cssi/SciSciGPT-SciSciNet huggingface dataset:
Kernel Machine Testing for Risk Prediction with Stratified Case Cohort Studies

Large assembled cohorts with banked biospecimens offer valuable opportunities to identify novel markers for risk prediction. When the outcome of interest is rare, an effective strategy to conserve limited biological resources while maintaining reasonable statistical power is the case cohort (CCH) sampling design, in which expensive markers are measured on a subset of cases and controls. However, the CCH design introduces significant analytical complexity due to outcome-dependent, finite-population sampling. Current methods for analyzing CCH studies focus primarily on the estimation of simple survival models with linear effects; testing and estimation procedures that can efficiently capture complex non-linear marker effects for CCH data remain elusive. In this article, we propose inverse probability weighted (IPW) variance component type tests for identifying important marker sets through a Cox proportional hazards kernel machine (CoxKM) regression framework previously considered for full cohort studies (Cai et al., 2011). The optimal choice of kernel, while vitally important to attain high power, is typically unknown for a given dataset. Thus, we also develop robust testing procedures that adaptively combine information from multiple kernels. The proposed IPW test statistics have complex null distributions that cannot easily be approximated explicitly. Furthermore, due to the correlation induced by CCH sampling, standard resampling methods such as the bootstrap fail to approximate the distribution correctly. We, therefore, propose a novel perturbation resampling scheme that can effectively recover the induced correlation structure. Results from extensive simulation studies suggest that the proposed IPW CoxKM testing procedures work well in finite samples. The proposed methods are further illustrated by application to a Danish CCH study of Apolipoprotein C-III markers on the risk of coronary heart disease.
Moral Education and the “Tie that Binds” in Liberal Political Theory

I examine the search for a “tie that binds, “ or “core” values, in liberal political theory, specifically Rawls's recent arguments, and in proposals concerning moral education in the public schools. Both Rawls and the proponents of moral education appeal to consensus or shared values, but the search for core values in both theory and practice is only partly successful. Specifically, this search is misguided insofar as it does not reflect how values are embedded in specific institutions and practices. The various forms of moral education in the public schools, both implicit and explicit, illustrate a consensus about a range of moral and intellectual virtues that is broader and more complex than arguments for core values allow. Comparing arguments concerning core values in political theory and moral education suggests how liberal political theory might deal with questions of consensus, justification, and the task of political theory generally.
Double-tier interaction shuffled differential evolution algorithm and its application to optimal operation of cascade reservoirs

This paper develops an algorithm of double-tier interaction shuffled differential evolution(DISDE) for optimal operation of cascade reservoirs to avoid performance degradation and local trapping of a regular differential evolution algorithm.This new algorithm integrates the regular global search ability and the local search ability of shuffled frog leaping algorithm,and guarantees a diversity of particles on its upper layer quipped with the niche technology and a local searching ability on its lower layer quipped with independent population evolutionary and regular correspondence.In the overall functions,the lower layer provides high-quality solution of different structures to the layer upon it,and searching information updating is completed by information interaction between the double-tier structure.Comparison with the regular differential evolution algorithm and dynamic programming of successive approximation,shows the efficiency and superiority of the new algorithm in optimization of cascade reservoirs operation.
Sensitivity of Shock-Tube Chemiluminescence Measurements to the Optical Setup

Chemiluminescence measurements have been shown to be a non-intrusive and cost effective method to study chemical emission intensities and ignition delay times in shock-tube experiments [1].
Adaptive motion estimation schemes using maximum mutual information criterion: Research Articles

We consider the motion estimation problem in video coding. In our previous work, we proposed a new motion estimation method where motion estimation is formulated as an optimization problem and an adaptive system under the minimum error entropy (MEE) criterion is used for motion estimation. In this paper, we develop an adaptive system under the criterion of maximum mutual information to address the motion estimation problem. Our proposed motion estimation algorithms have very low encoding complexity and hence are ideally suited for wireless video sensor networks where limited bandwidth, restricted computational capability, and limited battery power supply impose stringent constraints on the video encoding system. Copyright © 2007 John Wiley & Sons, Ltd.
Amino-Sugars Enhance Recognition and Phagocytosis of Particles by Human Neutrophils

Neutrophils were examined for their ability to recognize and ingest beads coated with amino-derivatives of glucose, mannose, and galactose. Radioactive or fluorescent beads coated with any of the three sugars were ingested to an extent three times that observed with albumin-coated beads. Enhancement of ingestion of sugar-coated beads was much more evident when examined by electron micrographic studies. Inclusion of glucose or mannose in the medium with glucose- or mannose-coated beads caused a dose-dependent reduction of ingestion to control levels, but ingestion of galactose-coated beads was poorly inhibited. Similarly, galactose or fucose (6-deoxy-galactose) markedly inhibited ingestion of galactose-coated beads, but caused only a slight decrease in ingestion of glucose- or mannose-coated beads. Thus, neutrophils possess carbohydrate-binding membrane structures that can mediate recognition and ingestion of sugar-coated beads. Such carbohydrate recognition systems may underlie certain interactions of neutrophils and other surfaces.
Current surgical management of duodenal ulcers.

