cssi/SciSciGPT-SciSciNet huggingface dataset:
Clinical Applications of Skin Substitutes

A unique understanding of the components of mammalian skin has led to the development of numerous skin substitutes. These skin substitutes attempt to compensate for functional and physiologic deficits present in damaged tissue. Skin substitutes, when appropriately applied in optimized settings, offer a promising solution to difficult wound management. The body of literature on skin substitutes increases as the understanding of tissue engineering and molecular biology expands. Given the high cost of these products, future randomized large prospective studies are needed to guide the clinical applications of skin substitutes.
Postnatal diagnosis of Down syndrome: synthesis of the evidence on how best to deliver the news.

CONTEXT: Many parents of children with Down syndrome (DS) have expressed dissatisfaction with how they learned about their child9s diagnosis. DS remains the most common chromosomal condition, occurring in 1 of every 733 births, with the majority of children still diagnosed postnatally. OBJECTIVE: Our goal was to review systematically all available evidence regarding how physicians should approach the conversation in which they explain DS for the first time to new parents. METHODS: We searched online databases from 1960 to 2008, including Medline and PsychInfo, as well as Web sites maintained by academic organizations (eg, American Academy of Pediatrics) and other nonprofit or private organizations (eg, the National Down Syndrome Society), by using the terms “Down syndrome,” “trisomy 21,” “mongolism,” “prenatal diagnosis,” “postnatal care,” and “delivery of health care.” Articles were selected that answered ≥1 research question, established a priori: (1) Who is the best person to communicate the news? (2) When is the best time to share the news? (3) Where is the best place or setting to deliver the news? (4) What information should be delivered? and (5) How should the news be communicated? All studies were evaluated for quality according to the method outlined by the US Preventative Services Task Force. Final recommendations were based on the strength of evidence. RESULTS: Parents prefer to receive the diagnosis together in a joint meeting with their obstetrician and pediatrician. The conversation should take place in a private setting as soon as a physician suspects a diagnosis of DS. Accurate and up-to-date information should be conveyed, including information about local support groups and resources. CONCLUSION: By implementing a few cost-neutral measures, physicians can deliver a postnatal diagnosis of DS in a manner that will be deemed by new parents as sensitive and appropriate.
Two adjacent genes encoding copper-induced-type metallothioneins in Tetrahymena thermophila may have resulted from a relatively recent gene duplication

Tetrahymena thermophila is a valuable model organism for the study of metallothioneins, which play important roles in the metabolism of essential metal ions and in heavy-metal detoxification. Starting from a T. thermophila expressed sequence tag (EST) originally annotated as a Zn–Cu–Cd metallothionein (GenBank Acc #BM394105), we determined the genomic sequence corresponding to this EST and its flaking region. The sequence contains two adjacent genes encoding metallothioneins of the copper-induced type: the MTT2 gene (submitted to GenBank by Boldrin et al. as Cu-inducible while this work was in progress) and a second, novel gene (MTT4), located ∼1.4 kb downstream from and with same orientation as MTT2. Our entire sequenced segment is contained in the T. thermophila whole-genome sequence recently completed at TIGR. Both MTT4 and MTT2 are intronless and encode two nearly identical proteins (two differences out of 108 amino acids). The 5′ and 3′-flanking regions of both the metallothionein genes show significant sequence similarity as well, suggesting recent gene duplication. All glutamines use the CAA codon, reminiscent of codon usage observed in highly expressed Tetrahymena genes. MTT4 and MTT2 map to a 1.5-Mb macronuclear chromosome from the right arm of micronuclear chromosome 2. Supported by NIH grant RR02931. Sequence data were obtained from The Institute for Genomic Research Tetrahymena website, http://www.tigr.org/tdb/e2k1/ttg/
An immunophenotypic comparison of metanephric metaplasia of Bowman capsular epithelium with metanephric adenoma, Wilms tumor, and renal development: a case report and review of the literature.

Metanephric metaplasia of the parietal epithelium of the Bowman capsule is a rare pathologic finding of unknown pathogenesis that has occurred in patients with widespread malignant neoplasms of various types. We report this finding in a 25-year-old woman with partial expression of the Carney triad who died of a disseminated gastrointestinal stromal tumor, specifically a gastric stromal sarcoma. The metaplasia involved both kidneys diffusely. It originated in the parietal epithelium of the Bowman capsule, extended into the proximal tubules, and focally surrounded the glomeruli in a semicircular manner. Immunohistochemical analysis revealed that the cells of metanephric metaplasia expressed the Wilms tumor gene product, bcl-2 protein, and CD57 and cytokeratin 7 and keratin AE1/AE3 focally, but not CD56. This immunophenotype parallels that of metanephric adenoma, Wilms tumor, and nephrogenic rests and overlaps with antigen expression in certain periods of renal development.
Swarming motility and the control of master regulators of flagellar biosynthesis

Swarming motility is the movement of bacteria over a solid surface powered by rotating flagella. The expression of flagellar biosynthesis genes is governed by species-specific master regulator transcription factors. Mutations that reduce or enhance master regulator activity have a commensurate effect on swarming motility. Here we review what is known about the proteins that modulate swarming motility and appear to act upstream of the master flagellar regulators in diverse swarming bacteria. We hypothesize that environmental control of the master regulators is important to the swarming phenotype perhaps at the level of controlling flagellar number.
Formation of downhill esophageal varices as a rare but serious complication of hemodialysis access: a case report and comprehensive literature review.

