cssi/SciSciGPT-SciSciNet huggingface dataset:
Editor's Top Five Article Picks 2015

Elsevier has provided a new opportunity for editors to pick five articles that they deem to be exemplary over the past couple years. In Clinical Simulation in Nursing, I had a plethora of wonderful options. My choices offered our readers new thoughts, ideas, or ways of approaching simulation or research that are of note. Without further ado, here are my five choices. Haupt and Beauvais (2014) provides a forward-thinking research article using simulation to prepare patients and families preoperatively, for what will be required in the postoperative period. This is one of the first articles we have published in which simulation is used for teaching patients rather than health care providers or students. This article demonstrates an emerging and potentially National Institutes of Health (NIH) funded idea for the use of simulation. Nestel et al. (2014) provide food for thought about the use of confederates in simulation. Too often we forget to clarify roles for all concerned or tend to dismiss the fact that students often know people we press into service in the confederate role. This can fundamentally change scenario interactions, learning, and intended outcomes. Paige and Morin (2015) provide a report of the new research design called Q methodology. This study provided new ways of looking at simulation design. Readers who like both qualitative and quantitative research will be interested in this methodology. Readers who like both qualitative and quantitative research will enjoy this research approach. Sideras et al. (2015) completed a multisite study using prelicensure nursing programs to evaluate changes in knowledge, attitudes, and empathy toward patients with schizophrenia. The authors provide a nice model for others interested in multisite studies to replicate. Mental health remains an understudied area in simulation research. Zigmont et al. (2015) provide an example of a Kirkpatrick level III outcome at the organizational level (a change in behavior) using simulation. The authors completely restructured their new nurse orientation program using simulation as a major teaching modality. This restructuring reduced overall orientation time by 35% and provided more than $500,000 in cost savings for the institution. The authors not only describe how they did this, but they also provide an entire 128 page appendix describing the program in depth, for others to assess and use. What a magnanimous thing to do! All these articles are now promotionally free, which means any reader can access, read, and share them for free, through this e-mail link: http://www.editorschoice.elsevier. com/index.cfm/journal/details?id¼2228.
Impact of an Antimicrobial Stewardship Program on Patient Safety in Veterans Prescribed Vancomycin.

Abstract Purpose This study aimed to determine the safety impact of an antimicrobial stewardship program (ASP) on vancomycin-associated nephrotoxicity and to examine risk factors contributing to the development of toxicity. Methods This was a retrospective chart review of data from 453 veterans receiving vancomycin in the VA Western New York Healthcare System between October 2006 and July 2014. Nephrotoxicity was defined as an increase in serum creatinine of ≥0.5 mg/dL or by 50% of baseline for 2 consecutive days. Findings Patients receiving vancomycin after the implementation of the ASP were less likely to develop nephrotoxicity (odds ratio [OR] = 2.06; 95% CI, 1.02–4.28). Nephrotoxicity occurred in 6.84% of patients from the pre-ASP cohort and in 3.75% of patients after the implementation of the ASP. Predictors of nephrotoxicity included hospital service (surgical service, OR=2.29; 95% CI, 1.13–4.64), elevated maximum trough concentration (unit OR=1.15; 95% CI, 1.10–1.20), and concurrent piperacillin/tazobactam therapy (OR = 3.21; 95% CI, 1.43–7.96). The number of vancomycin trough concentration measurements per patient did not vary between the pre-ASP and ASP groups. Implications ASPs represent an important aspect of a patient-safety initiative in order to reduce vancomycin-associated nephrotoxicity. Concurrent piperacillin/tazobactam therapy, surgical service, and elevated maximum trough concentration were risk factors for nephrotoxicity.
Nanostructure Determination by Co-Refining Models to Multiple Datasets

The results of the work are contained in the publications resulting from the grant (which are listed below). Here I summarize the main findings from the last period of the award, 2006-2007: • Published a paper in Science with Igor Levin outlining the “Nanostructure Problem”, our inability to solve structure at the nanoscale. • Published a paper in Nature demonstrating the first ever ab-initio structure determination of a nanoparticle from atomic pair distribution function (PDF) data. • Published one book and 3 overview articles on PDF methods and the nanostructure problem. • Completed a project that sought to find a structural response to the presence of the so-called “intermediate phase” in network glasses which appears close to the rigidity percolation threshold in these systems. The main result was that we did not see convincing evidence for this, which drew into doubt the idea that GexSe1-x glasses were a model system exhibiting rigidity percolation.
Alexander Feldman. Dramas of the Past on the Twentieth-Century Stage: In History’s Wings

ABSTRACT: This book seeks to define and analyse a particular twentieth- (and twenty-first-) century dramatic genre, “historiographic metatheatre,” which the author discusses only with relation to plays produced on the London stage.
Investigation of the Structure and Spectroscopy of H5+ Using Diffusion Monte Carlo

