cssi/SciSciGPT-SciSciNet huggingface dataset:
CB4-02: Validation of a Natural Language Processing Protocol for Detecting Heart Failure Signs and Symptoms in Electronic Health Record Text Notes

Background/AimsEarly detection of Heart Failure (HF) could help change the natural history of one of the most costly and disabling conditions among older patients through early intervention with treatments. We describe natural language processing (NLP) methods and validation results for detection of major and minor Framingham criteria in electronic health record (EHR) clinical notes as a first step towards early detection of HF.MethodsData for this study were from 6,355 primary care incident heart failure cases identified using Geisinger EHR data between 2001 and 2010 and from 26,052 controls. Text data were from Office Visit, Case Manager, and Radiology notes in the four-year period before diagnosis of HF in cases and a comparable period for controls. Text analysis comprised:During training, NLP results were iteratively validated against the judgments of a cardiologist. The final system was tested against gold standard annotations reflecting the consensus judgments of four trained coding experts.ResultsOver an 8-week period of iterative training, the NLP results on a dataset of 65 encounter notes improved from a positive predictive value (PPV) of 0.741 and a sensitivity (Se) of 0.504 to a final PPV of 0.931 and a Se of 0.939. On the consensus gold standard dataset of 200 cases and 200 controls, the fully-trained system achieved a PPV of 0.925 and a Se of 0.896.DiscussionThe NLP system can accurately identify affirmations and denials of Framingham criteria, which can directly reduce physicians workload for HF-related chart reviews and for possible early detection of HF. In addition, the integrated NLP components and our validation methodology can be adapted for application beyond HF.
Evidence for hexadecapole vibrations in A ≈ 170 deformed nuclei; New results for 168Yb

Abstract Dominating proton structure has been identified in the Kπ=3+ band of 168Yb, contrasting with neutron structure in the corresponding band of 172Yb. A region of low-lying Kπ=3+ bands is now established, with N=98−104, Z=68−72. For all stable nuclei in this region, the IπK=4+3 state is excited by inelastic deutron scattering.
Time‐of‐day variations in oculomotor function: 1. Tonic accommodation and tonic vergence

Time-of-day variations were studied both in tonic accommodation and in tonic vergence. Thirty-six male volunteers were measured once in the morning and at one other time on the same day. The mean baseline value of tonic accommodation was 2.02 D. Time-of-day variations were found, with a late evening measure being +0.6 D greater than the morning value. No independent time-of-day fluctuations were found in tonic vergence. Post-hoc analysis, however, showed that tonic vergence tended to shift in the same direction as an individual's tonic accommodation during the afternoon. During the evening, tonic vergences tended to shift oppositely to tonic accommodation.
Parallel MIMO detection algorithm based on householder transformation

A parallel MIMO detection algorithm (HPD) based on Householder transformation is proposed to improve the high bit error performance when the sorted QR decomposition detection algorithm (SQRD) is detected in Rayleigh slow fading channel. It transforms the channel matrix columns orthogonally based on Householder transformation to avoid solving the upper triangular matrix and sorts the channel matrix only once. In the processing of judging signal, it proposes a parallel processing of judged signal's feedback and received signal's interference cancellation, so the detection performance is improved distinctly. Under the environment of multiple scattering wireless communications, the simulation experiment results show that compared to the sorted QR decomposition algorithm, the complexity of the HPD algorithm is reduced dramatically.
Observation of Raman self-focusing in an alkali-metal vapor cell

We report an experimental demonstration of Raman self-focusing and self-defocusing in a far-off resonant alkali-metal atomic system. The key idea is to drive a hyperfine transition in an alkali-metal atom to a maximally coherent state with two laser beams. In this regime, the two-photon detuning from the Raman resonance controls the nonlinear index of the medium.
Non-Partner Violence Against Women Who Use Drugs in San Francisco

This article examines non-partner violence among women who use methamphetamine (N = 322), recruited in an inner-city neighborhood of San Francisco. The combined prevalence of non-partner physical or sexual violence in the past 6 months was 28%, roughly equal to the prevalence of partner violence (26%). In multivariate analysis, factors associated with non-partner violence included frequent subsistence difficulty (adjusted odds ratio [AOR] = 2.43, 95% confidence interval [CI] = [1.3, 4.6]) and sex trade (AOR = 2.27, 95% CI = [1.4, 4.1]). Having a steady male partner was not protective against non-partner violence. Violence perpetrated by non-partners should be considered when assessing social and structural factors that influence women’s health.
A Pilot Walking School Bus Program to Prevent Obesity in Hispanic Elementary School Children: Role of Physician Involvement With the School Community