Background Proximal or “downhill” esophageal varices are a rare complication of superior vena caval (SVC) obstruction. Few reports describe downhill varices in dialysis patients with catheter-related SVC occlusion.
Relationship of the P: Ratio to Thyroid Hormone Content of Isolated Rat Liver Mitochondria

SummaryAn isotope equilibrium technique was used to measure mitochondrial thyroid hormone concentration in thyroidectomized, partially thyroidectomized, and intact rats in order to correlate this with the P:O ratios in the mitochondria from these animals. The data suggest that thyroidectomized rats have P:O ratios higher than normal rats. Furthermore, there appears to be an inverse linear relationship between mitochondrial thyroid hormone content and the P:O ratio.
Window taper functions for subaperture processing.

It is well known that the spectrum of a signal can be calculated with a Discrete Fourier Transform (DFT), where best resolution is achieved by processing the entire data set. However, in some situations it is advantageous to use a staged approach, where data is first processed within subapertures, and the results are then combined and further processed to a final result. An artifact of this approach is the creation of grating lobes in the final response. The nature of the grating lobes, including their amplitude and spacing, is an artifact of window taper functions, subaperture offsets, and subaperture processing parameters. We assess these factors and exemplify their effects.
Piezoresistive properties of ceramic strain sensors with controlled nanoporosity

A ceramic strain gage based on reactively sputtered indium tin oxide thin films is being developed to monitor the structural integrity of components employed in aerospace propulsion systems that operate at temperatures in excess of 1500°C. When relatively thick indium-tin-oxide (ITO) strain gages were prepared by reactive sputtering in oxygen:argon atmospheres and annealed in nitrogen, an extremely stable piezoresistive response was observed at temperatures as high as 1530°C. SEM and AFM of these sensor surfaces after high temperature exposure revealed a partially sintered microstructure with interconnected nanoporosity. Specifically, the microstructure consisted of a contiguous network of uniform sized ITO particles with well-defined necks between individual particles. When these microstructures were compared to those of relatively thin ITO sensors sputtered in nitrogen:argon:oxygen atmospheres, i.e. ITO films prepared in a nitrogen rich plasma, the average pore size and particle size was estimated to be an order of magnitude smaller than those associate with thick ITO sensors. In the nitrogen sputtered films, enhanced electrical conduction along the surfaces of the contiguous ITO particles resulted in a very stable and large piezoresistive response with a gage factor of 11.4 and a drift rate of 0.0001%/hour at 1560°C. The improved performance realized when the ITO films were processed in nitrogen may be extended to other ITO based sensors including gas sensors and the advantages of films processed in this manner will be discussed.
Network Analysis of the Post-Soviet Integration Processes: Hierarchical Ranking and Joint Cluster Analysis of Attributional and Relational Data of the Former Soviet States

The identification of main drivers behind the post-Soviet integration processes has been one of the great academic challenges for the region’s experts. This article seeks to go beyond the existing literature by introducing a new analytical approach based on “big data” and social network analyses to post-Soviet regional studies, and employing a wider and more appropriate range of variables and cases than is usual. This is the first research to explicitly and systematically investigate the distinctiveness of the post-Soviet states ranking and similarities. The study was conducted at an egocentric level of network analysis, comparing fifteen former Soviet states across 188 measures of political institutions, economic development, social welfare structures, and international affiliations and alliances gathered over the period of twenty-one years of the post-Soviet independence.
Impact of Neonatal Iron Status, Gestational Age, and Gender on Auditory Brainstem Responses at Birth

Iron (Fe) deficiency in utero may impact auditory nerve myelination. Auditory brainstem response (ABR) provides a non-invasive means of assessing the maturation of central auditory system. To asses...
Changing Demographics and Injury Profile of New Traumatic Spinal Cord Injuries in the United States, 1972–2014