The results of diffusion Monte Carlo (DMC) calculations of the ground and selected excited states of H5+ and its deuterated analogues are presented. Comparisons are made between the results obtained from two recently reported potential surfaces. Both of these surfaces are based on CCSD(T) electronic energies, but the fits display substantial differences in the energies of low-lying stationary points. Little sensitivity to these features is found in the DMC results, which yield zero-point energies based on the two surfaces that differ by between 20 and 30 cm–1 for all twelve isotopologues of H5+. Likewise, projections of the ground state probability amplitudes, evaluated for the two surfaces, are virtually identical. By using the ground state probability amplitudes, vibrationally averaged rotational constants and dipole moments were calculated. On the basis of these calculations, all isotopologues are shown to be near-prolate symmetric tops. Further, in cases where the ion had a nonzero dipole moment, the ...
Disruption of epithelial barrier by quorum-sensing N-3-(oxododecanoyl)-homoserine lactone is mediated by matrix metalloproteinases.

The intestinal epithelium forms a selective barrier maintained by tight junctions (TJs) and separating the luminal environment from the submucosal tissues. N-acylhomoserine lactone (AHL) quorum-sen...
Validating a Model for Information Literacy Instruction for Elementary School Students: A Study

A qualitative study was conducted with third-grade students to validate and ascertain the efficacy of an empirically-based model integrating features from research into information-seeking behavior and information literacy and specifically developed for information literacy instruction of younger elementary school students. Une etude qualitative a ete menee aupres des eleves de troisieme annee dans le but de valider et de verifier l'efficacite d'un modele empirique integrant des aspects de la recherche sur le comportement de recherche d'information et sur la competence informationnelle, modele developpe specifiquement pour l'enseignement des competences informationnelles aux eleves les plus jeunes a l'ecole primaire.
Using High-Performance Computing to Support Water Resource Planning

In recent years, decision support modeling has embraced deliberation-withanalysis— an iterative process in which decisionmakers come together with experts to evaluate a complex problem and alternative solutions in a scientifically rigorous and transparent manner. Simulation modeling supports decisionmaking throughout this process; visualizations enable decisionmakers to assess how proposed strategies stand up over time in uncertain conditions. But running these simulation models over standard computers can be slow. This, in turn, can slow the entire decisionmaking process, interrupting valuable interaction between decisionmakers and analytics.
Identifying and Improving Value in Patients with Chronic Disease

More than 10 million children in the USA have a chronic condition that requires healthcare. Children with chronic illness require distinct strategies to achieve best outcomes. Value, defined as outcome and patient experience divided by the cost of health care value, has emerged as a critical metric in health care and may be very applicable to the population of children with chronic conditions. With increased value, the patient, provider, and payer should benefit. While the concept of a value metric has face validity, the definition and application face challenges. The perspective of the payer, provider, health care system and the patient and family are not always aligned. Patient-centered care requires that the provider respect patient’s preferences and that care is integrated and coordinated. Quality of life, plays a critical role in decision-making especially with chronic disease management. At the population level, a value metric, if validated, might be able to forecast the impact of distinct improvement efforts and help to prioritize their efforts. The role of value as a driving force in health care is clear both at the individual and at the population level. Understanding value will improve decision-making but the details of the metric must be carefully validated at the condition level.
Carbon nanofiber electrode array for the detection of lead

Abstract A nanoelectrode array of vertically aligned carbon nanofibers was evaluated for the detection of Pb 2 + by anodic stripping voltammetry. The achieved detection limit of 1.73 nM is well below the environmental guidelines. The approach provides a safer alternative to the mercury electrodes commonly used for the detection of heavy metals.
Surface Plasmon Enhanced Fluorescence of Glycine-Dimer-Functionalized Silver Nanoparticles

We present experimental results on the fluorescence of glycine-dimers-functionalized silver nanoparticles. Silver nanoparticles were synthesized by using a solid state thermal reduction of silver nitrate in a glycine matrix yielding polydisperse silver nanoparticles. For particles of average core diameter of 23 nm the fluorescence quantum yield was determined to be 5.2+/−0.1 % and depended non-monotonically on the size of the nanoparticles. The fluorescence emission of the glycine dimers was enhanced by the strong local electric field due to the surface plasmon resonance in silver nanoparticles. The application of small fluorescent silver nanoparticles of average diameters 5 +/− 4 nm as imaging markers for yeast cells was demonstrated. The nanoparticles were able to penetrate yeast cell membranes and accumulate inside the vesicles within the cell. The luminescence was observed after 12 h of incubation inside the nuclei of about 10% of the cells suggesting that silver nanoparticles penetrated into the nuclei of the cells.
Typical Skin Injuries in Children With Autism Spectrum Disorder.

