cssi/SciSciGPT-SciSciNet huggingface dataset:
Thoracoscopic lobectomy is associated with improved short-term and equivalent oncological outcomes compared with open lobectomy for clinical Stage I non-small-cell lung cancer: A propensity-matched analysis of 963 cases

OBJECTIVES: Previous literature has reported lower morbidity for video-assisted thoracoscopic surgery lobectomy (VL) compared with open lobectomy (OL); however, most comparative studies have been retrospective and have failed to compare well-matched patient groups, therefore allowing selection bias to influence results. Furthermore, oncological adequacy of VL has recently been questioned, particularly with respect to lymphadenectomy. This study aimed to evaluate short- and long-term outcomes of a large cohort of consecutive patients with c-stage I non-small-cell lung cancer (NSCLC) that underwent either VL or OL. METHODS: Consecutive patients with c-stage I NSCLC who underwent lobectomy without preoperative therapy were reviewed. Univariable, multivariable and propensity-matched analyses were performed. VL patients who underwent conversion to OL were analysed within the VL group. RESULTS: VL was performed in 307 (32%) patients and OL in 656 (68%). Twenty-two (7%) patients converted from VL to OL. Although there were no differences in overall p-stage grouping, there were fewer patients with pT2 tumours in the VL group (39 vs 48%, P= 0.012) and fewer patients with squamous cell histology (26 vs 18%, P= 0.006). These differences resolved after propensity matching. In unmatched and matched analyses, VL was associated with less overall morbidity, less pulmonary morbidity, fewer atrial arrhythmias, shorter chest tube duration and shorter hospital stay than patients who had OL. Thirty-day in-hospital mortality was 0.3 and 1.4%, for VL and OL groups, respectively (P= NS). In unmatched analysis (log rank), 5-year survival favoured VL (78 vs 68%, P= 0.007); however, after propensity matching there was only a trend towards improved survival with VL (78 vs 73%, P= 0.071). Multivariable Cox regression analysis revealed VL (hazard ratio (HR) 0.64, 95% confidence interval (CI) 0.46–0.92), male sex (HR 1.43, 95% CI 1.10–1.86), Zubrod performance status (HR 3.42, 95% CI 1.26–9.29) and increasing age (HR 1.04, 95% CI 1.03–1.06) to be independent predictors of survival. CONCLUSIONS: Patients with clinical Stage I NSCLC undergoing VL have less perioperative morbidity compared with matched OL controls. Regional lymphadenectomy, nodal upstaging, overall and disease-free survival were similar between VL and OL groups. In experienced centres, VL is an acceptable operation for patients with c-stage I NSCLC.
Avoiding mismatch in allograft anterior cruciate ligament reconstruction: correlation between patient height and patellar tendon length.

Purpose: The purpose of this study was to evaluate whether a correlation exists between patient height and soft-tissue patellar tendon length. Methods: Magnetic resonance imaging (1.5 T) was performed for knee pathology on 403 patients. The patellar tendon length was measured in the midsagittal plane by a board-certified musculoskeletal radiologist. Patient height was recorded to the nearest inch. Patients were grouped into 6 subgroups with 4-inch range intervals based on height. The entire study group was analyzed. Subgroup analysis and gender analysis were performed to determine statistical significance. Results: The mean patellar tendon length was 45 7 mm (range, 30 to 66 mm). Wide ranges were noted among each height subgroup irrespective of gender. Significant differences were noted between most height subgroups independent of gender. Conclusions: This study showed that a correlation exists between patient height, gender, and patellar tendon length. Although variation occurs among patients of the same height, significant differences in mean patellar tendon lengths do exist between patients in different height subgroups. Clinical Relevance: Parameters are provided using patient gender and height to reduce the potential for graftconstruct mismatch when ordering bone‐patellar tendon‐bone allografts for anterior cruciate ligament reconstruction.
Disparate Molecular, Histopathology, and Clinical Factors in Head and Neck Squamous Cell Carcinoma Racial Groups

ObjectiveThere is a lack of consensus regarding the causes of the differences in the higher incidence of and the mortality from head and neck squamous cell carcinoma (HNSCC) in African Americans (AA) versus Caucasian Americans (CA). We examined a comprehensive array of risk factors influencing health and disease in an access-to-care, racially diverse, primary HNSCC cohort.Study DesignCross-sectional study.SettingPrimary care academic health care system.Subjects and MethodsThe cohort of 673 patients comprised 391 CA and 282 AA (42%). Risk variables included demographic, histopathology, and clinical/epidemiologic factors. Tumor DNA was interrogated for loss and gain of 113 genes with known involvement in HNSCC/cancer. Logistic regression for univariate analysis was followed by multivariate modeling with determination of model predictability (c-index).ResultsOf the 39 univariate differences between AA and CA, multivariate modeling (c-index = 0.81) retained 7 differences (P < .05). AA were less likely to be m...
RENAL SYNDROMES IN DIABETES

