cssi/SciSciGPT-SciSciNet huggingface dataset:
Pelvic Inflammatory Disease: Considerations Related to Therapy

Since the early 1970s, the Centers for Disease Control (CDC) and the U.S. Public Health Service have recommended regimens of therapy for gonorrhea and its recognized complications, including pelvic inflammatory disease (PID). This paper summarizes the current situation with regard to PID and provides background information essential to the reassessment and possible revision of the current (1979) CDC recommendations [1]. Pelvic inflammatory disease is the most important complication of gonorrhea in terms of morbidity, personal suffering, and economic loss [2]. According to Curran [3], more than 850,000 episodes occur each year, resulting in more than 200,000 hospitalizations, more than 100,000 surgical procedures, and about 2,500,000 visits to the offices of private physicians. The direct and indirect costs of PID and PID-associated ectopic pregnancy in 1979 are estimated to have been $1.25 billion. The postsalpingitic state is associated with an increased risk of recurrence of PID. Also, each episode increases the risk of other consequences, such as infertility, ectopic pregnancy, pelvic adhesions, chronic pelvic pain, dyspareunia, and tuboovarian abscess [2, 4-7]. Many of these conditions ultimately lead to major pelvic surgery [2, 7-9]. The treatment of pelvic inflammatory disease, more than that of many other sexually transmitted
Simultaneous Determination of Regression Equations for Body Composition, Body Measurements and Metabolic Rate in Rats

Summary56 normal male albino rats, with body weights from 180 to 650 grams were analyzed for total body fat (lipid), protein, non-lipid, and water, and had measurements made of their oxygen consumption, nose-anus length, and chest and abdomen circumferences. All these variables were regressed upon the 4-hour fasted body weight and the appropriate regression equations determined.
Association of Distance Traveled for Surgery with Short- and Long-Term Cancer Outcomes

The influence of distance traveled for treatment on short- and long-term cancer outcomes is unclear. Patients with colon, esophageal, liver, and pancreas cancer from 2003 to 2006 were identified from the National Cancer Data Base (NCDB). Distance traveled for surgical treatment was estimated using zip code centroids. Propensity scores were generated for probability of traveling farther for treatment. Mixed effects logistic regression for 90-day mortality and Cox regression for 5-year mortality were compared between patients treated regionally and those traveling from farther away. The mean distance traveled for all patients for surgical resection was 30.0 ± 227 miles, with a median distance of 7.5 (interquartile range 14.4) miles. Patients who were aged ≥80 years, on Medicaid, or African American were less likely to be in the fourth quartile of distance (Q4) traveled for surgery. Patients who were in Q4 had a lower risk-adjusted 90-day mortality compared to Q1 for colon [odds ratio (OR) 0.89, 95 % confidence interval (CI) 0.82–0.96], liver (OR 0.49, 95 % CI 0.3–0.78), and pancreatic (OR 0.74, 95 % CI 0.56–0.98) cancer. Similarly, patients in Q4 for all tumor types had a lower risk-adjusted 5-year mortality compared to patients in Q1; colon (hazard ratio (HR) 0.96, 95 % CI 0.93–0.99), esophagus (HR 0.84, 95 % CI 0.75–0.94), liver (HR 0.75, 95 % CI 0.62–0.89), and pancreas (HR 0.87, 95 % CI 0.80–0.95). Greater travel distance for surgical resection of gastrointestinal cancers is associated with lower 90-day and 5-year mortality outcomes. This distance bias has implications for regionalization and reporting of cancer outcomes.
An Archaeological Survey of a Proposed Water Main in Val Verde County, Texas

During September 11-13,1985, the Center for Archaeological Research, The University of Texas at San Antonio, conducted an archaeological survey of a proposed water main pipel ine for the Department of the Army, Al buquerque District, Corps of Engineers. The pedestrian survey identified one archaeological site (41 VV 810) that produced no temporally diagnostic artifacts. Construction of the water main will not adversely affect the site.
Simulation of Dynamos chaotic system based Simulink

Dynamos chaotic system has complex vectors.In order to study the dynamic behaviors of Dynamos chaotic system,the system is translated into the real kinetics equation in combination with with the complex Dynamos equation of the system.The graph visualization and parameter adjustable characteristics of Simulink is utilized.The system circuit was simulated.The results show that it has chaotic behaviors under certain parameters of the system,and the two real variables of the same complex vector have synchronous features.It show that the system has abundant chaotic behaviors.
Data of enzymatic activities of the electron transport chain and ATP synthase complexes in mouse hepatoma cells following exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)

2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is the most widely studied ligand of the aryl hydrocarbon receptor (AHR). The AHR-dependent TCDD-induced mitochondrial hyperpolarization (Tappenden et al., 2011) [1] and reduced oxygen consumption rate of intact mouse hepatoma cells (Huang et al., in press) [2] in the previous studies suggest that these alterations can be related to enzymatic activities of the electron transport chain (ETC) and ATP synthase in oxidative phosphorylation (OXPHOS) system. Here, we evaluated the activity of each complex in the OXPHOS system using in vitro enzymatic assays. The calculated enzymatic activity of each complex was normalized against the activity of citrate synthase. To combine each value from an independent experiment, normalized enzyme activities from cells exposed to TCDD were converted to fold changes via comparison to the activity relative to time-matched vehicle control. The averaged fold change for each treatment suggests more replicates are needed in order to clearly evaluate a difference between treatments.
Ligand specificity of state transitions in the cholinergic receptor: behavior of agonists and antagonists.

