cssi/SciSciGPT-SciSciNet huggingface dataset:
The Effects of Local Anesthesia Administration on Pain Experience During Interventional Spine Procedures: A Prospective Controlled Trial.

Objective . It has been postulated that local anesthetic administration may be the most painful part of interventional spine procedures. Despite this, there is a lack of evidence supporting the commonly used traditional technique of anesthetic delivery as part of these procedures. This study tested three hypotheses: 1) alternative method of local anesthesia injection is superior to the traditional method; 2) using the traditional method of injection is not superior to using no local anesthetic; and 3) treatment needle size, anesthetic injection technique, and sedation are associated with pain experienced during procedures. Design . Prospective, multicenter clinical trial of 127 participants who underwent elective bilateral symmetric interventional spine procedures in outpatient spine clinics. Methods . Primary outcomes were pain scores during and after procedures to examine the influence of anesthetic injection method and treatment needle gauge on pain experience using linear mixed model regression analysis. A post-hoc comparison of estimated marginal mean pain scores was completed on both anesthetic injection method and treatment needle gauge. Conclusions . The alternative method was superior ( P < 0.05) to the traditional method on post procedural pain scores. Injecting local anesthetic with the traditional or alternative method was not superior to using no local anesthetic. Treatment needle size, pain at one inch of treatment needle insertion, and baseline pain were all significantly ( P < 0.05) associated with overall procedural pain. Further studies are needed optimize and justify local anesthetic injections for these procedures.
Ignition of THKP and TKP pyrotechnic powders

We have conducted Simultaneous Thermogravimetric Modulated Beam Mass Spectrometry (STMBMS) experiments on igniter/actuator pyrotechnic powders to characterize the reactive processes controlling the ignition and combustion behavior of these materials. The experiments showed a complex, interactive reaction manifold involving over ten reaction pathways. A reduced dimensionality reaction manifold was developed from the detailed 10-step manifold and is being incorporated into existing predictive modeling codes to simulate the performance of pyrotechnic powders for NW component development. The results from development of the detailed reaction manifold and reduced manifold are presented. The reduced reaction manifold has been successfully used by SNL/NM modelers to predict thermal ignition events in small-scale testing, validating our approach and improving the capability of predictive models.
Transarterial Therapy for Colorectal Liver Metastases

Until recently, hepatic arterial therapies (HAT) had been used for colorectal liver metastases after failure of first-, second-, and third-line chemotherapies. HAT has gained greater acceptance in patients with liver-dominant colorectal metastases after failure of surgery or systemic chemotherapy. The current data demonstrate that HAT is a safe and effective option for preoperative downsizing, optimizing the time to surgery, limiting non-tumor-bearing liver toxicity, and improving overall survival after surgery in patients with colorectal liver-only metastases. The aim of this review is to present the current data for HAT in liver-only and liver-dominant colorectal liver metastases.
Optical Microfluidics for Cell Studies

We apply optical microfluidic methods to cell studies including: nanoliter polymerase chain reaction amplification of DNA/RNA, useful for circulating tumor cells; and preparing artificial bilayers, useful for transmembrane protein function.
In vitro Study of Drug-contained Serum with Chinese Medicines Nourish Liver and Kidney on B16 Melanocyte Cytotoxicity,Melanin Synthesis and cAMP

Objective:To study effects of drug-contained serum with Chinese Medicines nourish liver and kidney on melanocytes(B16) cytotoxicity and melanin synthesis and cAMP;explore the possible roles of nourish liver and kidney decoction in vitiligo treatment.Methods:Mice B16 cells were cultivated in vitro.Different concentrations rat of drug-contained serum were added to the culture medium during logarithmic growth phase.Cytotoxicity,melanin and cAMP were measured by MTT assay,NaOH assay and radioimmunoassay respectively.Use the rat serum while do not have Chinese Medicine with the same concentrations as controls.Results:There is no significant difference between the control and the drug-contained serum tested group as to B16 cytotoxicity;as to the level of synthesized melanin and cAMP,there is significant increase(P0.05) in 20%serum drug-contained serum.Conclusion:In vitro study notes that drug-contained serum with herbal decoction of nourish liver and kidney do not have effect on B16 proliferation,while could promote melanin synthesis and level of cAMP.
Study on occupational stress of worders in electronics industry in Changsha City and its influencing factors