Renal disorders attributed to diabetes mellitus are increasingly recognized as the dominant feature of long-term management. Renal failure in diabetic patients is the most commonly recognized cause of irreversible uremia in the United States, Europe, and Japan. Treating hypertension and normalizing hyperglycemia slows the previously thought inexorable progress of renal insufficiency in diabetes. Once end-stage renal disease has developed, either dialytic therapy or a renal transplant affords life extension, often with excellent rehabilitation.
Modeling lot routing software through discrete-event simulation

Intel has recently developed lot-routing tools that can theoretically minimize both local and overall lot movement flexibility of existing automated material handling systems (AMHSs) and minimize the time needed to retrieve lots for processing. In order to gain insight into how the lot-routing rules impact manufacturing and how they should be configured, Intel uses two different analysis tools. First, a static spreadsheet model is used to determine the impact of new lot-routing rules in terms of AMHS lot movement volume. The second level of analysis is to use dynamic discrete-event simulation to determine the impact on AMHS and equipment utilization. Both methods are used to determine how tool policy rules should be set for each operation in the process flow, and to minimize the impact on the AHMS and enhance performance, while meeting manufacturing requirements. The static model analysis showed that ideal use of the lot-routing algorithm had a very significant impact on AMHS transport requirements. The dynamic discrete-event modeling showed that the lot-routing policies can be modified to enhance system performance. These modifications resulted in key lessons about configuring the lot-routing software.
Differential racial/ethnic patterns in substance use initiation among young, low-income women

Background: Accumulating research suggests that the gateway hypothesis of substance use may not apply equally across different race/ethnicity groups. Objectives: The current study examines racial and ethnic differences in patterns of initiation of licit and illicit substance use. Methods: A cross-sectional survey was conducted among 696 low-income women between the ages of 18 and 31 who sought gynecological care between December, 2001 and May, 2003 in southeast Texas. Results: Overall, White women fit the classic profile of drug use initiation patterns, with those initiating tobacco and beer/wine at earlier ages being more likely to use illicit drugs. Conversely, African-American and Hispanic women initiated tobacco and beer/wine at much later ages than White women, but they were as likely to use illicit drugs. Conclusions: To be optimally effective, prevention efforts may need to be tailored to fit the race/ethnicity of the audience. Further studies are suggested to investigate specific risk factors rela...
Comparison of two gelling agents for screwworm (Diptera: Calliphoridae) larval diets.

A sodium polyacrylamide polyacrylate gelling agent, Water-Lock G-400, and a galactan polysaccharide agent, carrageen an, were compared for solidifying larval diets of the screwworm, Cochliomyia hominivorax (Coquerel). Water-Lock diet produced larger pupae with less larval mortality than did carrageen an diet. Pupae from larvae reared on the Water-Lock diet exhibited higher emergence and produced adults with higher fecundity. Water-Lock diet also produced larger larvae at 56 h after oviposition. Densities in excess of 300 mg of eggs (16,200 eggs) per liter of Water-Lock gelled diet did not increase larval yield but did reduce larval weight and survival.
Involvement of an Inducible Fructose Phosphotransferase Operon in Streptococcus gordonii Biofilm Formation

Oral streptococci, such as Streptococcus gordonii, are the predominant early colonizers that initiate biofilm formation on tooth surfaces. Investigation of an S. gordonii::Tn917-lac biofilm-defective mutant isolated by using an in vitro biofilm formation assay showed that the transposon insertion is near the 3′ end of an open reading frame (ORF) encoding a protein homologous to Streptococcus mutans FruK. Three genes, fruR, fruK, and fruI, were predicted to encode polypeptides that are part of the fructose phosphotransferase system (PTS) in S. gordonii. These proteins, FruR, FruK, and FruI, are homologous to proteins encoded by the inducible fruRKI operon of S. mutans. In S. mutans, FruR is a transcriptional repressor, FruK is a fructose-1-phosphate kinase, and FruI is the fructose-specific enzyme II (fructose permease) of the phosphoenolpyruvate-dependent sugar PTS. Reverse transcription-PCR confirmed that fruR, fruK, and fruI are cotranscribed as an operon in S. gordonii, and the transposon insertion in S. gordonii fruK::Tn917-lac resulted in a nonpolar mutation. Nonpolar inactivation of either fruK or fruI generated by allelic replacement resulted in a biofilm-defective phenotype, whereas a nonpolar mutant with an inactivated fruR gene retained the ability to form a biofilm. Expression of fruK, as measured by the β-galactosidase activity of the fruK::Tn917-lac mutant, was observed to be growth phase dependent and was enhanced when the mutant was grown in media with high levels of fructose, sucrose, xylitol, and human serum, indicating that the fructose PTS operon was fructose and xylitol inducible, similar to the S. mutans fructose PTS. The induction by fructose was inhibited by the presence of glucose, indicating that glucose is able to catabolite repress fruK expression. Nonpolar inactivation of the fruR gene in the fruK::Tn917-lac mutant resulted in a greater increase in β-galactosidase activity when the organism was grown in media supplemented with fructose, confirming that fruR is a transcriptional repressor of the fructose PTS operon. These results suggest that the regulation of fructose transport and metabolism in S. gordonii is intricately tied to carbon catabolite control and the ability to form biofilms. Carbon catabolite control, which modulates carbon flux in response to environmental nutritional levels, appears to be important in the regulation of bacterial biofilms.
Myasthenia gravis and myasthenic syndromes