Pediatric skin injuries have primarily been described in typically developing children. Our objectives were to describe the prevalence and pattern of skin injuries of children with autism spectrum disorder (ASD), to describe how this compared with previously demonstrated skin injury locations in typically developing children, and to identify differences in skin injury frequency and locations between autistic children with and without self-injurious behaviors (SIBs). Children with ASD were recruited between September of 2011 and September of 2014. Demographic information was obtained from the caregiver. All skin injuries and their locations were documented. Of the 41 children enrolled, half were reported to have SIBs. The most identified skin injury locations were the legs, knees, and back. Children with autism (1) obtain skin injuries frequently and in similar locations as typically developing children and (2) rarely obtain skin injuries to locations that are considered uncommon for accidental injuries de...
Application of a neural network for reflectance spectrum classification

Traditional reflectance spectrum classification algorithms are based on comparing spectrum across the electromagnetic spectrum anywhere from the ultra-violet to the thermal infrared regions. These methods analyze reflectance on a pixel by pixel basis. Inspired by high performance that Convolution Neural Networks (CNN) have demonstrated in image classification, we applied a neural network to analyze directional reflectance pattern images. By using the bidirectional reflectance distribution function (BRDF) data, we can reformulate the 4-dimensional into 2 dimensions, namely incident direction × reflected direction × channels. Meanwhile, RIT’s micro-DIRSIG model is utilized to simulate additional training samples for improving the robustness of the neural networks training. Unlike traditional classification by using hand-designed feature extraction with a trainable classifier, neural networks create several layers to learn a feature hierarchy from pixels to classifier and all layers are trained jointly. Hence, the our approach of utilizing the angular features are different to traditional methods utilizing spatial features. Although training processing typically has a large computational cost, simple classifiers work well when subsequently using neural network generated features. Currently, most popular neural networks such as VGG, GoogLeNet and AlexNet are trained based on RGB spatial image data. Our approach aims to build a directional reflectance spectrum based neural network to help us to understand from another perspective. At the end of this paper, we compare the difference among several classifiers and analyze the trade-off among neural networks parameters.
Standing on the Edge: Engineering Students Grapple with Skill-based Automation

Abstract A shift to production systems that are skill-based rather than Taylorist (removing skill and intellectual effort) in their design has been widely endorsed. We focus on one major barrier to the transition to skill-based systems: the conceptual barrier inherent in engineering as it is currently taught. Engineering students who are later exposed to a worker-centered view of production and to the ideas of skill-based automation describe in extended interviews a pervasive, and sometimes acute, sense of conceptual and emotional conflict caused by the perceived clash between an engineering approach and a skill-based approach to production. Because it is impossible for students by themselves to reconcile these apparently conflicting views, and because there are few institutional roles available to people who can “see both sides,” students must remain painfully “on the edge” or choose one “side” over the other. To relieve the sense of conflict and to remove a barrier to skill-based automation, we suggest several possible avenues for research and action.
Some Factors that Influence Transfer of Oddity Performance in the Pigeon

In Experiment 1, five pigeons were trained on a six-key oddity-from-sample procedure. The third peck on the sample key lighted only one comparison stimulus. Every third peck on the sample key lighted another comparison stimulus up to a maximum of five stimuli. A peck on the key that presented the nonmatching comparison stimulus produced grain. Pecks to matching stimuli darkened the comparison keys and repeated the trial. Performance dropped to near chance levels and recovered rapidly after three novel oddity problems were provided. Experiment 2 shows that having trials that present novel stimuli alternate with trials that present familiar stimuli yields better transfer of oddity performance than direct replacement of familiar stimuli. Experiment 3 demonstrates that sequential presentation of the comparison stimuli maintains higher accuracy levels relative to trials that simultaneously illuminate all the comparison keys. Experiment 4 confirms the results of Experiment 3 and suggests that the sample ratio value is also an important variable.
Location-dependent impacts of liming and crop rotation on bacterial communities in acid soils of the Pacific Northwest

Abstract The cropping systems of northern Idaho and eastern Washington are dominated by a cereal-based (winter wheat) rotation that is exclusively rainfed. Following the green revolution, the productivity of wheat increased dramatically with semi-dwarf varieties and inexpensive synthetic fertilizers. However, long-term and frequent use of ammonium-based nitrogen fertilizers has resulted in the gradual acidification of fields in the region, with reduced productivity and symptoms of aluminum toxicity in some locations. A micronized liquid formulation of lime (calcium carbonate) was evaluated at three locations to mitigate soil acidification in comparison to a no-lime control. To examine how liming affects bacterial community structure, soil samples were taken in the spring in wheat and pea rotations 7 and 19 months after lime application, DNA was extracted and the V1-V3 portion of the 16S rRNA gene was amplified and sequenced with Illumina MiSeq. pH was only increased ∼0.2–0.3 units in most locations, and liming only had a significant effect on bacterial community composition at one location (Pullman). Liming had no consistent or significant effect on community richness or diversity. Location had a stronger effect on communities than liming or crop rotation, but some specific taxa increased in relative abundance in response to liming, including the families Cytophagaceae and Flavobacteriaceae (Phylum Bacteroidetes), A4b (Phylum Chloroflexi), and Opitutaceae (Phylum Verrucomicrobia). A number of operational taxonomic units (OTU) in Chitinophagaceae and Xanthomonadaceae were increased by liming at the Pullman location, which had 3–4 X more OTUs affected by liming than the other locations. Streptomycetaceae and Oxalobacteraceae were more abundant in root zone soil of wheat than pea. In conclusion, there was a strong interaction between liming and location in determining soil bacterial composition, but specific components of the bacterial community responded to even minimal increases in soil pH.
Model Development by Modal Analysis

