cssi/SciSciGPT-SciSciNet huggingface dataset:
Substrate Interactions in the Formation of Amorphous Silicon/Dielectric Interfaces

Using Remote PECVD we have deposited layers of “device quality” a-Si:H and Si-based dielectrics. We find that the formation of depletion or accumulation layers at a-Si:H/dielectric interface depends on the specific dielectric (SiO2 or Si3N4) and on the film deposition sequence. In addition, we have studied process-gas/substrate interactions by in-situ Auger Electron Spectroscopy (AES) and determined that Si-O or Si-N bonds are produced at a-Si and c-Si surfaces exposed to plasma excited He/O2, or NH3 mixtures, respectively. These process-gas/substrate interactions occur in parallel with film deposition and are correlated with the electronic properties of the interfaces, and the layer deposition sequence.
DECLINE OF BIAN JING AND FLOURISH OF CITIES GROUP IN THE CENTRAL PLAIN—— Approach on the Influence of the Development of Modern Mining Industry on He Nan's Economic Development

Starting with regional economic history, the paper brought into light how modern mining industry promote flourish of He Nan's economic development, it also got general inference.
Analysis of effect of Tuberculosis Control Project in Lu'an during 2005-2009

Objective:To evaluate and analyze the effection of Tuberculosis Control Project in Lu'an during 2005~2009.Methods:TB control informations in Lu'an during 2005~2009 were collected by county and district TB staff.Results:50969 cases of suspected tuberculosis patients were diagnosised during 2005~2009,22920 cases of active pulmonary tuberculosis patients were found,of which there were 16184 cases of smear-positive TB patients.Active pulmonary tuberculosis registration rate dropped from 82.15/10 million to 54.66/10 million.The registration rate of smear-positive dropped from 54.13/10 million to 42.81/10 million.Cure rate of new smear-positive TB patients increased from 85.02% to 92.11%.Treatment completion rate of initial patients with smear-negative TB rose from 87.17% to 93.78%.The overall arrival rate of patients rose from 76.54% to 94.97%.Conclusions:Significant results and the planning objective were achieved after full implementation of the tuberculosis control project in Lu'an,The technology policy of the project was successful,promoting the sustainable development of TB control of Lu'an City.
A Perspective on Telmisartan and Cardiovascular Risk

The angiotensin receptor blockers (ARBs) are well established as safe and effective in the treatment of arterial hypertension. Telmisartan is an ARB with potent blood-pressure lowering effects. It has a long terminal half-life of about 24 hours (the longest of any of the ARBs), which enables it to sustain blood pressure reductions in the early morning hours, after the previous morning dosing. Unlike the angiotensin-converting enzyme (ACE) inhibitors, the ARBs have not been shown to reduce mortality and morbidity in high-risk patients with coronary disease, peripheral vascular disease, cerebrovascular disease, or diabetes with cardiovascular risk factors without evidence of heart failure or low ejection fraction. Two studies, the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and the Telmisartan Randomized AssessmeNt Study in ACE-I INtolerant Subjects with Cardiovascular Disease (TRANSCEND) trial, are examining the benefits of ARBs alone and in combination with ACE inhibitors in high-risk patients.
Bilateral Renal Cell Carcinoma in Von Hippel-Lindau Syndrome: Treatment with Staged Bilateral Nephrectomy and Hemodialysis

AbstractA case of bilateral renal cell carcinoma associated with von Hippel-Lindau syndrome and treated successfully with staged bilateral nephrectomy and hemodialysis is reported. The literature is reviewed with special emphasis on early diagnosis based on family history. Hemodialysis is a logical treatment modality. This disease, unlike adult renal cell carcinoma, is multifocal and poorly treated with partial nephrectomy.
Distributed Incremental Graph Analysis

Distributed frameworks, such as MapReduce and Spark, have been developed by industry and research groups to analyze the vast amount of data that is being generated on a daily basis. Many graphs of interest, such as the Web graph and Social Networks, increase their size daily at an unprecedented scale and rate. To cope with this vast amount of data, researchers have been using distributed processing frameworks to analyze these graphs extensively. Most of these graph algorithms are iterative in nature. In our previous work, we introduced an efficient design pattern to handle a family of iterative graph algorithms in a distributed framework. Unfortunately, in most of these iterative algorithms, such as for Page-Rank, if the graph is modified with the addition or deletion of edges or vertices, the Page-Rank has to be recomputed from scratch. In this paper, we are introducing an improved design pattern for such algorithms to handle graph updates in an incremental fashion. Our method is to separate the graph topology from the graph analysis results. At each iteration step, each node participating in this graph analysis task, in addition to reading a single graph partition, it reads all the current analysis results from the distributed file system (DFS). These results are correlated with the local graph partition using a special merge-join and the new improved analysis results are calculated and stored to the DFS, one partition from each worker node. To handle continuous updates, an update function collects the changes to the graph and applies them to the graph partitions in a streaming fashion. Once the changes are made, the iterative algorithm is resumed to process the new updated data. Since a large part of the graph analysis task has already been completed on the existing data, the new updates require fewer iterations to compute the new graph analysis results as the iterative algorithm will converge faster.
Transport in Liquid-Phase Electrochemical Devices