More than a decade ago myasthenic symptoms were observed in rabbits immunized with acetylcholine receptor (AChR) [119] and AChR deficiency was found at the neuromuscular junction in human myasthenia gravis (MG) [36]. By 1977 the autoimmune character of MG and the pathogenic role of AChR antibodies had been established by several measures. These included the demonstration of circulating AChR antibodies in nearly 90% of patients with MG [87], passive transfer with IgG of several features of the disease from human to mouse [149], localization of immune complexes (IgG and complement) on the postsynaptic membrane [30], and the beneficial effects of plasmapheresis [20, 123]. Substantial subsequent progress has occurred in understanding the structure and function of AChR and its interaction with AChR antibodies. The relationships of the concentration, specificities, and functional properties of the antibodies to the clinical state in MG have been carefully analyzed, and the mechanisms by which AChR antibodies impair neuromuscular transmission have been further investigated. The clinical classification of MG has been refined, the role of the thymus gland in the disease has been further clarified, and new information has become available on transient neonatal MG. The prognosis for generalized MG is improving, but there is still no consensus on its optimal management. Novel therapeutic approaches to MG are now being explored in animal models. Recognition of the autoimmune origin of acquired MG also implied that myasthenic disorders occurring in a genetic or congenital setting had a different cause. As a result, a number of congenital myasthenic syndromes have come to be recognized and investigated. Finally, an acquired disorder of neuromuscular transmission different from MG, the Lambert-Eaton myasthenic syndrome, has also been shown to have an autoimmune basis. In this syndrome, active zone particles of the presynaptic membrane are direct or indirect targets of the pathogenic autoantibodies.
Preparation of Self-Supporting Holmium Targets

A technique for producing thin self-supporting (150 to 500 μg/cm2) 165Ho targets on a 1 in. diameter target holder by vacuum evaporation using an electron bombarding source is described.
Recent Developments in Aircraft Control

9 0 HENRY T. NAGAMATSTJ Tests of a Fairing to Reduce the Drag of a Supersonic Swept-Wing Root. W. F. HILTON The Effect of Thickness on Airfoils with Constant Vertical Acceleration at Supersonic Speeds JOHN C. MARTIN AND NATHAN GERBER Theoretical and Experimental Pressure Recovery of Sweptback Normal Shock Inlets .GEORGE D. DICKIE, JR. Buckling Efficiencies of Plate Materials at Elevated Temperatures.GEORGE GERARD Extension of the Statistical Approach to Buffeting and Gust Response of Wings of Finite Span. H. W. LIEPMANN
Introduction to Insights Gained from Wildlife Research in the Context of Global Anthropogenic Change

The language and subject matter offered in this issue of the ILAR Journal represent a departure from standard discourse on research animal welfare. Although the overall character of such a departure will become evident, the contributions herein reinforce and expand upon the shared, established tenets of research animal welfare. Through the work and experience of contributing wildlife research professionals, this issue of the ILAR Journal offers a diverse consortium of wildlife topics ranging from policy to conservation to disease investigation, all against the backdrop of the complexities of effective compliance and oversight when the research subjects are wild. The articles provide insights into the complex dynamic that is animal welfare in the framework of wildlife research from diverse perspectives. Material presented in this issue contributes to our existing philosophies on research animal welfare while simultaneously introducing the research animal professional to new perspectives, hopefully allowing us all to walk a familiar, well-trodden path with new eyes. The express aim of the issue is to introduce traditional oversight personnel to a deeper understanding of the topics covered herein.
An application of recreation resource assessment techniques to inform management action in an urban-proximate natural area

Abstract Urban populations in North America are increasing, putting added pressure on urban-proximate natural areas which provide urban residents with a natural location for respite and recreation. The application of traditional recreation management techniques – generally utilized in federally owned, public lands – can provide an understanding of the biophysical and social conditions of a natural area. In order to better measure both current biophysical and social conditions, set a baseline for future monitoring, and inform future management actions, an interdisciplinary approach was taken at the Swaner Preserve and EcoCenter in Park City, Utah. Trail assessments, visitor use estimations and social science visitor surveys were conducted to provide an understanding of recreation use. Results from the study indicate that despite high levels of use, trails on the Swaner Preserve are in a condition that is acceptable to managers; with the exception of a few locations where high levels off-trail use occurs. Visitors to the natural area, although mostly local, were largely unaware of the other interpretative and educations activities provided by the Swaner Preserve and EcoCenter. Results from the study led to various management and stewardship suggestions which were presented to the Swaner Preserve and EcoCenter managers. Managers utilized these science-based suggestions to make various management changes on the Swaner Preserve. Overall, traditional recreation management techniques can provide the baseline information that natural area managers need to begin long-term monitoring efforts in a reasonable amount of time with a relatively small staff. Management implications ● The study presents recommendations for the management of urban natural areas characterized by an increasing year-round use and encroaching development. ● This comprehensive framework of a social-ecological approach that can be used by managers of smaller, local natural areas to balance dual missions of natural resource protection and managing for recreation use. ● The best management results can be expected when applying this social-ecological approach in a comprehensive manner while working closely with natural area managers. ● The approach presented in this study is (1) able to meet the specific needs and objectives of natural areas managers, (2) cost effective in terms of time and labor, and (3) can be easily replicated at other urban-proximate natural areas and/or be used for long-term monitoring.
“Germany”, Asset Class Contagion, and Contagious Stability*