Forty-three percent of Hispanic children, 6 to 11 years old, in the United States are overweight or obese.1 Minority status and poverty in urban communities have been found to contribute to childhood obesity.2,3 Given the clear role of environmental contributors to obesity, physicians are increasingly asked to go beyond their clinical practice to support school and community programs that help prevent obesity.4 The Walking School Bus (WSB), an innovative program designed to cut down on traffic congestion while providing a safe way to walk children to school, may offer clinicians a novel approach to obesity prevention.5 Walking to school is an affordable mode of transportation that may help reduce the high prevalence of childhood obesity.6 This brief report outlines principal findings from a pilot WSB program used by school-based health center physicians in collaboration with their school and community. Full details of implementation are reported elsewhere.7 The University of New Mexico School-Based Health Center (UNM SBHC) provides primary care to a predominantly Hispanic elementary school located in the zip code area with the highest percentage of families less than 185% of the federal poverty level in Albuquerque. Student obesity was voiced as a concern by parents and teachers to SBHC physicians at the elementary school. This prompted UNM SBHC to collaborate with the school and community to test the feasibility of a modified WSB program as a strategy to prevent obesity among the elementary school students.
Growth of Neurotropic Viruses in Extraneural Tissues. I. MM Virus in the Feet of Hamsters

Summary and ConclusionAfter inoculation into the pad of the hind foot of a hamster, MM virus increases in amount in the local tissue. Subsequent increases in virus in the blood and viscera are in turn followed by appearance of the virus in the central nervous system. It appears certain that the virus grows in the foot. Whether the growth occurs in subcutaneous tissue, muscles, or nerve endings was not determined in these experiments.
Visualization of Clustered Directed Acyclic Graphs without Node Overlapping

Conventional force directed graph drawing methods aim to produce aesthetically pleasing visualization of graphs. The edges of the graph have more or less equal length, and there are as few crossing edges as possible. This paper proposes a new e-spring algorithm for visualizing clustered directed acyclic graphs (DAGs) without node overlapping, extended from the popular spring embedder model. In our framework, nodes are modeled as nonuniform charged particles with weights, and a final drawing is derived by adjusting the positions of the nodes according to a combination of spring forces and repulsive forces derived from electrostatic forces between the nodes. Experimental results and visualization/analysis of this method are reported.
Isometric Strength Fatigue Patterns in Female Subjects.

Abstract Following two sessions to establish maximum strength, 33 female subjects were given 30 trials of isometric wrist flexion on each limb with intertrial rest period conditions of 10 and 20 seconds. Subjects were ranked on the basis of the mean strength of the right wrist on test Day 2 and divided into three groups of 11 subjects each, representing high, middle, and low levels of strength. Analysis of variance of the fatigue curve trends suggested that: (a) fatigue patterns were not the same under any of the four conditions, with the low level of strength group exhibiting the most discrepant patterns; (b) fatigue patterns of the female subjects showed marked similarity to comparative male data, even though the males were almost twice as strong as the females; (c) the six between-hand contrasts by levels of strength showed right and left fatigue pattern similarity with only one exception. It was concluded that the data strengthened the argument that an overall or composite pattern curve will seldom re...
The Pre-Diabetic, Insulin-Resistant State

Adult-onset type 2 diabetes is a late outcome of metabolic and inflammatory processes that predate glucose level elevation by many years. The negative effects of these processes on the health of older adults are enhanced by the inter-relationship of these processes with those associated with “aging”. Insulin resistance occurs prior to the elevated serum glucose levels that define diabetes. Obesity is the primary factor that leads to insulin resistance. The pre-diabetic insulin-resistant condition can have serious cardiovascular consequences, including subclinical or clinical cardiovascular disease and cardiovascular autonomic dysfunction. It can also have serious non-cardiovascular consequences, such as renal disease, cognitive decline, impaired mobility, frailty, interference with circadian rhythms, sleep apnea, bone disease and liver disease. Methods for attenuating the rise in glucose levels in those who have insulin resistance include pharmacological interventions and lifestyle change. Lifestyle changes include weight reduction and increased physical activity, which can be effective even in those with a genetic predisposition to diabetes and can ameliorate the decreased insulin sensitivity that is associated with aging.
Configurational Multiplicity of Porphyrin π Cation Radicals: Nickel π−π Dimers

The molecular structure of the Ni(II)OEP+ClO4- π cation radical is reported (OEP = 2,3,7,8,12,13,17,18-octaethylporphyrin). The vibrational spectrum of a single crystal, recorded with an FT-IR microspectrometer, shows the 2A1u HOMO occupancy marker band predicted for an OEP cation radical. The radical crystallizes as a cofacial π−π dimer, (NiOEP+ClO4-)2·2CH2Cl2, in an eclipsed configuration with the following parameters: mean interplanar separation = 3.36 A, Ni−Ni = 3.41 A, Ct−Ct = 3.46 A, lateral shift = 0.83 A, translational slip angle = 13.9°, and zero rotation of equivalent N−Ni−N axes. This dimeric configuration differs significantly from that of a related (NiOEP+ClO4-)2·8CH2Cl2 dimer and from those of several other metallo (M) OEP radical dimers described previously. The present results offer exceptions to generalizations recently proposed regarding the geometry and extent of π−π interactions in fully and partially oxidized MOEP+ dimeric π cation radicals such as (MOEP+)2 and (MOEP)2+. Indeed, the ...
Observations on arteriovenous communications in lungs of dogs.