Transport of reactants and products in liquid-fed electrochemical cells is critical in terms of reactant utilization, concentration polarizations, and coulombic efficiencies. Design of electrochemical flow cells can benefit from adequately detailed models that capture the locally variable impact of reactant depletion and product build-up on electrochemical reactions throughout the cell. This chapter illustrates the importance of transport modeling by presenting a finite-volume, two-dimensional (2-D) model of a liquid-phase electrochemical cell with simple cell geometry, but complex multistep chemistry at each electrode incorporating parasitic reactions and/or mixed potentials. The modeled cell involves two half-cell reactions, borohydride (\(\mathrm{BH_{4}^{-}}\)) oxidation and hydrogen peroxide (H2O2) reduction, in planar flow channels with electrodes separated by flowing liquid-phase electrolytes and an ion-exchange membrane . This generic cell topology is representative of many fuel cells and flow batteries. The finite-volume model solves for conservation of mass, momentum, species, and charge in both the cathode and anode flow channels for ideal, dilute, and concentrated electrolytes. The model couples the flows to complex boundary conditions at the electrochemically active electrode surfaces and the selective ion-exchange membrane. Model results show that the balance of advection, diffusion, and migration in the liquid electrolytes results in complex profiles that predict boundary layer build-up and significant advection perpendicular to the flow path. The direct borohydride-hydrogen peroxide fuel cell transport model, used to illustrate these concepts, shows how liquid-phase transport limits conversion and dictates cell voltages within the context of the competing reactions at the two electrodes. The chapter ends by demonstrating how such a model can be implemented in design studies to explore strategies for improving practical cell performance.
Recent advances in protein analysis by capillary and microchip electrophoresis

This review article describes the significant recent advances in the analysis of proteins by capillary and microchip electrophoresis during the period from mid-2014 to early 2017. This review highlights the progressions, new methodologies, innovative instrumental modifications, and challenges for efficient protein analysis in human specimens, animal tissues, and plant samples. The protein analysis fields covered in this review include analysis of native, reduced, and denatured proteins in addition to Western blotting, protein therapeutics and proteomics.
Fiscal Policy Beyond the Budget : Quasi-Fiscal Activities in the Energy Sectors of the Former Soviet Union

A decade into the transition, many successor states of the Former Soviet Union (FSU) continue to use pervasive energy sector quasi-fiscal activities, especially low energy prices and the toleration of payment arrears, to provide large implicit and untargeted subsidies to households and enterprises. These quasi-fiscal activities disguise the size of the government, cause over-consumption and waste, and contribute to macroeconomic imbalances. Based on two case studies--one of an energy-exporting country (Azerbaijan) and one of an energy-importing country (Ukraine)--and a survey of other FSU countries, the study finds that energy quasi-fiscal activities have declined in some of the energy-importing countries (e.g., Armenia, Kyrgyz Republic, Ukraine), but risen in energy-rich countries (e.g., Azerbaijan, Russia, Turkmenistan), largely on account of higher international oil prices. We found that energy sector payment arrears have triggered tax and other payment arrears by energy companies, and helped to perpet...
Diversification of HP1-like Chromo Domain Proteins in Tetrahymena thermophila.

Proteins that possess a chromo domain are well-known for their roles in heterochromatin assembly and maintenance. The Heterochromatin Protein 1 (HP1) family, with a chromo domain and carboxy-terminal chromo shadow domain, targets heterochromatin through interaction with histone H3 methylated on lysine 9 (H3K9me2/3). The structural and functional diversity of these proteins observed in both fission yeast and metazoans correlate with chromatin specialization. To expand these studies, we examined chromo domain proteins in the ciliate Tetrahymena thermophila, which has functionally diverse and developmentally regulated heterochromatin domains. We identified thirteen proteins similar to HP1. Together they possess only a fraction of the possible chromo domain subtypes and most lack a recognizable chromo shadow domain. Using fluorescence microscopy to track chromatin localization of tagged proteins through the life cycle, we show evidence that in T. thermophila this family has diversified with biological roles in RNAi-directed DNA elimination, germline genome structure, and somatic heterochromatin. Those proteins with H3K27me3 binding sequence characteristics localize to chromatin in mature nuclei, whereas those with H3K9me2/3 binding characteristics localize to developing nuclei undergoing DNA elimination. Findings point to an expanded and diversified family of chromo domain proteins that parallels heterochromatin diversity in ciliates.
A Sub-Threshold Low-Power Integrated Bandpass Filter for Highly-Integrated Spectrum Analyzers