Abstract Objective To document trends in the demographic and injury profile of new spinal cord injury (SCI) over time. Design Cross-sectional analysis of longitudinal data by injury years (1972–1979, 1980–1989, 1990–1999, 2000–2009, 2010–2014). Setting Twenty-eight Spinal Cord Injury Model Systems centers throughout the United States. Participants Persons with traumatic SCI (N=30,881) enrolled in the National Spinal Cord Injury Database. Interventions Not applicable. Main Outcome Measures Age, sex, race, education level, employment, marital status, etiology, and severity of injury. Results Age at injury has increased from 28.7 years in the 1970s to 42.2 years during 2010 to 2014. This aging phenomenon was noted for both sexes, all races, and all etiologies except acts of violence. The percentage of racial minorities expanded continuously over the last 5 decades. Virtually among all age groups, the average education levels and percentage of single/never married status have increased, which is similar to the trends noted in the general population. Although vehicular crashes continue to be the leading cause of SCI overall, the percentage has declined from 47.0% in the 1970s to 38.1% during 2010 to 2014. Injuries caused by falls have increased over time, particularly among those aged ≥46 years. Progressive increases in the percentages of high cervical and motor incomplete injuries were noted for various age, sex, race, and etiology groups. Conclusions Study findings call for geriatrics expertise and intercultural competency of the clinical team in the acute and rehabilitation care for SCI. This study also highlights the need for a multidimensional risk assessment and multifactorial intervention, especially to reduce falls and SCI in older adults.
Convergence rates of finite difference stochastic approximation algorithms part I: general sampling

Stochastic optimization is a fundamental problem that finds applications in many areas including biological and cognitive sciences. The classical stochastic approximation algorithm for iterative stochastic optimization requires gradient information of the sample object function that is typically difficult to obtain in practice. Recently there has been renewed interests in derivative free approaches to stochastic optimization. In this paper, we examine the rates of convergence for the Kiefer-Wolfowitz algorithm and the mirror descent algorithm, under various updating schemes using finite differences as gradient approximations. The analysis is carried out under a general framework covering a wide range of updating scenarios. It is shown that the convergence of these algorithms can be accelerated by controlling the implementation of the finite differences.
The management of tumors of the upper cervical spine.

Summary Tumors of the atlas and axis are exceedingly uncommon lesions. A review of the literature provided 28 cases, of which two-thirds were the result of metastatic processes. Benign endoplasms in this region may cause serious sequelae resulting from impingement upon the lower brainstem, upper cervical cord, and vertebral arteries. Vigorous therapeutic endeavors should be undertaken with the aim of achieving complete amelioration of pain, reversal of neurologic impairment, and attainment of cervical stability. Although the underlying disease process in the majority of patients may be a terminal condition, improved longevity combined with the presence of disabling pain and neurologic compromise demands carefully planned treatment. Important points discussed include the following: 1. It is necessary to establish tissue diagnosis by the appropriate method. The transpharyngeal needle biopsy of Ottolenghi is a safe and dependable method for obtaining tissue from the anterior elements of C1 and C2. 2. Cord compression may result from two basic mechanisms, and it is necessary to resort to cervical myelography to distinguish between the two. 3. Flexion and extension views, cineradiography, angiography, and tomography may assist in patient evaluation. 4. Guidelines for planning the surgical approach are offered, as well as preferred exposure techniques. 5. Anterior surgery in this region is a major undertaking and should be reserved for patients with benign anterior tumors or cancer patients with a good prognosis and specific indications. 6. Tracheostomy should be carried out to avoid postoperative complications after anterior surgery. 7. Whenever possible, bone grafting should be used to establish cervical fusion. Several drawbacks to successful bone grafting exist in the case of metastatic disease. Some of these factors may be circumvented with the use of methyl methacrylate alone or in combination with a bone graft. Acrylic also allows early postoperative ambulation without the need for cumbersome external immobilization devices.
The Cradle of the East: Supplementary Comments

Book reviews are too often regarded as an insignificant form of scholarly activity. Journal editors ask us to review a book in 800 words or less. Grant applications ask us to list publications but to omit book reviews. Book reviews do not count, it is rumored, in the publish-or-perish deliberations of tenure committees. This slight regard for reviews -- which is at times accompanied by a decrease in their competence and value (viz. the JAS reviewer [and presumably JAS editor] who thought that Chuanatzu and Chuang Chou were two separate philosophers) -- threatens the health of the field. I believe that good book reviews are vital, especially to our teaching. As lecturers who range over a wide range of materials and eras, we all rely on that questionable, tenuous process by which we abstract material from books in fields in which we are not specialists, and pass it on as quasi-truth. Serious book reviews introduce an essential, critical element into that process. They help keep us honest and alert. They generate the dialogue between the author and ourselves, and the author and the reviewer, upon which the evolution of historical understanding must continually depend. Such considerations are particularly important when a book is on a major topic and likely to be consulted and quoted widely by people outside the field. It is these considerations that lead me to publish here a technical addendum to a book that I have already reviewed elsewhere.
The Major Histocompatibility Complex as an Antibiosenescent System

