cssi/SciSciGPT-SciSciNet huggingface dataset:
51. Stumpfe Herztraumen

Bei der Behandlung von stumpftraumatischen Herzschadigungen hat sich bei uns folgender Behandlungsplan bewahrt:
Calendar-Based Rising Time Schemes

This chapter presents a previously unknown form of rising time scheme which is founded upon the calendar. Three cuneiform texts whose contents were not previously understood are shown to contain a rising time scheme which relates culminating points at or behind ziqpu stars with sunrise and sunset on day 15 of months in the schematic 360-day calendar. The underlying rising time scheme is fully reconstructed and shown to be founded on the assumption from MUL.APIN that the solstices and equinoxes take place on the 15th day of Months I, IV, VII and X in the schematic calendar. Finally, a previously misunderstood text is shown to contain an extension of the monthly scheme to give the culminating points at sunrise and sunset on every day of the schematic year.
Cyclic sieving for two families of non-crossing graphs

We prove the cyclic sieving phenomenon for non-crossing forests and non-crossing graphs. More precisely, the cyclic group acts on these graphs naturally by rotation and we show that the orbit structure of this action is encoded by certain polynomials. Our results confirm two conjectures of Alan Guo.
Risk of axillary node metastasis in Paget disease with invasive ductal carcinoma.

1054 Background: Paget disease of the nipple is a rare manifestation of breast cancer that is associated with underlying invasive ductal carcinoma in approximately 60% of cases. The underlying path...
Five hacks for digital democracy.

Beth Simone Noveck urges researchers to work out how technology can improve public institutions.
Next-generation sequencing in non-muscle-invasive bladder cancer—a step towards personalized medicine for a superficial bladder tumor

Urothelial bladder cancer is the most common cancer of the urinary system. Exposure to toxins and carcinogens from urine plays an essential role in the pathogenesis of this disease.
Average element pattern for a three dimensional array

With 5G communication technology on the horizon, the number of wireless elements that can be connected to a single base station is going to be increased. This increase in the number of wireless elements means that there is increased density in elements which could allow antenna arrays to be created. These wireless elements will be randomly scattered in three dimensions and there is currently not a method to optimize this scenario into a coherent array system. One advance needed to allow for the optimization for a three dimensional array is determining ways to understand and deal with the effects of the mutual coupling between elements in three dimensions. This paper discusses the method needed to find an average active element pattern by following two basic steps.
Effects of a PICU Status Asthmaticus De-Escalation Pathway on Length of Stay and Albuterol Use.

Objectives Evaluate the effects of an asthma de-escalation clinical pathway on selected outcomes for patients admitted to a PICU with status asthmaticus. Design Time series quality improvement trial. Setting PICU in a tertiary care children's hospital. Patients Children age 2-18 years old with a known diagnosis of asthma presenting with status asthmaticus. Intervention One-hundred five admissions to a PICU for status asthmaticus were treated according to a new de-escalation pathway between August 15, 2015, and August 30, 2016. This group was compared with a prepathway group of 141. Measurements and main results Primary outcome was variability in PICU length of stay. Secondary outcomes were median PICU length of stay, median hospital length of stay, and median duration a patient received continuous nebulized albuterol. The effectiveness of the intervention was tracked using control charts. The postpathway group demonstrated decreased variability of PICU length of stay and time receiving continuous albuterol. Statistically significant decreases were seen in median PICU length of stay (16 vs 13 hr; p = 0.0009), median duration a child spent receiving continuous nebulized albuterol (10.8 vs 7.3 hr; p = 0.0008), and median hospital length of stay (37 vs 31 hr; p = 0.02). Total number of asthma assessments completed by respiratory therapists increased from 741 to 1,087. Conclusions Implementation of a PICU asthma de-escalation pathway demonstrated statistical decrease in the reported measures for children with status asthmaticus. Although the clinical significance of these changes may be debatable, the results demonstrate that efforts to standardize asthma care in the PICU setting is an area in need of further study.
Segmentation of Shapes

An algorithm for segmenting 2D shapes into parts is described. The segmentation is constructed from the local symmetry axes of the shape. The local symmetry axes are determined by analyzing the local symmetries of the level curves of a function which is the solution of an elliptic PDE. The segmentation has the structure of a directed graph. The shapes need not be presmoothed and the algorithm may be applied to a complex scene consisting of many objects.
Psychological Interventions in Childhood Chronic Illness

Children and adolescents with chronic illnesses face extraordinary psychological stressors, which often occur alongside or because of burdensome medical treatment regimens. Illness-related pressure and worry plague family members as well. These children and families need psychological support to help them comply with doctors' orders and to cope with issues such as restricted physical activity, frequent absences from school, and social problems. This book is designed to advance scientific understanding of interventions that promote psychological adaptation and adherence to treatment for children and adolescents with chronic health conditions. Throughout the book, key research findings concerning illness management, reducing noncompliance, and improving psychological outcomes are brought to light. The author lays out research priorities and discusses clinical applications that integrate research into practice. Psychologists who provide clinical care in pediatric settings will learn about new interventions that can be tailored to the individual needs of children and families coping with asthma, diabetes, cancer, sickle-cell anemia, arthritis, and cystic fibrosis. Researchers will find guidance on the design, methodology, measurement, and ethics of testing interventions with children and families.
FOURIER DESCRIPTOR CLASSIFICATION OF MAGNETITE BUILDUP IN PWR STEAM GENERATORS.