In Chaps. 1–5, we assumed a model and then used that model to determine the system response in the time or frequency domain (or both). More often, however, we have an actual dynamic system and would like to build a model that we can use to represent its vibratory behavior in response to some external excitation. For example, in milling operations, the flexibility of the cutting tool–holder–spindle–machine structure (and sometimes the workpiece) determines the limiting axial depth of cut to avoid chatter, a self-excited vibration (Schmitz and Smith 2009). In this case, the dynamic response at the free end of the tool (and/or at the cutting location on the workpiece) is measured. Using this measured response, a model in the form of modal parameters can be developed for use in a time-domain simulation1 of the milling process. How can we work this “backward problem” of starting with a measurement and developing a model? To begin, we need to determine the modal mass, stiffness, and damping values from the measured frequency response function (FRF).
Treatment Implications of Situational Variability in Cognitive and Negative Symptoms of Schizophrenia

Cognitive impairments and negative symptoms in schizophrenia are associated with poorer outcomes and are typically resistant to pharmacological interventions. However, these features can vary drama...
Defining adverse events of anti-programmed-death-1 (Anti-PD1) agents using FDA adverse event reporting system (FAERS).

e14568Background: Anti-PD1 inhibitors are a promising therapeutic option in oncology. They have received FDA-approval in treating metastatic and relapsed non-small cell lung cancer, kidney cancer, ...
Impact of Atmospheric Circulation on Temperature, Clouds, and Radiation at Summit Station, Greenland, with Self-Organizing Maps

AbstractThe Greenland Ice Sheet (GrIS) plays a crucial role in the Arctic climate, and atmospheric conditions are the primary modifier of mass balance. This analysis establishes the relationship be...
Do Hospitals Participating in Accountable Care Organizations Discharge Patients to Higher Quality Nursing Homes

We examined whether hospitals participating in Medicare's Shared Saving Program increased the use of highly rated skilled nursing facilities (SNFs) or decreased the use of low-rated SNFs hospital-wide after initiation of their accountable care organization (ACO) contracts compared with non-ACO hospitals. Using a difference-in-differences design, we estimated the change in the probability of discharge to 5-star and 1-star SNFs among all beneficiaries discharged from ACO-participating hospitals after the hospital initiated ACO participation. After joining an ACO, the percentage of hospital discharges going to a high-quality SNF increased by 3.4 percentage points on a base of 15.4% (95% confidence interval [CI] 1.3-5.5, P = .002) compared with non-ACO-participating hospitals. The probability of discharge from an ACO-participating hospital to low-quality SNFs did not change significantly compared with non-ACO-participating hospitals. Our findings indicate that ACO-participating hospitals were more likely to discharge patients to highly rated SNFs after they began their ACO contract but did not change the likelihood of discharge to lower rated SNFs in comparison with non-ACO hospitals.
Giant Chemical and Excellent Synergistic Raman Enhancement from a 3D MoS2–xOx–Gold Nanoparticle Hybrid

Raman spectroscopy fingerprinting features many technological applications. For this purpose, the weak Raman signals need to be boosted dramatically by surface-enhanced Raman spectroscopy (SERS), which provides immense Raman enhancement via plasmonic and chemical mechanisms (CM). In this manuscript, we reveal the giant chemical as well as extremely high SERS enhancement from a three-dimensional MoS2-x O x -gold nanoparticle (GNP) hybrid, which has capability for ultrasensitive label-free sensing of chemical and biological molecules. Notably, reported data show that the chemical enhancement for the MoS2-x O x surface is ∼105, which is comparable with the plasmonic enhancement factor (EF) by GNP. Reported data show that the total Raman EF is ∼1013 from the GNP-MoS2-x O x hybrid. Intriguingly, combined experimental and theoretical finite difference time domain stimulation modeling findings show that the synergistic effect of electromagnetic mechanism and CM is responsible for huge SERS enhancement. Experimental results demonstrate that a proposed hybrid SERS platform can be used for fingerprint sensing of different multiple drug resistance bacteria at 5 cfu/mL concentration. Importantly, the current manuscript provides a good strategy for manipulating the SERS sensitivity to 13 orders of magnitude, which is instrumental for next-generation technological applications of Raman spectroscopy.
Changes in deep soil organic carbon and soil properties beneath tree windbreak plantings in the U.S. Great Plains