Low-power analog filter banks provide frequency analysis with minimal power and space requirements, making them viable solutions for integrated remote audio- and vibration-sensing applications. Compared with their digital counterparts, analog filter banks are better suited to achieve the lower power consumption necessary for IoT applications. In this work, the design and implementation of a sub-threshold complementary metal-oxide semiconductor (CMOS) integrated low-power tunable bandpass filter channel for signal spectrum analysis and signal discrimination is presented, including performance improvements to stability and precise matching between filter stages. The 8th-order filter channel achieves an effective Q-factor of 4.5 and dynamic range of 60 dB, has an operational frequency range from 2 kHz to 100 kHz, and consumes 256 µW nominally at the highest center frequency. An integrated analog Gm-C filter topology is selected for this application. Functionally, the high-Q bandpass filter transfer function is implemented via four cascaded 2nd-order filter cells and is fabricated in 130-nm 1.2-V CMOS technology, making it suitable for use in monolithic integrated spectral analysis (MISA) applications.
De novo pure erythroid leukemia: refining the clinicopathologic and cytogenetic characteristics of a rare entity

Per the revised fourth edition World Health Organization classification of acute myeloid leukemia, pure erythroid leukemia is now the sole type of acute erythroid leukemia. The diagnosis of this rare entity is often challenging and the cytologic overlap with non-neoplastic (eg, megaloblastic anemia) and neoplastic entities (eg, other types of acute leukemia and non-hematopoietic malignancies) warrants a significant degree of clinical, laboratory, immunophenotypic, and genetic investigation. Given the limited number of reports of this rare and diagnostically challenging entity, we report detailed clinicopathologic characteristics from 15 patients, the largest series thus far, of primary de novo pure erythroid leukemia to provide further diagnostic insights into this entity and reveal strategies for making the diagnosis. We found that de novo pure erythroid leukemia is a disease of adults (median age 68 years), exhibits a striking male predominance, is universally associated with an abnormal karyotype and has an exceedingly poor overall median survival of 1.4 months. Given the general inability of immunophenotypic markers to discriminate neoplastic from non-neoplastic erythroid proliferations, key features identified in this study to help establish the diagnosis of pure erythroid leukemia and exclude mimickers include circulating pronormoblasts, clear-cut dysplasia in erythroid, granulocytic, and/or megakaryocytic lineage, utilization of a broad immunophenotypic panel, TP53 immunohistochemical positivity, and identification of a complex, often highly complex, karyotype. Given the gravity of a diagnosis of de novo pure erythroid leukemia, it should be rendered with utmost confidence.
A Novel Orally Available Asthma Drug Candidate That Reduces Smooth Muscle Constriction and Inflammation by Targeting GABAA Receptors in the Lung

We describe lead compound MIDD0301 for the oral treatment of asthma based on previously developed positive allosteric α5β3γ2 selective GABAA receptor (GABAAR) ligands. MIDD0301 relaxed airway smooth muscle at single micromolar concentrations as demonstrated with ex vivo guinea pig tracheal rings. MIDD0301 also attenuated airway hyperresponsiveness (AHR) in an ovalbumin murine model of asthma by oral administration. Reduced numbers of eosinophils and macrophages were observed in mouse bronchoalveolar lavage fluid without changing mucous metaplasia. Importantly, lung cytokine expression of IL-17A, IL-4, and TNF-α were reduced for MIDD0301-treated mice without changing antiinflammatory cytokine IL-10 levels. Automated patch clamp confirmed amplification of GABA induced current mediated by α1–3,5β3γ2 GABAARs in the presence of MIDD0301. Pharmacodynamically, transmembrane currents of ex vivo CD4+ T cells from asthmatic mice were potentiated by MIDD0301 in the presence of GABA. The number of CD4+ T cells observ...
Comparing the Economic Impact of Natural Disasters Generated by Different Input–Output Models: An Application to the 2007 Chehalis River Flood (WA)

Due to the concentration of assets in disaster-prone zones, changes in risk landscape and in the intensity of natural events, property losses have increased considerably in recent decades. While measuring these stock damages is common practice in the literature, the assessment of economic ripple effects due to business interruption is still limited and available estimates tend to vary significantly across models. This article focuses on the most popular single-region input-output models for disaster impact evaluation. It starts with the traditional Leontief model and then compares its assumptions and results with more complex methodologies (rebalancing algorithms, the sequential interindustry model, the dynamic inoperability input-output model, and its inventory counterpart). While the estimated losses vary across models, all the figures are based on the same event, the 2007 Chehalis River flood that impacted three rural counties in Washington State. Given that the large majority of floods take place in rural areas, this article gives the practitioner a thorough review of how future events can be assessed and guidance on model selection.
The Elusive Concept of Expertise: Who Counts as an Expert?