Several cholinergic ligands, including a series of methylene-linked bisquaternary ammonium compounds, have been examined for their ability to induce a state transition in the membrane-associated cholinergic receptor where there is a slow increase in affinity for the associating ligand. All of the agonists tested, as well as certain antagonists, notably the metaphiic antagonists, convert the receptor to a higher affinity state. Moreover, the rate of receptor conversion appears to be independent of the ligands’ capacity to activate the receptor. By applying the two-state cyclic scheme used to explain desensitization to these affinity increases, the apparent binding constants of each ligand for the R and R’ receptor states were determined. Full agonists have a 300-fold higher affinity for the R’ state while the classical antagonists (i.e., d-tubocurarine and gallamine) have the same affinity for both receptor states. Apparent negative cooperativity is observed for the antagonists. Partial agonists, which are represented by the methylene-linked bisquaternary series have ratios of affinities for the two states which lie between these extremes. The metaphilic antagonists, which appear to be unique in situ in showing enhanced antagonism for receptors previously conditioned by agonist, will in themselves effect a conversion in receptor state. The structural specificity for the ligands’ capacity to effect a conversion in receptor state lends further support to the contention that the conversion from the low to high affinity state in vitro and receptor desensitization involve the same molecular transition.
Coupled Multiple Musculo-Neurovascular Variations in Same Upper Limb: A Case Report and Clinical Significances

Variantes del nervio mediano y cabezas adicionales de los musculos flexores del antebrazo, se relacionan con la arteria mediana persistente (AMP). Presentamos los resultados de una AMP (diametro 3,25 mm), un nervio mediano pinzado y cabezas accesorias de los musculos flexor profundo de los dedos (FPD) y flexor largo del pulgar (FLP) que coexisten con una arteria braquiorradial (ABR) (diametro 1,8 mm) en el miembro superior izquierdo de un cadaver de sexo masculino de 65 anos. El nervio mediano proporciona un anillo para el paso de la AMP sobre la union de los tercios proximal y medio del antebrazo. Ambos musculos accesorios se colocaron por delante de la arteria ulnar, con la arteria braquiorradial ubicada superficialmente en el brazo y en el antebrazo. El diametro notable de la AMP puede ser la causa del sindrome del tunel carpiano, mientras que la ABR hipoplasica puede plantear algunos desafios en su seleccion como buen conducto para la cateterizacion y otras intervenciones quirurgicas como la cirugia de revascularizacion coronaria a partir del miembro superior. De interes clinico se considera la posible reduccion en el suministro de sangre debido a la compresion de los 2 musculos accesorios a la arteria ulnar y la posible inyeccion fallida de drogas debido a la ubicacion superficial de la arteria braquiorradial, cercana a las venas.
A Voting-Based Distributed Cooperative Spectrum Sensing Strategy for Connected Vehicles

In this paper, we propose a novel distributed cooperative sensing algorithm for connected vehicles. The adaptive energy detection threshold, which is used to decide whether the channel is busy, is optimized in this paper by using a computationally efficient numerical approach. The proposed optimization approach minimizes the probability of an incorrect detection as a function of both the probability of false alarm and the probability of missed detection. By considering both probabilities when computing the probability of incorrect detection, to the best of the authors' knowledge, the proposed approach is novel. During the energy detection process, large-scale fading, multipath fading, Doppler effect, and transmission errors affecting the control messaging process are accounted for in order to provide a practical solution for connected vehicles. Once the available channels have been detected, the vehicles share this information using broadcast control messages. Each vehicle evaluates the available channels by voting on the information received from one-hop neighbors, where the credibility of each neighbor is weighted during the voting process. An interdisciplinary approach referred to as entropy-based weighting is used to define the neighbor, as well as the vehicle's own credibility. The voting mechanism is switched between the proposed voting mechanism and the traditional voting approach obtained from the current state of the art in order to maintain a balance between the computational cost/latency and robust spectrum sensing. Experimental results show that by using the proposed distributed cooperative spectrum sensing mechanism, spectrum detection error converges to zero.
Imaging Registries and Single-Center Series.

