related to drug use, and heavy daily marijuana use including "dabbing," ingestion of THC candy, and smoking up to several grams a day. Discussion Cannabinoid hyperemesis syndrome (CHS) consists of intractable emesis, abdominal pain, and weight loss. There is often a history of symptom amelioration with bathing and showering. These patients may or may not admit to heavy marijuana use. Cannabis effects vary and are dose dependent. Historically, CHS would require over a year of heavy daily use. In this day and age of higher THC potency marijuana and even higher THC potency "dabs," it is anticipated that more cases of cannabis related syndromes in general, and CHS in particular will be presenting more frequently to ambulatory and emergency room settings. The patients will potentially be younger and have a shorter duration of heavy cannabis use before symptoms start. A high index of suspicion will be required to prevent expensive and potentially invasive workups and thus delaying diagnosis and treatment.
Exploring the Social Determinants of Drinking Sugary Beverages Leading to Chronic Illness Among Latina/o Populations.

Introduction:The aim of this qualitative study was to assess Latina/o students’ sugary drink consumption patterns and understand the social determinants leading to this consumption behavior in orde...
Countering Data and Control Plane Attack On OLSR Using Passive Neighbor Policing and Inconsistency Identification

In this paper, we perform a comprehensive analysis on different types of blackhole attacks on MANETs and investigate the impact of these attacks on both Data and Control planes of the OLSR routing protocol. Our proposed models called Neighbor Watch Model (NWM) and Inconsistency Measurement Model (IMM), empowers each node to depend on itself to identify and isolate malicious nodes. We utilized the concept of passive neighbor watching (local vigilance) for NWM and introduced inconsistency identification mechanism for IMM. We design two different versions of both model, namely Local-NWM/IMM and Global-NWM/IMM, and utilize them against five major blackhole attack scenarios possible in a MANET with OLSR as the routing protocol. Our model reduces the impact of malicious nodes in the network and identifies/isolates such nodes by feeding correct link state information to OLSR continuously, without introducing any redundancy. We evaluate the performance of our models by emulating network scenarios in Common Open Research Emulator (CORE) for static as well as dynamic topologies. From our findings, it is observed that both proposed models greatly mitigate the impact of data and control blackhole attacks under all attack scenarios and improves the packet delivery performance of OLSR. Global-NWM/IMM performs much better than Local-NWM/IMM, but requires some modifications to OLSR.
Associations of Vestibular Tests With Penn Acoustic Neuroma Quality of Life Scores After Resection of Vestibular Schwannoma.

OBJECTIVE Determine associations between preoperative caloric testing and video head impulse testing (vHIT) with baseline and postoperative Penn Acoustic Neuroma Quality of Life (PANQOL) scores following resection of vestibular schwannoma (VS). STUDY DESIGN Retrospective case series. SETTING Two tertiary referral hospitals. PATIENTS Adult patients with unilateral VS, preoperative calorics, vHIT, and dizziness handicap inventory (DHI) score. INTERVENTIONS Surgical resection of VS and postoperative surveys. MAIN OUTCOME MEASURES PANQOL scores. RESULTS Forty-three patients were included (58.1% women) with a median age of 54 years (range, 28-82). Mean tumor size was 14.8 mm (σ=8.6), and 28 (65.1%) were right-sided. Average preoperative vHIT gain was 0.7 (σ = 0.3). Covert and overt saccades were present in 8 (25%) and 14 (42.4%) patients, respectively. Average preoperative unilateral weakness was 47% (σ = 33.2). Translabyrinthine approach was performed in 26 (60.5%) patients. No significant difference of PANQOL scores was noted at baseline or over time between patients with normal (>0.8) or abnormal ( 50%) had significantly higher baseline PANQOL scores compared with those with < 25% or 25 to 50% (p = 0.02), but had significant improvement in scores over time (p = 0.01). Higher preoperative DHI preoperatively was significantly associated with worse PANQOL scores at all timepoints (β=0.57, p = 0.0064). No differences in PANQOL scores amongst surgical approaches were observed. CONCLUSION Preoperative vestibular testing with vHIT, calorics, DHI, and baseline PANQOL surveys may allow for patient counseling regarding postoperative quality of life over time.
Skin-conformal, soft material-enabled bioelectronic system with minimized motion artifacts for reliable health and performance monitoring of athletes

Recent advances in biosensors, bioelectronics, and system integration allow the development of wristband-type devices for health and performance monitoring of athletes. Although these devices provide adequate sensing outputs, they suffer from signal loss due to improper contact of a rigid sensor with the skin. In addition, when a rubber band tightly secures the sensor to the skin, the gap between sensor and skin causes inevitable motion artifacts, resulting in corrupted data. Consequently, the rigidity and bulky form factor of the existing devices are not suitable for a practical use since athletes typically go through strenuous activities during training and matches. Here, we introduce a soft, wearable flexible hybrid electronics (WFHE) with integrated flexible sensors and circuits in an ultrathin, low-modulus elastomer. The thin-film bioelectronic system avoids the use of bulky, rigid sensors, while providing negligible mechanical and thermal burdens to the wearer. Enabling conformal contact between sensor and skin minimizes undesired motion artifacts. A set of computational and experimental studies of soft materials, flexible mechanics, and system packaging provides key fundamental design factors for a comfortable, reliable, waterproof bioelectronic system. Skin conformal WFHE with sparse signal reconstruction enables reliable, continuous monitoring of photoplethysmogram, heart rate, and activities of athletes. Development of a quantitative analysis between impact force and impact velocity extracted from motion acceleration provides an objective assessment of an athletic punching force. Collectively, this study shows the first demonstration of a wireless, soft, thin-film electronics for a real-time, reliable assessment of athletic health and performance.
Medication Discrepancies in Older Veterans Receiving Home Healthcare

In a prospective cohort study of Veterans and community health nurses, we enrolled hospitalized older Veterans referred to home care for skilled nursing and/or physical or occupational therapy for posthospitalization care. We assessed preadmission activities of daily living and instrumental activities of daily living, health literacy, numeracy, and cognition. Postdischarge phone calls identified medication errors and medication reconciliation efforts by home healthcare clinicians. Veterans Administration-based community health nurses completed surveys about content and timing of postdischarge interactions with home healthcare clinicians. We determined the types and frequency of medication errors among older Veterans receiving home healthcare, patient-provider communication patterns in this setting, and patient characteristics affecting medication error rates. Most Veterans (24/30, 80%) had at least one discordant medication, and only one noted that errors were identified and resolved. Veterans were asked about medications in the home healthcare setting, but far fewer were questioned about medication-taking details, adherence, and as-needed or nonoral medications. Higher numeracy was associated with fewer errors. Veterans Administration community health nurses reported contact by home healthcare clinicians in 41% of cases (7/17). Given the high rate of medication errors discovered, future work should focus on implementing best practices for medication review in this setting, as well as documenting barriers/facilitators of patient-provider communication.