Emphasis on the reliability and safety of nuclear power plants has contributed to a growing interest in the development of rigorous preventive maintenance schemes. A major part of the effort has been directed at methods of inspecting steam generators in as much as they serve as a crucial link in the transfer of power from the nuclear reactor to the steam turbine. Steam generators typically consist of Inconel tubes anchored at intervals with carbon steel support plates as shown in figure 1. The primary coolant from the nuclear reactor circulates through these tubes. Heat is transfered to the secondary coolant by conduction through the tube wall generating steam which is used for running the turbine.
On the absolute center of a set in an edge

In this paper a generalization of the one-center problem is made by defining the center of an arbitrary set of points in a set. Necessary and sufficient conditions are obtained for a point to be a center of a set in an edge of the network.
Toward a Dual-Motive Depth Psychology of Self and Social Behavior

Motivational constructs involving the defense and enrichment of the self have been employed either separately or in combination in a wide variety of analyses of human behavior throughout the history of psychology. Whereas the defensive orientation has traditionally been the domain of psychoanalytical theorists, the growth orientation has been espoused most prominently by proponents of humanistic psychology. Interestingly, there currently seems to be a resurgence in analyses relying on these two distinct types of motives in contemporary academic psychology. Although our own terror management theory and research focuses exclusively on defensive motivation, we recognize that defensive concerns are not the only forces impinging on human behavior. The primary purpose of this chapter is therefore to expand our conceptualization to consider the role of growth and enrichment motives in human behavior and to explore the interplay of such motives with the defensive terror management motives that have been the focus of our previous work. Consideration of these motive systems in tandem will ultimately produce a richer, more balanced, and more complete understanding of human behavior than could be provided by exclusive reliance on terror management theory in its original form. In the following pages, we present a theoretical and empirical overview of terror management theory, a conceptualization of the nature and functioning of a separate growth-oriented enrichment motive system, and a consideration of the interplay between the two systems.
The bismuth tetramer Bi4: the ν3 key to experimental observation.

The spectroscopic identification of Bi4 has been very elusive. Two constitutional Bi4 isomers of Td and C2v symmetry are investigated and each is found to be a local energetic minimum. The optimized geometries and vibrational frequencies of these two isomers are obtained at the CCSD(T)/cc-pVQZ-PP level of theory, utilizing the Stoll, Metz, and Dolg 60-electron effective core potential. The fundamental frequencies of the Td isomer are obtained at the same level of theory. The focal point analysis method, from a maximum basis set of cc-pV5Z-PP, and proceeding to a maximum correlation method of CCSDTQ, was employed to determine the dissociation energy of Bi4 (Td) into two Bi2 and the adiabatic energy difference between the C2v and Td isomers of Bi4. These quantities are predicted to be +65 kcal mol−1 and +39 kcal mol−1, respectively. Two electron vertical excitation energies between the Td and C2v electronic configurations are computed to be 156 kcal mol−1 for the Td isomer and 9 kcal mol−1 for the C2v isomer. The most probable approach to laboratory spectroscopic identification of Bi4 is via an infrared spectrum. The predicted fundamentals (cm−1) with harmonic IR intensities in parentheses (km mol−1) are 94(0), 123(0.23), and 167(0) for the Td isomer. The moderate IR intensity for the only allowed fundamental may explain why Bi4 has yet to be observed. Through natural bond orbital analysis, the C2v isomer of Bi4 was discovered to exhibit “long-bonding” between the furthest apart ‘wing’ atoms. This long-bonding is postulated to be facilitated by the σ-bonding orbital between the ‘spine’ atoms of the C2v isomer.
Next-Generation Tools to Study Autonomic Regulation In Vivo

The recent development of tools to decipher the intricacies of neural networks has improved our understanding of brain function. Optogenetics allows one to assess the direct outcome of activating a genetically-distinct population of neurons. Neurons are tagged with light-sensitive channels followed by photo-activation with an appropriate wavelength of light to functionally activate or silence them, resulting in quantifiable changes in the periphery. Capturing and manipulating activated neuron ensembles, is a recently-designed technique to permanently label activated neurons responsible for a physiological function and manipulate them. On the other hand, neurons can be transfected with genetically-encoded Ca2+ indicators to capture the interplay between them that modulates autonomic end-points or somatic behavior. These techniques work with millisecond temporal precision. In addition, neurons can be manipulated chronically to simulate physiological aberrations by transfecting designer G-protein-coupled receptors exclusively activated by designer drugs. In this review, we elaborate on the fundamental concepts and applications of these techniques in research.
Pancreaticopleural Fistula: A Rare Presentation and a Rare Complication