In this paper, I examine the effects of socially constructed financial market lending patterns in the Eurozone crisis. Under the assumption that the crisis is one of sovereign debt, the term “conta...
Capacity and Capability Building for National HRD A Multi-Level Conceptual Framework

Human resource development (HRD) scholars have grappled with the question of developing theoretical and conceptual frameworks that capture the complexities of building human capital capacity and ca...
Clostridium difficile infection after restorative proctocolectomy and ileal pouch anal anastomosis for ulcerative colitis.

Aim Clostridium difficile infection (CDI) of the ileal pouch following restorative proctocolectomy (RPC) is becoming increasingly recognized. We aimed to understand better (i) the associated risk factors, (ii) treatment practices and (iii) the pouch diversion and failure rate in patients who developed CDI of the pouch after RPC for ulcerative colitis (UC). Method Patients who tested positive for C. difficile of the pouch between 2007 and 2010 were included in the analysis. Data collected included patient demographics, time from RPC to documented CDI, the treatment of CDI and rate of excision of the pouch. Results Of 2785 patients recorded in the hospital CDI database, 15 had had an RPC with ileal pouch anal anastomosis. The median age was 44 years and the median interval from RPC to first documented episode of CDI was 3 years. Thirteen (81%) patients had had multiple episodes of pouchitis before and after CDI infection, and all were symptomatic at the time of testing for CDI. Within 30 days of the diagnosis of CDI, six (40%) patients were taking immunosuppressive medication, seven (47%) were taking a proton pump inhibitor and 12 (80%) had received antibiotics. Five patients required hospitalization for CDI and four had severe infections characterized by a serum creatinine more than 1.5 times baseline (n = 3) and a white cell count above 15 000 (n = 1). Six patients who underwent endoscopy had severe inflammation of the pouch including the presence of a pseudomembrane in one case. Ten patients were treated with metronidazole alone and five with vancomycin. Two patients had recurrent CDI of the pouch during a median follow-up period of 2.9 years and one had CDI refractory to medical management. This patient required diversion of the pouch with an ileostomy for refractory CDI but no patient required excision of the pouch. Conclusion All 15 patients developing CDI of the pouch were successfully treated with antibiotics and only one required surgery in the form of an ileostomy.
Selection of alternative local flaps in the leg and foot.

The lower extremity has always provided the plastic surgeon with some of the most perplexing problems of soft tissue coverage. Only in recent years has it been possible to offer patients several reliable local flaps, which have largely supplanted the standard cross-leg flap. Axial, muscle, and myocutaneous flaps and their dissection and applications are discussed.
Sub-barrier one- and two-neutron pickup measurements in S 32 + 93 Nb, Mo 9 8 , 1 0 0 reactions at 180°

Excitation functions for sub-barrier one- and two-neutron pickup reactions were measured for ${\mathit{E}}_{\mathrm{lab}}$\ensuremath{\le}106 MeV in $^{32}\mathrm{S}$${+}^{93}$Nb, $^{98,100}\mathrm{Mo}$ systems by detecting targetlike recoils at 0\ifmmode^\circ\else\textdegree\fi{} using a recoil mass spectrometer. The slopes of transfer probability vs distance of closest approach are in good agreement with binding energies, indicating the absence of a ``slope anomaly.'' Angle-integrated transfer cross sections derived from measured 180\ifmmode^\circ\else\textdegree\fi{} yields are consistent with enhancements in previously measured fusion yields for the $^{32}\mathrm{S}$${+}^{98,100}$Mo systems.
Selection on metabolic pathway function in the presence of mutation-selection-drift balance leads to rate-limiting steps that are not evolutionarily stable

While commonly assumed in the biochemistry community that the control of metabolic pathways is thought to be critical to cellular function, it is unclear if metabolic pathways generally have evolutionarily stable rate limiting (flux controlling) steps. A set of evolutionary simulations using a kinetic model of a metabolic pathway was performed under different conditions to evaluate the evolutionary stability of rate limiting steps. Simulations used combinations of selection for steady state flux, selection against the cost of molecular biosynthesis, and selection against the accumulation of high concentrations of a deleterious intermediate. Two mutational regimes were used, one with mutations that on average were neutral to molecular phenotype and a second with a preponderance of activity-destroying mutations. The evolutionary stability of rate limiting steps was low in all simulations with non-neutral mutational processes. Clustering of parameter co-evolution showed divergent inter-molecular evolutionary patterns under different evolutionary regimes. This study provides a null model for pathway evolution when compensatory processes dominate with potential applications to predicting pathway functional change. This result also suggests a possible mechanism in which studies in statistical genetics that aim to associate a genotype to a phenotype assuming independent action of variants may be mis-specified through a mis-characterization of the link between individual gene function and pathway function. A better understanding of the genotype-phenotype map has potential applications in differentiating between compensatory changes and directional selection on pathways as well as detecting SNPs and fixed differences that might have phenotypic effects. This article was reviewed by Arne Elofsson, David Ardell, and Shamil Sunyaev.
Multi-user Interference Modeling and Experimental Characterization for Pulse-based Terahertz Communication