Whereas knowledge about the MHC has been accumulated chiefly by investigators oriented toward immunology, evidence exists that gene systems other than those concerned exclusively with immune function but lying in the same chromosomal region influence a number of processes involved in the biology of aging [4]. These include genes regulating the levels of free radical scavengers such as SOD and catalase. We have shown that levels of re-pair capacity of UV-induced DNA damage segregate with alleles of the MHC [1]. Repair of this form of damage is directly related to maximum life spans of species. Levels of mixed function oxidase (MFO) are also related to species life spans. MFOs “detoxify” the wide variety of simple organic chemicals in the environment. By contrast, the immune system must “detoxify” complex organic chemicals (proteins, etc.). The MFO system must, therefore, like the immune system, be highly polymorphic and multiple allelic.
The Supreme Court Beat: A View from the Press

“Unlike anybody else in town, Supreme Court justices don't covet the press.… The Court doesn't leak, the Court doesn't spin. The Court is there, and you make of it what you do. … It's almost like it's another time, it's another era.” Pete Williams, NBC News Students of American politics who study the Supreme Court often take as the starting point for their analyses the notion that the Court is a unique and fundamentally “different” kind of institution in our tripartite governmental system, featuring a merging of law and politics that distinguishes it from the American legislative and executive branches as well as from most other national judiciaries. Similarly, many journalists who cover the institution attest to the unique nature of the Supreme Court beat when contrasting it with reporting on the other branches of government. Indeed, ABC News legal correspondent Tim O'Brien suggested that the Court is not, in the final analysis, a “Washington” beat at all: “I don't even think of covering the Supreme Court really as a Washington assignment.… [O]ften, unlike any other beat in town, I will not have any shot in my piece from Washington.… [I]t's a national beat, but not a Washington beat.” In the following two chapters we will examine the environment in which Supreme Court journalists operate and the world that they inhabit. First, in chapter 2, we will explore the distinctive nature of the Court beat, with particular attention paid to the numerous manifestations of that distinctiveness.
Type-specific detection of herpes simplex virus type 1 and type 2 using the cobas® HSV 1 and 2 test on the cobas® 4800 platform.

ABSTRACTIntroduction: HSV-1 and HSV-2 are among the most common causes of sexually transmitted infections (stis) globally. these infections are strongly associated with increased risk of hiv acquisition and rare, but devastating, neonatal disease. available treatment options can reduce HSV transmission and improve quality of life. accurate diagnosis early in disease can improve patient management.Areas covered: This paper describes the clinical manifestations of HSV infection often used for clinical diagnostic purposes. The paper then describes the evolution of laboratory diagnostic assays. Serology, culture and molecular diagnostics are described since all are currently in use. The features and performance characteristics of the cobas 4800 HSV1 and HSV2 Test (cobas HSV) on the cobas 4800® system (cobas 4800) are described in detail.Expert commentary: Diagnosis of HSV has historically been unreliable or technically difficult, but the availability of molecular assays such as the cobas HSV test for detectio...
An Energy-Efficient Hybrid Data Collection Scheme in Wireless Sensor Networks

We propose an energy-efficient hybrid data collection architecture based on controllably mobile infrastructure for a class of applications in which sensor networks provide both low-priority and high-priority data. High-priority data require a data delivery scheme with low latency and high fidelity. Meanwhile low-priority data may tolerate high-latency data delivery. Our approach exploits the design of a network that supports a hybrid data delivery scheme to enhance the network performance and reduces total network energy usage. In our system design two delivery schemes are deployed for purposes of comparison. The first is the traditional ad hoc approach to deliver high-priority data with high fidelity and low latency. The second presents a controllable infrastructure in the sensor field, which acts as low-priority data collection agent. Through simulations, we show that our proposed approach can provide substantial energy saving in this class of sensor application compared to the traditional multihop approach used alone.
Case Citation Patterns in the U.S. Courts of Appeals and the Legal Academy

ABSTRACTIs there a disconnect between the priorities that make cases important to the legal academy and American courts and judges? We use previously unexplored data on the decisions of federal appellate judges to cite cases compared to the decisions of legal academics to cite the same cases. One component of our approach is an investigation of case-level characteristics, and we focus on these and other factors that structure decisions to cite cases across three different contexts: within a federal circuit, by courts out of circuit, and in law review articles. Our results highlight a divergence between what prompts judges and those in the legal academy to cite cases, and, to our knowledge, this is the first study to compare the drivers of court citation with those of law review citation.
Focusing coherent x-rays with refractive optics

Refractive lenses have been used successfully to focus incoherent x-ray emission in the wavelength range from 2 to .5A with focal lengths on the order of one meter. A stack of N lens elements is employed to reduce the focal length by the factor N over a single element, and such a lens is terms a Compound Refractive Lens (CRL). Contrary to intuition, misalignment of parabolic lens elements doesn't alter the focusing properties and results in only a small reduction in transmission. Coherent x-ray sources are being developed with wavelengths of 1-1.5A and source diameters of 50- 80micrometers , and the CRL is ideally suited to produce a small, intense image. Chromatic aberration increase the size of the image and so it is important to provide chromatic correction to minimize the image dimensions. Pulse broadening due to the dispersion of the lens material is negligible. Intensity gain is in the range from 105 to 10+$6), where gain is defined as the intensity ratio in an image plane with and without the lens in place. Maximum image intensity is obtained when the CRL is placed a distance of 100 to 200 m from the source, and the typical diameter of the focused spot is about one micron.© (2001) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Insights into the Pathogenesis of Pancreatic Cystic Neoplasms