Pancreaticopleural fistula (PPF) is a rare complication of pancreatitis that requires a high index of clinical suspicion as patients typically present with pulmonary symptoms related to the pleural effusion rather than pancreatitis. Diagnosis is made by detection of amylase in the pleural fluid. Magnetic resonance cholangiopancreatography can aid in visualizing the fistula. We present a case of massive left pleural effusion secondary to a PPF due to acute on chronic pancreatitis.
A temperature-programmed desorption study of NO on Rh particles supported on α-Al2O3 {0001}

Abstract The adsorption and dissociation of NO on Rh α- Al 2 O 3 {0001} was studied as a function of Rh particle size using temperature-programmed desorption (TPD). Samples were prepared by vapor depositing varying amounts of Rh onto the sapphire crystal at 300 K. Auger electron spectroscopy indicated that the Rh formed three-dimensional particles under these conditions, and an average Rh particle diameter was estimated from the CO adsorption uptake and the amount of metal deposited. On particles larger than 5 nm, the TPD results were essentially identical to those for Rh(111) and Rh(110), with approximately 60 to 80% of the NO dissociating. Molecular NO desorbed in a peak centered at 440 K, and N2 desorbed in peaks at 460, 550, and above 600 K. For smaller Rh particles, the molecular desorption peaks and the fraction of NO dissociating remained unaffected; however, significant changes were observed in the N2 desorption features. The N2 feature at 460 K, which has been assigned to a reaction between NO and N atoms, disappears for very small particles and the N atom recombination peak at 550 K shifts above 600 K. By comparing these results to those obtained for various single crystals, we conclude that changes observed with particle size are related to site geometry; however, the desorption rates from small particles cannot be considered to be a simple sum of the rates for different single crystals. It is shown that these changes in the N2 desorption rates with particle size may be responsible for observed structure sensitivity in NO reduction by CO.
Impact of a Hands-on Knee Exam Workshop on Medical Student Clinical Examination Scores.

Introduction The goal of this research project was to retrospectively evaluate the effect of a voluntary hands-on musculoskeletal knee exam workshop, presented to medical students in the family medicine rotation at the University of Toledo, on the outcomes of a required objective structured clinical examination (OSCE). Methods We analyzed student OSCE scores for both knee and back exams before (July 2011 to June 2012) and after (August 2013 to June 2015) the workshop was offered. The analysis was based on those who attended the voluntary knee exam workshop and those who did not. We compared scores between the two groups of students using two-tailed t testing and χ2 testing, and assessed the correlation of attending the workshop to passing the knee OSCE. Results One hundred eighty-seven students attended the workshop and 279 did not. During the period when the workshop was offered, the overall mean score on the knee OSCE was 59.5% for the 187 who attended the workshop and 35.9% for the 116 who did not, which was significantly different (P<.001). A χ2 test with α=0.05 showed that attending the workshop correlated with completing at least 70% of maneuvers acceptably during the knee OSCE (P<.001). Conclusions Our study yielded positive outcomes on OSCE scores, comparable to other studies that investigated the effect of similar teaching techniques. Comparison of the scores of those who attended the knee workshop on the simpler back exam OSCE, in which no workshop was offered, demonstrated the efficacy of the workshop.
Biological Ice-Nucleating Particles Deposited Year-Round in Subtropical Precipitation

ABSTRACT Airborne bacteria that nucleate ice at relatively warm temperatures (>−10°C) can interact with cloud water droplets, affecting the formation of ice in clouds and the residency time of the cells in the atmosphere. We sampled 65 precipitation events in southeastern Louisiana over 2 years to examine the effect of season, meteorological conditions, storm type, and ecoregion source on the concentration and type of ice-nucleating particles (INPs) deposited. INPs sensitive to heat treatment were inferred to be biological in origin, and the highest concentrations of biological INPs (∼16,000 INPs liter−1 active at ≥–10°C) were observed in snow and sleet samples from wintertime nimbostratus clouds with cloud top temperatures as warm as –7°C. Statistical analysis revealed three temperature classes of biological INPs (INPs active from −5 to –10°C, −11 to –12°C, and −13 to –14°C) and one temperature class of INPs that were sensitive to lysozyme (i.e., bacterial INPs, active from −5 to –10°C). Significant correlations between the INP data and abundances of taxa in the Bacteroidetes, Firmicutes, and unclassified bacterial divisions implied that certain members of these phyla may possess the ice nucleation phenotype. The interrelation between the INP classes and fluorescent dissolved organic matter, major ion concentrations (Na+, Cl−, SO42−, and NO3−), and backward air mass trajectories indicated that the highest concentrations of INPs were sourced from high-latitude North American and Asian continental environments, whereas the lowest values were observed when air was sourced from marine ecoregions. The intra- and extracontinental regions identified as sources of biological INPs in precipitation deposited in the southeastern United States suggests that these bioaerosols can disperse and affect meteorological conditions thousands of kilometers from their terrestrial points of origin. IMPORTANCE The particles most effective at inducing the freezing of water in the atmosphere are microbiological in origin; however, information on the species harboring this phenotype, their environmental distribution, and ecological sources are very limited. Analysis of precipitation collected over 2 years in Louisiana showed that INPs active at the warmest temperatures were sourced from terrestrial ecosystems and displayed behaviors that implicated specific bacterial taxa as the source of the ice nucleation activity. The abundance of biological INPs was highest in precipitation from winter storms and implied that their in-cloud concentrations were sufficient to affect the formation of ice and precipitation in nimbostratus clouds.
Wet chemical etching of cadmium telluride photovoltaics for enhanced open-circuit voltage, fill factor, and power conversion efficiency