SummaryLucite spheres of 75-80 μ introduced into the pulmonary arteries of heart-lung preparations under physiologic pressures will pass from pulmonary arteries to veins. In contrast, microspheres of 300 μ size did not pass through the pulmonary vasculature.
Investigation on the pyrethrin pesticide residues in vegetables in Hangzhou city

Objective To investigate the status of pyrethrin pesticide residues in market vegetables in Hangzhou city. Methods Vegetables were sampled randomly from farm fair and supermarkets in Hangzhou city in 2012. Eight kinds of pyrethrin pesticides residues in samples were determined by gas chromatography. Results A total of 95 vegetable samples were detected,the total detection rate of the pyrethrin pesticide was 12. 6%,while the exceeding rate was 2. 1%. Cyhalothrin was most frequently detected in all the 8 pyrethrin pesticides. Conclusion In 2012,the detection rate of pyrethrin pesticide residues in market vegetables of Hangzhou city was higher,but the exceeding rate was at a relatively low level.
Determination of cyproheptadine hydrochloride of compound dexamethasone cream

Objective To establish a method for determining the content of cyproheptadine hydrochloride in compound dexamethasone cream. Methods A ultraviolet spectrophotometric method was used for the determination of cyproheptadine hydrochloride in compound dexamethasone cream.The detection wavelength was at 284 nm. Results The linear range for the cyproheptadine hydrochloride was 5.0-30.0 μg/ml(r=0.999 9).The average recovery rate was 100.0%,and RSD was 0.94%(n=9). Conclusion The method is accurate,reliable,simple and feasible,and could be used for the quality control and the determination of cyproheptadine hydrochloride in compound dexamethasone cream.
Pressure-relieving strategies for preventing and treating pressure sores

Pressure-relieving strategies remain the foundation for the prevention and treatment of pressure sores. Although the published literature is inadequate, rational treatment decisions can be made if they are based on an understanding of the mechanisms by which pressure relief results with a particular device or strategy. This article reviews the theoretic and practical approaches to managing tissue loads so that rational choices of the most cost-effective strategies for preventing and treating pressure sores can be made when caring for patients.
Fairness and the Strengths of Agents' Claims

John Broome has proposed a theory of fairness according to which fairness requires that agents’ claims to goods be satisfied in proportion to the relative strength of those claims. In the case of competing claims for a single indivisible good, Broome argues that what fairness requires is the use of a weighted lottery as a surrogate to satisfying the competing claims: the relative chance of each claimant's winning the lottery should be set to the relative strength of each claimant's claim. In this journal, James Kirkpatrick and Nick Eastwood have objected that the use of weighted lotteries in the case of indivisible goods is unacceptable. In this article, I explain why Kirkpatrick and Eastwood's objection misses its mark.
Abstract 4584: Apoptosis-mediated AXL activation: Contribution to metastatic cancers

AXL is a receptor tyrosine kinase that is widely expressed in a variety of cancers and is predictive of poor patient outcome. This receptor is an essential epithelial-to-mesenchymal transition-induced regulator of cancer metastasis and is related to the occurrence of treatment resistance. AXL activation requires both the lipid moiety phosphatidylserine (PtdSer) and the bridging protein ligand Gas6. PtdSer is only available to mediate AXL activation when it is externalized on cell membranes, an event that occurs specifically during apoptosis. For that reason, we aimed to identify if apoptotic cell debris is capable of activating AXL on cancer cells and how this would affect the metastatic capacity of these cells. In a non-AXL expressing tumor cell line (HCC827) apoptosis was induced by means of UV-irradiation. We detected AXL activation of AXL-expressing MDA-MB-231 cells that were treated with HCC827 cell debris, suggesting that apoptotic debris of dying tumor cells is capable of activating AXL in surviving surrounding tumor cells. Next we determined the contribution of PtdSer-mediated AXL activation to the migration of MDA-MB-231 cells in a wound scratch assay. The addition of warfarin, which prevents autocrine Gas6 binding to PtdSer, decreased migration to a similar extent as the AXL inhibitor R428. This study revealed that PtdSer-mediated AXL activation contributes to the migration properties of MDA-MB-231 cells. As we detected AXL activation upon addition of PtdSer-containing apoptotic cells debris, this suggests that the induction of apoptosis by cancer therapeutics might enhance the metastatic capacities of neighboring surviving tumor cells. This finding may broadly impact the oncology field given AXL9s widespread expression among different types of cancers, and provides a rationale for the design of novel combination therapies for decreasing tumor metastasis. Citation Format: Annelien Zweemer, Aaron Meyer, Douglas Lauffenburger. Apoptosis-mediated AXL activation: Contribution to metastatic cancers. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4584.
Amphiphilic Hybrid Nano Building Blocks with Surfactant-Mimicking Structures

We report the preparation and self-assembly of amphiphilic hybrid nano building blocks (NBBs) with surfactant-mimicking structures. These NBBs, composed of hydrophilic silica-like heads tethered with well-defined one or two hydrophobic polystyrene (PS) tails, were prepared by efficient intramolecular cross-linking via silane chemistry. Using a series of “AB” diblock copolymers (BCPs) and “ABA” tri-BCPs of PS and poly(tert-butyl acrylate-co-3-(trimethoxysilyl)propyl methacrylate) (P(tBA-co-TMSPMA)), the intramolecular self-folding of P(tBA-co-TMSPMA) blocks and the deprotection of tert-butyl groups were demonstrated to be an efficient method to prepare amphiphilic NBBs with a hydrophilic silica head tethered by one or two PS tails. The formation of NBBs was carefully studied by gel permeation chromatography, nuclear magnetic resonance spectroscopy, and transmission electron microscopy. The self-assembly of these amphiphilic NBBs was further investigated by fixing the molecular weight of PS tails and varyin...
Patterns and predictors of severe postpartum anemia after Cesarean section.