Duodenal ulcer disease is less prevalent now in the United States than it was a few decades ago. Improved medical therapy has decreased greatly the need for surgical control of chronic ulcer pain. Most operations are now performed for acute life-threatening ulcer complications. Proximal gastric vagotomy has emerged as the safest, least harmful, and best procedure for most patients with intractable pain or perforation and for selected patients with hemorrhage. Modification of the operation using laparoscopic techniques currently is under evaluation
Management of Noninvasive Cancer of the Endometrium

Ninety per cent of all endometrial neoplasms is adenocarcinoma, and the disease occurs most commonly after menopause. Aspects discussed include endometrial hyperplasia, risk factors, symptoms, diagnosis, and treatment.
Can Panpsychism Become an Observational Science

In 2011, I was invited to participate in a symposium at the London headquarters of the British Interplanetary Society. The subject of the symposium was the contributions of philosopher/science-fiction-author Olaf Stapledon. Instead of concentrating on the many technological projections in Stapledon’s masterwork Star Maker , I elected to investigate whether there is any evidence to support his core metaphysics—that the universe is in some sense conscious and that a portion of stellar motion is volitional (as an alternative to Dark Matter). Stars do not possess neurons or tubules, but the spectral signatures of cooler stars such as the Sun reveal the presence of simple molecules. A universal proto-consciousness field congruent with vacuum fluctuations could interact with molecular matter via the contribution of the Casimir Effect to molecular bonds. Surprisingly, there is observational evidence that cooler stars move somewhat faster around the galactic center than their hotter sisters. This velocity difference, called Parenago’s Discontinuity, occurs in the stellar temperature distribution where molecular spectral lines become apparent. Data from Allen’s Astrophysical Quantities and the European Hipparcos space observatory reveal that Parenago’s Discontinuity is found in main sequence stars as far as ~260 light years from the Sun and in giant stars at distances greater than 1,000 light years. As discussed in the paper, local explanations for Parenago’s Discontinuity seem inadequate. Gaia, a successor to Hipparcos, is currently on station observing positions and motions of ~1 billion stars in our galaxy. If the Discontinuity is a galaxy-wide phenomenon, the volitional star hypothesis will be advanced. One way that a minded star could alter its galactic trajectory is by the emission of a uni-directional jet. Such jets have been observed in young stars. Future work will hopefully show how uni-directional jets correlate with star temperature and distance from the galactic center. It is therefore not impossible that panpsychism can emerge from philosophy to become a subdivision of observational astrophysics.
Enhancing the Role of Internists in the Transition From Pediatric to Adult Health Care

The transition from adolescence to adulthood is replete with unique challenges that our current health system is illprepared to meet. The authors discuss the factors that make provision of quality ...
Default Mode Network Subsystems Are Differentially Disrupted in Posttraumatic Stress Disorder

Abstract Background Posttraumatic stress disorder (PTSD) is a psychiatric disorder characterized by debilitating re-experiencing, avoidance, and hyperarousal symptoms following trauma exposure. Recent evidence suggests that individuals with PTSD show disrupted functional connectivity in the default mode network, an intrinsic network that consists of a midline core, a medial temporal lobe (MTL) subsystem, and a dorsomedial prefrontal cortex (PFC) subsystem. The present study examined whether functional connectivity in these subsystems is differentially disrupted in PTSD. Methods Sixty-nine returning war veterans with PTSD and 44 trauma-exposed veterans without PTSD underwent resting-state functional magnetic resonance imaging. To examine functional connectivity, seeds were placed in the core hubs of the default mode network, namely the posterior cingulate cortex (PCC) and anterior medial PFC, and in each subsystem. Results Compared to control subjects, individuals with PTSD had reduced functional connectivity between the PCC and the hippocampus, a region of the MTL subsystem. Groups did not differ in connectivity between the PCC and dorsomedial PFC subsystem or between the anterior medial PFC and any region within either subsystem. In the PTSD group, connectivity between the PCC and hippocampus was negatively associated with avoidance/numbing symptoms. Examination of the MTL and dorsomedial PFC subsystems revealed reduced anticorrelation between the ventromedial PFC seed of the MTL subsystem and the dorsal anterior cingulate cortex in the PTSD group. Conclusions Our results suggest that selective alterations in functional connectivity in the MTL subsystem of the default mode network in PTSD may be an important factor in PTSD pathology and symptomatology.
Review: The accuracy of troponin T and I tests in acute MI depends on timing after onset of symptoms

Source Citation Ebell MH, Flewelling D, Flynn CA. A systematic review of troponin T and I for diagnosing acute myocardial infarction. J Fam Pract. 2000 Jun;49:550-6. 10923557 (All 2001 articles wer...
Evidence-Based Assessment and Single-Case Research: A Commentary for the Special Issue on Direct Behavior Ratings:

The purpose of this commentary is to provide observation on the contributions to the special issue and remark on the broader implications of the research. As noted throughout the special issue, the intent was to demonstrate the use of progress monitoring within a problem-solving framework to evaluate student social and behavioral development using direct behavior ratings (DBR). Leveraging single-case research methods through adherence to the What Works Clearinghouse (WWC) standards, the articles included in the special issue provide examples for using DBR to assess student response-to-intervention while also illustrating a number of psychometric considerations that can strengthen the evidence base for progress-monitoring tools more broadly. In this commentary, we argue that the research included in the special issue provides a framework for conceptualizing evidence-based assessment for progress-monitoring instruments using single-case methods. Toward this end, the commentary provides an overview of the co...
Rebuilding Migratory Flyways Using Directed Conditional Covering

There has been much recent research on site selection for species preservation, although most of this research has focused on terrestrial plant and animal species. There is increasing evidence that lack of suitable habitat for migratory birds is contributing to their diminishing numbers. We extend the literature of site selection with a specific application to migratory birds. We develop reserve planning models, based on the novel idea of Directed Conditional Covering, to identify “superior” configurations of locations to be included in migratory flyways.
Generalization of the Clauser-Horne-Shimony-Holt inequality self-testing maximally entangled states of any local dimension

The Clauser-Horne-Shimony-Holt inequality (CHSH) is one of the most popular and well-studied witnesses of Bell's theorem, separating classical from quantum correlations. In this work, for every $d\ensuremath{\ge}2$, we present a generalization of the CHSH inequality with the property that maximal violation is achieved uniquely by the maximally entangled state of local dimension $d$. This provides an avenue for device-independent certification of maximally entangled states of arbitrary local dimension.
Mechanisms and Extrapolation in the Abortion-Crime Controversy

John Donohue and Steven Levitt’s seminal and controversial article, The Impact of Legalized Abortion on Crime, famously argues that the legalization of abortion in 1973 in the Unites States is a significant factor explaining the surprising decline in crime rates that occurred there in the 1990s. In this chapter, I examine the role of extrapolation in Donohue and Levitt’s study and draw three main philosophical conclusions. First, several different types of causal claims might be at issue in an extrapolation—including claims about mechanisms and probabilistic causal effects—and these distinctions matter for methodology because different conditions may be required to support extrapolation in each case. Secondly, scientific study of a phenomenon typically generates evidence at a variety of levels of aggregation, and this has important implications for extrapolation. The third and final point follows on the heels of the second. Like almost all other scientific inferences, extrapolations are normally components of a complex web of interrelated evidence that must be considered together in assessing a hypothesis.
Anesthesia and Perioperative Medicine

The perioperative preparation of children presenting for surgery aims to identify medical problems that influence the outcome and to institute management strategies to reduce those problems. Respiratory complications remain the most significant cause of morbidity and mortality in modern pediatric anesthesia [1]. Some common medical problems that are encountered in daily clinical practice include the child with an upper respiratory tract infection (URTI), the child with allergies, and the child with asthma. The ideal management of these problems invokes discussion almost on a daily basis because the guidelines are not clear-cut, and the risks may be significant and even potentially life-threatening, particularly when managed incorrectly. Comorbidity involving any combination of these problems significantly increases the risk [2–8].
To ban or not to ban? The effect of permissive versus restrictive laptop policies on student outcomes and teaching evaluations

Abstract As technologies have become more portable, scholars have turned their attention to whether the use of electronic devices during lecture positively or negatively affects student performance in the class. In this study, I investigate the effects of banning laptops in the classroom through an experiment conducted over two semesters in an introductory American politics course at a large, public four-year university. Overall, I find that banning laptops is more likely to hinder student performance in the class than help. Although students find many elements of the course to be more helpful to their learning in the laptop-free sections, this does not translate to greater student achievement or lead to significantly different evaluations on the official university teaching evaluations. Overall, these findings suggest that although instructors are not penalized for banning laptops from their classrooms, they ought to carefully consider the extent to which such policies are helpful to student progress in large lecture classes.
Improving Apparent Cause Analysis Reliability: A Quality Improvement Initiative.