Objective To investigate the occupational stress status of electronics industry workers and its influencing factors in Changsha so as to provide scientific evidence for implementing effective interventions. Methods A total of 788electronics industry workers selected by stratified random cluster sampling were enrolled in this study.Self-designed questionnaires were used to collect the workers' general information,and occupational stress inventory-revised edition(OSIR)was employed to assess their occupational stress status.Epidata3.1was used to build a database,and SPSS 13.0was used for statistical analysis. Results The scores of occupational roles questionnaire(180.66±24.15)and personal strain questionnaire(101.63±20.57)were higher than those of the Southwest norm,and the differences were statistically significant(P0.05).The score of personal resources questionnaire(118.33±19.48)was lower than that of the Southwest norm,with statistically significant difference(P0.05).Multiple linear regression analysis showed that the assembly line of the job(t=2.687,P0.05),task discomfort(t=4.087,P0.05),role ambiguity(t=2.263,P0.05),task conflict(t=11.729,P0.05),responsibility(t=5.354,P0.05)and work environment(t=10.144,P0.05)were the risk factors for stress reactions;while living with the family(t=-1.981,P0.05),elder age group(t=-2.841,P 0.05),entertainment and relaxation(t=-2.817,P0.05),self-healthcare(t=-3.064,P0.05)and social support(t=-3.726,P0.05)were the protective factor for stress reactions. Conclusions The occupational stress of worders in electronics industry in Changsha City is generally higher than those of general occupational groups.The electronic industry should implement countermeasures,such as optimizing the organizational structure and management,improving the work environment,propagating occupational health-related knowledge,enhancing occupational health surveillance and creating agood corporate culture,to mitigate workers' occupational stress and promote their physical and mental health.
Isothermal Titration Calorimetry

Isothermal titration calorimetry is an ideal technique for measuring biological binding interactions. It does not rely on the presence of chromophores or fluorophores, nor does it require an enzymatic assay. Because the technique relies only on the detection of a heat effect upon binding, it can be used to measure the binding constant, K, the enthalpy of binding, DeltaH degrees and the stoichiometry, or number of binding sites, n. This chapter describes instrumentation, experimental design, and the theoretical underpinnings necessary to run and analyze a calorimetric binding experiment.
Hepatitis B: diagnosis and treatment

The hepatitis B virus (HBV), a member of the Hepadnaviridae family, was discovered 30 years ago. Since that time, clinical and basic research has led to a clear understanding of the epidemiology and natural history of infection and the pathogenesis of the resulting liver injury. Physicians are now able to accurately diagnose acute and chronic infection, though our understanding of viral quantitation and its impact on disease course and treatment response is evolving. Hepatitis B must now be considered a preventable disease, since acute infection can be effectively prevented by either passive or active immunization. However, when acute infection does occur, it evolves into chronic hepatitis or a chronic infectious carrier state in a variable proportion of cases, depending on the age and underlying immune competence of the patient. Chronic infection can be treated, though the effectiveness of available antiviral and immunomodulatory agents is less than complete. Finally, variants of the HBV are being recognized, and coinfection with the defective viroid known as hepatitis D (formerly delta agent) has been described.
FOREST FOR THE TREES

Often when you're trying to solve a problem, you pull out a pen or pencil and grab a handy piece of paper to write down a column of numbers, draw a diagram, or make a list. In solving the problem, you might sum the numbers, trace lines in the diagram, or match items of the list with items of a second list. These auxiliary scribblings are used to organize information – as with the list or column of numbers – or represent objects so they can be easily manipulated – as with the diagram. Data structures are the algorithmic analog of these handy pieces of paper. In Chapter 11 we saw that browsers and web servers in a computer network exchange information by bouncing small packages of data from one computer to another until they arrive at their final destination. How can we represent a computer network so that an algorithm can figure out what sequence of computers to use in transferring a data package? For that matter, how do we represent airline schedules, circuit diagrams, computer file systems, road maps and medical records so that they can be manipulated algorithmically? Many algorithms use special data structures to represent their inputs and outputs or to perform intermediate calculations. In Chapter 7 we used lists and vectors to keep track of journal entries.
Determining the critical points and coexistence curve of multi-species equilibria using Gaussian Process Regression

Abstract We present a method for reconstructing the liquid-vapor coexistence curve and associated location of critical points of multi-species mixtures from experimental or simulation data, using Gaussian Process Regression. The distinguishing feature of the proposed method is that it does not require knowledge of the equation of state, as assumed by the currently prevalent methods for calculating the coexistence properties of mixtures. The proposed technique is validated using synthetic data generated from the Peng-Robinson equation of state, experimental data, as well as Gibbs Ensemble Monte Carlo simulation data. These validation studies show that the proposed method is robust to statistical noise and scarcity of data even in the vicinity of the critical point.
Evaluating Optimal Phase Ordering in Obfuscation Executives

Obfuscation is a software protection technique that aims to increase the difficulty and amount of resources required to understand programs from the perspective of a malicious end user. The order and number of obfuscating transformations is determined by an obfuscation executive and the optimal arrangement of transformation defines the phase ordering problem. In this paper, we report on a case study evaluation for determining the optimal phase ordering for an obfuscation executive. We analyze obfuscation effectiveness of variants generated by Tigress, a dynamic virtualizing obfuscator with four transformation types. We test the evaluation of multiple orderings against a symbolic virtual machine to determine the strengths and weaknesses of each combination. We use overhead (cost) and effectiveness as the tradeoff space to determine the best sequence and ordering of transformations within this context. Our results show that, ideally, applying control flow transformation, data encoding, abstract transforms, and then dynamic virtualization provides the highest effectiveness on average against symbolic execution attacks.
Informing and Equipping Parents of People With Intellectual and Developmental Disabilities