Abstract Randomized controlled trials are often regarded as the pinnacle of research designs, valued for their rigor and internal validity. However, their high costs and selected patient populations limit their applicability, and complementary study designs are needed to guide evidence. In the realm of cardiovascular imaging, research designs using single-center series and registries have contributed key foundational insights into diagnosis, resource use and cost patterns, and prognosis as derived from practical, “real-world” settings. This review highlights the strengths and limitations of these study designs, provides notable examples, and indicates future directions for research.
Cyclopentadienyl Cobalt Complexes as Precatalysts for Electrocatalytic Hydrogen Evolution

Electrocatalytic hydrogen evolution is reported with a series of dicationic cobalt complexes [CpCo(N^N)(CH3CN)](ClO4)2 (Cp = cyclopentadienyl; N^N = bipyridine, pyrazolylpyridine, phenylazopyridine) using N,N-dimethylformamidinium buffer as the proton source in acetonitrile. The catalytic current profiles obtained for each complex are very similar to each other with overpotentials ranging from 1.2 to 1.4 V, which suggests a common active catalytic species. Further electrochemical studies demonstrate that these complexes are unstable under electrocatalytic conditions: the bidentate nitrogen ligand is readily lost upon reduction in the presence of acid, initially generating [CpCo(CH3CN)3]+, which undergoes further decomposition to surface-adsorbed species that are responsible for the observed electrocatalysis.
Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management.

Adjuvant endocrine therapy (AET) utilization is linked to improved clinical outcomes among breast cancer survivors (BCS); yet, AET adherence rates remain suboptimal. Little is known about provider perspectives regarding barriers and facilitators to AET-related symptom management (SM). In this study, we examined provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. We conducted three focus groups (FGs) with a multidisciplinary group of healthcare providers (n = 13) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM. FGs were audiotaped, transcribed, and analyzed using qualitative software to identify key themes. Providers described patient-, provider-, and system-level barriers and facilitators to AET-related SM. At the patient-level, barriers included competing demands, limited time/resources, and possible misattribution of some symptoms to AET, while family/social relationships and insurance emerged as important facilitators. Discomfort with SM, limited time, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Provider-level facilitators included routine symptom documentation and strong provider relationships. Care fragmentation and complexity of the cancer care delivery system were described as system-level barriers; however, survivor clinics were endorsed by providers. Provider perspectives on AET-related SM can shed light on SM barriers and facilitators spanning multiple levels of the cancer care delivery system. Strategies for improving AET-related SM in BCS include increasing patients’ knowledge and engagement in SM, equipping providers with efficient SM strategies, and improving coordination of symptom-related services through survivorship programs.
Chapter 9's Neutral Experts

U.S. municipalities are risking unprecedented financial problems. Local pension funds, backed by politically motivated promises and shaky assumptions, threaten to destabilize even the wealthiest cities in the country. Most cities and towns are ill-prepared to deal with the effects of a large-scale pension crisis, and many are compounding pension problems with other unsustainable debt obligations. Bankruptcy is one tool that municipalities can use to address pensions and debt overhang. Although filings under chapter 9 of the Bankruptcy Code briefly rose following the Great Recession, municipalities today increasingly seek out alternatives to manage fiscal distress, to varying degrees of success. Scholars have long sought to understand chapter 9’s shortcomings and to prescribe remedies to make chapter 9 a more useful and palatable option. This Article contributes to this effort by exploring a common, yet understudied, problem with chapter 9 — the sheer difficulty judges face in applying the generalized plan confirmation standards to wildly different entities — and drawing connections to similar problems facing the bankruptcy system as a whole. Using municipal bankruptcy as a framework, this Article demonstrates the difficulty that both debtors and judges have in articulating an entity’s best path forward, out of bankruptcy. In drawing parallels to similar struggles outside of the chapter 9 context, the Article identifies a commonly proposed resolution: the appointment of a neutral expert to perform carefully prescribed roles. The Article then analyzes whether and how such an expert would be beneficial in the chapter 9 context, as well as the benefits — including legitimacy, clarity, and transparency — of establishing formal processes for selecting, appointing, and utilizing experts in chapter 9.
Ictal and Interictal EEG

The EEG is an essential part of the initial evaluation of patients presenting with paroxysmal episodes and the surgical evaluation of patients with medically intractable seizures. The EEG is often ordered in the outpatient setting with or without concomitant video. Ictal EEG recordings are most commonly obtained in inpatient Epilepsy Monitoring Units with concomitant video, facilitating clinicoelectrographic correlations. This chapter will cover the basic morphologic features of interictal and ictal discharges and their clinical significance.
Exploring Effectiveness of Programs and Tools for 3D Printing Wearable Product

Due to the rapid adoption of digital fabrication technologies, such as 3D printing, the textile and apparel industry is recognizing the unique advantage of efficiently prototyping complex objects for various customized products. Today, 3D apparel design pioneers who have been trained in traditional practice lack the knowledge in 3D CAD and are often collaborating with 3D CAD experts in 3D printing product development. More importantly, the most popular 3D CAD programs are designed for engineers and thus lack intuitive features suitable for traditional apparel designers and products. This design case study investigates the effectiveness of popular 3D CAD program (Rhino) and tools (3D mouse) for the traditional apparel designer in wearable product prototyping. Findings suggest that 3D CAD program like Rhino challenges the way an apparel designer interprets CAD tools in creating various complex forms and reconsider orders of operation in product development.
Consumer factors predicting level of treatment response to illness management and recovery.