Introduction Apparent cause analysis (ACA) is a process in quality improvement used to examine events. A baseline assessment of completed ACAs at a tertiary care free-standing pediatric academic hospital revealed they were ineffective due to low-quality analysis, unreliable action plans, and poor spread, leading to error recurrence. The goal of this project was to increase ACA action plan reliability scores while maintaining or decreasing turnaround time. Methods The Model for Improvement served as the framework for this quality improvement initiative. We developed a key driver diagram, established measures, tested interventions using plan- do-study-act cycles, and implemented the effective interventions. To measure reliability, we created a high reliability toolkit that links each action item/intervention to a level of reliability and scored each ACA action plan to determine overall reliability score. Action plans scored as low level of reliability required revision before implementation. Results Average ACA action plan reliability scores increased from 86.4% to 96.1%. ACA turnaround time decreased from a baseline of 13 days to 8.6 days. Stakeholders reported a subjective increase in satisfaction with the revamped ACA process. Conclusions Incorporating high reliability principles into ACA action plan development increased the effectiveness of ACA while decreasing turnaround time. The high reliability toolkit was instrumental in providing an organizational resource for approaching this subset of cause analyses. The toolkit provides a way for safety/quality leaders to connect with stakeholders to design highly reliable solutions that improve safety for patients, families, and staff.
Biased signaling agonist of dopamine D3 receptor induces receptor internalization independent of β-arrestin recruitment

Agonist-induced internalization of G protein-coupled receptors (GPCRs) is a significant step in receptor kinetics and is known to be involved in receptor down-regulation. However, the dopamine D3 receptor (D3R) has been an exception wherein agonist induces D3Rs to undergo desensitization followed by pharmacological sequestration - which is defined as the sequestration of cell surface receptors into a more hydrophobic fraction within the plasma membrane without undergoing the process of receptor internalization. Pharmacological sequestration renders the receptor in an inactive state on the membrane. In our previous study we demonstrated that a novel class of D3R agonists exemplified by SK608 have biased signaling properties via the G-protein dependent pathway and do not induce D3R desensitization. In this study, using radioligand binding assay, immunoblot or immunocytochemistry methods, we observed that SK608 induced internalization of human D3R stably expressed in CHO, HEK and SH-SY5Y cells which are derived from neuroblastoma cells, suggesting that it is not a cell-type specific event. Further, we have evaluated the potential mechanism of D3R internalization induced by these biased signaling agonists. SK608-induced D3R internalization was time- and concentration-dependent. In comparison, dopamine induced D3R upregulation and pharmacological sequestration in the same assays. GRK2 and clathrin/dynamin I/II are the key molecular players in the SK608-induced D3R internalization process, while β-arrestin 1/2 and GRK-interacting protein 1(GIT1) are not involved. These results suggest that SK608-promoted D3R internalization is similar to the type II internalization observed among peptide binding GPCRs.
Insular Magnetoencephalography Dipole Clusters in Patients With Refractory Focal Epilepsy.

Purpose The clinical significance of magnetoencephalography (MEG) dipole clusters in the insular region in patients with focal epilepsy, when present in conjunction with MEG dipole clusters in other regions of the brain is not known. Methods All patients (adult and pediatric) with MEG dipole clusters involving the insula were retrospectively evaluated. Patients who underwent any form of surgical intervention were included in the study. Data obtained included age, sex, seizure characteristics, MRI brain, EEG, MEG, intracranial EEG, type of intervention, and seizure outcomes. Results Twenty-four patients (12 adults and 12 pediatric) were included. Eight patients had one staged intervention and 16 had intracranial evaluation. Ten of 11 patients (91%) with insular coverage by stereotactic EEG had interictal insular spikes, and 5 of 11 patients (45%) had ictal onset from the insula. Combined Engel (I & II) outcomes were seen in five patients with resections/ablations involving the insula MEG dipole clusters as compared with eight patients where the insular MEG dipole clusters were not resected/ablated. Conclusions Insular MEG dipole clusters identified on surface MEG correlated with interictal spikes in intracranial stereotactic electrode contacts in the insula. The presence of insular MEG dipole clusters, however, does not definitively imply a primary insular onset epilepsy.
Understanding activist intentions: An extension of the theory of planned behavior

The current study used the Theory of Planned Behavior (TPB) to examine multiple structural models of low-risk and high-risk activist intentions (Ajzen, 1991). Results indicated a good model fit for both a traditional TPB model (CFI = .96; RMSEA = .06; SRMR = .05; χ2(125) = 283.28, p < .001) and an identity TPB model (CFI = .95; RMSEA = .06; SRMR = .05; χ2 (194) = 434.20, p < .001). The identity TPB model, which included activist identity as a mediator for the TPB variables, accounted for notably more variance in both low-risk activist intentions (44.2% in comparison to 20.1%) and high-risk activist intentions (27.3% in comparison to 12.2%) than the traditional TPB model. The current study increases our understanding of factors that may contribute to low-risk and high-risk activist intentions and highlights the importance of an activist identity to both. The merits of each of the structural models and the practical implications for practice and research are discussed.
Can NSAIDs Be Used Safely for Analgesia in Patients with CKD?: COMMENTARY