Abstract The importance of supporting families with members who have intellectual and developmental disabilities (IDD) is well-established in both policy and research. Yet little is known about how...
Exploring the perceptions of campus climate and integration strategies used by international students in a US university campus

This study explored the perceptions of a US university campus climate by international students and analyzed strategies that they used to socially and academically integrate their campuses. The sam...
Penampilan Agronomis dan Pendugaan Parameter Genetik 100 Galur Padi Generasi Lanjut pada Kondisi Cekaman Kekeringan

The condition of rice field without any irrigation is one of the problems in the rainfed land. This rice field only relies on the existence of water during the rainy day. This causes the limitation of water availability which affect plant growth. This study aimed to know the performance of the rice advance lines, estimated the value of genetic parameters and obtains the best line on drought condition. As many as 100 advance lines (> F8) for drought tolerant were tested using Augmented Design in five blocks. A total of six-check varieties were included in the experiment. The research was conducted at Dry Season of 2015 in ICRR-Sukamandi Experimental Field. The result showed that on the drought condition gained the average value for plant height as 103,44 cm, number of productive tillers as 12 tillers, percentage of filling pine grains reached 60,46%, leaf color index as 39,37, and weight of 1.000 grains averaged as 26,34 g, while weight grain per 5 clumps as 166,34 g. Yield trait was converted to hectares as 3,77 t ha -1 in drought conidition. Almost all characters had wide variability, high heritability values and high percentage of expected genetic advance except the number of filling grains per panicle trait. Lines BP17572c-SBY-1-CRB-2-SKI-1-3-PWK-2, ZX115-SKI-0-IND-2-SKI-1-PWK-2, BP30104e, BP17572c-SBY-1-CRB-2 -SKI-1-4-PWK-2, and BP17554-1c-SBY-1-CRB-8-SKI-1-6-PWK-2 provided the best performance with higher yield potential than the best check i.e. Inpari 13. There are ten promising lines which can be continued to the preliminary test for the assembly of rainfed rice varieties
Inflammatory markers as predictors of depression and anxiety in adolescents: Statistical model building with component-wise gradient boosting.

Abstract Background Immune system abnormalities have been repeatedly observed in several psychiatric disorders, including severe depression and anxiety. However, whether specific immune mediators play an early role in the etiopathogenesis of these disorders remains unknown. Methods In a longitudinal design, component-wise gradient boosting was used to build models of depression, assessed by the Mood-Feelings Questionnaire-Child (MFQC), and anxiety, assessed by the Screen for Child Anxiety Related Emotional Disorders (SCARED) in 254 adolescents from a large set of candidate predictors, including sex, race, 39 inflammatory proteins, and the interactions between those proteins and time. Each model was reduced via backward elimination to maximize parsimony and generalizability. Results Component-wise gradient boosting and model reduction found that female sex, growth- regulated oncogene (GRO), and transforming growth factor alpha (TGF-alpha) predicted depression, while female sex predicted anxiety. Limitations Differential onset of puberty as well as a lack of control for menstrual cycle may also have been responsible for differences between males and females in the present study. In addition, investigation of all possible nonlinear relationships between the predictors and the outcomes was beyond the computational capacity and scope of the present research. Conclusions This study highlights the need for novel statistical modeling to identify reliable biological predictors of aberrant psychological behavior.
FGF21 is a Hormonal Mediator of the Human “Thrifty” Metabolic Phenotype

Fibroblast growth factor 21 (FGF21) regulates energy expenditure (EE) and influences weight change during low-protein overfeeding in rodent models. The change in EE after a low-protein overfeeding diet is a predictor of weight change in humans and a feature of the "thrifty" metabolic phenotype. However, there are no studies showing an association between circulating FGF21 and diet-related EE in humans. We assessed the changes in plasma FGF21 concentrations after 24 h of seven dietary interventions with different macronutrient content while in a whole-room indirect calorimeter in 64 healthy subjects with normal glucose regulation. Plasma FGF21 concentration consistently increased by threefold only after the two low-protein (3%) overfeeding diets, one high in carbohydrate (75%) and the other high in fat (46%), with larger increases in FGF21 being associated with greater increases in 24-h EE. Subjects with smaller increases in FGF21 after the low-protein high-fat diet gained more weight after 6 months in free-living conditions. Therefore, the individual predisposition to weight gain over time can be assessed by 24-h overfeeding a low-protein diet and measurements of plasma FGF21 concentrations. Individuals with a blunted FGF21 response to a low-protein diet have a thrifty metabolism and are at risk for future weight gain.
The Development of the North Pacific Jet Phase Diagram as an Objective Tool to Monitor the State and Forecast Skill of the Upper-Tropospheric Flow Pattern

AbstractPrevious studies employing empirical orthogonal function (EOF) analyses of upper-tropospheric zonal wind anomalies have identified the leading modes of North Pacific jet (NPJ) variability t...
"Education, Philanthropy, and Governance: A New Look at Lincolnshire Schools in the Sixteenth and Seventeenth Centuries"

Through an examination of cases filed in Chancery under the Law of Charitable Uses and local documents from the Lincolnshire Archives, this article explores how schools in Lincolnshire functioned a...
μ-Opioid Receptor Activation Directly Modulates Intrinsically Photosensitive Retinal Ganglion Cells.