OBJECTIVE This study aims to identify consumer-level predictors of level of treatment response to illness management and recovery (IMR) to target the appropriate consumers and aid psychiatric rehabilitation settings in developing intervention adaptations. METHOD Secondary analyses from a multisite study of IMR were conducted. Self-report data from consumer participants of the parent study (n = 236) were analyzed for the current study. Consumers completed prepost surveys assessing illness management, coping, goal-related hope, social support, medication adherence, and working alliance. Correlations and multiple regression analyses were run to identify self-report variables that predicted level of treatment response to IMR. RESULTS Analyses revealed that goal-related hope significantly predicted level of improved illness self-management, F(1, 164) = 10.93, p < .001, R2 = .248, R2 change = .05. Additionally, we found that higher levels of maladaptive coping at baseline were predictive of higher levels of adaptive coping at follow-up, F(2, 180) = 5.29, p < .02, R2 = .38, R2 change = .02. Evidence did not support additional predictors. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Previously, consumer-level predictors of level of treatment response have not been explored for IMR. Although 2 significant predictors were identified, study findings suggest more work is needed. Future research is needed to identify additional consumer-level factors predictive of IMR treatment response in order to identify who would benefit most from this treatment program. (PsycINFO Database Record
Coronary stenting decreased restenosis after angioplasty

Source Citation Rodriguez AE, Santaera O, Larribau M, et al. Coronary stenting decreases restenosis in lesions with early loss in luminal diameter 24 hours after successful PTCA. Circulation. 1995 ...
Behavioral Activity of Hydrocarbons Emitted by Honeybee Waggle Dancers

Waggle-dancing honeybee foragers emit four hydrocarbons that have been shown to stimulate colony foraging by reactivating experienced foragers and increasing the number of recruitment dances. These hydrocarbons, the alkanes tricosane and pentacosane, and the alkenes (Z)-9-tricosene and (Z)-9-pentacosene, are part of the array of social insects cuticular lipids which have been well studied in the context of nestmate recognition. This study seeks to determine which of the dance hydrocarbons produce the behavioral responses of forager bees by using a binary choice behavioral assay for attraction or repulsion to the volatile phase of the dance compounds. We found no significant deviation from random choice for single dance compounds and pairs of compounds, but bees were significantly attracted to a mixture of the three compounds (Z)-9-tricosene, tricosane, and pentacosane. These results suggest synergy among the waggle-dance hydrocarbons, which was unexpected based on previous research where, in the context of nestmate recognition, alkenes have been shown to play a key role in eliciting behavioral responses. Synergy among the waggle-dance hydrocarbons may provide specificity that facilitates adaptive, context-specific behavioral responses to this subset of cuticular hydrocarbons.
Parts and Pieces: Evolutionary and Biological Models

Human behavior is neurochemically based because humans are organic creatures. This is not to say that the human body is just a bag of chemicals. It is an organized system of neurochemical reactions that permits higher-order thinking, consciousness, volition, and altruism. Interconnected networks of neurocircuits allow the body to respond to the environment and act on it. Detection of stimuli, perception, cognition, memory, emotion states, feelings, and behavior are functions of internal neural and neurochemical processes. Internal sexual feelings and external sexual behavior are also products of neural and neurochemical processes.
Search-Based Stress Testing the Elastic Resource Provisioning for Cloud-Based Applications

One of the main benefits of cloud computing is to enable customers to deploy their applications on a cloud infrastructure that provisions resources (e.g., memory) to these applications on as-needed basis. Unfortunately, certain workloads can cause customers to pay for resources that are provisioned to, but not fully used by their applications, and as a result their performances then deteriorate beyond some acceptable thresholds and the benefits of cloud computing may be significantly reduced or even completely obliterated. We propose a novel approach to automatically discover these workloads to stress test elastic resource provisioning for cloud-based applications. We experimented with four non-trivial applications on the Microsoft Azure cloud to determine how effectively and efficiently our approach explores a very large space of the workload parameters’ values. The results show that our approach discovers the first irregular workload faster in the search space of over \(10^{40}\) input combinations compared to the random approach, and it discovers more irregular workloads that result in much higher costs and performance degradations for applications in the cloud.
Monocoque shell and tube heat exchanger for thermoacoustics