BACKGROUND Postpartum anemia is associated with maternal and perinatal morbidity. Population-level data may inform guideline development for postpartum anemia screening. Our objectives were to evaluate the associations between potential predictors (predelivery anemia and postpartum hemorrhage [PPH]) with severe postpartum anemia after Cesarean section. STUDY DESIGN AND METHODS Data were collected from 70,939 hospitalizations for Cesarean section performed at Kaiser Permanente Northern California facilities between 2005 and 2013. Severe postpartum anemia was defined as a hemoglobin (Hb) level of less than 8 g/dL before hospital discharge. Using multivariable logistic regression, we assessed the associations between predelivery anemia and PPH with severe postpartum anemia. Distributions of these characteristics among women with severe postpartum anemia were evaluated. RESULTS The overall rate of severe postpartum anemia was 7.3% (95% confidence interval [CI], 7.1%-7.4%). Severe postpartum anemia was strongly associated with a predelivery Hb level between 10 and 10.9 g/dL (adjusted odds ratio [aOR], 5.4; 95% CI, 4.89-5.91), predelivery Hb level of less than 10 g/dL (aOR, 30.6; 95% CI, 27.21-34.6), and PPH (aOR, 8.45; 95% CI, 7.8-9.16). The proportions of women with severe postpartum anemia were highest for those experiencing PPH but no predelivery anemia (12.2%; 95% CI, 11.0%-13.6%) and those who did not incur PPH nor predelivery anemia (10.7%; 95% CI, 9.6%-12.0%). CONCLUSIONS Our findings suggest that PPH and predelivery anemia are strong independent risk factors for severe postpartum anemia. Optimization of patients' Hb before delivery may reduce the incidence of severe anemia after Cesarean section.
How will precipitation change in extratropical cyclones as the planet warms? Insights from a large initial condition climate model ensemble

The extratropical precipitation response to global warming is investigated within a 30-member initial condition climate model ensemble. As in observations, modeled cyclonic precipitation contributes a large fraction of extratropical precipitation, especially over the ocean and in the winter hemisphere. When compared to present day, the ensemble projects increased cyclone-associated precipitation under twenty-first century business-as-usual greenhouse gas forcing. While the cyclone-associated precipitation response is weaker in the near-future (2016–2035) than in the far-future (2081–2100), both future periods have similar patterns of response. Though cyclone frequency changes are important regionally, most of the increased cyclone-associated precipitation results from increased within-cyclone precipitation. Consistent with this result, cyclone-centric composites show statistically significant precipitation increases in all cyclone sectors. Decomposition into thermodynamic (mean cyclone water vapor path) and dynamic (mean cyclone wind speed) contributions shows that thermodynamics explains 92 and 95% of the near-future and far-future within-cyclone precipitation increases respectively. Surprisingly, the influence of dynamics on future cyclonic precipitation changes is negligible. In addition, the forced response exceeds internal variability in both future time periods. Overall, this work suggests that future cyclonic precipitation changes will result primarily from increased moisture availability in a warmer world, with secondary contributions from changes in cyclone frequency and cyclone dynamics.
Focusing on trauma-focused psychotherapy for posttraumatic stress disorder

Trauma-focused psychotherapy for posttraumatic stress disorder (PTSD) includes a range of theoretical approaches, but primarily is based on cognitive-behavioral theory. Eye Movement Desensitization and Reprocessing is another type of trauma-focused psychotherapy. Although there is some evidence to support present-centered and interpersonal approaches, trauma-focused psychotherapies have the most empirical support and are the most effective for treating PTSD and related problems.
“Family”: Surviving the Don’t Ask, Don’t Tell Years

The idea of writing about the trials and tribulations I experienced while serving in the Navy as a lesbian during “Don’t Ask, Don’t Tell” sounded so appealing. I love talking about it at parties and gatherings, so writing about it should be a piece of cake. The thing is, in order to write about it, I had to examine those first 13 years of my Navy career. Once I started doing that, I realized very quickly that I didn’t have it as hard as most of my fellow LGBT service members had it. I really didn’t. Yes, I had some shitty times. Yes, I was scared that my career could end any day, but I still remember those years fondly. Maybe, my brain has chosen to erase all the anxiety and anger I felt during those years, or maybe it really hadn’t been that bad for me.
Expansion of the Genetic Alphabet: A Chemist's Approach to Synthetic Biology.