The debate in this issue of Kidney360 addresses the quandary that exists regarding the safety of nonsteroidal anti-inflammatory drug (NSAID) use in patients with CKD. This is an important issue because pain syndromes are common in patients with CKD. Whereas NSAIDs are a widely used and effective analgesic, they can be associated with several adverse clinical kidney syndromes (Table 1), particularly in patients with underlying CKD (1,2). Clinicians struggle to achieve adequate analgesia while also avoiding toxicity in this group. However, is avoiding NSAIDs in patients with CKD too restrictive and unnecessary? Our two expert debaters Erin Baretto and Bruce Guthrie tackle the conundrum of whether NSAIDs can be safely used in patients with nondialysis CKD. They will present the PRO and CON sides of the debate. We provide background on NSAID therapy in patients with CKD to set the stage for the debate. View this table: Table 1. Clinical kidney syndromes of nonsteroidal anti-inflammatory drugs Pain management in patients with CKD is limited by a number of analgesic drug-related adverse effects (3). Reduced GFR and impaired tubular secretion put patients with AKI or CKD at increased risk of drug-related nephrotoxicity because of increased accumulation of parent drugs, and their metabolites, from impaired metabolism and excretion (4). A significant number of drugs with potential toxicity are concomitantly prescribed to patients with advanced CKD (5). As such, NSAIDs are considered a class of drugs that should be avoided in patients with CKD, particularly those with advanced CKD (6,7). This approach has led to increased opioid administration and …
Abstract IA04: Stroma-driven resistance to PI3K/mTOR inhibition

PI3/mTOR pathway, a major regulator of cellular growth and metabolism, is mutated in ~70% of breast cancers and conveys resistance towards estrogen receptor- and HER2-targeted therapies. Unfortunately, targeting the PI3K pathway in the clinic has been hampered by emergence of drug resistance, often through rewiring of their signaling pathways rather than through mutations, a phenomenon called adaptive resistance that is often observed with targeted therapies. Our previous data have shown that adaptive resistance requires input from the tumor microenvironment. Cancer cells require the presence of extracellular matrix proteins to elicit drug resistance; without matrix contact the tumor cells died. Our data also show that fibroblasts secrete matrix proteins that increase cellular survival of epithelial cells under starvation and PI3K and mTOR inhibition. To investigate the identity and role of the secreted proteins that drive resistance, we performed mass-spectrometry and cytokine analysis of fibroblast secretomes treated with PI3K inhibitors. These data have identified several candidate proteins as potential drivers of stroma-mediated drug resistance, and we will discuss how targeting these proteins can increase the efficacy of PI3K- and mTOR-targeted therapies. Citation Format: Taru Muranen. Stroma-driven resistance to PI3K/mTOR inhibition [abstract]. In: Proceedings of the AACR Special Conference on Targeting PI3K/mTOR Signaling; 2018 Nov 30-Dec 8; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Res 2020;18(10_Suppl):Abstract nr IA04.
“A Woman Is a Sometime Thing”: (Re)Covering Black Womanhood in Porgy and Bess

This essay reexamines the legendary opera-musical Porgy and Bess by first tending to its origins in the dual phenomenon of early 1920s racialized sonic experimentation and the Southern literary con...
Global development cooperation in a COVID-19 world

COVID-19 and the economic response have amplified and changed the nature of development challenges in fundamental ways. Global development cooperation should adapt accordingly. This paper lays out the urgency for new methods of development cooperation that can deliver resource transfers at scale, oriented to addressing climate change and with transparency and better governance. It looks at what is actually happening to major donor countries’ development cooperation programs and where the principal gaps lie, and offers some thoughts on how to move forward, notwithstanding the clear geopolitical rivalries that are evident. The most immediate challenge is to provide a level of liquidity support to countries ravaged by the global economic downturn. Many developing countries will see double-digit declines in GDP, with some recording downturns not seen in peacetime. Alongside the short-term challenge of recovery, COVID-19 has laid bare longer-term trends that have pointed for some time to the lack of sustainability—environmental, social, and governance—in the way economic development was occurring in many places, including in advanced economies. This new landscape has significant implications for development cooperation in terms of scale, development/climate co-benefits, and transparency and accountability.
β-Ga2O3 on Si (001) grown by plasma-assisted MBE with γ-Al2O3 (111) buffer layer: Structural characterization

β-Ga2O3 was deposited in thin film form by plasma-assisted molecular beam epitaxy at 670 °C and 630 °C onto a γ-Al2O3 (111) buffer layer grown at 840 °C by e-beam evaporation on a clean Si (001) surface. The β-Ga2O3 film was 66 nm thick, stoichiometric, and strongly textured, as determined by x-ray reflectivity, x-ray photoelectron spectroscopy, reflection high-energy electron diffraction, x-ray diffraction, and transmission electron microscopy, with three basal growth planes (201), (101), and {310}, including one twin variant {310}. The observed basal growth planes correspond to the close-packing planes of the distorted face-centered cubic oxygen sublattice of β-Ga2O3. Local structural ordering can be thought to occur due to a continuation of the oxygen sublattice from the γ-alumina buffer layer into the β-gallia film. Each β-Ga2O3 growth plane further gives rise to 12 symmetry-derived rotational in-plane variants, resulting in a total of 48 domain variants. Atomistic models of possible gallia–alumina interfaces are presented.
Endovascular Treatment of Infective Endocarditis-Related Acute Large Vessel Occlusion Stroke.