Abstract Intrinsically photosensitive retinal ganglion cells (ipRGCs) encode light intensity and trigger reflexive responses to changes in environmental illumination. In addition to functioning as photoreceptors, ipRGCs are post-synaptic neurons in the inner retina, and there is increasing evidence that their output can be influenced by retinal neuromodulators. Here we show that opioids can modulate light-evoked ipRGC signaling, and we demonstrate that the M1, M2 and M3 types of ipRGCs are immunoreactive for μ-opioid receptors (MORs) in both mouse and rat. In the rat retina, application of the MOR-selective agonist DAMGO attenuated light-evoked firing ipRGCs in a dose-dependent manner (IC50
Book review: Medical Ethics and the Future of Healthcare

This wide ranging compilation of lectures, hosted by the Adelaide Hospital Society in Dublin in 1999, kicks off with a great overview of the current state of medical ethics. This sets the stage for an edited text that is meant to provide the lay reader with a basic introduction to medical ethics. Unfortunately, the varied chapters fall victim to discontinuity, reducing this work to an insufficient reference resource. The book does cover some of the basics of ethics, such as patient autonomy …
Synergies of four emerging technologies for accelerated adoption of electric vehicles: Shared mobility, wireless charging, vehicle-to-grid, and vehicle automation

Abstract This technical note discusses the synergetic attributes of four emerging technologies that have significant potentials to enhance smart and sustainable urban mobility, and ultimately improve urban sustainability. Shared mobility, wireless charging, vehicle-to-grid (V2G) integration, and vehicle automation have complementary features that rectify the practical barriers and implementation restrictions of each other. We attempt to bridge between transportation research studies and the environmental sustainability community, discuss the recent findings, and identify critical knowledge gaps to better understand the synergies and mutual benefits of these emerging technologies and avoid unintended environmental consequences.
The Second Limit Formula and L-series

Let k be a number field and o = ok the ring of algebraic integers. Let f be an ideal of o. (Unless otherwise specified, ideal means contained in o.) We shall consider Gauss sums formed with characters (the generalization to number fields is due to Hecke).
Analyzing the Urban-Rural Vaccination Coverage Disparity through a Fair Decomposition in Zhejiang Province, China

Objectives: Exploring determinants underlying disparities in full vaccination coverage (FVC) can contribute to improved immunization interventions. FVC and its risk factors in Zhejiang province have been studied, yet the determinants explaining the rural-urban disparity in FVC have not been studied. This study aimed to disentangle the factors explaining rural-urban disparities in FVC of vaccine doses scheduled during the first year of life in Zhejiang province. Methods: We used data from a vaccination coverage survey among children aged 24-35 months conducted in 2016. The outcome measure was full vaccination status, and the grouping variable was the area of residence. Descriptive statistics were used to analyze the FVC and rural-urban residence across the exposure variables. The Fairlie decomposition technique was used to decompose factors contributing to explaining the FVC disparity. Results: There were 847 children included in this study, of which 49.6% lived in a rural area. FVC was 94% in rural areas and 85% in urban areas. A disparity of 9% to the advantage of the rural areas and the exposure variables explained 81.1% of the disparity. Maternal factors explained 49.7% of the explained disparity with education, occupation, and ethnicity being the significant contributors to the explained disparity. Children's birth order and immigration status contributed somewhat to the explained inequality. Conclusion: There was a significant disparity in FVC in Zhejiang province, a disadvantage to the urban areas. Policy recommendations or health interventions to reduce the inequality should be focused on eliminating poverty and women's illiteracy, targeted at migrant children or children from minority ethnicities.
Investigational Biomarkers for Checkpoint Inhibitor Immune-Related Adverse Event Prediction and Diagnosis.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of multiple cancers. However, these promising therapies may also cause immune-related adverse events (irAEs) in a substantial proportion of patients. These autoimmune phenomena may affect almost any organ system and may occur at almost any point in therapy. In some instances, these toxicities are life-threatening and potentially permanent. Diverse clinical presentation and unpredictable timing further complicate their anticipation and diagnosis. CONTENT: To improve patient safety and selection for ICI use, biomarkers for irAE diagnosis and prediction are under development. Clinicians may use traditional laboratory markers such as routine chemistries, creatinine clearance, thyroid function tests, and serum cortisol/adrenocorticotrophic hormone to monitor for specific irAEs, but noted aberrations may not necessarily represent an immune-mediated etiology. Novel biomarkers have the potential to be more specific to assist in the diagnosis of irAEs. The prediction of irAEs is more challenging. Apart from a history of autoimmune disease, no other clinical parameters are routinely used to project risk. Biomarker candidates under investigation for irAE diagnosis and prediction include blood cell analysis, chemokines/cytokines, autoantibodies, and genetic predisposition, such as human leukocyte antigen haplotype. Among other emerging candidates are immune-cell subsets, T-cell repertoire, fecal microbiome, tumor genomics, and radiomic characterization. SUMMARY: Several conventional laboratory indexes of end-organ dysfunction are currently in routine clinical use for irAE monitoring and diagnosis. Novel biomarkers for the prediction and diagnosis of these irAEs, which primarily characterize patient immune function, represent an area of active investigation.
Evidence for a second type of fibril branch point in fibrin polymer networks, the trimolecular junction