There is an ongoing debate in the philosophy and psychology of skill as to the nature of expertise. On the one side of this debate are those who maintain that although novices need to think about, deliberate over, and pay attention to their developing skills, experts perform optimally in the absence of conscious skill-directed attention, while on the other side, are those who maintain that experts generally are consciously engaged in their execution of their skills. What, exactly, do the various proponents of each side of this debate mean by “expert” when they claim that experts either do or do not consciously attend to their movements in action? The aim of this paper is to describe and critically analyze some of the uses of the term “expert” in the expertise literature, along with the criteria that have been employed to identify experts and, ultimately, to suggest a conceptualization of expertise that may facilitate a more productive debate over the question of whether experts think in action.
What good are counterexamples

Intuitively, Gettier cases are instances of justified true beliefsthat are not cases of knowledge. Should we therefore conclude thatknowledge is not justified true belief? Only if we have reason totrust intuition here. But intuitions are unreliable in a wide rangeof cases. And it can be argued that the Gettier intuitions have agreater resemblance to unreliable intuitions than to reliableintuitions. What’s distinctive about the faulty intuitions, Iargue, is that respecting them would mean abandoning a simple,systematic and largely successful theory in favour of a complicated,disjunctive and idiosyncratic theory. So maybe respecting theGettier intuitions was the wrong reaction, we should instead havebeen explaining why we are all so easily misled by these kinds ofcases.
Safer Sex Among HIV+ Women: The Role of Relationships

Among 230 HIV+ women in New York City, 105 had been heterosexually active in the last 90 days and 54% of these reported unsafe sex. Contrary to our hypotheses based on relational theory, respondents with steady partners were more likely to have unprotected sex than nonpartnered women. However, among respondents with steady partners, the degree of commitment to the relationship was positively associated with condom use. The only other correlate of unprotected sex was current drug use. Almost all steady partners were aware of the woman's HIV status, and, contrary to our hypothesis, respondents were not more likely to have protected sex with HIV− than HIV+ steady partners. The discussion considers self-in-relation theory, culture, power, and contextualistic behaviorism.
UNIT 3.13 Ribonucleases

Ribonucleases (RNases) with different sequence specificities are used for a variety of analytical purposes, including RNA sequencing, mapping, and quantitation. One very common application for RNase A is presented in this unit and involves hydrolyzing RNA that contaminates DNA preparations. Two other commonly used RNases, RNase H and RNase T1, are also described. In addition, many commercially available RNases are sequence-specific endoribonucleases, a property has been used for enzymatic sequencing of RNA.
NanoNeuroRFID: A Wireless Implantable Device Based on Magnetoelectric Antennas

A major obstacle during the design of brain–computer interfaces is the unavailability of a neural implantable device that is µ-scale in size and is wireless, self-powered, and long-lasting. The current state-of-the-art implantable devices suffer from various limitations. Electromagnetic-based wireless devices are big in size because of their large antenna, which must be larger than one-tenth of the wavelength of the operational frequency. Ultrasound-based wireless devices, in addition to their low data rate, have massive loss in the skull and need an intermediate electromagnetic transceiver under the skull. Furthermore, almost all state-of-the-art wireless devices use micro-electrodes for neuronal recording, which are not reliable in long-term monitoring applications because of the direct contact between the tissue and metal electrodes. In this paper, we propose a novel, wireless, and ultra-compact implantable device termed NanoNeuroRFID. At the core of this device, there is a magnetoelectric (ME) antenna array. ME antennas are smart and ultra-miniaturized (<200 μm diameter) and can perform multiple tasks. First, can harvest electromagnetic energy to power the NanoNeuroRFID system. Their limit of the detection for RF magnetic fields is 40 pT; second, they can sense quasi-static neuronal magnetic fields as small as 200 pT without direct contact to the tissue, allowing a long lifetime and reliable neural recording; and third, they can communicate with an external transceiver, and their operational frequency could be 10 to 100 s of MHz, where tissue loss is small.
Patients Who Leave the Emergency Department Without Being Seen and Their Follow-Up Behavior: A Retrospective Descriptive Analysis

Abstract Background Past studies suggest that patients who leave without being seen (LWBS) by a physician from a hospital’s emergency department (ED) represent a quality and safety concern, and thus LWBS rates have often been used as an ED performance metric. There are few recent studies, however, that have examined the characteristics of the LWBS population at hospitals in the United States. Objective This study describes the LWBS population at a multi-hospital academic health system. Methods This was a retrospective study of electronic medical record data from EDs at two academic hospitals with a shared patient population that analyzed all LWBS visits during the 45-month period between July 2012 and March 2016. Demographic and clinical variables, including patient characteristics, chief complaint, acuity, and evidence of ongoing medical care, were assessed. Results During the study period, 2.4% of patients presenting to the study EDs left without being seen. This population tended to have lower-acuity chief complaints and nearly triple the number of ED visits as the general ED patient; 7.8% sought follow-up care from outpatient clinics and 24.8% returned to the ED within 7 days. Of this latter group, 11.5% were subsequently admitted for inpatient care, representing 0.068% of the total ED census during the study period. Conclusions LWBS patients are high ED utilizers who may be effectively targeted by “hotspotting.” Our 11.5% admission rate at return after LWBS compares favorably with the overall 20.9% admission rate at the study EDs and represents a small minority of all LWBS visits. Given the paucity of return ED visits after interval clinic encounters, our data suggest that patients who were seen in clinic had their medical complaint adequately resolved on a non-emergent outpatient basis, and that increased LWBS rates may reflect poor access to timely clinic-based care rather than intrinsic systemic issues within the ED.
Center Variation and Risk Factors for Failure to Complete 6 Month Postdonation Follow-up Among Obese Living Kidney Donors.