Agroforestry systems such as tree windbreaks became a common practice in the U.S. Great Plains following a large tree planting program during the Dust Bowl of the 1930s. Tree windbreaks combine the potential to increase biomass and soil carbon (C) storage while maintaining agricultural production. However, our understanding of the effect of trees on soil organic carbon (SOC) is largely limited to the upper 30 cm of the soil. This study was conducted in the Great Plains to examine the impact of tree plantings ranging in age from 15 to ~ 115-years on SOC storage and relevant soil properties. We quantified SOC stocks to 1.25 m depth within eight tree plantings and in the adjacent farmed fields within the same soil map unit. Soil samples were also analyzed for inorganic carbon, total nitrogen, pH (in water and KCl), bulk density, and water stable aggregates. Averaged across sites, SOC stocks in the 1.25 m were 16% higher beneath trees than the adjacent farmed fields. Differences ranged from + 10.54 to a – 5.05 kg m−2 depending on the site, climate, and tree species and age. The subsurface soils (30-125 cm) beneath trees stored 7% more SOC stocks than the surface 30 cm (9.54 vs. 8.84 kg m−2), respectively. This finding demonstrates the importance of quantifying C stored at deeper depths under tree-based systems when tree SOC sequestration is being assessed. Overall, our results indicate the potential of trees to store C in soils and at deeper depths.
“I want to serve but the public does not understand:” Prosocial motivation, image discrepancies, and proactivity in public safety

Abstract Scholars typically find that prosocial motivation is positively related to employee proactivity. However, we argue that in highly visible contexts such as public safety, this relationship is contingent on how employees think the public sees their jobs. Specifically, drawing on image discrepancy theories, we hypothesize that the relationship between prosocial motivation and proactive behavior is weakened when employees believe that the public fails to understand the difficulties of their jobs. This interaction is supported in multisource studies of 183 police officers across six agencies (Study 1a) and 238 firefighters across eight stations (Study 1b). In a time-separated, multisource study of 203 police officers at a metropolitan agency (Study 2), we further find that the interaction indirectly relates to proactivity via employees’ physical engagement. Overall, our studies highlight the importance of accounting not only for employees’ prosocial motivation, but also their perceived public image, especially in highly visible, high-risk contexts.
Productivity Panel & Discussion

As our community members continue to share their productivity journey, this popular panel topic returns to SIGUCCS with new faces. Listen to panel participants share their planning strategies, tools, and experiences then join in on the conversation with other attendees.
A Nine-Level Inverter for Single Phase PV Applications

Multi Level Inverters (MLI) are commonly used in high voltage and high power applications due to their lower filtering requirements, smaller dv/dt transitions and better EMI/EMC performance. This paper presents a Single Phase Nine Level Inverter (SPNLI) using a coupled inductor. The proposed converter has low switch count, fewer capacitors and better reliability. Detailed operation of the proposed SPNLI and its control in standalone operation are discussed. An active energy buffer is also added to SPNLI to supply double line frequency component thereby reducing DC bus capacitance requirement. MAT-LAB SIMULINK based simulation results are presented to validate the proposed topology.
Conceptual Foreknowings: An Integrative Review of Hope:

Hope is a universal humanuniverse living experience. To advance nursing knowledge of hope as a universal humanuniverse living experience, the scholar dwelled with printed material on hope and explored with pattern preferences. The purpose of this paper is to set forth the conceptual foreknowings arising from the integrative review of literature from diverse disciplines. Four themes arose from the review, which are elaborated here.
Active learning-driven quantitative synthesis–structure–property relations for improving performance and revealing active sites of nitrogen-doped carbon for the hydrogen evolution reaction

While quantitative structure–property relations (QSPRs) have been developed successfully in multiple fields, catalyst synthesis affects structure and in turn performance, making simple QSPRs inadequate. Furthermore, catalysts often have multiple active sites preventing one from obtaining insights into structure–property relations. Here, we develop a data-driven quantitative synthesis–structure–property relation (QS2PRs) methodology to elucidate correlations between catalyst synthesis conditions, structural properties and observed performance and to provide fundamental insights into active sites and a systematic way to optimize practical catalysts. We demonstrate the approach to the synthesis of nitrogen-doped catalysts (NDCs) made via pyrolysis for the performance of the electrochemical hydrogen evolution reaction (HER), quantified by the onset potential and the current density. We determine crystallinity, nitrogen species type and fraction, surface area, and pore structure of the NDCs using XRD, XPS, and BET characterization. We demonstrated that an active learning-based optimization combined with various elementary machine learning tools (regression, principal component analysis, partial least squares) can efficiently identify optimum pyrolysis conditions to tune structural characteristics and performance with concomitant savings in materials and experimental time. Unlike previous reports on the importance of pyridinic or graphitic nitrogen, we discover that the electrochemical performance is not driven by a single catalyst property; rather, it arises from a multivariate influence of nitrogen dopants, pore structure and disorder in the NDC materials. Identification of active sites can help mechanistic understanding and further catalyst improvement.
Asymptomatic macrocephaly: to scan or not to scan