Cadmium telluride (CdTe) is one of the leading photovoltaic technologies with a market share of around 5%. However, there still exist challenges to fabricate a rear contact for efficient transport of photogenerated holes. Here, etching effects of various iodine compounds including elemental iodine (I2), ammonium iodide (NH4I), mixture of elemental iodine and NH4I (I−/I3− etching), and formamidinium iodide were investigated. The treated CdTe surfaces were investigated using Raman spectroscopy, X-ray diffraction (XRD), scanning electron microscopy, and energy-dispersive X-ray spectroscopy. The CdTe devices were completed with or without treatments and tested under simulated AM1.5G solar spectrum to find photoconversion efficiency (PCE). Based on Raman spectra, XRD patterns, and surface morphology, it was shown that treatment with iodine compounds produced Te-rich surface on CdTe films, and temperature-dependent current–voltage characteristics showed reduced back barrier heights, which are essential for the formation of ohmic contact and reduce contact resistance. Based on current–voltage characteristics, the treatment enhanced open-circuit voltage (VOC) up to 841 mV, fill factor (FF) up to 78.2%, and PCE up to 14.0% compared with standard untreated CdTe devices (VOC ∼ 814 mV, FF ∼ 74%, and PCE ∼ 12.7%) with copper/gold back contact.
Ugandan Jajjas: Antecedents and rewards of caring for grandchildren in the context of HIV

AIMS AND OBJECTIVES The findings presented in this manuscript address two key research questions: (a) What factors contribute to the initiation and maintenance of the caregiving role as performed by the grandparent-caregivers; and (b) What are the perceived benefits of caregiving as reported by grandparent-caregivers? BACKGROUND Grandparents in sub-Saharan Africa have cared for their grandchildren for generations, yet little is known about this role in the context of the HIV epidemic. Although the impact of the epidemic is overwhelmingly negative, specifically in Uganda, knowledge of familial context and underlying motivations and rewards that incentivise grandparent-caregivers remains limited in the literature. METHODS Using a constructivist grounded theory approach, we explored the experiences of 32 Ugandan grandparents of grandchildren affected by HIV. Data were collected using a semi-structured and open-ended interview guide, participant observation and fieldnotes. Data analysis included open, focused and axial coding. FINDINGS The data revealed the influences of extended familial structures and of cultural and gender expectations on the decision-making processes and rewards of caregiving as perceived by the grandparent-caregivers. DISCUSSION AND RECOMMENDATION These findings provide a broad foundation for policy, practice, research and education interventions needed to support grandparents so they can enjoy the benefits of raising their grandchildren. IMPLICATIONS FOR PRACTICE Our findings can guide education programs and clinical practice for nurses, nursing students, and other health providers on cultural considerations for holistic care provided for older adults-especially older caregivers.
Hardware-in-the-Loop CPS Security Architecture for DER Monitoring and Control Applications

Deeper penetration of interoperable cyber-physical distributed energy resources (DER) and their utility-wide remote monitoring and control drastically increases cybersecurity attack surface. Utilities require to adopt the DER interconnection and communication standards to a range of autonomous, advanced and curve-based grid-support functions to securely monitor and control DER devices for ensuring power quality, voltage, and system frequency. In this paper, we present DER monitoring and control (DERMC) cyber-physical system (CPS) architecture including standard communication protocols such as IEEE 2030.5 [1] and discuss various stealthy cyber attack vectors that affect communications and operations of DER. We propose a hardware-in-the-loop (HIL) CPS security architecture and testbed design with industry-grade software and hardware systems and a real-time digital simulator for high-fidelity grid impact characteristic analysis against cyber attack vectors. We use the testbed to demonstrate impact characteristics for modified IEEE 13 bus system including 11 solar photovoltaic units. The experiments demonstrated significant results by 100% real-time performance and zero overruns.
Sex-Specific Effects of the Nlrp3 Inflammasome on Atherogenesis in LDL Receptor-Deficient Mice.

Highlights •In this study we observed sex-specific effects of the NLRP3 inflammasome on atherogenesis in LDLR-deficient mice, with NLRP3 inflammasome playing a more prominent role in atherosclerosis in female mice than in males. •Sex hormones may be involved in NLRP3 inflammasome–mediated atherogenesis and may underlie differential responses to anti-NLRP3 therapy between males and females. •Testosterone may play an inhibitory role by blocking NLRP3 inflammasome and inflammation in atherogenesis, whereas female sex hormones may promote NLRP3 inflammasome–mediated atherosclerosis. •The results of the present study may help design future clinical trials, with the objective to personalize cardiovascular care for men and women.
Digilantism, discrimination, and punitive attitudes: A digital vigilantism model:

In this article, I propose and apply a digital vigilantism model to a specific incident that occurred in Mexico, where the death of two innocent people was filmed through Facebook Live. Using a mix...
Reflections on the Doctrinal and Big-Picture IssuesRaised by the Constitutional Challenges to the PatientProtection and Affordable Care Act (Obamacare)

The challenges to the federal healthcare statute enacted last year, the Patient Protection and Affordable Care Act (PPACA or Act), that are currently winding their way through the federal courts — and the few decisions that have embraced these challenges so far — appear to suffer from a problematic blend of doctrinal hypertechnicality, theoretical imprecision, and (understandable but misplaced) fear of an all-powerful Congress. None of this is to say it will be impossible for any of these challenges ultimately to succeed. Instead, it is to say that any such success would either be revolutionary (in the way that Justice Clarence Thomas’ desire to return to nineteenth century cases concerning the scope of federal power would, if implemented, completely upend the current constitutional convention), or it would be tailored to reach a particular result on a particular contentious issue (in the way Bush v. Gore is viewed by many as a ruling good for only one day and one election). To date, the prominent challenges to the PPACA sound, as a matter of law if not political rhetoric, in federalism rather than a rights-based libertarianism. As anyone following these litigations knows, the focal point for the constitutional attacks has been the so-
A Systematic Review Supporting the Society for Vascular Surgery Guidelines on the Management of Carotid Artery Disease

ABSTRACT Background To support the development of guidelines on the management of carotid disease, a writing committee from the Society for Vascular Surgery has commissioned this systematic review. Methods We searched multiple data bases for studies addressing 5 questions: medical management vs. carotid revascularization (CEA) in asymptomatic patients, CEA vs. CAS in symptomatic low surgical risk patients, the optimal timing of revascularization after acute stroke, screening high risk patients for carotid disease, and the optimal sequence of interventions in patients with combined coronary and carotid disease. Studies were selected and appraised by pairs of independent reviewers. Meta-analyses were performed when feasible. Results Medical management compared to carotid interventions in asymptomatic patients was associated with better early outcome during the first 30 days. However, CEA was associated with significantly lower long-term rate of stroke/death at 5 years. In symptomatic low risk surgical patients, CEA was associated with lower risk of stroke, but a significant increase in MI compared to CAS during the first 30 days. When the long-term outcome of transfemoral CAS vs. CEA in symptomatic patients were examined using pre-planned pooled analysis of individual patient data from four randomized trials, the risk of death or stroke within 120 days of the index procedure was 5.5% for CEA and 8.7% for CAS, which lends support that over the long-term, CEA has superior outcome than transfemoral CAS. When managing acute stroke, the comparison of CEA during the first 48 hours to that between day 2 and day14 did not reveal a statistically significant difference on outcomes during the first 30 days. Registry data show good results with CEA performed in the first week, but not within the first 48 hours. A single risk factor, aside from PAD, was associated with low carotid screening yield. Multiple risk factors greatly increase the yield of screening. Evidence on the timing of interventions in patients with combined carotid and coronary disease was sparse and imprecise. Patients without carotid symptoms, who had the carotid intervention first, compared to a combined carotid intervention and CABG, had better outcomes. Conclusions This updated evidence summary will support the SVS clinical practice guidelines for commonly raised clinical scenarios. CEA was superior to medical therapy in long-term prevention of stroke/death over medical therapy. CEA was also superior to transfemoral CAS in minimizing long-term stroke/death for symptomatic low risk surgical patients. CEA should optimally be performed between 2-14 days from the onset of acute stroke. Having multiple risk factors increases the value of carotid screening.
Socioeconomic impact of the conservation reserve program in North Dakota

Abstract The short‐run economic impacts of the Conservation Reserve Program (CRP) in North Dakota are estimated by using an input‐output model together with results from a statewide survey of CRP participants. Net direct reductions in production expenditures and household income resulting from the program totaled $55 million, with about 62 percent of the effect occurring in the retail sector. The total impact of the program is about $141 million, or only about 0.5 percent of the state's baseline economic activity. Local areas with high concentration of CRP land and businesses that depend heavily on farm input sales may be affected disproportionately.
Preoperative opioid usage predicts markedly inferior outcomes 2 years after reverse total shoulder arthroplasty.