BACKGROUND Living kidney donors in the United States who were obese at donation are at increased risk of end-stage renal disease and may benefit from intensive postdonation follow-up. However, they are less likely to have complete follow-up data. Center variation and risk factors for incomplete follow-up are unknown. METHODS Adult living kidney donors with obesity (body mass index, ≥30 kg/m) at donation reported to the Scientific Registry of Transplant Recipients from January 2005 to July 2015 were included (n = 13 831). Donor characteristics were compared by recorded serum creatinine at 6 months postdonation, and multilevel logistic regression models were used to estimate odds of 6-month creatinine. RESULTS After adjustment, older age, female sex, and donation after implementation of new center follow-up requirements were associated with higher odds of 6-month creatinine, with lower odds for obese donors with a history of smoking, biologically related donors, and at centers with higher total living donor volume. 23% of variation in recorded 6-month serum creatinine among obese donors was attributed to center (intraclass correlation coefficient: 0.232, P < 0.001). The adjusted probability of 6-month creatinine by center ranged from 10% to 91.5%. CONCLUSIONS Tremendous variation in recorded 6-month postdonation serum creatinine exists among obese living donors, with high volume centers having the lowest probability of follow-up. Moreover, individual-level characteristics such as age, sex, and relationship to recipient were associated with recorded 6-month creatinine. Given increased risk for end-stage renal disease among obese living donors, center-level efforts targeted specifically at increasing postdonation follow-up among obese donors should be developed and implemented.
Isolation, culture, and downstream characterization of primary microglia and astrocytes from adult rodent brain and spinal cord

Abstract Background Neuroimmunologists aspire to understand the interactions between neurons, microglia, and astrocytes in the CNS. To study these cells, researchers work with either immortalized cell lines or primary cells acquired from animal tissue. Primary cells reflect in vivo characteristics and functionality compared to immortalized cells; however, they are challenging to acquire and maintain. New Method Established protocols to harvest primary glia use neonatal rodents, here we provide a method for simultaneously isolating microglia and astrocytes from brain and/or spinal cord from adult rodents. We utilized a discontinuous percoll density gradient enabling easy discrimination of these cell populations without enzymatic digestion or complex sorting techniques. Results We found cells isolated from the percoll interface between 70 %−50 % were microglia, as they express ionizing calcium-binding adaptor molecule 1 (Iba1) in immunocytochemistry and CD11bhi and CD45lo using flow cytometry. Isolated cells from the 50 %−30 % interface were astrocytes as they express glial fibrillary acidic protein (GFAP) in immunocytochemistry and Glutamate aspartate transporter (GLAST)-1 using flow cytometry. Cultured microglia and astrocytes showed a functional increase in IL-6 production after treatment of lipopolysaccharide (LPS). Comparison with Existing Methods Our method allows for rapid isolation of both microglia and astrocytes in one protocol with relatively few resources, preserves cellular phenotype, and yields high cell numbers without magnetic or antibody sorting. Conclusion Here we show a novel, single protocol to isolate microglia and astrocytes from brain and spinal cord tissue, allowing for culturing and other downstream applications from the cells of animals of various ages, which will be useful for researchers investigating these two major glial cell types from the brain or spinal cord of the same rodent.
The Central Dot Sign : A Specific Post-gadolinium Enhancement Feature of Intramedullary Spinal Cord Metastases.

Peripheral enhancement characteristics on magnetic resonance imaging (MRI), namely the rim and flame signs, are specific for intramedullary spinal cord metastases (ISCM) compared to primary cord masses. The study compared the frequency of a novel finding—the central dot sign—in ISCMs versus primary intramedullary masses. In this study 45 patients with 64 ISCMs and 64 control patients with 64 primary intramedullary cord masses were investigated and 2 radiologists blinded to lesion type independently evaluated MR images for the presence of a central dot sign: a punctate focus of enhancement in/near the center of an enhancing intramedullary mass. The frequency of this sign in the two patient groups was compared. A total of 63 enhancing ISCMs in 44 patients and 54 enhancing primary cord masses in 54 patients were included. The central dot sign was identified in 6% (4/63) of enhancing ISCMs in 9% (4/44) of patients and in none (0/54) of the enhancing primary cord masses (p = 0.038, per patient). The specificity for diagnosing ISCMs among spinal cord masses was 100%. The central dot sign was present in the axial plane only in two ISCMs and in the axial and sagittal planes in two ISCMs. The two ISCMs harboring the central dot sign also demonstrated both the previously described rim and flame signs, and two also demonstrated the rim sign alone. The central dot sign is not sensitive but highly specific for ISCMs compared to primary spinal cord masses. The rim and/or flame signs may or may not be concurrently present in ISCMs.
Multiple ways to kill bacteria via inhibiting novel cell wall or membrane targets.

The rise of antibiotic-resistant infections has been well documented and the need for novel antibiotics cannot be overemphasized. US FDA approved antibiotics target only a small fraction of bacteri...
Influence of Age of Onset on Huntington's Disease Phenotype.