Macrocephaly is a common finding in infants and is often idiopathic or familial. In the absence of clinical signs and symptoms, it can be difficult to determine when concern for underlying pathology is justified. The objectives of this study were to determine the utility of screening head ultrasound (US) in asymptomatic infants with macrocephaly and to identify clinical factors associated with significant US findings. A 20-year retrospective review was performed of infants undergoing head US for macrocephaly or rapidly increasing head circumference. Data collected included age, gender, head circumference at birth and at the time of US, specialty of the ordering physician, US findings, computed tomography (CT) or magnetic resonance imaging (MRI) findings, and clinical course including interventions. Four hundred and forty infants met inclusion criteria. Two hundred and eighty studies (64%) were found to be normal, 137 (31%) had incidental findings, 17 (3.8%) had indeterminate but potentially significant findings, and 6 (1.4%) had significant findings. Twenty of the 23 infants with indeterminate or significant findings had subsequent CT or MRI. This confirmed significant findings in eight infants (1.8%): three subdural hematomas, two intracranial tumors, two aqueductal stenoses, and one middle fossa cyst. Five of the eight infants required surgical procedures. The only statistically significant association found with having a significant finding on head US was head circumference at birth. Ultrasound is a useful initial study to evaluate infantile macrocephaly, identifying several treatable causes in our study and, when negative, effectively excluding significant pathology.
HIV-Related Stigma Moderates the Relation Between Perceived Susceptibility and HIV Testing Intention Among Heterosexual (but Not Sexual Minority) College Students:

HIV-related stigma remains a considerable barrier to engaging at-risk populations in HIV testing and prevention programs. We assessed the moderating role of HIV-related stigma on the relation betwe...
Gender trends of authors presenting at a regional vascular surgery meeting.

Abstract Objective We hypothesized a potential gender disparity within a regional society like the Southern Association of Vascular Surgery (SAVS) when compared with vascular surgery demographics in the region. To assess this, we analyzed meeting and membership participation at the SAVS compared with regional data from the Society of Vascular Surgery as well as board certification in vascular surgery published by the American Board of Surgery (ABS). Methods The published programs from the SAVS Annual Meeting from 2012 to 2019 were analyzed for membership, presenter gender, type, topic, discussant gender, moderator gender, postgraduate course presenter gender, and manuscript publication demographics. The ABS was petitioned and yearly Vascular Surgery diplomate (ABS-VS) gender from member states of the SAVS was examined for the same period. Fisher's exact Student's t-test and analysis of covariance were used. Results There were 257 total presentations (184 podium, 71.6%; 73 poster, 28.4%). A total of 61.4% (n = 43) of presentations by females were podium presentations, compared with 75.4% (n = 141) by males (P = .03). Females were less likely to be published when compared with their male counterparts (41.8% vs 58.7%, P = .02). The percentage of female gendered presenters statistically increased over the time period examined compared with a decrease in male presenters (R2 = 0.61, m = 1.27 vs R2 = 0.08, m = −0.35, P = .02). Female presenters had a female discussant 10.5% of the time compared with male presenters who had a male discussant 95.1% of the time (P Conclusions We found that female presenters at the SAVS Annual Meeting were less likely to be podium presenters, interface with other female discussants, and publish manuscripts when compared with their male counterparts. Statistically, female members were underrepresented within the SAVS membership rolls when compared with known boarded female vascular surgeons among southern member states. This gender gap highlights a unique opportunity to enhance and potentially increase mentorship opportunities for female trainees who are presenting and/or attending this regional vascular surgery meeting.
Addressing learner anxiety via reflective practice.

BACKGROUND Medical students experience anxiety when learning the pelvic, breast and male genitourinary exam (also known as sensitive physical exams). Reflection can help students process emotionally challenging learning experiences and help give those experiences meaning. We describe the development of a reflection module to enhance reflection during sensitive exam instruction. APPROACH We developed this module following Kern's Six Step Method for curriculum development, including a targeted needs assessment. Informed by educational reflection theory, the module addressed all elements of reflection. The module was optional, asynchronous and administered online, requiring minimal administrative support. Prior to sensitive exam instruction, participants identified goals and values and named emotions. Following exam instruction, participants again named their emotions and then self-evaluated whether they had met their goals and upheld their values. EVALUATION Participants found the module to be a useful modality to reflect. Most notably, they identified the naming of emotions, goals and values clarification and the opportunity to reflect both prior to and after an educational experience as helpful. Younger students found the module particularly helpful. IMPLICATIONS An online, low-resource, asynchronous reflection module is feasible and can be a way for students to reflect on challenging learning experiences. In addition to using with sensitive exam instruction, the module can be applied to activities such as anatomic dissection, ethics workshops or clinical learning.
A Phase 2 Study of 5-Day Preoperative Radiotherapy for Patients With High-Risk Primary Soft Tissue Sarcoma.