BACKGROUND Reverse total shoulder arthroplasty (RTSA) has proved to be a highly effective treatment for rotator cuff-deficient conditions and other end-stage shoulder pathologies. With value-based care emerging, identifying predictive factors of outcomes is of great interest. Although preoperative opioid use has been shown to predict inferior outcomes after anatomic total shoulder arthroplasty and rotator cuff repair, there is a paucity of data regarding its effect on outcomes after RTSA. We analyzed a series of RTSAs to determine the influence of preoperative opioid use on clinical and radiographic outcomes at a minimum of 2 years' follow-up. METHODS A retrospective review of primary RTSA patient data revealed 264 patients with ≥2 years of clinical and radiographic follow-up. Patients were classified as preoperative opioid users (71 patients) if they had taken narcotic pain medication for a minimum of 3 months prior to surgery or as opioid naive (193 patients) at the time of surgery. Assessments included preoperative and postoperative visual analog scale pain scores, American Shoulder and Elbow Surgeons scores, strength, and range of motion, as well as complications and revisions. Radiographs were analyzed for signs of loosening or mechanical failure. The Mann-Whitney U and Fisher exact tests were used for comparisons between groups. Statistical significance was set at P < .05. RESULTS The mean patient age was 69.9 years, and the mean follow-up time was 2.8 years. Opioid users were significantly younger (66.1 years vs. 70.7 years, P < .001) at the time of surgery and had significantly higher preoperative rates of mood disorders, chronic pain disorders, and disability status (all P < .05). Postoperatively, opioid users had inferior visual analog scale pain scores (2.59 vs. 1.25, P < .001), American Shoulder and Elbow Surgeons scores (63.2 vs. 75.2, P < .001), active forward elevation (P < .001), and internal and external rotational shoulder strength (all P < .05) compared with opioid-naive patients. Periprosthetic radiolucency (8.45% vs. 2.07%, P = .026) and subsequent revision arthroplasty (14.1% vs. 4.66%, P = .014) occurred more frequently in opioid users than in opioid-naive patients. Both groups improved from baseline preoperatively to most recent follow-up in terms of functional outcomes and pain. CONCLUSION Preoperative opioid use portended markedly inferior clinical outcomes in patients undergoing RTSA. Additionally, opioid users had significantly increased rates of periprosthetic radiolucency and revision. Preoperative opioid use appears to be a significant marker for adverse outcomes after RTSA.
Sustained reduction of discharge opioid prescriptions in an enhanced recovery after thoracic surgery program: A multilevel generalized linear model.

Abstract Background Enhanced Recovery After Surgery programs have been shown to effectively reduce opioid prescriptions at discharge after their implementation in several institutions, but little is known regarding the sustainability of this effect. Understanding opioid prescribing patterns after long-term implementation of Enhanced Recovery After Surgery initiatives may help guide further opioid prescription reduction and improvements. Our group aimed to determine whether reductions in opioid prescriptions at discharge are sustained in an Enhanced Recovery After Surgery program for thoracic surgery. Methods This retrospective cohort included 2,081 patients undergoing thoracic surgery within a 4-year Enhanced Recovery After Surgery program from March 2016 through April 2020. Our Enhanced Recovery After Surgery protocol included a standardized multimodal analgesic regimen (ie, preoperative gabapentin, tramadol, intercostal nerve block with liposomal bupivacaine, and intraoperative acetaminophen, and ketorolac) and the rest of the interventions recommended by the Enhanced Recovery After Surgery society guidelines. Our primary outcomes were the presence of opioid prescriptions at discharge (hydrocodone, hydromorphone, and oxycodone) and the total opioid amount prescribed (morphine equivalent daily dose). Multilevel generalized linear models were used to account for surgeon variabilities and types of thoracic resection. Results Over the study period, the rate of opioid prescriptions at discharge reduced from 35% (Mar 2016) to 25% (Apr 2020), and the amount of opioid prescribed declined from 184 ± 321 morphine equivalent daily dose to 94 ± 251 morphine equivalent daily dose. In multilevel generalized linear models, there was a sustained downward trend in opioid prescriptions over the study period (β -11.8 morphine equivalent daily dose per year, P = .048), which was also directly correlated with the use of minimally invasive surgery (β -84.9 morphine equivalent daily dose for video-assisted thoracoscopic surgery, P Conclusion Our Enhanced Recovery After Surgery program for thoracic surgery contributed to a sustained reduction of opioid prescriptions at discharge, which positively correlated with the duration of its implementation and the use of minimally invasive surgical techniques but was negatively impacted by the amount of intraoperative opioid administration.
The Earth System Science Pathfinder Orbiting Carbon Observatory (OCO) Mission

A viewgraph presentation describing the Earth System Science Pathfinder Orbiting Carbon Observatory (OCO) Mission is shown. The contents include: 1) Why CO2?; 2) What Processes Control CO2 Sinks?; 3) OCO Science Team; 4) Space-Based Measurements of CO2; 5) Driving Requirement: Precise, Bias-Free Global Measurements; 6) Making Precise CO2 Measurements from Space; 7) OCO Spatial Sampling Strategy; 8) OCO Observing Modes; 9) Implementation Approach; 10) The OCO Instrument; 11) The OCO Spacecraft; 12) OCO Will Fly in the A-Train; 13) Validation Program Ensures Accuracy and Minimizes Spatially Coherent Biases; 14) Can OCO Provide the Required Precision?; 15) O2 Column Retrievals with Ground-based FTS; 16) X(sub CO2) Retrieval Simulations; 17) Impact of Albedo and Aerosol Uncertainty on X(sub CO2) Retrievals; 18) Carbon Cycle Modeling Studies: Seasonal Cycle; 19) Carbon Cycle Modeling Studies: The North-South Gradient in CO2; 20) Carbon Cycle Modeling Studies: Effect of Diurnal Biases; 21) Project Status and Schedule; and 22) Summary.
International Law in Antiquity: State relations in ancient civilizations