Background: Older patients with Huntington’s disease (HD) are often thought to have a slower progressing disease course with less behavioral symptoms than younger patients. However, phenotypic differences based on age of onset have not been well characterized in a large HD population. This study will determine the difference in manifestations and disease progression between patients with young, typical, and late onset adult HD at different stages of disease. Methods: Data obtained from Enroll-HD. Adults with manifest HD were included. Age groups were defined as young onset (YO: 20-29 years), typical onset (TO: 30–59 years), and late onset (LO: 60+ years). Subjects were categorized by TFC score, from Stage I (least severe) to Stage V (most severe). Motor, cognitive, and behavioral symptoms were analyzed. Descriptive statistics and Bonferroni p-value correction for pairwise comparison were calculated. Results: 7,311 manifest HD participants were included (612 YO, 5,776 TO, and 923 LO). The average decline in TFC score from baseline to second visit (1.5–2.5 years) was significantly faster for YO (–1.75 points) compared to TO (–1.23 points, p = 0.0105) or LO (–0.97 points, p = 0.0017). Motor deficits were worse for LO participants at early stages of HD, and worse for YO participants at advanced stages. YO and TO participants had greater burden of behavioral symptoms at early stages of disease compared to LO. Discussion: YO is predictive of a faster functional decline for adults with HD when compared to those with TO and LO. Motor and behavioral manifestations differ based on age of onset. Highlights: This study compares HD manifestations while controlling for disease severity, detailing robust phenotypic differences by age of onset alone. These findings have implications for the clinical management of HD symptoms and have the possibility to improve prognostic and treatment precision.
The Large-Scale Vorticity Balance of the Antarctic Continental Margin in a Fine-Resolution Global Simulation

Author(s): Paloczy, Andre; McClean, Julie L; Gille, Sarah T; Wang, He | Abstract: ABSTRACTThe depth-integrated vorticity budget of a global, eddy-permitting ocean/sea ice simulation over the Antarctic continental margin (ACM) is diagnosed to understand the physical mechanisms implicated in meridional transport. The leading-order balance is between the torques due to lateral friction, nonlinear effects, and bottom vortex stretching, although details vary regionally. Maps of the time-averaged depth-integrated vorticity budget terms and time series of the spatially averaged, depth-integrated vorticity budget terms reveal that the flow in the Amundsen, Bellingshausen, and Weddell Seas and, to a lesser extent, in the western portion of East Antarctica, is closer to an approximate topographic Sverdrup balance (TSB) compared to other segments of the ACM. Correlation and coherence analyses further support these findings, and also show that inclusion of the vorticity tendency term in the response (the planetary vorticity advection and the bottom vortex stretching term) increases the correlation with the forcing (the vertical net stress curl), and also increases the coherence between forcing and response at high frequencies across the ACM, except for the West Antarctic Peninsula. These findings suggest that the surface stress curl, imparted by the wind and the sea ice, has the potential to contribute to the meridional, approximately cross-slope, transport to a greater extent in the Amundsen, Bellingshausen, Weddell, and part of the East Antarctic continental margin than elsewhere in the ACM.
A 15-Year Analysis of International Medical Graduates Matching Into Diagnostic Radiology Residency Programs in the United States

Rationale and Objectives To analyze the trends in international medical graduates (IMGs) matching into diagnostic radiology residency programs in the United States (US). Materials and Methods The National Resident Match Program data was accessed for years 2005–2020 and diagnostic radiology residency-specific data was extracted for US MD, osteopathic (DO), and IMG applicants. IMGs were categorized into US-citizen IMGs and non-US citizen IMGs per the National Residency Match Program. Variables collected for each year included the number of positions, number of applicants in each group, positions filled/unfilled, and fill rate of each group. Additional data for some years included USMLE Step 1 score, United States Medical Licensing Examination (USMLE) Step 2 clinical knowledge (CK) score, number of research experiences, number of abstracts/publications, and additional degrees obtained. Trends were analyzed using simple linear regression model and p value Results The number of diagnostic radiology residency programs increased from 203 (2006) to 212 (2020). The total number of diagnostic radiology residency positions increased from 1011 (2006) to 1113 (2020), with the peak of 1145 in 2014. The overall “match rate,” that is, proportion of positions filled to positions available, increased from 96.4% (2006) to 97.3% (2020), with a brief decline to 86.7% in 2015. Among the filled positions, the proportion filled by US medical school graduates significantly declined from 89.7% (2006) to 69.2% (2020) (p Conclusion There is an increasing proportion of IMGs, especially the non-US citizen IMGs, matching into US radiology residency programs in the last decade. Diagnostic radiology remains a competitive specialty evidenced by average USMLE scores higher than national average and research experiences of matched candidates.
Association of Affordable Care Act Implementation With Ambulance Utilization for Asthma Emergencies in New York City, 2008-2018.