The transmission of one-hundred-femtosecond-long pulses by following an on-off keying modulation spread in time has been recently proposed as a way to enable Terahertz (THz)-band (0.1-10 THz) communications over short distances. The transmission of ultra-short pulses minimizes the probability of collisions due to the very small time that the channel is occupied by each user. However, given that many of the envisioned applications of THz-band communications involve very large node densities, multi-user interference results unavoidably. In this paper, a stochastic model of multi-user interference is developed and experimentally validated. The model takes into account the fact that the interference power at the receiver is not a combination of the received powers from the individual nodes, rather the power of the combination of the signal amplitudes. For this, first, the probability density function (PDF) of the interference generated by one interfering node at the receiver is obtained starting from the PDFs of the pulse received energy and the PDF of the pulse shape. Then, the model is extended to account for multiple nodes which can constructively or destructively interfere. Finally, the developed model is experimentally validated and numerical results are provided.
Effects of fluid flow on the electric field distribution in charged liquid dielectrics

A one dimensional drift dominated conduction model is used with a flowing charged dielectric to describe the transient and dc steady state electric field and space charge distributions. This work extends past similar work1 but now allows for forced convection of the liquid dielectric in the same or opposite direction of the electric field resulting in convection currents as well as conduction and displacement currents. The resulting governing partial differential equations are of the hyperbolic type and are solved using the method of characteristics. Particular case studies examine the steady state distributions.
Properdin Levels in Individuals with Chemotherapy-Induced Neutropenia

BACKGROUND Neutrophils produce and carry key components of the alternative pathway (AP) of complement, including properdin (P). The effect of chemotherapy-induced absolute neutropenia on circulating P levels and AP function has not been previously established. METHODS We prospectively measured free P levels in serum from 27 individuals expected to develop neutropenia after administration of chemotherapy for hematological malignancies in preparation for hematopoietic stem cell transplantation and here describe the relationship between serum P levels and the neutrophil count over time. RESULTS When the absolute neutrophil count (ANC) was >500 cells/mm3 pre-chemotherapy, P levels were significantly higher than P levels associated with an ANC ≤500 cells/mm3 (median values 8392 ng/mL and 6355 ng/mL, respectively; P = .001). Pairwise comparison between pre-chemotherapy P levels and P levels at initial or last documented neutropenia before recovery showed a significant decline (P < .0001). No correlation was observed between P levels during neutropenia and after recovery of neutropenia in 20 subjects for which postneutropenia samples were obtained. A small but significant (P = .02) decrease in AP hemolytic activity was noted between baseline (preneutropenia) and samples obtained at the onset of neutropenia, but only with low (6.25%) and not higher (12.5 or 25%) serum concentrations. CONCLUSIONS A decline in P levels and AP activity could contribute to the increased risk of infection in neutropenic patients and warrants further study.
Neurotransmitter Switching in the Developing and Adult Brain

Neurotransmitter switching is the gain of one neurotransmitter and the loss of another in the same neuron in response to chronic stimulation. Neurotransmitter receptors on postsynaptic cells change to match the identity of the newly expressed neurotransmitter. Neurotransmitter switching often appears to change the sign of the synapse from excitatory to inhibitory or from inhibitory to excitatory. In these cases, neurotransmitter switching and receptor matching thus change the polarity of the circuit in which they take place. Neurotransmitter switching produces up or down reversals of behavior. It is also observed in response to disease. These findings raise the possibility that neurotransmitter switching contributes to depression, schizophrenia, and other illnesses. Many early discoveries of the single gain or loss of a neurotransmitter may have been harbingers of neurotransmitter switching.
Predictors of Chronic Opioid Use in Newly Diagnosed Crohn's Disease

Background and Aims:Patients with Crohn's disease (CD) are often prescribed opioids chronically to manage pain associated with their disease. However, little evidence exists to support this practice. Here, we examine newly diagnosed patients with CD with and without chronic opioid use (COU) and soug
The association between ambient fine particulate matter and incident adenocarcinoma subtype of lung cancer