ConspectusThe information available to any organism is encoded in a four nucleotide, two base pair genetic code. Since its earliest days, the field of synthetic biology has endeavored to impart organisms with novel attributes and functions, and perhaps the most fundamental approach to this goal is the creation of a fifth and sixth nucleotide that pair to form a third, unnatural base pair (UBP) and thus allow for the storage and retrieval of increased information. Achieving this goal, by definition, requires synthetic chemistry to create unnatural nucleotides and a medicinal chemistry-like approach to guide their optimization. With this perspective, almost 20 years ago we began designing unnatural nucleotides with the ultimate goal of developing UBPs that function in vivo, and thus serve as the foundation of semi-synthetic organisms (SSOs) capable of storing and retrieving increased information. From the beginning, our efforts focused on the development of nucleotides that bear predominantly hydrophobic nu...
The Mark of a Woman’s Record: Gender and Academic Performance in Hiring:

Women earn better grades than men across levels of education—but to what end? This article assesses whether men and women receive equal returns to academic performance in hiring. I conducted an aud...
The Madness of Romantic Obsession in Fowles’ The Collector

As Fowles’ novels go, The Collector is one of the least complex in terms of structure, yet it is quite complex on both social and psychological levels as well as on a stylistic one. Fowles was deeply influenced by the work of the French writer, Alain-Fournier, and his perceptions of women are not entirely divorced from those. The novel is symbolic. The girl (Miranda) represents good humanity, hope for the future, intelligence, and love while the young man (Clegg) her abductor, represents the opposite: the generous versus the mean. The essay attempts to show how Fowles interrogates the notion of romantic madness, vis-a-vis Clegg’s kidnapping of Miranda, through one of the maddest characters in twentieth-century literature.
Deep network for retinal disease classification based on limited clinical OCT angiography datasets (Conference Presentation)

Optical coherence tomography angiography (OCT-A) is a novel non-invasive imaging technique that provide the visualization of retinal microvasculature. However, the quantification and evaluation of OCT-A are still a challenge for the diagnosis for ophthalmology. Deep convolutional neural network (CNN) architectures were initially designed for the task of natural image classification, delivering promising precision in computer vision tasks and recent research has applied deep CNN to biomedical image processing tasks and produces impressive outcomes. However, so far, there is no report relating to the application of large deep neural networks on a small annotated OCT-A dataset. We collected and annotated OCT-A datasets that contain diabetic retinopathy (DR), uveitis, dry age-related macular degeneration (AMD) patients, and normal cases. We propose a transfer learning CNN model for automated disease classification using clinical OCT-A images. The CNN model is pre-trained on the ImageNet dataset and fine-tuned the top feedforward layers of the model to fit the classification task during the training process. The proposed approach can offer a real-time evaluation and discrimination of retinal pathologies with a depth-encoded OCT-A projected image. Our results show great accuracy of transfer learning CNN model on the classification task with the limited dataset. The CNN model with the pre-trained weights has better performance in comparison with an SVM using HOG feature approach.
Tractability of Approximation for Some Weighted Spaces of Hybrid Smoothness

A great deal of work has studied the tractability of approximating (in the L2-norm) functions belonging to weighted unanchored Sobolev spaces of dominating mixed smoothness of order 1 over the unit d-cube. In this paper, we generalize these results. Let r and s be non-negative integers, with r ≤ s. We consider the approximation of complex-valued functions over the torus \(\mathbb {T}^d=[0,2\pi ]^d\) from weighted spaces \(H^{s,1}_\varGamma (\mathbb {T}^d)\) of hybrid smoothness, measuring error in the \(H^r(\mathbb {T}^d)\)-norm. Here we have isotropic smoothness of order s, the derivatives of order s having dominating mixed smoothness of order 1. If r = s = 0, then \(H^{0,1}(\mathbb {T}^d)\) is a well-known weighted unachored Sobolev space of dominating smoothness of order 1, whereas we have a generalization for other values of r and s. Besides its independent interest, this problem arises (with r = 1) in Galerkin methods for solving second-order elliptic problems. Suppose that continuous linear information is admissible. We show that this new approximation problem is topologically equivalent to the problem of approximating \(H^{s-r,1}_\varGamma (\mathbb {T}^d)\) in the \(L_2(\mathbb {T}^d)\)-norm, the equivalence being independent of d. It then follows that our new problem attains a given level of tractability if and only if approximating \(H^{s-r,1}_\varGamma (\mathbb {T}^d)\) in the \(L_2(\mathbb {T}^d)\)-norm has the same level of tractability. We further compare the tractability of our problem to that of \(L_2(\mathbb {T}^d)\)-approximation for \(H^{0,1}_\varGamma (\mathbb {T}^d)\). We then analyze the tractability of our problem for various families of weights.
Opioid Peptides and Long-term Potentiation in the Hippocampus

ABSTRACT To study the involvement of hippocampal opiatergic elements in the formation of long-term potentiation (LTP) we investigated the characteristics of LTP in Schaffer collaterals – CA 1 synaptic system on rat hippocampal slice preparations under pharmacological activation and blockade of opiate receptors, LTP development and magnitude were compared in control slices and 3 groups of preparations which were incubated during tetanization with following substances: 1. metenkephalin, 0.05 µM; 2. metenkephalin releaser kyotorphin, 5 µM; 3. opiate antagonist naloxone, 5 µM. There were no difference between groups in LTP development. The mean LTP magnitude was found to increase significantly by metenkephalin. Analogous but not significant increase was observed under kyotorphin treatment, which supposedly stimulated the release of endogenous metenkephalin. Unexpected tendency to increase the average LTP magnitude was also shown by naloxone. Although these data are difficult to interpret in the single frameworks because of similar effects of opiate receptor agonists and antagonist they suggest the modulatory role of opioid system in LTP.
Global spatial disorientation: Clinico-pathologic correlations