Fibrin molecules polymerize to double-stranded fibrils by intermolecular end-to-middle domain pairing of complementary polymerization sites, accompanied by fibril branching to form a clot network. Mass/length measurements on scanning transmission electron microscopic images of fibrils comprising branch points showed two types of junctions. Tetramolecular junctions occur when two fibrils converge, creating a third branch with twice the mass/length of its constituents. Newly recognized trimolecular junctions have three fibril branches of equal mass/length, and occur when an extraneous fibrin molecule initiates branching in a propagating fibril by bridging across two unpaired complementary polymerization sites. When trimolecular junctions predominate, clots exhibit nearly perfect elasticity.
Judicial Decision-Making: The Influence of Case Salience on Trial Court Sentencing

There is consensus among several scholars that case salience affects US Supreme Court decision making even if there is disagreement on how to measure salience (Epstein and Segal 2000; Unah and Hancock 2006; etc). Vining and Wilhelm (2010) contend that state supreme court justices are equally affected by case salience, building upon prior studies (e.g. Hall 1992) that indicate these justices act strategically when deciding cases in order to minimize electoral opposition. Separately, the literature consists of several studies which measured factors influencing state criminal court judicial sentencing. Notably, the effect of case salience on state criminal sentencing has been minimally studied. In an on-going study of two trial courts, we raised questions about case salience and criminal sentencing. Using multivariate logistic regression analysis, we first test whether judges decide to sentence defendants given the salience of particular cases. We further analyze sentencing lengths when judges decide to sentence offenders. In addition, we examined case as pre-trial publicity generated by prosecutor’s press release and local media coverage. With this paper, we attempt to fill gaps in the literature about the effect of case salience on the sentencing behavior of state criminal court judges.
Reconstructive Plastic Surgery for Blast and Burn Injuries

The injuries that result from burn and blast injuries are complex and treatment must be individualized to each patient. There are, however, principles of plastic and reconstructive surgery that guide the treatment of this patient population. They include the initial triage of life and then limb-threatening wounds, adequate tissue debridement of devitalized and contaminated tissue, operative fixation of orthopedic injuries, and finally adequate tissue coverage. The key component beyond these principles is the emphasis on early and frequent collaboration between specialty services in order to obtain the best functional result for the patient.
Characterization of rice cultivar response to florpyrauxifen-benzyl

Many factors such as environment, herbicide rate, growth stage at application, and days between sequential applications can influence the response of a crop to herbicides. Florpyrauxifen-benzyl is a new broad-spectrum, POST herbicide that was commercialized for use in U.S. rice production in 2018. Field experiments were conducted in 2018 at the Pine Tree Research Station (PTRS) near Colt, AR, and the Rice Research and Extension Center (RREC), near Stuttgart, AR, to evaluate crop injury and yield response of three rice cultivars to sequential applications of florpyrauxifen-benzyl. Greenhouse and growth chamber experiments were conducted at the Altheimer Laboratory in Fayetteville, AR, to evaluate cultivar responses when florpyrauxifen-benzyl was applied at 30 or 60 g ae ha−1 to rice exposed to different temperature regimes or at various growth stages. Three rice cultivars were used in all experiments: long-grain variety ‘CL111’, medium-grain variety ‘CL272’, and long-grain hybrid cultivar ‘CLXL745’. CL111 exhibited sufficient tolerance to florpyrauxifen-benzyl with only 10% visible injury and no effect on yield. CL272 showed 15% injury 3 wk after the second application in the field experiment when applications were made 14 d apart. Additionally, 12% injury was observed in greenhouse studies when florpyrauxifen-benzyl was applied at 30 g ae ha−1, averaged over various growth stages at application. Florpyrauxifen-benzyl did not reduce the yield of CL272 in field experiments, indicating that CL272 can recover from florpyrauxifen-benzyl injury. As much as 64% injury was observed for CLXL745 at 3 wk after application (WAA) when sequential herbicide applications were made 4 d apart. High levels of injury occurred in the growth chamber and greenhouse studies for this cultivar as well. Sequential applications of florpyrauxifen-benzyl reduced yields of CLXL745 in nearly all treatments. Data from these experiments suggest that CL272 and CLXL745 are sensitive to sequential applications of florpyrauxifen-benzyl. Growers must follow the prescribed guidelines for using florpyrauxifen-benzyl in these cultivars and others like it.
Classroom Policy and Narcissistic Behavior: A Game-Theoretic Approach

We describe the rise in intergenerational narcissistic behavior amongst college students and educational issues that this trend creates in the classroom, including entitlement and academic dishones...
The first Jean Benedetti lecture (2020) Stanislavsky and Film: Con and Pro