Abstract Objectives Embolic stroke is a frequent complication of infective endocarditis yet lacks acute treatment as intravenous thrombolysis should be avoided due to high risk of intracerebral hemorrhage. Mechanical thrombectomy for large vessel occlusion may be a promising treatment but there is limited data on safety outcomes in infective endocarditis. Materials and methods In this multi-center retrospective case series, we reviewed data from patients with infective endocarditis-related large vessel occlusion who underwent mechanical thrombectomy in 9 US hospitals. Results We identified 15 patients at 9 hospitals. A minority presented with signs suggesting infection (2 patients (14%) had fever, 7 (47%) were tachycardic, 2 (13%) were hypotensive, and 8 (53%) had leukocytosis). The median National Institute of Health Stroke Score decreased from 19 (range 9-25) at presentation to 7 post-thrombectomy (range 0-22, median best score post-thrombectomy), and the median modified Rankin Scale on or after discharge for survivors was 3 (range 0-6). Approximately 57% of patients had a modified Rankin Scale between 0 and 3 on or after discharge. Hemorrhagic transformation was observed in 7/15 (47%). The mechanical thrombectomy group had 2/9 petechial hemorrhagic transformation (22%), compared to 4/6 parenchymal hematomas (67%) in the tissue plasminogen activator + mechanical thrombectomy group. Conclusions Our findings suggest that patients with large vessel occlusion due to infective endocarditis may not present with overt signs of infection. Mechanical thrombectomy may be an effective treatment in this patient population for whom intravenous thrombolysis should be avoided.
Extorial Solutions for Fractional and Partial Difference Equations with Applications: A Scientific Explanation

we introduce a new function, which is defined by replacing polynomials withpolynomial factorials in the expansion of exponential function denoted by entitled as extorial function, an original and unique contribution. The identities that must be used with difference operators and factorials are mentioned. In the RL circuit, these identities are used to find solutions to the difference and discrete partial difference equations for heat and current flows. The above results are supported by numerical verifications. On the basis of the findings, the solution for current flow in the RL circuit is effectively derived after formulating the current flow as the discrete and fractional equations.
Solid-state nuclear magnetic resonance of spin-9/2 nuclei 115 In and 209 Bi in functional inorganic complex oxides.

Indium and bismuth are technologically important elements, in particular as oxides for optoelectronic applications. 115 In and 209 Bi are both I = 9/2 nuclei with high natural abundances and moderately high frequencies but large nuclear electric quadrupole moments. Leveraging the quadrupolar interaction as a measure of local symmetry and polyhedral distortions for these nuclei could provide powerful insights on a range of applied materials. However, the absence of reported nuclear magnetic resonance (NMR) parameters on these nuclei, particularly in oxides, hinders their use by the broader materials community. In this contribution, solid-state 115 In and 209 Bi NMR of three recently discovered quaternary bismuth or indium oxides are reported, supported by density functional theory calculations, numerical simulations, diffraction and additional multinuclear (27 Al, 69,71 Ga, and 121 Sb) solid-state NMR measurements. The compounds LiIn2 SbO6 , BiAlTeO6 , and BiGaTeO6 are measured without special equipment at 9.4 T, demonstrating that wideline techniques such as the QCPMG pulse sequence and frequency-stepped acquisition can enable straightforward extraction of quadrupolar tensor information in I = 9/2 115 In and 209 Bi even in sites with large quadrupolar coupling constants. Relationships are described between the NMR observables and local site symmetry. These are amongst the first reports of the NMR parameters of 115 In, 121 Sb, and 209 Bi in oxides.
Deaggregation of multi-hazard damages, losses, risks, and connectivity: an application to the joint seismic-tsunami hazard at Seaside, Oregon

This paper presents a methodology to deaggregate the results of a multi-hazard damage analysis by extending the traditional multi-hazard damage analysis to consider both population characteristics and independent hazards. The methodology is applied to the joint seismic-tsunami hazard at Seaside, Oregon, considering four infrastructure systems: (1) buildings, (2) transportation network, (3) electric power network and (4) water supply network. Damages to all infrastructure systems are evaluated, and the networked infrastructures are used to inform parcel connectivity to critical facilities. US Census data and a probabilistic housing unit allocation method are implemented to assign detailed household demographic characteristics at the parcel level. Six dimensions of deaggregation are introduced: (1) spatial, (2) hazard type, (3) hazard intensity, (4) infrastructure system, (5) infrastructure component, and (6) housing unit characteristics. The damages, economic losses and risks, and connectivity to critical facilities are deaggregated across these six dimensions. The results show that deaggregated economic loss and risk plots can allow community resilience planners the ability to isolate high-risk events, as well as provide insights into the underlying driving forces. Geospatial representation of the results allows for the identification of both vulnerable buildings and areas within a community and is highlighted by the spatial pattern of parcel disconnection from critical facilities. The incorporation of population characteristics provides an understanding of how hazards disproportionately impact population subgroups and can aide in equitable resilience planning.
Trends in Adoption and Maturation of Telehealth Programs at Teaching Hospitals and Health Systems.