Two patients presenting with the acute onset of bilateral parietal lobe damage showed initially the features of Balint's syndrome. After most of its manifestations had cleared, both patients exhibited severe disorders of spatial orientation: acoustic ataxia, inability to localize objects in space. In addition, 1 patient showed a topographical disorientation and abnormalities of whole body movements. This patient came to post-mortem examination, which revealed bilateral and fairly symmetrical old and recent infarctions of the superior parietal lobules. In the light of these observations and previous reports, it is suggested that the reported abnormalities of whole body movements can be explained on the basis of a visuo-motor intrahemispheric disconnection due to the bilateral lesion of the dorsal parietal lobe. In addition, the global spatial disorientation is analysed and is thought to be the manifestation of a derangement of a specific function centered in the parietal lobe. Moreover, it is pointed out that topographic disorientation does not require the concomitant failure of oculomotor mechanisms for its production. The topography of the anatomical lesion is considered in relation to current concepts on brain damage after severe hypotension and cardiac arrest. It is concluded that this group of patients is most likely at risk of developing behavioural abnormalities akin to the ones here reported.
Stress and aging act through common mechanisms to elicit neuroinflammatory priming

Abstract Over the course of an animal’s lifespan, there is a protracted breakdown in basic homeostatic functions. Stressors (both psychological and physiological) can accelerate this process and compromise multiple homeostatic mechanisms. For example, both stress and aging can modulate neuroinflammatory function and cause a primed phenotype resulting in a heightened neuroinflammatory profile upon immune activation. Microglia, the brain’s resident myeloid cell, produce “silent” immune machinery in response to stress and aging that does not cause immediate immune activation; rather, these changes prime the cell for a subsequent immune insult. Primed microglia exhibit a hyperinflammatory response upon immune activation that can exacerbate pathology. In this review, we will explore parallels between stress- and aging-induced neuroinflammatory priming. First, we will provide a background on the basic principles of neuroimmunology. Next, we will discuss evidence that neuroinflammatory responses become primed in the context of both stress and aging. We will also describe cell-specific contributions to neuroinflammatory priming with a focus on microglia. Finally, common mechanisms underlying priming in the context of stress and aging will be discussed: these mechanisms include glucocorticoid signaling; accumulation of danger signals; dis-inhibition of microglia; and breakdown of circadian rhythms. Overall, there are multifarious parallels between stress- and aging-elicited neuroinflammatory priming, suggesting that stress may promote a form of premature aging. Further unravelling mechanisms underlying priming could lead to improved treatments for buffering against stress- and aging-elicited behavioral pathologies.
Erfolgsfaktoren von Innovations-Labs in der Assekuranz

Abgeschaut aus anderen Branchen und dem Silicon Valley grunden immer mehr Versicherer Innovations‐Labs zur Entwicklung von neuen Geschaftsideen. Oftmals betreten sie hiermit Neuland und zahlen teures Lehrgeld. Eine Untersuchung zeigt, welche Ziele verfolgt werden, welche Modelloptionen bestehen und welche Phasen bei der Implementierung durchlaufen werden.
Neoadjuvant chemotherapy for high‐risk prostatic adenocarcinoma

Introduction Neoadjuvant chemotherapy in high-risk, locally advanced prostate cancer remains an understudied area of prostate cancer. Chemotherapy continues to be a viable option. The combination with surgery may be desired but lacks data for complete recommendation. Case presentation We demonstrate the successful utilization of chemotherapy in the neoadjuvant arena. A 70-year-old male was diagnosed with high-risk prostate cancer on biopsy. Upon multiparametric magnetic resonance imaging, the patient had local rectal wall invasion and stage T4 N0 M0 after a negative bone scan. After treatment with androgen-deprivation therapy and docetaxel, repeat multiparametric magnetic resonance imaging showed regression of rectal invasion. The patient elected for prostatectomy and avoided proctectomy and colostomy. The patient's postoperative prostate-specific antigen was undetectable on initial follow-up. Conclusion We show that neoadjuvant chemotherapy merits further study and may provide a more permanent surgical option for patients.
Stress monitoring of prestressing strands in corrosive environments using modulated higher-order guided ultrasonic waves:

This article investigates a guided ultrasonic wave–based data fusion approach for nondestructively monitoring stress redistribution in strands under active corrosion. Within this approach, the stre...
Cultural and political attitudes towards paying to support airport sustainability projects

The current research explores different factors affecting individuals' support for airports implementing environmentally-friendly programs. Using social identity theory, the researchers manipulated participants' identification with one of the two major political parties to explore the relationship between political affiliation and support for environmentally-friendly initiatives. Participants (recruited from the USA and India) were presented with a hypothetical scenario in which 12 different sustainable aviation projects would be implemented at their local airport. Implementation of these projects would include a $15 fee to their ticket price. Participants were then asked to indicate their support for the additional fee for each of the 12 programs. Results from this study indicate significant differences in acceptance of sustainable aviation programs based on a variety of political and cultural factors. In general, liberals/progressives and Indians were more willing to pay the additional fee, regardless of the type of program.
On Exotic Lagrangian Tori in CP2