Stanislavsky distrusted cinema as a distraction for the actor and a poor substitute for the communion between audience and stage. His only intensive engagement with film came in 1923 when a Hollywo...
Electronic health record alerts enhance mass screening for chronic hepatitis B

To measure the effect of an electronic health record (EHR) alert on chronic hepatitis B (CHB) screening among at-risk Asian and Pacific Islanders (API). API patients who had not yet completed hepatitis B surface antigen (HBsAg) testing were identified by a novel EHR-based population health tool. At-risk API patients in Cohort 1 (primarily privately insured) and Cohort 2 (includes Medicare and/or Medicaid) were randomized to alert activation in their electronic medical charts or not. In total, 8299 API were found to be deficient in HBsAg completion at baseline within our health system. In Cohort 1, 1542 patients and 1568 patients were randomized to the alert and control respectively. In Cohort 2, 2599 patients and 2590 patients were randomized to the alert and control respectively. For both cohorts combined, 389 HBsAg tests were completed in the alert group compared to 177 HBsAg tests in the control group (p < 0.0001; OR = 2.3; 95% CI 1.94-2.80), but there was no increased detection of HBsAg positivity from the alert (15 versus 13 respectively, p = 0.09; OR = 0.5; 95% CI 0.24-1.09). Our results demonstrate that personalized, automated electronic alerts increase screening for CHB, but more comprehensive measures are needed to detect HBsAg positive patients.NIH Trial Registry Number: NCT04240678.
Cognitive, language, and school performance in children and young adults treated for low-grade astrocytoma in the posterior fossa in childhood.

BACKGROUND Pilocytic astrocytoma is the most common brain tumour type in childhood located in the posterior fossa, and treated mainly with surgery. These tumours have low mortality, but knowledge concerning its long-term outcome is sparse. AIM The aim of this study was to investigate whether children treated for pilocytic astrocytoma in the posterior fossa had late complications affecting cognition, language and learning. METHODS This descriptive single-centre study includes eight children and 12 adults treated as children for pilocytic astrocytoma in the posterior fossa, with a mean follow-up time of 12.4 (range 5-19) years. Well-established tests of intelligence, executive, language and academic function were used. RESULTS Intelligence tests showed average results compared with norms. Five patients scored <-1 SD (70-84) and 3 low average (85-92) on full scale IQ. The patients scored average on subtests regarding executive function, except for significantly lower results in inhibition/switching (p = .004). In Rey complex figure test half of the patients scored below -1 SD. Language tests were normal except for significantly lower results in naming ability (p = .049) and in inference (p = .046). In academic tests, results were average, except for significantly lower results in reading speed (p = .024). Patients with learning difficulties performed worse in the tests. CONCLUSIONS The patients' functional outcome was favourable but, a not-negligible part of the patients displayed neurocognitive difficulties as revealed by extensive neuro-cognitive and academic testing. Thus, it is important to identify those in need of more thorough cognitive and pedagogic follow-up programmes, including school interventions.
Smartpens: Note-Taking Technology for Students with Learning Disabilities

For students with learning disabilities (SWLD), note-taking during lectures and discussions is a cognitively demanding task. The multitasking elements of recording verbal information and the temporal nature of a verbal lecture make it difficult for SWLD to record notes effectively. Smartpens are new technology that can help students to become better note takers by storing verbal lecture information and syncing it up later when students amend their notes. This article provides an overview of the research on smartpens, including two smartpen strategies that improved the note taking of SWLD, and tips for teachers about how to use these strategies in the classroom.Subscribe to LDMJ
Enhancing Value-Based Care With a Walk-in Clinic: A Primary Care Provider Intervention to Decrease Low Acuity Emergency Department Overutilization.

Background Emergency department overutilization is a known contributor to the high per-capita healthcare cost in the United States. There is a knowledge gap regarding the substitution effect of walk-in clinic availability in primary care provider (PCP) offices and emergency department utilization (EDU). This study evaluates associations between PCP availability and EDU and analyzes the potential cost savings for health systems. Methods A retrospective cohort analysis compared low acuity EDU rates in established patients at a family medicine residency's PCP office before and after walk-in clinic implementation. The practice had 12 providers, 12 residents, and a patient panel of approximately 7,000-8,000. Inclusion criteria were met if patients were: (1) established with the PCP office, (2) had a low acuity emergency department (ED) visit (emergency index score level 4 or 5) OR had a walk-in clinic visit at the family practice. ED visits were tracked from January 2018 to January 2020 and encounters were compared numbers to pre and post-implementation of a walk-in clinic. Cost savings for comparable management was estimated with average price differences for low acuity encounters in the ED versus clinic. Results Over the two-year timeframe, there were 10,962 total visits to the ED by family practice patients, 4,250 of these visits were low acuity. Despite gross monthly increases of EDU from 2018-2020, after implementation of a walk-in clinic in 2019, rates of total EDU decreased by 1.5% and low acuity utilization rates also decreased. The average annual patient census nearly doubled from 5,763 to 8,042. T-tests confirmed statistical significance with p-values <0.05. Average low acuity ED visits ($437) cost 4.9 times more than comparable PCP office visits ($91). Managing 2,387 patients in the walk-in clinic resulted in an estimated annual cost savings of $825,902. Conclusion Extended walk-in availability in primary care offices provides non-ED capacity for low acuity management and might mitigate low acuity ED utilization while providing more cost-effective care. This study supports similarly described pre-hospital diversions in reducing ED over-utilization by increasing access to care. Higher levels of evidence are needed to establish causality.
Unsteady Flowfield Around Tandem Cylinders as Prototype for Component Interaction in Airframe Noise