The primary assumption of this study is that there existed at certain times and places in antiquity authentic systems of States which were disposed, through their interactions, to conceive of rules of state behavior, norms that we might call today the law of nations or international law. This assumption has been debated quite extensively. Indeed, it goes to the heart of my thesis - that ancient peoples were able to envision exogenous limits on State conduct in international relations. This chapter provides a cursory, and by no means exhaustive, answer to the question whether State systems and international relations existed in the three times and places considered in this book: the ancient Near East (from 1400 to 1150 BCE and 966 to 700 BCE), the Greek city-States (from 500 to 338 BCE), and the wider Mediterranean during the period of Roman expansion (from 358 BCE to 168 BCE). My primary goal here is to trace the outlines of a defensible posture concerning the existence of authentic State systems in antiquity, while, at the same time, giving an overview of the historiographic literature on this subject. Although most of this material will be familiar to students and scholars of ancient and classical history, it is less familiar to international lawyers, and, anyway, it is necessary to cover this ground before any intelligble observations can be made regarding the nature of a law of nations in antiquity.
Wideband DTV passive ISAR system design

Advanced operational modes for passive radar, including inverse synthetic aperture radar (ISAR), require particular consideration with respect to the receiver hardware. The spatial and spectral diversity of passive illuminators necessitates a wideband system with a large dynamic range beyond the already demanding requirements for single channel system due to direct signal interference. Here, a novel, hybrid high/low side downconversion scheme is shown to maximize the number of illuminators without sacrificing receiver dynamic range. Features of American digital television (DTV) signals are demonstrated along with their impact on passive systems. An extension to the efficient calculation of the range-Doppler surface is presented. This technique preserves integration gain and exceeds the unambiguous range/Doppler tradeoff of conventional pulsed radar systems. Finally, initial experimental ISAR results for a commercial airliner are shown to demonstrate discernible structure using a single 6 MHz DTV illuminator.
Premium Financed Surprises: Cancellation of Indebtedness Income and Financed Life Insurance

The last decade saw a tremendous expansion in the use of premium financed life insurance for high net worth individuals. Billions of dollars in premium finance loans were sold as low risk options for purchasing high-value life insurance. But the collapse of the secondary market for life insurance policies eliminated the primary exit strategy for insureds who purchased policies utilizing premium finance loans. When the option of selling the policies on the secondary market evaporated, most viewed the best course of action as surrendering the policies in satisfaction of the loan or allowing the policy to lapse.But while handing back an underwater policy will eliminate all, or at least most, of the debt on the policy, this cancellation of debt (COD) has potentially dire income tax consequences that must be examined by insureds and their advisers. A taxpayer will usually realize income from COD when a premium finance loan is forgiven. But a number of factors may reduce or eliminate the insured's exposure: the identity of the taxpayer, the structure of the trust holding the policy, the structure of the loan, and the applicability of exceptions to the inclusion of COD income in gross income. Each of these factors must be analyzed to determine whether the insured should be prepared for a doomsday tax scenario or whether the insured will walk away from the deal relatively unscathed.
A crystal definition for symplectic multiple dirichlet series

We present a definition for Weyl group multiple Dirichlet series (MDS) of Cartan type C, where the coefficients of the series are given by statistics on crystal graphs for certain highest-weight representations of Sp(2r, ℂ). In earlier work (Beineke et al., Pacific J. Math., 2011), we presented a definition based on Gelfand–Tsetlin patterns, and the equivalence of the two definitions is explained here. Finally, we demonstrate how to prove analytic continuation and functional equations for any multiple Dirichlet series with fixed data by reduction to rank one information. This method is amenable to MDS of all types.
Cigarette Smoking and Body Form in Peptic Ulcer

The cigarette smoking histories of physicians with peptic ulcer have been determined. Physicians with gastric or duodenal ulcers have smoked more than comparable control subjects. Those with duodenal ulcer started smoking at an earlier age than did control subjects. However, among those physicians who smoked cigarettes, patients and control subjects did not differ in percentage who had stopped, years smoked, or number of packs smoked per day. It is suggested that cigarette smoking and peptic ulcers result from a common cause; the role of smoking in the etiology of ulcer must be questioned. Body form as measured by height, weight, and ponderal index \( h e i g h t / w e i g h t 3 \) was compared between smokers and nonsmokers as well as between patients and control subjects. These comparisons were made for age 21 and for the time of the study in 1968. Physicians with duodenal ulcer were more slender than controls in 1968, but did not differ at age 21. The reported linearity of persons with duodenal ulcer therefore may be secondary to the ulcer rather than associated directly with a cause of ulcer. Physicians with gastric ulcer did not differ from controls. No association between body form and cigarette smoking could be demonstrated among duodenal ulcer patients; control smokers as well as all smokers were significantly more slender than nonsmokers in 1968 but not at age 21.
Writing a Protocol

Abstract Writing a research protocol is a key step in the conversion of a set of ideas for a research project into a coherent infrastructure that will result in obtaining data to support or refute a stated hypothesis. The written protocol document serves as a guide for investigators and staff conducting the study and also contains the information needed for regulatory bodies, such as the Institutional Review Board, Food and Drug Administration, and others, to conduct their reviews. The protocol addresses rationale, scientific aims, targeted population, and procedures and risks within the regulatory framework where the study will be conducted. It should account for the protection of its subjects through monitoring and analysis of risks, with an emphasis on maximizing the protections of its participants while ensuring the integrity of the data. This chapter will outline the process, structure, and examples of the important elements and considerations when writing a protocol.
Modelling Choice Decision Time