We construct an exotic monotone Lagrangian torus in CP2 using techniques motivated by mirror symmetry. We show that it bounds 10 families of Maslov index 2 holomorphic discs, and it follows that this exotic torus is not Hamiltonian isotopic to the known Cliffordand Chekanov tori.
Non-parametric stochastic subset optimization for reliability-based importance ranking of bridges in transportation networks

Abstract Establishing reliability-based importance ranking of bridges in a transportation network usually entails significant computational efforts, especially for large-scale networks. This paper proposes a non-parametric stochastic subset optimization (NP-SSO) algorithm to efficiently identify the reliability-based importance ranking of bridges. It first generates failure samples from an augmented failure distribution and then directly establishes the importance ranking by comparing the number of failure samples for each bridge. To improve the efficiency, an iterative NP-SSO algorithm is established by restricting the search space to the subset of bridges identified in the previous iteration. For each iteration, the modified accept-reject algorithm with adaptive kernel sampling density (AKSD) is adopted to efficiently generate failure samples. The proposed NP-SSO algorithm is highly efficient for identification of important bridges, and the number of iterations only grows logarithmically with respect to the number of bridges, and NP-SSO is especially useful for large-scale networks with many bridges. The effectiveness and efficiency of NP-SSO are demonstrated through identifying the importance ranking of bridges in the transportation network of Los Angeles and Orange counties.
Malaria: Mosquitos Suck!

Malaria is a mosquito-borne infection that, while uncommon in the USA, it causes significant disease in other parts of the world. Because it is rare in the USA, it can be easily missed if a thorough history is not obtained. Initial symptoms of malaria are generally nonspecific, but fever is present in almost all patients, with the patterns of fever depending on the species of parasite. In cases of severe malaria, neurological symptoms such as dizziness, confusion, disorientation, and seizures may occur. Uncomplicated malaria can be treated with oral agents after diagnosis has been confirmed by laboratory investigations. Complicated or severe malaria is a medical emergency and should be treated aggressively with IV antimalarial agents.
Reply to Kenyon, "Are Differences in the Oral Microbiome Due to Ancestry or Socioeconomics?"

We thank Dr. Kenyon for his careful reading of our paper ([1][1], [2][2]). First, he speculated that the differences in relative abundance of the 13 most common taxa between European-Americans (EAs) and African-Americans (AAs) may be due to inadequate control of covariates. Then, he expressed
Screening for Intimate Partner Violence in a Pediatric ED: A Quality Improvement Initiative.

OBJECTIVE Intimate partner violence (IPV) is a serious public health concern and impacts the entire family unit, particularly children. We implemented an IPV screening and referral program in an urban pediatric emergency department (ED) and aimed to screen 30% of patient families for IPV by January 1, 2017. METHODS We used a quality improvement initiative using a nonverbal screening card to screen families when the caregiver was the sole adult present and spoke English and/or Spanish, and the patient was medically stable. Interventions included education, culture of screening initiatives, feedback, and process changes to emergency medical record (EMR) documentation. The primary outcome measure was percentage of caregivers screened in the ED over time. Our balancing measure was ED length of stay. RESULTS After process improvement implementations that include requiring IPV screen documentation in the EMR, using Research Electronic Data Capture for referrals, and standardizing and simplifying the screening process, caregiver screening rates increased to 30% and have remained consistently at or above that rate during the 15-month postevaluation phase. This intervention did not impact length of stay in the ED. CONCLUSIONS An innovative multiphase quality improvement approach to screen for IPV using a nonverbal screening card and technology within the EMR was successfully implemented in our pediatric ED. Both IPV screening and documentation rates demonstrated greatest improvement and sustainability after process improvements over other initiatives.
Fabrication and characterization of Cu2O/Cu-WO3 bilayers for lateral programmable metallization cells

Abstract Lateral Programmable Metallization Cell (PMC) structures rely on metal electrodeposition in a long channel consisting of a solid electrolyte layer between an anode and a cathode. Integration of these devices with CMOS circuitry demands using materials such as copper and tungsten for the electrodes, and an oxide of tungsten (WO3) doped with Cu for the electrolyte. However, low diffusivity of Cu in WO3 and its high resistivity results in a slow electrodeposition process. Our solution to this problem involves the use of a Cu2O/Cu-WO3 bilayer, formed by oxidation of a thin Cu film on a WO3 layer and a simultaneous diffusion of Cu into the WO3 at moderate temperatures. This creates a Cu-WO3 solid electrolyte with a semiconducting Cu2O coating that brings electrons to where the ions are most abundant and thereby greatly increases the electrodeposition rate. In this paper, an investigation of thin film Cu oxidation is presented along with the diffusion kinetics of Cu in WO3. The Cu was oxidized in air to form Cu2O with an activation energy of 0.70 eV. The diffusion analysis showed activation energy of Cu diffusion in WO3 was 0.74 eV, which we believe is the first time this value has been reported.
Building a foundation for utilizing evidence based practice in conjunction with research in baccalaureate nursing program