With the current epidemic of diagnosed pancreatic cystic neoplasms on the rise, a substantial amount of work has been done to unravel their biology, thus leading to implications on clinical decision making. Recent genetic profiling of resected human specimens has identified alterations in signaling pathways involving KRAS and GNAS signaling as early events in the pathogenesis of intraductal pancreatic mucinous neoplasms. Progressively, mutations in genes such as TP53, SMAD4, RNF43, and others are thought to characterize invasive and advanced lesions. The role of inflammation in fueling the growth and transformation of these cysts has also begun to be studied with greater interest. A number of promising clinical studies have attempted to integrate these genetic insights into classifying these cysts and treating patients. We have reviewed existing literature on similar lines besides commenting on some useful animal models that recapitulate molecular and phenotypic progression of these cysts.
This review of virtual speech therapists for speech disorders suffers from limited data and methodological issues

(1) What types of speech disorders have been treated via virtual speech therapists (VSTs)?(2) How effective are VSTs?(3) What kinds of technological elements have been adopted in VSTs?Design: The a...
Cardiovascular Disease Risk in Obstructive Sleep apnea: An Update

Cardiovascular disease (CVD) is the number one cause of death globally, accounting for 31% of all deaths in the world, and one out of every three deaths in the United States, in 2017 [1]. It is estimated that 90% of CVD is preventable, with traditional risk factors including tobacco use, excessive alcohol consumption, and unhealthy diet and physical inactivity, leading to hypertension, diabetes, dyslipidemia, and obesity. The epidemic of obesity has increased over the past decade, affecting an estimated 37.7% of adults, and 18% of children, in the US, and projected to rise to 51% of the population, a 130% increase, by 2030 [2]. This obesity epidemic has ushered in a new, highly prevalent, but largely underdiagnosed CVD risk factor: obstructive sleep apnea (OSA). OSA affects 34% of men, and 17% of women in the United States [3]. It is characterized by repetitive episodes of hypoventilation and complete apnea during sleep caused by total pharyngeal collapse and airway obstruction, despite normal breathing effort and drive. OSA’s impact on CVD appears to be due to recurrent cardio metabolic perturbations experienced when repetitively attempting to breath against an occluded airway, precipitating nightly episodes of hypoxia, sleep disturbance, and sympathetic nervous system surges, culminating in elevated blood pressure and heart rate, endothelial dysfunction, systemic inflammation and insulin resistance-all mechanisms involved in the pathogenesis of CVD (Figure 1) [4]. Accumulating evidence has linked OSA to multiple cardiovascular disorders including hypertension, type 2 DM, coronary artery disease, heart failure and cardiac arrhythmias (Figure 2). Open in a separate window Figure 1 Pathophysiological mechanisms linking obstructive sleep apnea to cardiovascular disease.
The Chief Danger in Europe at Present

The League of Nations was facing a number of challenges before the terrorist attack at Marseilles in 1934. French Foreign Minister Louis Barthou contended that the hostility between Italy and Yugoslavia over the future of the Balkans was the main threat to European peace. Much as before the First World War, southeastern Europe forced governments to consider the nature and implications of “terrorism,” both domestic and international. Still, there was little discussion over how best to counter this threat to peace. While worries about political instability in Europe had intensified in the months before Alexander’s murder, there was no sense of urgency about cooperating to combat state-supported terrorism. The terrorist attack at Marseilles would provide the missing incentive for an international approach to the problem.
Derby of a ‘difficult’ history: the Poland-Russia match at Euro 2012§

Throughout history, Eastern Europe has been an arena of contestation between Poland and Russia in terms of which state holds the most geopolitical influence over the region. Yet the spawned rivalry...
The Psychological Evaluation and Therapy of Psychogenic Impotence

The appreciation of any clinical contribution should be preceded by the caveat “Consider the source.” All conclusions are subtly influenced by the author’s assumptions, philosophical perspective, and/or other biases. The scientific ideal that the progression from observations to conclusions should be absolutely logical is rarely achieved. In clinical arenas, progress is made when investigators dealing with the same problems from different perspectives reach similar conclusions.
The Centers for Public Health Preparedness Program: from vision to reality.