Importance Emergency medical services (EMS) are an essential component of the health care system, but the effect of insurance expansion on EMS call volume remains unclear. Objective This study investigated the association between health insurance expansion and EMS dispatches for asthma, an ambulatory care–sensitive condition. We hypothesized that insurance expansion under the Patient Protection and Affordable Care Act (ACA) would be associated with decreased EMS dispatches for asthma emergencies. Design, Setting, and Participants This cohort study examined 14 865 267 ambulance calls dispatched within New York City from 2008 to 2018, including 217 303 calls for asthma-related emergencies, and used interrupted time series analysis to study the change in the annual incidence of EMS dispatches for asthma emergencies after implementation of the ACA. Multivariable linear regression examined the association between the uninsured rate and the incidence of asthma-related dispatches, controlling for population demographic characteristics and air quality index. Exposures Implementation of ACA on January 1, 2014. Main Outcomes and Measures Incidence of EMS dispatches for asthma emergencies per 100 000 population per year (ie, asthma EMS dispatch rate) as classified by the 911 call–taker. Results In this study of 217 303 EMS dispatches for asthma-related emergencies, there was a decrease in the asthma EMS dispatch rate after implementation of the ACA, from a mean (SD) of 261 (24) dispatches per 100 000 population per year preintervention to 211 (47) postintervention (P = .047). This decrease in asthma EMS dispatch rate after ACA implementation was significant on interrupted time series analysis. Prior to 2014, the annual asthma EMS dispatch rate was increasing by 11.8 calls per 100 000 population per year (95% CI, 6.1 to 17.4). After ACA implementation, the asthma EMS dispatch rate decreased annually by 28.5 calls per 100 000 population per year (95% CI, −37.6 to −19.3), a significant change in slope from the preintervention period (P Conclusions and Relevance Insurance expansion within New York City under the ACA was associated with a significant reduction in the asthma EMS dispatch rate. Insurance expansion may be a viable method to reduce EMS utilization for ambulatory care–sensitive conditions such as asthma.
Characterization of dementia with Lewy bodies (DLB) and mild cognitive impairment using the Lewy body dementia module (LBD-MOD)

Introduction The National Institute on Aging Alzheimer's Disease Research Center program added the Lewy body dementia module (LBD-MOD) to the Uniform Data Set to facilitate LBD characterization and distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). We tested the performance of the LBD-MOD. Methods The LBD-MOD was completed in a single-site study in 342 participants: 53 controls, 78 AD, and 110 DLB; 79 mild cognitive impairment due to AD (MCI-AD); and 22 MCI-DLB. Results DLB differed from AD in extrapyramidal symptoms, hallucinations, apathy, autonomic features, REM sleep behaviors, daytime sleepiness, cognitive fluctuations, timed attention tasks, and visual perception. MCI-DLB differed from MCI-AD in extrapyramidal features, mood, autonomic features, fluctuations, timed attention tasks, and visual perception. Descriptive data on LBD-MOD measures are provided for reference. Discussion The LBD-MOD provided excellent characterization of core and supportive features to differentiate DLB from AD and healthy controls while also characterizing features of MCI-DLB.
The Human Simulation Continuum: Integration and Application

The demand to integrate human simulation (HS) into experiential activities within health professions and professional fields beyond healthcare has seen a significant growth over the past few decades. To best meet this demand, a comprehensive understanding of the intricacies of human-based simulation is required. In this chapter we will identify and explore the full spectrum within the human simulation modality and introduce the concept of The Human Simulation Continuum Model. We will demonstrate how to apply the HS Continuum Model in the decision-making process in the day-to-day routine of simulation educators and simulationists. We will provide tools on how to select the appropriate HS application, provide sample scenarios and their unique challenges and discuss how to select human role players to meet curricular learning objectives.
Relationship of neuropathic pain component and osteoarthritis stage in patients with knee osteoarthritis

Aim: The aim of this study was to determine the frequency of neuropathic pain (NP) in patients with knee osteoarthritis (OA) and the relationship between knee OA stage and NP degree.Materials and Methods: This study included 63 patients (11 male, 52 female; mean age 62.4 ± 11.9 years; range 40-89 years) who were diagnosed with knee OA according to the American College of Rheumatology between January and May 2019. For all the participants, the knee pain was evaluated with the Visual Analog Scale (VAS), the functional evaluation was performed through Western Ontario and McMaster University (WOMAC) Osteoarthritis Index, and the neuropathic pain (NP) component was evaluated through Pain-DETECT Questionnaire (PDQ). The Kellgren-Lawrence grading system was used to determine radiological severity.Results: Of the total, 18 patients (28.5%) were classified as possible NP and 15 patients (23.5 %) were classified as likely NP. The symptom durations of the patients with final NP diagnosis were longer (p<0.05). The PDQ score was determined to be moderate and positively correlated with the WOMAC subscale scores and total score (pain score: r=0.450, p<0.001; stiffness score: r=0.4011, p=0.001; physical function score: r=0.397, p=0.001; total score: r=0.424, p=0.001). A positive and weak correlation was detected between the knee OA stage and neuropathic pain scores (p<0.05; r: 0.265).Conclusion: This study showed that the underlying cause of knee pain in the significant part of knee-OA patients has the NP component. Knee-OA patients with neuropathic pain component had higher rates of OA-related disability. There was a poor correlation between NP scores and radiographically advanced osteoarthritis symptoms. However, we suggest that further studies should be conducted with larger sample groups, the NP component should be kept in mind and should be included in the treatment plan for the knee-OA patients.
Medical Advice and Vaccinating: What Liability?