A power/exponential law of choice reaction time is proposed as an alternative to the classical Hick-Hyman's law and the Sternberg's law of memory search. A reanalysis of some experimental data, including those by Hick, Hyman and Sternberg, indicates that this alternative law provides at least as good fits to experimental data as do the Hick-Hyman's and Sternberg's laws. Some important implications of this finding are pointed out concerning the rate of change of information and the nature of the memory search process for the Sternberg's paradigm. Language: en
Role of spin-orbit coupling in the metal-insulator transition in two-dimensional systems

We propose an experiment, which would allow us to pinpoint the role of spin-orbit coupling in the metal-nonmetal transition observed in a number of two-dimensional systems at low densities. Namely, we demonstrate that in a parallel magnetic field the interplay between the spin-orbit coupling and the Zeeman splitting leads to a characteristic anisotropy of resistivity with respect to the direction of the in-plane magnetic field. Though our analytic calculation is done in the deeply insulating regime, the anisotropy is expected to persist far beyond that regime.
pQCD Structure and Hadronization in Jets and Heavy-ion Collisions

Implications of hadronization as a rapid traversal of the QCD phase boundary are explored for correlation structures in jets, N-N collisions and heavy-ion collisions. Hadronization viewed as a partition of the prehadonic system restricts the scale interval over which power-law jet correlation structures survive. Rapid traversal of the QCD phase boundary may result in a lattice-like residual structure in N-N and A-A conifiguration space accessible to momentum-space correlation analysis via Hubble flow.
Discussion of “Large-strain elastic viscoplastic consolidation analysis of very soft clay layers with vertical drains under preloading”

where vs ′ and vf ′ are the effective vertical stress reached before the removal of surcharge and final effective vertical stress, respectively. According to the observed ground surface settlements in Fig. 9 and the pore-water pressure measurements in Fig. 10, end of primary (EOP) consolidation was probably reached near 610 days when the 20 kPa surcharge was removed. The post-surcharge secondary settlement is computed using (Terzaghi et al. 1996, p. 110)
Cell Proliferation Patterns in an Autogenous Rat Sarcoma

The cell proliferation pattern of the methylcholanthrene-induced autogenous rat sarcoma was investigated by continuous labeling with tritiated thymidine (H-TDR), double-labeling with H-TDR and C-TDR, and by following the serial decay of the grain count Frequency distribution after pulse labeling with H-TDR. The data showed that only 40-60% of the initial S cohort completed mitosis and entered the succeeding cycle. About 20-35% of the S cohort left the cycle for long residence in G2, and 20-40% of the residual S cohort, after mitosis, remained in G1 for long intervals. Cells subsequently re-entered the cycle from both nonproliferative compartments. The growth fraction was 39%, and the cells in G2O and in Glo were 38% and 23% of the population, respectively. The transit times of two-thirds of the G1O cells were greater than 13 days, and for two-thirds of the cells in G2O the transit times exceeded 1 week. The continual turnover of the proliferative and nonproliferative compartments was a major determinant of tumor growth—J Natl Cancer Inst 50: 403-414, 1973.
On the computation and the effectiveness of discrete sine transform

Abstract The effectiveness of the discrete sine transform (DST) in terms of residual correlation as developed by Hamidi and Pearl[1] is investigated. Based on this criterion, the DST is compared with other discrete transforms such as cosine (DCT)[2] and Fourier (DFT)[3]. The odd-even property of the DST is established. Based on this, the DST is computed through the Walsh-Hadamard transform (WHT). This development parallels that of Jones et al.[4] for other transforms such as slant (ST), DFT, DCT, etc.
1989 CEDAR Meeting

The fourth annual meeting of the CEDAR (Coupling, Energetics, Dynamics of Atmospheric Regions) initiative was held June 21–26 at the National Center for Atmospheric Research (NCAR) in Boulder, Colo.; 222 scientists including 66 students attended. Barbara Emery of NCAR was local meeting organizer. The increase in student attendance, double the year before, was a meeting highlight. The high quality of poster papers pointed to the excellent caliber of the students. The CEDAR initiative has, from the start, emphasized support for students. Their response augurs well for the future of aeromony.
An integrated model for interaction between melt flow and non-equilibrium solidification in thermal spraying

Abstract In this paper, a micro/macro-integrated model based on the VOF scheme is presented that accounts for free surface movement, thermal contact resistance, and fluid instability. A sub-model is developed to include the non-equilibrium solidification phenomena at the solid/liquid interface. The melt flow is incorporated into the microscopic model through prescribing a velocity profile that is obtained from the interpolation of melt velocities on the macroscopic grids near the interface. To improve the efficiency of the integration between the melt flow and the microscopic model, a relational database is developed and applied to the integrated micro/macro model. Three velocity profiles, e.g., linear, parabolic, and cubic velocity profiles, are considered and the results are compared with those obtained from the diffusion model.