©2010 Association of Schools of Public Health In 1999, colleagues at the Centers for Disease Control and Prevention (CDC) and leaders from the public health community conceptualized the creation of a network of practice-oriented training and applied public health research centers in accredited schools of public health (SPHs), leading to the creation of the Centers for Public Health Preparedness (CPHPs). This network of academically based centers was modeled structurally after existing networks, such as the National Institute for Occupational Safety and Health Education and Research Centers, the Injury Prevention Research Centers, and the CDC Prevention Research Centers, which are based primarily in SPHs throughout the nation. In those instances, CDC leaders had developed networks of academically based training and research centers with stable, ongoing funding such that:
Plastic Strain Ratio and Texture Coefficients in Orthotropic Sheets of Cubic Metals

Since first demonstrated by Stickels and Mould [1], there has been ample evidence that some elastic and plastic anisotropic parameters of cold-rolled and annealed steel sheets are correlated. These correlations suggest that some formability parameters of steel sheets (e.g., the average (plastic) strain ratio \( {\bar r} \), the planar anisotropy Δr, etc.), which are usually determined by destructive tests, could possibly be inferred from nondestructive measurements of elastic anisotropic parameters. Indeed, much work has been done lately in exploring the possibility of on-line determination of r-value of steel sheets by ultrasonic techniques. [2–5]
Fundamentals of Medical Physiology.

Fundamentals of Medical Physiology is a concise textbook of medical physiology written for first- and second-year medical students or anyone interested in learning the core principles of physiology through an introduction to clinical cases in the context of each organ system. The book is divided into 10 sections, each prefaced with a general outline of topics covered, a brief overview of an organ system, and presentation of a relevant clinical case followed by open-ended questions to think about while reading the section. While the organization of chapter topics is conventional, the book’s focus on highlighting recurring themes underlying physiological mechanisms (e.g., homeostasis, energy, balance of forces, reservoir, flow, elasticity, and cell-cell communication) is novel and provides the reader with additional, alternative ways in which to assimilate and integrate information. Schematic diagrams, illustrations, tables, and figures are amply provided and are useful in understanding and reviewing key information. Unfortunately, the first section, “Foundations of Physiology,” which covers basic cell biology and the concept of control systems contributing to homeostasis, is not as detailed as the other sections and thus is best taken as a brief 24-page refresher. As a side note, minor errata are also present in the text, most of which are identifiable in context. For example, microfilaments are incorrectly introduced as being “~35 nm in diameter,” but the same chapter subsection also provides the correct relative diameters of microtubules and intermediate filaments. Perhaps subsequent editions of the textbook will address these issues. The strength of the textbook lies in its ability to promote active learning by applying acquired physiological knowledge to clinical cases. The initial case and open-ended questions of each section, as well as case-based “Applying What You Know” questions at the end of each chapter, are engaging even for the non-medical student and provide a broad conceptual framework that helps the reader fit pieces of information together. Importantly, answers to all questions and a concise case analysis from both clinical and physiological perspectives are given at the end of each section. Furthermore, an access code is provided for a supplementary interactive online study aid, WinkingSkull.com PLUS, which includes two additional clinical cases on the cardiovascular and respiratory systems and 814 images from the Atlas of Anatomy with a timed test feature. The online program also gives readers the option of displaying anatomy labels in English or Latin. Taken together, these qualities make Fundamentals of Medical Physiology a valuable resource.
Self-Regulation in the Pharmaceutical Industry: The Exposure of Children and Adolescents to Erectile Dysfunction Commercials.

Context Spending on direct-to-consumer advertising (DTCA) for prescription pharmaceuticals has risen to record levels, five times as much as in 1996 in inflation-adjusted dollars. Major health care provider organizations have called for additional regulation of DTCA. These organizations argue that the negative impact of such advertising outweighs the informational value claimed by the pharmaceutical industry. The industry maintains that further restrictions on DTCA are not warranted because it is successfully self-regulating via "guiding principles" for DTCA as certified by firm executives. Methods The authors measured recent industry spending on DTCA and used regression models of Nielsen Monitor-Plus data to assess pharmaceutical firm self-regulation after the public disclosure of noncompliance with industry self-regulatory principles, specifically regarding the exposure of children and adolescents to broadcast advertisements for erectile dysfunction drugs. Findings Public disclosure of noncompliance with self-regulatory DTCA standards did not bring advertising into compliance. Results demonstrate that firms failed to meet the industry standard during every quarter of the six-year period of this study. Conclusions Results support previous research findings that pharmaceutical self-regulation is a deceptive blocking strategy rather than a means for the industry to police itself. Policy recommendations include broadcast restrictions on adult content and deincentivizing DTCA via tax reform.
Lifetime cancer risks from hazardous air pollutants in US public school districts.