Over the last few years, outbreaks of vaccine preventable diseases have become more common. A large part of the problem is the growth of the number of people who choose not to vaccinate their children. By rejecting the scientific consensus that the small risks of vaccinating are far outweighed by their substantial benefits, some parents are leaving their own children at increased risk and also putting others at risk. This article focuses on the role of the doctor and the doctor's advice about vaccinating or abstaining from vaccines. It examines whether the doctor should be liable if an unvaccinated patient contracts a disease and is harmed herself or infects others. The starting point of the article is that vaccination is recommended by professional organizations, supported by a majority of physicians, is the safer course, and hence advising to vaccinate on schedule is the standard of care. Given that, the article argues that doctors advising vaccination should not be liable if parents reject that advice. In contrast, doctors who do not recommend vaccination should be liable. This includes both doctors that passively accept a decision not to vaccinate and doctors who advise against regulation, though the latter are more culpable and may be subject to higher liability.
Binding of Drugs and ATP by P-Glycoprotein and Transport of Drugs by Vesicles from Human Multidrug-Resistant Cells

The determination by Juliano and Ling (1976), Beck et al. (1979), and Biedler and Peterson (1981) that the membranes of multidrug-resistant (MDR) rodent and human cells contained a high-molecular-weight glycoprotein (termed P-glycoprotein, P170) suggested that this protein might be involved in some way in mediating MDR (see also Chapters 12, and 14). This association of P-glycoprotein with the MDR phenotype was strengthened when the extent of MDR was found to correlate with the amount of P-glycoprotein expression in a variety of cells (Kartner et al., 1983, 1985; Ling, 1985; Ueda et al., 1986). The independent cloning from human MDR cells of amplified DNA sequences (termed MDR1) which encode an mRNA of 4.5 kb whose levels correlate with extent of MDR in all cell lines examined (Roninson et al., 1984, 1986; Shen et al., 1986a), and the demonstration by sequence analysis and cross-hybridization of cDNA clones that this mRNA encoded P-glycoprotein (Ueda et al., 1986, 1987a; Chen et al., 1986; Gros et al., 1986a, Gerlach et al., 1986), provided further evidence for a role of P-glycoprotein in MDR (see also Chapters 3 and 4). Furthermore, the P-glycoprotein gene is transferred from MDR human and rodent cells when MDR is transferred in DNA-mediated transformation experiments (Shen et al., 1986b; Gros et al., 1986b; Deuchars et al., 1987; Ueda et al., 1986). Finally, the expression of cloned human and mouse cDNAs for the mdr gene confers a complete phenotype of MDR on recipient cells (Ueda et al., 1987b; Gros et al., 1986c). Hence, P-glycoprotein is responsible for MDR. This chapter addresses the question of how P-glycoprotein confers MDR on sensitive cells.
Framing: An Epistemological Analysis

The goal of this paper is to define framing as a basic form of knowledge. Starting point is a discussion of a variety of different approaches to and classifications of frames and framing as provided in the literature. The outcome of this discussion is that the confusion we can observe with regard to these concepts results from the fact that researchers are mostly ambivalent about some crucial questions that should be answered in order to get a clear understanding of frames and framing: (1.) Are frames cognitive structures or something that is present only in our language? (2.) Is framing an unconscious activity or is it possible to frame something at will? (3.) Do we have access to our own frames and framing practice so that we can choose between different frames? (4.) Are frames holistic structures involving a person's complete belief system, or are they particular sets of opinions, or attitudes, concerning limited fields of experience? (5.) If frames are particularistic cognitive structures, how can their interaction with other particularistic cognitive structures be explained, and how can we distinguish them from other cognitive structures like strategies, routines, scripts, opinions, beliefs, values, and attitudes?
Fluorescence lifetime imaging microscopy.

Publisher Summary Fluorescence lifetime imaging microscopy (FLIM) produces spatially resolved images of fluorophore lifetime (the property describing how rapidly fluorescence decays), providing another dimension of information for visualizing fluorophores and an additional source of contrast. The basics of fluorophore lifetime, including the characteristics of fluorophore decay, a discussion of factors affecting fluorescence lifetimes, and the usefulness of lifetimes as a source for contrast. Both time domains (TD) and frequency-domain (FD) approaches (including data analysis) are described along with an introduction to different microscopy methods for lifetime imaging. Various applications of FLIM, ranging from commonly used fluorescence resonance energy transfer (FRET)-FLIM to fluorescence correlation spectroscopy (FCS)-, MS-MP-, and video-rate FLIM are also outlined in this chapter. Continuing advances in technology for microscopy and the developing appreciation that fluorescence lifetime is a sensitive means for evaluating microenvironment will likely help make FLIM a critical research tool for cell biology by providing a new way for cell biologists to detect, visualize, and investigate structure and function in biological systems.