Synergistic application of experiments and numerical simulations is crucial to understanding the underlying physics of airframe noise sources. The current effort is aimed at characterizing the details of the flow interaction between two cylinders in a tandem configuration. This setup is viewed to be representative of several component-level flow interactions that occur when air flows over the main landing gear of large civil transports. Interactions of this type are likely to have a significant impact on the noise radiation associated with the aircraft undercarriage. The paper is focused on two-dimensional, time-accurate flow simulations for the tandem cylinder configuration. Results of the unsteady Reynolds Averaged Navier-Stokes (URANS) computations with a two-equation turbulence model, at a Reynolds number of 0.166 million and a Mach number of 0.166, are presented. The experimental measurements of the same flow field are discussed in a separate paper by Jenkins, Khorrami, Choudhari, and McGinley (2005). Two distinct flow regimes of interest, associated with short and intermediate separation distances between the two cylinders, are considered. Emphasis is placed on understanding both time averaged and unsteady flow features between the two cylinders and in the wake of the rear cylinder. Predicted mean flow quantities and vortex shedding frequencies show reasonable agreement with the measured data for both cylinder spacings. Computations for short separation distance indicate decay of flow unsteadiness with time, which is not unphysical; however, the predicted sensitivity of mean lift coefficient to small angles of attack explains the asymmetric flowfield observed during the experiments.
On the Importance of Listening and Intercultural Communication for Actions against Racism

In a period where racial inequities in the United States have garnered more attention and discussion as a result of social media (e.g., increased use of the #BlackLivesMatter hashtag; Anderson et al., 2020) and newer generations (Tatum, 2017b), it is important to ensure that communication between cultural groups is effective and produces systemic change. This article will review the failures of a “postracial” society, with emphasis on ineffective communication among Black, Indigenous People of Color and non-Black, Indigenous People of Color. The role of the listener during intercultural verbal exchanges will be examined, while highlighting the barriers and harmful results of ineffective communication. A behavioral conceptualization of effective listener behavior will be presented, which if implemented, may maintain and sustain social equity, inclusion, and justice. A call to action will be made to further investigate intercultural communication using behavior-analytic research methodologies and how such research might inform on how to functionally and precisely mediate reinforcement in the fight against racism.
Spectroscopic studies on papain and some inactive derivatives.

Abstract The fluorescence emission spectrum of papain is attributable to the tryptophan residues in this protein with little contribution from tyrosine residues. The pH dependence of the fluorescence intensity of unactivated papain follows closely the titration curve for a residue of apparent pK' of 6.6 at 25°, while that of active papain can be fitted by a curve obtained by the summation of the titration curves for groups of apparent pK' of 6.6 and 8.5 at 25°. Examination of the temperature dependence of the pH fluorescence profiles, as well as a study of several inactive papain derivatives in which the thiol group at the active site has been alkylated, indicates that the above pK' values can be ascribed to the side chain of a histidine residue and to the thiol group at the active site of the enzyme, respectively. The fluorescence of both active and unactivated papain is unchanged in the presence of ethylene glycol (40%, v/v), methanol (50%, v/v), or dioxane (20%, v/v). The circular dichroism spectra, as well as ultraviolet difference spectra produced by solvent perturbation, of active and unactivated papain were superimposable, indicating that activation of this enzyme is associated with little, if any, conformational change.
Effect of General Anesthetics on IOP in Rats with Experimental Aqueous Outflow Obstruction

PURPOSE To determine the effect of several common general anesthetics on intraocular pressure (IOP) after experimental aqueous outflow obstruction in the rat. METHODS A single episcleral vein injection of hypertonic saline was used to sclerose aqueous humor outflow pathways and produce elevated IOP in Brown Norway rats. Animals were housed in either standard lighting or a constant low-level light environment. Awake IOPs were determined using a TonoPen (Mentor, Norwell, MA) immediately before induction of anesthesia by either isoflurane, ketamine, or a mixture of injectable anesthetics (xylazine, ketamine, and acepromazine). For each anesthetic, IOPs were measured immediately after adequate sedation (time 0) and at 5-minute intervals, up to 20 minutes. RESULTS; Awake IOPs ranged from 18 to 52 mm Hg. All anesthetics resulted in a statistically significant (P: < 0.01) reduction in measured IOP at every duration of anesthesia when compared with the corresponding awake IOP. With increasing duration of anesthesia, measured IOP decreased approximately linearly for both the anesthetic mixture and isoflurane. However, with ketamine, IOP declined to 48% +/- 11% (standard lighting) and 60% +/- 7% (constant light) of awake levels at 5 minutes of anesthesia, where it remained stable. In fellow eyes, the SD of the mean IOP in animals under anesthesia was always greater than the corresponding SD of the awake mean. Anesthesia's effects in normal eyes and eyes with elevated IOP were indistinguishable. CONCLUSIONS All anesthetics resulted in rapid and substantial decreases in IOP in all eyes and increased the interanimal variability in IOPs. Measurement of IOP in awake animals provides the most accurate documentation of pressure histories for rat glaucoma model studies.
Electrochemical Processing, Organic