Heat exchangers can be a limiting factor to thermoacoustic power density. They can also be difficult to construct because of a tendency toward many small parts due to the small size of the thermal penetration depth. We present a heat exchanger that consists of around five pieces and yet has very small feature size and is easy to construct in large numbers. A sacrificial mandrel, consisting of a sheet with a lattice of specially shaped holes, is formed by casting in a mold with a lattice of specially shaped pins. The mandrel is plated with nickel, electroless nickel, or other metal. The mandrel is then removed by melting or dissolving, leaving a monocoque tube bundle. A screen mesh may be joined to one or both faces of the monocoque to act as fins to improve thermal contact to the working fluid that flows through the tubes. Coolant flows around the tubes within the monocoque shell. For a typical device, we find that without a mesh on the monocoque, lost work is minimized with tubes on the order of 8 mm long and spaced by 0.4 mm, but with a 100-mesh copper screen on both faces, the tubes can be a more manageable 3 mm long spaced by 4 mm.
Making Smart Thermostats Cost-Effective by Predicting the Future

As we move towards an era of green energy sources and smart home energy management systems, the way we address the power flow within the grid is changing. Thus, it is imperative to find suitable ways to manage power more efficiently. Demand management strategies play a very important role in this domain. Thermostatically controlled loads (TCLs) can help us design intelligent systems and decide how energy flows within the power grid, leading to better energy consumption patterns and generating savings for the end users. The concept of flexible control of TCLs has been under research for a while now, but there is still a lack of experiments where the concept is applied. This paper aims to reduce this backlog. The motivation behind this paper is manifold. Primarily, it calls for a need to address the issue of smart management of the customers’ demand. This is where thermostatically controlled loads (TCLs) come into the picture. The second motivation was to demonstrate the capabilities of a smart grid application in a classroom environment, with the use of basic material available in the market. The third and final motivation was to show that applying distributed control is, for grids on the demand side, more effective and a need of the hour. All these issues have been addressed in this paper. The outcome is an algorithm that can optimize power flow at the distribution level of the grid and handle demand load in a practical and efficient way. This algorithm, which has been implemented on a physical device to provide experimental results, can be further applied in prototypes for their use in homes with smart meters and other smart grid appliances. The results of this paper lead to an efficient management of the load.
The Impedance-Based Stability Analysis of the Single-Phase Solid State Transformer

The whole stability analysis of the single-phase solid state transformer (SST) is proposed in this paper. Firstly, the different SST concepts has been researched in literature and technical aspects. Meanwhile, plenty of inherent characteristics can potentially limit the application of the SST in microgrid, e.g. low-frequency oscillation and harmonic oscillation. As a result, the stability analysis of the SST in detail is discussed in this paper. First and foremost, the typical structure of the SST and its each subsystem controller are studied. Further, the stability analysis of the each subsystem is provided via closed-loop transfer function, respectively. In the end, the whole stability analysis based on $Z+Z$ type cascade system impedance analysis is studied. The impedance-based stability analysis method of the single-phase SST can be validated through relative simulation results.
Why Nuclear Imaging and Radiotherapy

Nuclear medicine is a diagnostic and therapeutic medical subspecialty that focuses on the use of radiopharmaceuticals for measuring in vivo molecular biology and for identifying and quantifying functional and molecular pathophysiology associated with a variety of disease processes. Molecules labeled with radionuclides—termed radiopharmaceuticals or radiotracers—are a fundamental component of the specialty. As such, radiopharmaceutical chemistry is a key discipline for nuclear medicine. This introductory chapter describes the fundamental principles of nuclear medicine, reviews the current and future applications of nuclear imaging and targeted radiotherapy, contrasts nuclear medicine with other approaches to imaging and therapy, delineates the scientific and technological tools key to the field, and highlights future directions for the specialty.
Delayed splenic hemorrhage: Myth or mystery? A Western Trauma Association multicenter study.

Abstract Background Multi-detector computed tomography imaging is now the reference standard for identifying solid organ injuries, with a high sensitivity and specificity. However, delayed splenic hemorrhage (DSH), defined as no identified injury to the spleen on the index scan but delayed bleeding from a splenic injury, has been reported. We hypothesized that the occurrence of DSH would be minimized by utilization of modern imaging techniques. Methods Data was retrospectively collected from 2006 to 2016 in 12 adult Level I and II trauma centers. All patients had an initial CT scan demonstrating no splenic injury but subsequently were diagnosed with splenic bleeding. Demographic, injury characteristics, imaging parameters and results, interventions and outcomes were collected. Results Of 6867 patients with splenic injuries, 32 cases (0.4%) of blunt splenic hemorrage were identified. Patients were primarily male, had blunt trauma, severely injured (ISS 32 (9–57) and with associated injuries. Injuries of all grades were identified up to 16 days following admission. Overall, half of patients required splenectomy. All index images were obtained using multi-detector CT (16–320 slice). Secondary review of imaging by two trauma radiologists judged 72% (n = 23) of scans as suboptimal. This was due to poor scan quality primary from artifact(23), single phase contrast imaging (16), and/or poor contrast bolus timing or volume (6). Notably, only 28% of scans in patients with DSH were performed with optimal scanning techniques. Conclusion This is the largest reported series of DSH in the era of modern imaging. Although the incidence of DSH is low, it still occurs despite the use of multi-detector imaging and when present, is associated with a high rate of splenectomy. Most cases of DSH can be attributed to missed diagnosis from suboptimal index imaging and ultimately be avoided.
Predicting fracture behavior of aluminum alloys