Less is known about the undergraduate nursing students’ ability to conduct beginning research. This study aims to explore and describe nursing students' experiences in planning and implementation of community health fairs; and utilizing evidence based practice integrated with research as a learning outcome. The study using a quantitative and descriptive design was conducted by senior nursing students during diverse community health events as a part of Gerontological nursing clinical. The students utilized three fall assessment tools: Balance and Gait test, Timed Up and Go test, and 10-year Fracture Risk Calculation. A total of 74 students participated in seven community health fair events focused on Fall Prevention. This health fair event was in conjunction with the National Fall Prevention Awareness week. A total of 201 older adults were served during the event by nursing students who provided screening process and related health education. Data were gathered and a group of students volunteered to complete the research process. The students participated in oral presentation in the Annual University Research Student Symposium and had poster presentation in the professional academic conference. Early systematic organized planning of the clinical experience gives students opportunity to integrate evidence based practice into research. Application of varied evidence based assessment tools focused on older adults enables students to understand the health issue in depth and the need for additional services. Health fair experiences improve students’ communication and education skills, reality of health issues of the target population in a community, and evidence based research.
Modeling and simulation of evanescent coupling to Si waveguides using SPP

One of the major challenges in integrated silicon photonics is the light coupling into and out of photonic circuits. Prism coupling, among waveguide coupling methods in the silicon photonics is a rather complex and costly one mostly due to the requirement of a prism with index of refraction higher than that of the effective index of the propagating mode in the waveguide. Surface plasmon polariton (SPP) allows the deployment of a fused silica prism instead of the high index prism, as indicated by our simulation using Lumerical FDTD software and Otto configuration of the SPP excitation scheme. Using the dispersion diagram the surface plasmon angle is determined to be 44◦ for the TM-mode of the incident beam. This is followed by examining the relevant parameters affecting the light coupling efficiency to a silicon waveguide of input dimensions of 220 750 nm. In Lumerical FDTD solver, two-dimensional simulation of plane waves of p-polarization enters the optical system at surface plasmon angle. This model reveals a coupling efficiency of 54% which at the very least is better than that of traditional prism coupling methods. For fabrication purposes, we could impose geometrical constraints on airgap height, making it a function of the waveguide and metal (silver in this case) strip thickness. Furthermore, we will show and discuss the effect of choice of the thickness for the Si waveguide, airgap, and silver layer on coupling efficiency from our mathematical model and Lumerical FDTD simulations.
Effects of W and Si microadditions on microstructure and the strength of dilute precipitation-strengthened Al–Zr–Er alloys

Abstract The effect of single or combined micro-additions of tungsten (0.03 at.%) and silicon (0.02–0.40 at.%) on the evolution of Al3(Zr,Er) (L12) nanoprecipitates in a cast Al-0.11Zr-0.005Er (at.%) alloy is investigated utilizing isochronal (200–600 °C) and isothermal (400, 425 and 450 °C) aging treatments. Atom-probe tomography measurements reveal that the slow-diffusing W, upon aging, partitions to the L12-nanoprecipitates (average composition of 0.11–0.37 at.% W; partitioning ratio of 5–12), without altering their crystal structure or spheroidal morphology, as confirmed by transmission electron microscopy. First-principles calculations indicate that W occupies the Al sublattice sites of Al3Zr(L12), leading to a small increase in the lattice parameter of the nanoprecipitates. In the low-Si (0.02 at.%) alloys, the precipitation and coarsening kinetics of nanoprecipitates are unaffected by W additions. A small enhancement in nanoprecipitate coarsening resistance is achieved, however, by W additions in the high-Si (0.4 at.%) alloys. The W-modified alloys exhibit significant improvements in compressive creep resistance at 300 °C; the threshold stress increases from 11 MPa in the W-free alloy to 15 and 16 MPa in the low-Si and high-Si alloys with W additions, respectively. This is explained by an increased lattice parameter mismatch between the L12-nanoprecipitates and the matrix, due to Er enrichment in the nanoprecipitates in the presence of W. Silicon additions, in alloys with and without W, lead to a higher peak microhardness (ΔHV ~90–110 MPa) and higher creep threshold stresses (Δσth ~2–4 MPa) by increasing the L12-nanoprecipitate number density, but at the expense of their long-term coarsening resistance.
Reducing Opioid Use in Patients Undergoing Cardiac Surgery — Preoperative, Intraoperative, and Critical Care Strategies

Patients undergoing cardiothoracic surgery are exposed to opioids in the operating room and intensive care unit and after hospital discharge. Opportunities exist to reduce perioperative opioid use at all stages of care and include alternative oral and intravenous medications, novel intraoperative regional anesthetic techniques, and postoperative opioid-sparing sedative and analgesic strategies. In this review, currently used and investigational strategies to reduce the opioid burden for cardiothoracic surgical patients are explored.
The dodo doctor's conundrum.

Winning Essay for the 4th Annual Enid Balint Essay Contest: Hearing the patient, Healing the clinician!