Background: Although early adopters of telehealth have built and sustained telehealth programs over long periods, little research has been conducted differentiating the characteristics of health systems at different stages of maturation. Methods: This study surveyed 165 major teaching hospitals and health systems from fiscal year 2015 through 2018 about the stage and characteristics of their telehealth services. Respondents reported (i) the progression level of their telehealth program, (ii) which of six services they provide, and (iii) greatest barriers and motivators to implementing telehealth, as well as their overall operational and financial characteristics. Results: Telehealth programs at teaching hospitals progressed steadily and adoption of a wide range of telehealth delivery modes expanded. Hospital operational and financial characteristics corresponding to both higher maturation and the adoption of more delivery modes were identified. Reported barriers and motivations were similar across maturation levels. Discussion: With telehealth's broader use and the heterogeneity of delivery modes being utilized, a binary metric of whether or not to implement telehealth does not sufficiently capture key differences in telehealth programs or differentiate implementation scope and scale across health systems. Conclusions: The findings suggest that programs at different levels of maturation are characteristically different from one another. Identifying factors related to mature telehealth programs may help guide policymakers, future telehealth program leaders, and other stakeholders in identifying barriers to continued investment in telehealth.
Deacylation-aided C–H alkylative annulation through C–C cleavage of unstrained ketones

Arene- and heteroarene-fused rings are pervasive in biologically active molecules. Direct annulation between a C–H bond on the aromatic core and a tethered alkyl moiety provides a straightforward approach to access these scaffolds; however, such a strategy is often hampered by the need of special reactive groups and/or less compatible cyclization conditions. It would be synthetically appealing if a common native functional group can be used as a handle to enable a general C–H annulation with diverse aromatic rings. Here, we show a deacylative annulation strategy for preparing a large variety of aromatic-fused rings from linear simple ketone precursors. The reaction starts with homolytic cleavage of the ketone α C–C bond via a pre-aromatic intermediate, followed by a radical-mediated dehydrogenative cyclization. Using widely available ketones as the robust radical precursors, this deconstructive approach allows streamlined assembly of complex polycyclic structures with broad functional group tolerance. Common native functional groups would be appealing as handles to enable C–H annulation with diverse aromatic rings. Now, this is achieved using ketones as unconventional alkyl radical precursors providing a practical method to synthesize biologically important fused-ring systems.
The Future of Atomic Absorption Spectroscopy

Recent work in atomic absorption has been concerned with the consolidation of the process as a routine analytical tool. However, the sensitivities being reported are far from those within the potential of the procedure. The major weakness seems to be the atomization step. Recent advances in this and other areas are discussed.
Lack of adverse effects from flumazenil administration: an ED observational study.

Abstract Background Flumazenil is an effective benzodiazepine (BZD) antagonist. Empiric use of flumazenil in the emergency department (ED) is not widely recommended due to concerns of seizures, which are commonly associated with coingestants and BZD withdrawal. Objective The objective of the study is to assess adverse events and clinical outcomes of flumazenil administration in known and suspected BZD overdose in an ED at a tertiary academic medical center. Methods This is a retrospective observational study of adult patients administered flumazenil for known or suspected BZD overdose in the ED over 7 years. Outcomes included mental status improvement, the incidence of seizures, and intubation of the trachea after flumazenil administration. Results Twenty-three patients were included in the analysis, of which 15 (65%) of patients experienced some type of clinically significant mental status improvement. No seizures were identified despite 7 (35%) reported proconvulsant coingestants. One patient required intubation of the trachea but was subsequently extubated in the ED. Conclusions A majority of patients had improved mental status after the administration of flumazenil. No patient experienced seizures. Additional studies that clarify the role of flumazenil for ED patients with suspected BZD toxicity are warranted.
Blood Plasma Levels of Radioactive Iodine-131 in the Diagnosis of Hyperthyroidism

Publisher Summary This chapter presents the blood plasma levels of radioactive iodine- 131 in the diagnosis of hyperthyroidism. The most widely applied technique involving the use of radioactive iodine in the diagnosis of hyperthyroidism is the measurement of the thyroid uptake after the oral administration of tracer doses. In an attempt to devise a diagnostic method of greater specificity, the determination of the plasma levels of protein-bound after the administration of tracer doses was introduced in 1950 and expanded in 1952. This method has been demonstrated to be of distinct value. The chapter presents data on the comparative usefulness of the two procedures discussed in the chapter—namely, 24-hour uptake by the thyroid gland and plasma levels of protein-bound I 131 after tracer doses. The chapter presents a case study involving a series of 96 untreated hyperthyroid patients and 404 normal subjects. These subjects were studied with radioactive iodine diagnostic techniques. The thyroid uptake at 24 hours after the tracer dose and the blood plasma levels of protein-bound at 72 hours after the tracer dose were determined in each patient. It was found that uptake studies were not as accurate a diagnostic method as the levels of protein-bound at 72 hours after the tracer dose. To reduce the diagnostic error of the uptake method to that attained by the determination of the protein-bound (1.6%), it is necessary to select a critical range rather than a critical value.
A simple model to help distinguish Necrotizing fasciitis from nonnecrotizing soft tissue infection