Adenocarcinoma (AC) is the most common lung cancer among non-smokers, but few studies have assessed the effect of PM2.5 on AC among never smokers. The purpose of this study was to assess the association between ambient PM2.5 and incident lung AC in the Adventist Health and Smog Study-2 (AHSMOG-2), a cohort of 80,044 non-smokers (81% never smokers) followed for 7.5 years (597,177 person-years) (2002–2011). Incident lung AC was identified through linkage with U.S. state cancer registries. Ambient PM2.5 levels at subjects’ residences were estimated for the years 2000 and 2001, immediately prior to study start. A total of 164 incident lung AC occurred during follow-up. Each 10 μg/m3 increment in PM2.5 was associated with an increase in the hazard rate of lung AC [HR = 1.31 (95% confidence interval (CI) 0.87–1.97)] in the single-pollutant model. Excluding those with prevalent non-melanoma skin cancer (NMSC) strengthened the association with lung AC (HR = 1.62 (95% CI, 1.11–2.36) for each 10 μg/m3 PM2.5 increment. Also, limiting the analyses to subjects who spent more than 1 h/day outdoors, increased the estimate (HR = 1.55, 95% CI: 1.05, 2.30). Increased risk of AC was observed for each 10 μg/m3 increment in ambient PM2.5 concentrations. The risk was higher among those without prevalent NMSC and those who spent more than 1 h/day outdoors.
Ocular Involvement in Patients with Fungemia in an Urban Tertiary Care Center

ABSTRACTPurpose: To illustrate the rate of endogenous endophthalmitis associated with fungemia and evaluate the importance of screening in a public city hospital.Methods: A retrospective review was...
Locke's Ontology of Relations

In his An Essay Concerning Human Understanding, Locke’s primary aim is to provide an empiricist theory of ideas that can support interesting results about the nature of language and knowledge. Within this theory, Locke distinguishes between simple ideas and complex ideas (E II.ii.1: 119). Roughly, an idea is complex if it has other ideas as parts; otherwise, it is simple. For Locke, as is well known, all simple ideas derive from sensation (perception through sight, taste, smell, hearing, or touch) or reflection (a form of introspection directed at mental acts) (E II.i.2–4: 104–106). Aetiology also plays a role in Locke’s classification of complex ideas: ideas of modes, ideas of substances, and ideas of relations. All complex ideas are formed by a voluntary act of combination or composition. Ideas of modes, such as numbers, beauty, and theft (E II.xii.5: 165) are formed without considering whether the combinations conform to real patterns existing in the world (E II.xi.6: 158, E II.xxii.1: 288, E II.xxxi.3: 376). Ideas of substances (such as human beings, sheep, and armies—E II.xii.6: 165), by contrast, are formed with a desire ‘to copy Things, as they really do exist’ (E II.xxxi.3: 377). Ideas of relations are like ideas of modes (E II.xxxi.14: 383–84), except that their aetiology includes, in addition to the mental act of composition, the distinct mental act of comparison on the basis of some respect or dimension (E II.xi.4: 157, E II.xxv.1: 319).
Modified Siwoloboff–Wiegand Procedure for the Determination of Boiling Points on a Microscale

Developing simpler, more accessible, and more affordable methods for the determination of the boiling point of microscale amounts of liquid may lead to increased utilization in research and teaching laboratories as an analytical technique. Our efforts toward that goal have revealed that digital hot plates can be used as the heat source. One option is to simply use a test tube and a digital thermometer, requiring 300 μL of liquid that accurately determines boiling points that range from 35 to 150 °C. An alternative method, requiring as little as 30 μL of liquid, utilizes a modified aluminum block and a temperature control probe coupled to the digital hot plate that results in the accurate determination of boiling points that range from 35 to 205 °C. Both modifications to the Siwoloboff–Wiegand method provide consistent, reliable, and accurate boiling points for a variety of liquids with a wide range of boiling points.
The cost-effectiveness of supported employment and sheltered workshops in Wisconsin (FY 2002-FY 2005)

This study explores the cost-effectiveness of supported employment and sheltered workshops in Wisconsin. Data from 1,118 supported employees and 209 sheltered workers with "most significant" mental retardation were compared. Results indicated that although supported employees generated greater initial costs per fiscal quarter, their cumulative costs were 33.7% cheaper than those of sheltered workers.
Reexamining the Role of Digital Technology in Public Administration: From Devastation to Disclosure

This article begins from the premise that the Internet is representative of a range of digital technologies that are constitutive of the current sociopolitical moment. Exploring and extending the w...
Popular non-support for international organizations: How extensive and what does this represent?

This paper investigates popular non-support for international organizations (IO), asking two questions. First, are attitudes within the mass public becoming less supportive of IOs? Second, how can we explain these IO attitudes, especially when the mass public appears to know relatively little about specific international institutions? Using survey data from the International Social Survey Programme’s National Identity module, fielded across multiple countries in 1995, 2003, and 2013, it reports that on average and within most countries, citizen attitudes about IOs have become less positive over time. To explain these attitudes, this paper argues that citizens tend to group things that appear as “international” such as cross-border economic flows and IOs. While citizens might feel positively or negatively about these international factors, this grouping implies that they view them similarly, based on what they can feel from the international level related to their job and income. Thus, less (more) skilled citizens who are hurt by (who benefit from) economic globalization should express more negative (positive) views about IOs. Controlling for cultural attitudes socialized through education, we find that skill is a statistically significant and substantively strong predictor of IO attitudes. We also show how this individual-level skill difference gets larger in countries that are more and/or less-favorably exposed to economic globalization.
Hemispheric Specialization and Cognitive Development: Implications for Mathematics Education.