A computational method has been developed to predict the material fracture failure process in flawed or cracked specimens. This method does not require experimental material fracture data. Finite element technique is employed to model the physical shape of the specimen. Nonlinear spring elements are introduced to model the material damage behavior near a flaw or a crack tip. Crack initiation and crack propagation conditions are developed to predict the crack initiation load, the extent of material damage, and the crack growth behavior. The introduction of nonlinear spring elements and the development of crack initiation and crack growth conditions are unique features for fracture prediction with the development of this method. To prove the feasibility of the method, two types of specimen made by two aluminum alloys with similar material stress-strain data were studied. Fracture predictions by this method are comparable to experimental data.
Relationship between iliotibial band syndrome and hip neuromechanics in women runners.

Abstract Background Atypical frontal plane hip kinematics are associated with iliotibial band syndrome in women runners. Gluteus medius is the primary muscle controlling the hip adduction angle during the loading response of stance. It is unclear if differences exist in gluteus medius activity magnitude and activity duration between runners with previous iliotibial band syndrome and controls. Furthermore, hip neuromechanics may change after a prolonged run. Research Question Do differences exist in the hip adduction angle and gluteus medius activity between women with previous iliotibial band syndrome and controls at the beginning and end of a 30-minute moderate paced treadmill run? Methods Thirty women participated (n = 15 controls). Lower extremity kinematics and gluteus medius activity were recorded at the start and end of a 30-minute treadmill run at participants’ self-selected pace. Hip kinematics and gluteus medius activity were analyzed via separate two-way (group x time) mixed-model analysis of variance with time as the repeated measure. Results Hip neuromechanics were similar at the start and end of a 30-minute treadmill run in women with previous iliotibial band syndrome and controls. However, hip adduction excursion was less in women with previous iliotibial band syndrome compared to controls. Average gluteus medius activity magnitude and activity duration were not significantly different between groups. Significance These findings support the growing body of literature that smaller hip adduction motion is related to previous iliotibial band syndrome in women. Regardless of injury history, gluteus medius activity was similar between groups during the loading phase of stance.
Gut Microbiota Modulate CD8 T Cell Responses to Influence Colitis-Associated Tumorigenesis.

Summary There is increasing evidence that gut microbiome perturbations, also known as dysbiosis, can influence colorectal cancer development. To understand the mechanisms by which the gut microbiome modulates cancer susceptibility, we examine two wild-type mouse colonies with distinct gut microbial communities that develop significantly different tumor numbers using a mouse model of inflammation-associated tumorigenesis. We demonstrate that adaptive immune cells contribute to the different tumor susceptibilities associated with the two microbial communities. Mice that develop more tumors have increased colon lamina propria CD8+ IFNγ+ T cells before tumorigenesis but reduced CD8+ IFNγ+ T cells in tumors and adjacent tissues compared with mice that develop fewer tumors. Notably, intratumoral T cells in mice that develop more tumors exhibit increased exhaustion. Thus, these studies suggest that microbial dysbiosis can contribute to colon tumor susceptibility by hyperstimulating CD8 T cells to promote chronic inflammation and early T cell exhaustion, which can reduce anti-tumor immunity.
Effects of visual attention modulation on dynamic effective connectivity and visual fixation during own-face viewing in body dysmorphic disorder

Abstract Background In individuals with body dysmorphic disorder (BDD), selective attention biases and aberrant visual scanning patterns may cause imbalances in global vs. detailed visual processing, contributing to perceptual distortions for appearance. The mechanistic effects of modifying visual attention on brain function in BDD, which may be critical to developing perceptual-based treatments, have not been explored. This study tested the effects of visual-attention modulation on dorsal and ventral visual stream activation and connectivity, and eye behaviors. Methods We acquired functional magnetic resonance imaging data in 37 unmedicated adults with BDD and 30 controls. Participants viewed their faces under two conditions: a) unconstrained (naturalistically), and b) holding their gaze on the center of the image (visual-attention modulation), monitored with an eye-tracking camera. We analyzed activation and dynamic effective connectivity in dorsal and ventral visual streams and visual fixation duration. Results Visual-attention modulation resulted in longer fixation duration and reduced activation in dorsal and ventral visual streams in both groups compared with naturalistic viewing. Longer fixation duration was associated with greater effective connectivity from V1 to early dorsal visual stream during the second naturalistic viewing, across groups. During naturalistic viewing, there was greater V1 to early dorsal visual stream connectivity after, compared with before, visual-attention modulation. Conclusions When viewing one’s face, longer visual fixation may confer greater communication in dorsal visual system, facilitating global/holistic visual processing. The finding that reduction in visual scanning while viewing one’s face results in persistent effects during unconstrained viewing has implications for perceptual retraining treatment design for BDD.
Democratizing Design and Fabrication Using Speech: Exploring co-design with a voice assistant