Purpose/Objective(s) Preoperative radiation therapy (RT) is an integral component of local control in soft tissue sarcoma (STS), but the conventional 5-week treatment course is burdensome for patients (pts). We conducted a single-institution phase 2 study of 5-day dose-equivalent preoperative RT for high-risk primary STS, which demonstrated acceptable rates of wound complications and 2-year toxicity. Here, we present results with longer follow-up, including additional pts from an expansion cohort. Materials/Methods The initial cohort accrued between April 2016 and May 2018 and included 52 pts with histologically confirmed extremity or trunk STS planning to undergo preoperative RT followed by surgery. The primary endpoint of the initial cohort was the rate of grade ≥2 radiation morbidity (fibrosis, lymphedema, or joint stiffness) at 2-years. An expansion cohort opened in October 2018 to compare wound complication rates between preoperative RT alone versus chemoRT and has enrolled an additional 47 pts. Patients received 30 Gy (RT alone) or 25 Gy (chemoRT) over 5 daily fractions to the primary tumor with standard margins. Here we report on pts with primary localized STS who completed preoperative RT and surgery in the initial and expansion cohorts (N = 79; chemoRT excluded). We assessed disease outcomes (local control, distant metastasis, and survival rates) and toxicity (grade ≥2 fibrosis, lymphedema, or joint stiffness) after minimum 2-year follow-up (N = 52). Fibrosis and joint stiffness were graded using RTOG/EORTC criteria, and lymphedema by Stern's scale. We also updated the major wound complication rate (defined per established criteria) after minimum 1-year follow up (N = 60). Results Of the 52 pts with minimum 2-year follow-up, predominant histologic subtypes included undifferentiated pleomorphic sarcoma, spindle cell sarcoma or sarcoma NOS (N = 24), myxofibrosarcoma (N = 8), and myxoid liposarcoma (N = 12). Median tumor size was 6.9 cm, and 15 pts had tumors ≥10 cm. At a median follow-up of 3 years, the local recurrence, distant metastasis and all-cause mortality rates were 6.5% (3 of 46 evaluable pts), 20.8% (10 of 48 evaluable pts), and 21.2% (11 of 52). Two of 3 pts (66%) with a local recurrence had undergone R1 resections, compared to 9 of 46 (19.5%) overall. The rate of overall grade ≥2 radiation morbidity in this same group was 13.0% (fibrosis: 5 pts, joint stiffness: 5 pts, lymphedema: 2 pts). Major wound complications were observed in 16 out of 60 (26.7%) evaluable pts. Conclusion Longer follow-up of a phase 2 study of 5-day pre-operative RT for pts with extremity/trunk STS demonstrates excellent local control. Rates of radiation fibrosis, joint stiffness and lymphedema, as well as wound complications, remain acceptable. We have also developed a web-based, interactive user interface for data visualization, which can help providers identify and understand relationships between baseline characteristics and clinical outcomes in our study.
Structural Studies of the Murine Ia Alloantigens

The I region of the murine major histocompatibility complex (MHC) regulates a variety of immune functions through the control of cellular interactions and antigen responsiveness (Benacerraf and McDevitt, 1972; reviewed in Klein, 1975; Shreffler and David, 1975; Katz, 1977). The gene products thus far demonstrated for the I locus are cell-surface glycoproteins, designated as the Ia (immune-associated) antigens (Shreffler et al., 1974). Numerous studies have demonstrated that anti-Ia alloantisera inhibit many I-region-controlled immune responses. These include the induction of both T-lymphocyte proliferation (R.H. Schwartz et al., 1976a, 1978a) and antibody synthesis (J.A. Frelinger et al., 1975; Niederhuber and Frelinger, 1976) by certain antigens, successful collaboration among immunocompetent cells (Katz et al., 1974; Pierce et al., 1976; Kappler and Marrack, 1976), immune suppression (Murphy et al., 1976; Tada et al., 1976; Pierres et al., 1978), and the induction of mixed-lymphocyte reactions (MLR) (Meo et al., 1975). Thus, the Ia antigens may function as recognition units that mediate interactions among cells and/or between cells and antigen.
TU‐E‐BRB‐01: Overview of DIR Advantages/Challenges and Workflow

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: 1. Compare/contrast commercial DIR software and QA options 2. Overview clinical DIR workflow for retreatment 3. To understand uncertainties introduced by DIR 4. Review TG-132 proposed recommendations
Update on the Biology of Transgender Identity