Abstract Background: Necrotizing fasciitis (NF) has been associated with certain "hard" clinical signs (hypotension, crepitance, skin necrosis, bullae, and gas on x-ray), but these may not always be present. Using results of a previous study, we developed a simple model to serve as an adjunctive tool in diagnosing NF (admission WBC > 15.4 × 10 9 /L or serum sodium [Na] Study Design: A retrospective review was conducted of consecutive NF (n = 31) and non-NF patients (n = 328) treated at a single institution during an 11-month period. Comparison of admission vital signs, physical examination findings, radiology results, and number of patients meeting model criteria was performed. Results: Ninety percent of NF patients and 24% of non-NF patients met model criteria (p Conclusions: Admission WBC greater than 15.4 × 10 9 /L and serum Na less than 135 mmol/L are useful parameters that may help to distinguish NF from non-NF infection, particularly when classic "hard" signs of NF are absent.
The association of stress-coping variables to quality of life among caregivers of individuals with traumatic brain injury.

The purpose of this study was to determine the degree to which stress-coping variables contribute to quality of life (QOL) among caregivers of individuals with traumatic brain injury (TBI). This study examined the direct effects of the following variables: functional competency, caregiving appraisal, coping, perceived social support, and family needs on QOL. In addition, the unique variance accounted for in QOL by each set was investigated, and whether perceived social support, coping, and family needs mediate or moderate the relationship between caregiving appraisal and QOL. The sample consisted of 108 caregivers recruited from support groups who were predominantly white females. The majority of care-recipients had a severe head injury. Measures administered were the Interpersonal Support Evaluation List, Family Needs Questionnaire, Modified Caregiving Appraisal Scale, and the World Health Organization Quality of Life - Brief Version. Results showed that the full model accounted for 68% of the variance in QOL; caregiving appraisal, perceived social support and family needs remained significant after other stress-coping variables were partialled; and of these sets, emotional social support, social needs, and perceived burden were the significant individual predictors. Emotional social support and social needs mediated the relationship between perceived burden and QOL.
Speaking for the Dead: Voice in Last Wills and Testament

A will is arguable the most important and personal legal document an individual ever executes. Much of the typical language in a will removes all traces of the individual. This personal legal document is ostensibly the individual's -- the testator's -- document. For a testator, contemplating the creation and execution of a will is the contemplation of the testator's own death. The resulting document memorializes the individual's personal wishes and hopes for individuals and entities that are important to the individual. The document plans for the continued care of loved ones and loved charitable causes. Despite the personal importance of the document and abundant self-referencing, the individual is not typically the document's author. Instead, an attorney drafts the document, facing the challenge of writing a personal document by invoking particular language that ensures the legal fulfillment of the individual's wishes. The typical result is a document that, despite the self-referencing, bears little resemblance to words used by the testator. This article examines voice in wills. First, this article considers the function of wills and the continued importance of the will in the age of will substitutes. Second, this article explores the concepts of voice and persona, including the applicability of those terms to wills. Third, this article analyzes voice in wills by contemplating voice in both non-attorney drafted wills and attorney drafted wills. Fourth, this article highlights five opportunities that enable the draftsperson to consciously craft a persona that appropriate injects the individual's voice into the will while ensuring that the will continues to be both substantially accurate and operative.
Managers' Perceptions of Career Advancement Obstacles for Women Managers in the Food Service Industry

(1997). Managers' Perceptions of Career Advancement Obstacles for Women Managers in the Food Service Industry. Journal of College & University Foodservice: Vol. 3, No. 1-2, pp. 41-56.
Atomic data for highly charged ions: Applications to X-ray laser design and thermonuclear fusion

Abstract A detailed understanding of a myriad of atomic processes is proving important for the development of short wavelength lasers and to the achievement of controlled thermonuclear fusion. A brief overview of some X-ray laser design issues is presented along with a discussion of relevant atomic data needs. Special attention is given to the need for experimental verification of rate coefficient data which are important for determining laser kinetics. Approaches to magnetic and inertial confinement fusion are reviewed with emphasis on atomic processes affecting both fuel burn and plasma diagnostics. Recent advances in the development of high power ICF drivers, both lasers and particle beams, are shown to suggest new areas of research involving very highly charged ions in dense hot plasmas.