A recent synthesis of existing evidence on the functioning of the human brain, together with new findings, indicates that the two hemispheres of the cerebral cortex process stimuli differently. For most right-handed persons, the left hemisphere treats stimuli serially, one at a time, whereas the right hemisphere processes stimuli many at a time as a gestalt. This functional difference renders each hemisphere superior in performing certain types of tasks; the left hemisphere is better at such tasks as reading, speaking, analytical reasoning, and arithmetic, and the right hemisphere is better at spatial tasks, recognizing faces, and music.
Characterizing patient-clinician chemotherapy-induced peripheral neuropathy assessment and management communication approaches.

Abstract Objective To describe the frequency and characteristics of chemotherapy-induced peripheral neuropathy (CIPN) assessment and management communication approaches between patients receiving neurotoxic chemotherapy and clinicians. Methods The data used in this analysis originated from a randomized controlled trial in which adults with cancer self-reported treatment-related symptoms using web-based symptom assessment technology. Three-to-six weeks after study initiation, each participant’s outpatient visit was audio-recorded. Audio recordings and associated clinician notes for 159 participants who received platinum and/or taxane-based chemotherapy were coded for the presence of several CIPN assessment and management communication characteristics. Results Participants received low cumulative neurotoxic chemotherapy doses (75%) at the time of audio recording. CIPN was discussed and documented in 44% and 46% of participant-clinician encounters. In symptomatic participants, clinicians asked an average of 0.7 open-ended questions, appropriately managed 70% of cases, and asked upper and lower extremity CIPN questions in 25% of cases. Conclusions Clinicians infrequently discussed and documented CIPN in participants with low CIPN severity, however appropriately managed mild CIPN. Development of interventions to translate existing recommended CIPN communication approaches into practice are required. Practice Implications Effective participant-clinician communication is required at each clinic visit during chemotherapy treatment to identify initial signs of CIPN and offer appropriate treatment.
Intelligent Voice Agent and Service (iVAS) for Interactive and Multimodal Question and Answers.

This paper describes MITRE’s Intelligent Voice Agent and Service (iVAS) research and prototype system that provides personalized answers to government customer service questions through intelligent and multimodal interactions with citizens. We report our novel approach to interpret a user’s voice or text query through Natural Language Understanding combined with a Machine Learning model trained on domain-specific data and interactive conversations to disambiguate and confirm user intent. We also describe the integration of iVAS with voice or text chatbot interface.
The effect different substrates have on the trueness and precision of eight different intraoral scanners.

Objective This in vitro study compares the newest generation of intraoral scanners to their older counterparts, and tests whether material substrates affect the trueness and precision of intraoral scanners (IOS). Material and methods A custom model, used as the reference standard, was fabricated with teeth composed of different dental materials. The reference standard scan was obtained using a three-dimensional (3D) optical scanner, the ATOS III. Experimental scans were obtained using eight different IOS, operated by experienced clinicians, using the manufacturer's recommended scanning strategy. A comprehensive metrology program, Geomagic Control X, was used to compare the reference standard scan with the experimental scans. Results For all scanners tested, except Trios3, the substrate does influence the trueness and precision of the scan. Furthermore, differences exist when comparing the same substrate across different scanners with some of the latest generation scanners clearly leaping ahead of the older generation regarding both trueness and precision. Conclusions Substrate type affects the trueness and precision of a scan. Active Triangulation scanners are more sensitive to substrate differences than their parallel confocal counterparts. Some scanners scan certain substrates better, but in general the new generation of scanners outperforms the old, across all substrates. Clinical significance The substrates being scanned play an import role in the trueness and precision of the 3D model. The new generation of scanners is remarkably accurate across all substrates and for complete-arch scanning.
Development of a Load Management Scheme for the Nigerian Deregulated Electricity Market Using Regression Model

Presently the wide electricity supply-demand gap created by insufficient generation in Nigeria has been one of the major challenges to socio-economic growth. This work developed a Load Management Scheme (LMS) that can aid effective planning of the future load demand at the distributions to suit the current Nigerian deregulated electricity market. Polynomial regression model was adopted to produce the algorithm for implementing the scheme. Coefficient of determination $({R^2})$ and adjusted coefficient of determination $\left( {R_{adj}^2} \right)$ were used as criteria to measure the adequacy of the model. The developed LMS was tested with sample five years load data (2012 - 2016) collected from 132/33 kV Transmission Station, Onikolobo, Abeokuta, Ogun State. The scheme’s projected load for five years (2017 - 2021) deviated averagely from the theoretical forecasted values by 4.5 × 10−4 The scheme is useful for providing insights required for planning towards an improved electricity service delivery.
Citrus Soil pH Testing Procedures

Maintaining the correct soil pH is essential to ensure optimal plant growth and crop yield. This new two-page document is an instructional sheet for citrus soil pH testing, written by Kelly Morgan and published by the UF/IFAS Department of Soil and Water Sciences.https://edis.ifas.ufl.edu/ss665
A Dimorphic Diagnosis of a Pleomorphic Disease: An Unusual Cause of Hypercalcemia.