The technology for electroorganic synthesis is surveyed starting with an overview of the electrochemical cells for this purpose. Cell design, electrode materials, and diapraghms are discussed as are cell current distribution and mass-transport phenomena. Features influencing good product selectivity for specific cell designs are presented together with the various commercially available cells. Cost analysis for electroorganic synthesis is reviewed. The electroorganic processes that have been commercialized or have been pilot planted are presented. Keywords: Electrochemical processing; Cell design; Industrial processes; Ion-exchange membranes; Adiponitrile
Ownership Concentration and Performance in Ukraine's Privatized Enterprises

This article investigates empirically the relationship between ownership concentration and performance in 376 partially and fully privatized Ukrainian enterprises. It finds that ownership concentration is positively associated with enterprise performance in Ukraine. The article also finds that concentration of ownership by foreign companies and banks is associated with better performance than ownership concentrated by the domestic owners. Ownership by Ukrainian investment funds and holding companies does not have a positive effect on performance. The article documents that, in contrast to predictions by many observers of early transition, privatization methods determined the long-term ownership structure of privatized firms. Copyright 2003, International Monetary Fund
Clinical Decision Making in the Treatment of Complex PTSD and Substance Misuse

Treating clients with complex posttraumatic stress disorder (PTSD) who also misuse substances presents a number of clinical challenges. The nature of complex PTSD is that we are faced with the far-reaching consequences of early and prolonged trauma on clients' lives, typically interfering with a host of emotional, relational, and functional capacities. Often substance misuse has become an offshoot of this experience, initially an "adaptive" response to unbearable circumstances, but over time exacerbating client dysfunction, at times leading to revictimization, and frequently culminating in a substance use disorder. Many clinicians feel overwhelmed in the face of this myriad of problems. This article provides an overview of some of the clinical choice points facing clinicians in this work: Where do we start? How do we proceed? What do we treat first? How do we handle a dysregulated client? The article attempts to provide some guidance about how to approach these multifaceted decisions, with an emphasis on attending to comorbidity, to assist clinicians in providing symptom-focused treatment for this complex population.
Spontaneous and Induced Mutation in Mycobacterium avium

Mycobacterium avium exhibits two colonial forms, transparent and opaque, on 7H10 agar. The transparent variant of M. avium B2900 undergoes a spontaneous transition to the opaque form at the rate of 4.7 x 10(-5) to 3.5 x 10(-4) per cell per generation. The two variants differ in cell morphology and mass; the opaque cells are two to three times as large as the transparent in terms of dry weight, total protein, deoxyribonucleic acid, or carbohydrate. A search for auxotrophic mutants resulted in the induction, by nitrosoguanidine or ultraviolet irradiation, of conditional, salt-sensitive mutants. One such mutant requires methionine and tryptophan supplementation for growth in a medium containing a buffer at high molarity. The clinical and physiological significance of these findings is discussed.
Multiple in vivo roles for the -12-region elements of sigma 54 promoters.

Alignment of sigma 54-dependent promoters indicates conservation of two sequence elements. Six nucleotides in the downstream −12 element were mutated individually to each nonconsensus nucleotide. mRNA levels were measured in vivo for each promoter under strongly activating conditions. The results showed that the consensus sequence was not the strongest promoter. Instead, the −12 consensus element consists of two subregions that behave differently when mutated. Single changes in the upstream TTT consensus subregion can lead to increases in transcription, whereas single changes in the downstream GC(A/T) can lead to decreases in transcription. Selected double mutations with changes in both subregions were constructed and studied in vivo. No double mutation increased promoter strength, and some decreased it. Mutant promoters were also assayed under nonactivating conditions in vivo. No mRNA was detected in 23 of the 24 promoters tested. However, one double mutant showed substantial levels of transcript, indicating that the −12 sequence was capable of specifying basal transcription under nonactivating conditions. Overall, the results show that the −12 region has multiple roles in transcription in vivo, including modulating both basal and induced RNA levels.
Raman Scattering From Rapid Thermally Annealed Tungsten Silicide Thin Films

Raman scattering as a technique for studying the formation of tungsten silicide is discussed. The tungsten silicide films were formed at temperatures up to 1350 C by rapid thermally annealing for 20 seconds tungsten films which had previously been sputter deposited on silicon substrates. The Raman data are correlated with sheet resistance measurements and scanning electron microscopy to show that rapid thermal annealing at higher temperatures for shorter times provides lower resistance tungsten silicide than reported in previous work.