Numerous studies have attempted to isolate biological factors in the development of transgender identities through research into genetics, prenatal hormone exposure, neuroanatomy, and cognitive processing. Genetic studies demonstrate that chromosomal variations are uncommon but may occur at higher rates than in the general population. Candidate genes have been investigated, with some positive results, though these have yet to be replicated. Investigations into the effects of hormone exposure on the developing fetus have focused on gender identity in intersex people, which is often unpredictable, and proxy markers for prenatal hormone exposure such as finger length ratio and birth order, which do not show clear trends in transgender groups. A few small neuroanatomical studies show distinctions in transgender people, but results are limited in their scope due to small sample sizes and confounding variables such as adult hormone exposure. Numerous studies demonstrate that male-to-female (MTF) transgender peo...
Intelligent Neural Network Based Decision Unit for Robot Safety

This article concerns the use of a neural system in a previously unreported, but highly significant, application in robotics safety. It presents a neural network based decision unit for a real-time robot safety system. The decision unit occupies a high level position in the sensory processing hierarchy, using information from signal processing and detection at lower levels. The developed neural network accepts the following input: a map containing potential collision zones encoded as belief values into grids, the magnitude of a robot's velocity vector, and the robot's steering angle. The neural network decision is based on computation of the scalar product of two vectors, the virtual repulsive force vector generated by the obstacle and the robot's velocity vector; it produces one of the following safety decisions: move as intended, slow down, or emergency stop. The effectiveness of this approach is verified by computer simulation. The response time of the neural network measured on the state of the art personal computer is 6 msec, and the correctness of the safety decisions exceeds 90%.
Rearing in natural and recovering tidal wetlands enhances growth and life‐history diversity of Columbia Estuary tributary coho salmon Oncorhynchus kisutch population

This study provides evidence of the importance of tributary tidal wetlands to local coho salmon Oncorhynchus kisutch populations and life-history diversity. Subyearling and, to a lesser extent, yearling O. kisutch life histories utilized various estuary habitats within the Grays River, a tidal freshwater tributary of the Columbia River estuary, including restoring emergent wetlands and natural forested wetlands. Migration timing data, size distributions, estuary residence and scale patterns suggest a predominance of subyearling migrant life histories, including several that involve extended periods of estuary rearing. Estuarine-rearing subyearling O. kisutch exhibited the greatest overall growth rates; the highest growth rates were seen in fish that utilized restoring emergent wetlands. These results contrast with studies conducted in the main-stem Columbia River estuary, which captured few O. kisutch, of which nearly all were hatchery-origin yearling smolts. Restoration and preservation of peripheral and tributary wetland habitats, such as those in the Grays River, could play an important role in the recovery of natural O. kisutch populations in the Columbia River and elsewhere.
Diabetes in Canada's First Nations

William Panton raises an interesting issue regarding the rarity of historical reports of type 2 diabetes among Aboriginal people in Canada.
Failure to detect hemagglutination-inhibiting antibodies with intact avian influenza virions.

Avian influenza viruses replicate in a variety of mammals and birds, yet hemagglutination inhibition tests show that postinfection sera from these animals (e.g., ferrets and ducks) have insignificant levels of antibodies (Hinshaw et al., Infect. Immun. 34:354-361, 1981). This suggested that avian influenza viruses, in contrast to mammalian viruses, may not induce a significant humoral response. Studies reported here indicate that avian influenza viruses do induce high levels of antibodies in ferrets, ducks, and mice and produce long-lived memory for cytotoxic T-cells in mice. The failure to detect hemagglutination-inhibiting antibodies to avian viruses was explained by the finding that antibodies to avian influenza viruses were not detectable in hemagglutination inhibition tests with intact virus yet were readily demonstrable when hemagglutinin subunits were used. In addition, these sera contained high levels of neutralizing antibodies to the avian virus. These findings suggest that the hemagglutinins of avian and mammalian influenza viruses may differ in their accessibility to antibodies or the biological consequence of antibody attachment or both. The practical consequence of these studies is that hemagglutination inhibition tests with intact avian viruses fail to detect antibody and do not correlate with virus neutralization. The avian virus used in these studies, A/Mallard/NY/6870/78 (H2N2), replicated and caused mortality in BALB/c mice, emphasizing that the host range and virulence of avian viruses extends to mammals. The above findings suggest that avian viruses could infect mammals in nature, yet seroepidemiological studies with conventional hemagglutination inhibition tests could give misleading results.
Experimental measurement of passive material and structural damping for flexible space structures

Among the design objectives for large space structures are the maintenance of tight dimensional tolerance and the reduction of settling time after disturbance input. Two options are under consideration for the design of flexible structures to meet these objectives, including an active control option and a passive control option. In connection with both options, it is necessary to include material and structural damping in the design. A description is presented of the results of an experimental investigation of the damping of metallic and fibrous composite materials, taking into account also the analytical modeling and experimental verification of frictional damping schemes. To demonstrate how material and frictional damping can be combined, a simple structural optimization is performed, indicating the potential for significant savings in mass by the addition of frictional dampers.