Abstract Background Histoplasmosis is a rare cause of 1, 25-dihydroxy vitamin-D-mediated hypercalcemia. In this study, we report 2 cases of hypercalcemia secondary to histoplasmosis seen at Mayo Clinic, Rochester and a review of cases reported in the literature. Methods We conducted a PubMed search using the keywords “hypercalcemia” and “histoplasmosis.” Fourteen cases of hypercalcemia secondary to histoplasmosis were reported between 1977 and 2020. We identified an additional 2 patients from our institution. Results We reviewed a total of 16 cases. The median age at presentation was 58.5 years (interquartile range, 41.5-68.75 years), and 13 of 16 patients (81.2%) were men. Serum parathyroid hormone level was available in 13 of 16 (81.25%) patients, of whom 11 patients (84.6%) had a low level, 1 patient (7.6%) had a normal level, and 1 patient (7.6%) had an elevated level. 1, 25-dihydroxy vitamin D level was reported in 9 of 16 (56.25%) patients. Of these, 5 patients (55.5%) had levels within normal limits, and 4 patients (44.4%) had levels above normal. Serum angiotensin-converting enzyme level was evaluated in 4 of 16 patients (25%), and it was elevated in all 4 (100%) cases. Four patients received corticosteroids before a diagnosis of histoplasmosis was made, which resulted in rapidly progressive disease and death in 2 patients. Conclusions In patients with granulomatous disorder and hypercalcemia, it is crucial to rule out infectious etiologies before initiating steroids. Histoplasmosis can cause nonparathyroid hormone-mediated hypercalcemia and, if not suspected, may have catastrophic implications.
Rethinking Citizenship, Self-Help, and Disability in Local Context: Solidaridad as disability citizenship in Nicaragua

The concept of citizenship was instrumental to the formation of the disability movement in the West by recasting disability as the denial of equal citizenship of persons with impairments. The disability movement expanded notions of citizenship by not only focusing on nondiscrimination and the protection of civil and political rights, but also the necessity of self-directed, but state-provided, social rights as prerequisite for substantive equality. With the passage of the Convention on the Rights of Persons with Disabilities, Western approaches to disability citizenship as state protected rights have globalized. Critical disability scholars are increasingly arguing that Western theories of disability, citizenship, and rights are inappropriate in local contexts in the Global South where weak welfare states are the reality. In such cases, self-help and mutual support are more determinative in the lives of disabled persons than formal rights. I extend these arguments by analyzing three grassroots disability associations in Nicaragua that assist their members achieve citizenship through self-help, service and solidaridad with the community.
Integrating Primary Care Appointments Into Resident Orientation.

Background Trainee well-being is a major concern for institutions and programs, yet many residents report suboptimal access to or contact with primary care for themselves. Objective To address the health care needs of residents, we developed a mechanism whereby all incoming residents were offered an appointment with a primary care clinician (PCP) during institutional intern orientation. Methods In April 2019, all incoming residents (17 specialties) were invited to participate. A collaboration involving the GME office and family medicine and internal medicine departments enabled interested residents to attend PCP appointments that were held at predesignated times during orientation and did not conflict with other orientation or learning activities. Residents received appointment details, and insurance billing processes were followed. A survey was administered to all participating PCPs and incoming residents 2 weeks following their scheduled PCP appointment. Results Of the 144 incoming residents, 118 (82%) participated. Among the 71 of 144 (49%) residents who responded to the survey, 94% indicated that they desired an appointment, with 90% attending the appointment as scheduled; 52% purposed their visit as an introduction for future appointments, while 15% requested prescription refills. All but one recommended that the initiative be offered again in the future. Seventy-two percent stated that participating in the PCP initiative definitely/probably led to improvements in self-care, and 76% indicated that participating definitely/probably made them more conscious of their health and well-being. Conclusions Integrating PCP appointments into orientation is feasible and was highly acceptable in a large academic medical center.
In-vacuum measurements of optical scatter versus annealing temperature for amorphous Ta2O5 and TiO2:Ta2O5 thin films.

Optical coatings formed from amorphous oxide thin films have many applications in precision measurements. The Advanced Laser Interferometer Gravitational-Wave Observatory (LIGO) and Advanced Virgo use coatings of SiO2 (silica) and TiO2:Ta2O5 (titania-doped tantala) and post-deposition annealing to 500°C to achieve low thermal noise and low optical absorption. Optical scattering by these coatings is a key limit to the sensitivity of the detectors. This paper describes optical scattering measurements for single-layer, ion-beam-sputtered thin films on fused silica substrates: two samples of Ta2O5 and two of TiO2:Ta2O5. Using an imaging scatterometer at a fixed scattering angle of 12.8°, in-situ changes in the optical scatter of each sample were assessed during post-deposition annealing to 500°C in vacuum. The scatter of three of the four coated optics was observed to decrease during the annealing process, by 25–30% for tantala and up to 74% for titania-doped tantala, while the scatter from the fourth sample held constant. Angle-resolved scatter measurements performed before and after vacuum annealing suggest some improvement in three of the four samples. These results demonstrate that post-deposition, high-temperature annealing of single-layer tantala and titania-doped tantala thin films in vacuum does not lead to an increase in scatter, and may actually improve their scatter.