Recent advances in artificial intelligence (AI) and voice interfaces have made possible the digital reincarnation of the draftsperson and craftsperson, capable of designing and producing custom work “to spec” for a reasonable cost. We present findings from an experiment using a Wizard-of-Oz-backed recreation of a voice assistant-based designer; participants describe a holiday ornament of their own imagination to the voice assistant, which elicits details and offers design choices before ultimately “creating” the ornament for the participant. For 8 out of 16 participants, a video channel allows the participant to see the designed object as it is iteratively designed and refined. We offer observations about the nature of the interactions between participants and the voice assistant, as well as quantitative measures of participant-reported cognitive load and predicted and actual satisfaction and accuracy of reproduction. Participants report greater satisfaction with their ornaments and experience reduced cognitive load if they can see them being designed; their expectations are higher if they cannot. 15 of 16 participants would use a voice assistant again for a design task.
Action in Healthcare Sustainability is a Surgical Imperative: This is a Novel Way to Do It.

Objective The healthcare system accounts for 8%-10% of all greenhouse gas emissions in the United States and hospital buildings are significant contributors. Operating rooms account for 20%-33% of all hospital waste. This may contribute to significant climate change and negatively affect public health. Physicians and surgeons must act to reduce our collective carbon footprint to improve the health of our patients. The traditional graduate medical education curriculum does not routinely train future generations of physicians in healthcare sustainability. We describes a fellowship program designed to change this. Design and Setting The Cleveland Clinic surgical residency has implemented a unique educational program. Here we describe the 5-year results of our novel fellowship program in health care sustainability, primarily focused on greening the operating room. Participants Selected General Surgery residents interested in healthcare sustainability and greening the operating room. Results We have successfully implemented a novel resident focused fellowship program in healthcare sustainability. Fellowship projects have led to significant reductions in our hospitals' collective carbon footprint. Conclusions Surgeons have a unique responsibility to reduce the carbon footprint of the Operating Room. Implementing a dedicated fellowship program or similar intensive educational experience in healthcare sustainability within the framework of a graduate medical education curriculum will help to ensure future generations of surgeons are thoughtful leaders in environmental stewardship.
Dynamic Spectrum Allocation in Urban Air Transportation System via Deep Reinforcement Learning

The emerging concepts of Urban Air Mobility (UAM) and Advanced Air Mobility (AAM) open a new paradigm for urban air transportation. A big challenge is that these new aerial vehicles will quickly saturate the already crowded aviation spectrum, which is an essential resource to ensure reliable communications for safe operations. In this paper, we consider an air transportation system where multiple aerial vehicles are operated to transport passengers or cargo from different sources to destinations along their pre-defined paths. During the flight, the minimum communication Quality of Service (QoS) requirement must be achieved to ensure flight safety. Our objective is to minimize the average mission completion time by jointly optimizing the velocity selection and spectrum allocation for all aerial vehicles. We formulate the optimization problem as a multi-stage Markov Decision Process (MDP) where the optimization variables are coupled together. A multi-agent Deep Reinforcement Learning (DRL) based solution is proposed where Value Decomposition Networks (VDN) algorithm is utilized to take discrete actions. Additionally, we propose a heuristic greedy algorithm as a baseline solution. Simulation results show that our learning based solution outperforms the heuristic greedy algorithm and another Orthogonal Multiple Access (OMA) solution in minimizing the mission completion time.
Polyisobutylene-containing block copolymers by sequential monomer addition

Novel poly(acenaphtylene-b-isobutylene-b-acenaphtylene) (PAc-PIB-PAc) triblock copolymers exhibiting thermoplastic elastomer (TPE) properties have been prepared. The synthesis involved the addition of acenaphtylene (Ac) to living polyisobutylene dications (⊕PIB⊕) obtained by living isobutylene (IB) polymerization induced by the dicumyl methyl ether (DiCumOMe)/TiCl4 initiating system at-80°C. The triblocks contain very short polyacenaphtylene (PAc) blocks (Mn≈9,000) and consequently yield very soft, low modulus TPEs. Efforts to develop conditions for the living carbocationic polymerization (LC⊕Pzn) of Ac have failed.
Obesity in Pregnancy