Background Children are sensitive to the health impacts of environmental contaminants, but research assessing outdoor environmental exposures for children and schools is underdeveloped. There are no national-level studies examining geographical and social disparities in air pollution exposure for children in school districts. Focusing on school districts is important because they are meaningful decision-making entities for schools. Methods Using data from the National Air Toxics Assessment, we spatially reallocated lifetime cancer risk (LCR) from hazardous air pollutants (HAPs) within US school district boundaries, and paired those estimates with school district level sociodemographic measures obtained through the Integrated Public Use Microdata Series National Historic Geographic Information System. We employed local Moran’s I to identify district-level hotpots and generalised estimating equations (GEEs) to quantify risk disparities. Results We identified hotspots of elevated LCR from all sources of HAPs (called ‘total’). A regional hotspot extends throughout the southeastern USA and smaller regional hotspots are present in southern Arizona, southern California and in California’s central valley. School districts with higher proportions of children, children with disabilities, foreign-born children, black children and multiracial/other race children, and lower proportions of Native American children, had greater total LCR (p Conclusions Geographical and social disparities in LCR across US school districts may be affecting children’s health and future potential. This new knowledge can inform policy changes, as school districts can advocate for the environmental health of children.
A Deep Learning Model for Wireless Channel Quality Prediction

Accurately modeling and predicting wireless channel quality variations is essential for a number of networking applications such as scheduling and improved video streaming over 4G LTE networks and bit rate adaptation for improved performance in WiFi networks. In this paper, we propose an encoder-decoder based sequence-to-sequence deep learning model that is capable of predicting future wireless signal strength variations based on past signal strength data. We consider two different versions of the deep learning model; the first and second versions use LSTM and GRU as their basic cell structure, respectively. In contrast to prior work that is primarily focused on designing models for particular network settings, the deep learning model is highly adaptable and can predict future channel conditions for different networks, sampling rates, mobility patterns, and communication standards. We compare the performance (i.e., the root mean squared error of future predictions) of our model with respect to two baselines&#x2014;i) auto-regression(1), and ii) linear regression for multiple networks and communication standards. In particular, we consider 4G LTE, WiFi, an industrial network operating in the 5.8 GHz range, Zigbee, and WiMAX networks operating under varying levels of user mobility and observe that the deep learning model provides significantly superior performance. Finally, we provide detailed discussion on key design decisions including insights into hyper-parameter tuning of the model.
Degradation and residual efficacy of beta-cyfluthrin as a surface treatment for control of Tribolium castaneum Herbst: Effects of temperature and environment

Abstract Concrete arenas were treated with the low and high label rates of beta-cyfluthrin Tempo SC Ultra® (10 and 20 mg Active Ingredient [AI]/m2, respectively) and stored during the summer and autumn in two separate years inside an empty grain bin, inside a rice mill, and inside a laboratory at an approximate ambient temperature of 27 °C. Bioassays were conducted by removing the arenas at 0 (1 day) to 10 weeks post-treatment from the three locations where they were stored, and exposing adults of Tribolium castaneum (Herbst), the red flour beetle, for 0.5–3 h on the arenas. Rapidity of knockdown was used to assess residual efficacy. Application rate was significant (P
Preallocating Resources for Distributed Memory Based FPGA Debug

Most internal FPGA debug methods require the use of Block-RAM (BRAM) memory for trace buffers. Recent work has shown the viability of replacing BRAMs with distributed, LUT based memory. Distributed memory (DIME) trace buffers are lean and can be utilized in large designs where other debug methods are unlikely to fit. Since LUTs are abundant on FPGA devices, there are nearly always some left unused after the user's design is placed, even for designs that utilize more than 90% of the FPGA's resources. DIME trace buffers are inserted into highly utilized designs within minutes using RapidWright. In this paper we contrast the previously used method of scavenging leftover LUT resources with a preallocation scheme that ensures a certain amount of memory LUTs are left available for distributed memory trace buffers. While causing virtually no penalty to the user design, preallocating memory LUT resources allows the very largest designs to utilize higher numbers of distributed memory trace buffers at lower timing penalties. We also show that depth of DIME trace buffers can be extended from 16 to 256 bits.
National Survey of Decision-Making for Antidepressants and Educational Level.

Background: Despite recommendations to screen adults for depression in primary care, little is known about how people across education levels decide to treat their depression and factors that influence their decision. Methods: We conducted a secondary analysis of a national, probability-based web survey in English-speaking adults aged 40 or older living in the United States who reported they discussed starting or continuing an antidepressant with their clinician in the past 2 years. Respondents answered questions about knowledge, decision-making process, and demographics. Education level was analyzed using 5 ordered categories. The Shared Decision Making (SDM) Process score was used to assess patient involvement. Descriptive statistics, χ2 tests, analysis of variance, and regression models were used to describe the data and test associations. Results: Of the 5682 people invited, 3396 answered questions about health decisions (59.8% response rate) and 385 reported discussing antidepressants. The mean percentage of knowledge questions answered correctly increased as education level increased (P = .008). The mean SDM Process score also increased with education (P = .001). There was an association between education and who made the treatment decision, suggesting that for respondents with less education, the clinician was more likely to decide (P = .001). Respondents with less education were less likely to report they would definitely make the same decision again (P = .000). Conclusions: Those with less education were even less informed, had lower SDM Process scores and were less likely to think they made the right decision about antidepressants. There is a need to ensure patients are better informed about and involved in treatment for depression.
The Influence of Entrepreneurial Mindsets on Student Design Problem Framing