Maternal obesity is becoming an increasingly prevalent condition. Women entering pregnancy with a body mass index (BMI) ≥ 30 kg/m2 face higher rates of maternal and fetal complications as a result of their obesity. Additionally, obese patients may have concomitant comorbidities that further increase pregnancy risks. Patients and their physicians must be aware of the risks faced in pregnancy and outline a plan of care including counseling, antepartum, intrapartum, and postpartum care in order to lower the risks as much as possible. In this chapter, we describe the epidemiology of maternal obesity, identify the metabolic changes seen in pregnancy, and detail the anticipated maternal, fetal, and obstetric risks. Finally, we examine the existing evidence surrounding pregnancy management, and delineate evidence-based guidelines for this patient population in order to decrease morbidity.
Finite Element Analysis of Wood-Stud Walls

A theoretical procedure based on the finite element model and linear step-by-step analysis for evaluating the behavior of wood-stud walls under combined bending and compression loads was developed and verified. The procedure accounts for the variations in material properties, nonlinear material behavior of studs, partial composite action and slip among the components, and the load sharing among the studs of various strengths and stiffnesses. I-beam wall sections and full-size walls are tested to verify the procedure. Theoretical and experimental deflections and slips at service loads and overloads, and the ultimate load of the tested wall panels showed good agreement. Parameter study investigating the effect of the joint and wall covering stiffness on the ultimate load is included. The developed procedure can be used to obtain the information necessary for improved structural and economic design of wood-stud walls for residential and commercial buildings.
The place of Emanuel Swedenborg in the spiritual saga of Scandinavia

Between 1749 and 1771 the Swede Emanuel Swedenborg (1688–1772) wrote and published eighteen religious works in Latin that he claimed were the foundation of a new Christian religion. He wrote that he had been called by God to unlock the spiritual secrets of the Bible through the doctrine of correspondences; to reveal the nature of the spiritual world based on experience in that realm; and to explain the keys to living a heavenly life. Stating in his last work, True Christianity (paragraph no. 779) that he was called only to write and publish, Swedenborg never­ attempted to found a church. Swedenborg published his books in Amsterdam and London, and if his 1758 print runs of 1,000 for five different works are typical, he had thousands of books available to distribute throughout Europe and he did so. However, the number of books in Scandinavia at the time of his death was probably fairly small. In 1772 there were less than a dozen readers in all of Europe, and only a small handful in Scandinavia. While awareness, education, and access are necessary prerequisites to the possibility of responding to these works, interest is essential. From the beginning, and over the years since their publication, individuals motivated to explore them seem to fall into the following categories: religious virtuosi/seekers; philosophers; occultists; artists, poets, and, writers. In this article the author, after a few remarks about issues on scholarship, turns her attention to three men with three different relationships to Swedenborg‘s religious writings, they are Edvard Munch (1863–1944), Soren Kierkegaard (1813–55), and August Strindberg (1850–1912). Then she makes an assessment of Swedenborg’s contribution to Scandinavia.
Vitamin D status is associated with relapse rate in pediatric-onset multiple sclerosis.

Objective We sought to determine if vitamin D status, a risk factor for multiple sclerosis, is associated with the rate of subsequent clinical relapses in pediatric-onset multiple sclerosis. Methods This is a retrospective study of patients with pediatric-onset multiple sclerosis or clinically isolated syndrome who were consecutively recruited into a prospective cohort at their clinical visit at the pediatric multiple sclerosis center of University of California, San Francisco or State University of New York at Stony Brook. Of 171 eligible patients, 134 (78%) with multiple sclerosis/clinically isolated syndrome were included in the cohort; a further 24 were excluded from this analysis due to lack of available serum (n = 7) or lack of follow-up (n = 17). Serum 25-hydroxyvitamin D3 levels were measured and were adjusted to reflect a deseasonalized value. The adjusted serum 25-hydroxyvitamin D3 level was the primary predictor in a multivariate negative binomial regression model in which the main outcome measure was the number of subsequent relapses. Results Among the 110 subjects, the mean unadjusted 25-hydroxyvitamin D3 level was 22 ± 9ng/ml. After adjustment for age, gender, race, ethnicity, disease duration, disease-modifying therapy, and length of follow-up, every 10ng/ml increase in the adjusted 25-hydroxyvitamin D3 level was associated with a 34% decrease in the rate of subsequent relapses (incidence rate ratio, 0.66; 95% confidence interval, 0.46–0.95; p = 0.024). Interpretation Lower serum 25-hydroxyvitamin D3 levels are associated with a substantially increased subsequent relapse rate in pediatric-onset multiple sclerosis or clinically isolated syndrome, providing rationale for a randomized controlled trial of vitamin D supplementation. ANN NEUROL 2010;67:618–624
Dissemination of coccidioidomycosis in pregnancy

Abstract Dissemination of primary benign coccidioidomycosis occurs frequently in the pregnant patient according to our analysis of 15 disseminated cases. The risk of death is nearly 100 per cent in untreated cases, and in endemic areas it may be the leading cause of maternal deaths. The fetus also may be infected. Treatment with the toxic fungistatic drug amphotericin B does salvage some patients.