Contribution: Increased understanding of the influence of a project-based multidisciplinary design and innovation course on students’ engineering design thinking, specifically regarding problem framing. Background: Entrepreneurship-related education has been offered to engineering and technology students, but its influence has been discussed mainly in terms of students’ self-efficacy or awareness of entrepreneurship or technological innovation, relying mostly on their self-reported data. Research Questions: 1) How do undergraduate students perceive the relationship between entrepreneurial mindsets and engineering design thinking after a project-based design course that integrates entrepreneurial activities and 2) How differently do they frame a design situation after this course? Methodology: This qualitative case study involved 14 undergraduate students pursuing a minor in design and innovation at a polytechnic institute. For more systematic data collection and analysis, a conceptual framework was developed based on literature about cognitive operations for problem framing and entrepreneurial engineering mindsets. Primary data were collected through semi-structured interviews and pre- and post-activities focused on problem framing. The interview and activity data were analyzed through multiple qualitative analysis approaches based on the conceptual framework. Findings: The analysis of the interview responses reveals the participants’ thoughts on the role of an entrepreneurial mindset in engineering design practice, and the comparison between their pre- and post-problem framing activities shows that they tended to focus more on Customer and Social problem elements and less on Technical and Business problem elements after the course. However, important questions remain to better understand the impact of this change on their design abilities.
Angular scattering of protons through ultrathin graphene foils: Application for time-of-flight instrumentation

Space plasma instruments often rely on ultrathin carbon foils for incident ion detection, time-of-flight (TOF) mass spectrometry, and ionization of energetic neutral atoms. Angular scattering and energy loss of ions or neutral atoms in the foil can degrade instrument performance, including sensitivity and mass resolution; thus, there is an ongoing effort to manufacture thinner foils. Using new 3-layer graphene foils manufactured at the Los Alamos National Laboratory, we demonstrate that these are the thinnest foils reported to date and discuss future testing required for application in space instrumentation. We characterize the angular scattering distribution for 3-30 keV protons through the foils, which is used as a proxy for the foil thickness. We show that these foils are ∼2.5-4.5 times thinner than the state-of-the-art carbon foils and ∼1.6 times thinner than other graphene foils described in the literature. We find that the inverse relationship between angular scattering and energy no longer holds, reaffirming that this may indicate a new domain of beam-foil interactions for ultrathin (few-layer) graphene foils.
Integrated Fragility Hip Fracture Program: A Model for High Quality Care.

BACKGROUND Hip fractures are a significant cause of morbidity and mortality among elderly patients. Coordinated multidisciplinary care is required to optimize medical outcomes. OBJECTIVE To determine the effect of the implementation of standardized, evidence-based protocols on clinical outcomes and mortality in patients with fragility hip fractures. INTERVENTIONS A multidisciplinary group was convened to define best practices in fragility hip fracture care and implement a fragility hip fracture clinical protocol at Yale-New Haven Hospital. Clinical outcomes in 2015, prior to program initiation, were compared with 2018, after the program was well established. MAIN OUTCOMES AND MEASURES Measured outcomes included 30-day mortality, blood transfusion utilization, adverse effects of drugs, venous thromboembolic complications, sepsis, myocardial infarction, mechanical surgical fixation complications during the index admission, length of stay, 30-day readmission, unexpected return to the operating room (OR) and time to the OR. RESULTS The implementation of the Integrated Fragility Hip Fracture Program was associated with significant reductions in 30-day mortality from 8.0% in 2015 to 2.8% in 2018 (P = .001). Significant reductions were also seen in use of blood transfusions (46.6% to 28.1%; P < .001), adverse effects of drugs (4.0% to 0%; P < .001), length of stay (5.12 to 4.47 days; P = .004), unexpected return to the OR (5.1% to 0%; P < .001), and time to the OR <24 hours (41.8% to 55.0%, P = .001). CONCLUSIONS An Integrated Fragility Hip Fracture Program using multidisciplinary care, physician and nursing engagement, evidence-based protocols, data tracking with feedback, and accountability can reduce mortality and improve clinical outcomes in patients with hip fractures.
The Future of Smart Textiles: User Interfaces and Health Monitors

This issue of Matter shows the versatility of smart textiles as healthcare monitors and textile-based displays in a pair of research articles. By taking advantage of intrinsic fiber behaviors such as stretching, twisting, and knittability, the authors enhance device functionality while maintaining user comfort.
COVID-19 and Labour Law: Latvia

The Latvian response to the COVID-19 crisis can be praised as successful since the pandemic reached its peak as early as 1 April and there has been a gradual decrease of new cases since then. Nonetheless, the consequences for the labour market are significant. Latvia adopted several measures, including a wage subsidy, income support for the self-employed, and tax relief for companies. However, some of these measures have been deemed ineffective and, in addition, there is evidence that circumvention of some labour laws is taking place in the shadow of the crisis.