cssi/SciSciGPT-SciSciNet huggingface dataset:
Running dry: The U.S. Southwest's drift into a drier climate state

Changes in precipitation have far-reaching consequences on human society and ecosystems as has been demonstrated by recent severe droughts in California and the Oklahoma region. Droughts are beside tropical cyclones the most costly weather and climate related extreme events in the U.S. We apply a weather type (WT) analysis to reanalysis data from 1979–2014 that characterize typical weather conditions over the contiguous United States. This enables us to assign precipitation trends within 1980–2010 to changes in WT frequencies and changes in precipitation intensities. We show that in the North Atlantic and Midwest region precipitation intensity changes are the major driver of increasing precipitation trends. In the U.S. Southwest, however, WT frequency changes lead to a significant precipitation decrease of up to −25% related to an increase in anticyclonic conditions in the North East Pacific. This trend is partly counteracted by increasing precipitation intensities.
Effect of 6-mercaptopurine ribonucleotides on DNA-dependent RNA polymerase activity.

6-Mercaptopurine ribonucleoside 59-triphosphate was found to be an inhibitor of DNA-dependent RNA polymerases from Escherichia coli and chicken myeloblastosis cells. The inhibitor appears to compete with GTP for its binding to RNA polymerase, resulting in a reduction of RNA chain initiations. Neither 6-mercaptopurine ribonucleoside nor its monophosphate derivative caused the inhibition. These studies suggest that the antineoplastic action of 6-mercaptopurine may in part be owing to the inhibition of the activity of DNA-dependent RNA polymerase, resulting in an inhibition of cellular RNA synthesis.
'Uram is what I say it is' : The challenge of the possibility superior Sanskrit-language thinking

Le debat qui oppose les theologiens qui envisagent l'Uram comme une realite metaphysique et ceux qui le concoivent comme une realite linguistique possede des caracteres postmodernes. D'un cote se trouvent les philosophes et les metaphysiciens, de l'autre, on retrouve les critiques litteraires. L'A. place les Mīmāmsakas et les Vedāntins du cote des derniers. Les Mīmāmsakas conferent le statut de realite ultime au sacrifice tout en niant une signification religieuse a toute realite extra-sacrificielle; elles menacent par consequent de relativiser le monde
ID: 44: LOCAL CONTROL OF OCULAR ADNEXAL LYMPHO-PROLIFERATIVE DISORDERS (OALD): SIMILAR OUTCOMES IN MALT AND NON-MALT HISTOLOGIES

Background The outcomes of local radiation therapy (RT) in MALT vs. non-MALT OALD are not known. Herein we present outcomes of local therapy in MALT vs. non-MALT OALD treated at a specialized lymphoma program. Methods The analysis included 112 consecutive patients (pts) with OALD diagnosed at our institution between 1975–2014. Histology was reviewed by an expert hematopathologist. The primary objective of the study was to assess the failure free survival (FFS) in pts. with marginal zone lymphoma of mucosa associated lymphoid tissue (MALT) of ocular adnexa (OA) and non–MALT OA lymphomas treated with local radiation therapy. Complete remission was defined as absence of any disease by imaging. Local failure was defined as any failure within the OA; extra-orbital failure was either regional (within the radiation field) or distant (for cases with limited stage disease at presentation). FFS was defined as time from treatment to any failure (local, regional and distant). FFS was estimated using the Kaplan-Meier methods. Results Baseline characteristics are shown in table 1. Of 112, 71(57.7%) of the pts had ocular MALT, and 41(33.3%) had non-MALT (23 follicular, 8 diffuse large cell B cell lymphomas, 3 mantle cell, 6 small lymphocytic lymphoma and 1 T cell lymphoma). Unilateral eye involvement (83.9%) with mass/swelling (55.3%) was the most common presentation. Staging was performed with CT scan and bone marrow biopsy in select cases (n=63, 51%). PET scan was utilized in 33 (29.4%) pts. but was able to upstage in only 5 cases. For ocular MALT, 62 (87.3%) received involved field radiation therapy (IFRT), 9 (12.6%) chemotherapy. For non-MALT, 34 (82.9%) had IFRT,7 (17%) chemotherapy. Among those who received IFRT, 55 (75%) in MALT and 21 (52%) in non-MALT had limited stage disease (I/II). Among OALD pts treated with only IFRT, 91.7% in ocular MALT and 90.9% in non-MALT achieved complete remission. Resolution of symptoms occurred in 83.3% and 93.3% of ocular MALT and non-MALT respectively. Failure rates of IFRT in ocular MALT vs. non-MALT were as follows: local (7% vs. 12.1%), regional (9.8% vs. 7.3%), and distant (5.6% vs 2.4%). Median follow-up was 3 (1–22) years in each group. Median time to failure was 14 years for ocular MALT and 9 years for non-MALT. 3 year and 5 year failure-free survival was 88% and 81% for ocular MALT and 78% and 71% for non-MALT respectively (log rank p=0.26 for FFS) (figure 1). Conclusions Both the MALT and non-MALT OALD pts achieved excellent disease control with IFRT with no significant difference in local, regional and distant failure rates. 3 year and 5 year failure free survival were comparable between the two groups. PET scan resulted in upstaging in 5% of pts but did not alter treatment selection, indicating that PET had minimal utility in initial staging of OALD.
Understanding the mechanisms of faecal microbiota transplantation

This Review summarizes mechanistic investigations in faecal microbiota transplantation (FMT), which has increasingly been adapted into clinical practice as treatment for Clostridium difficile infection (CDI) that cannot be eliminated with antibiotics alone. Administration of healthy donor faecal microbiota in this clinical situation results in its engraftment and restoration of normal gut microbial community structure and functionality. In this Review, we consider several main mechanisms for FMT effectiveness in treatment of CDI, including direct competition of C. difficile with commensal microbiota delivered by FMT, restoration of secondary bile acid metabolism in the colon and repair of the gut barrier by stimulation of the mucosal immune system. Some of these mechanistic insights suggest possibilities for developing novel, next-generation CDI therapeutics. FMT might also have potential applications for non-CDI indications. The gut can become a reservoir of other potential antibiotic-resistant pathogens under pressure of antibiotic treatments, and restoration of normal microbial community structure by FMT might be a promising approach to protect against infections with these pathogens as well. Finally, FMT could be considered for multiple chronic diseases that are associated with some form of dysbiosis. However, considerable research is needed to optimize the FMT protocols for such applications before their therapeutic promise can be evaluated.
Analysis of the effectiveness of the OSHA steel erection standard in the construction industry

Regulatory intervention is one of the most influential factors in preventing occupational safety in the construction industry. In 2002, the United States (US) Occupational Safety and Health Administration (OSHA) revised the steel erection standard, which is designed to protect employees from steel erection related hazards. The purpose of this study was to examine a measurable impact of the revised OSHA 29 CFR 1926, Subpart R using data from the Bureau of Labor Statistics. This study identified four safety measures: fatality rate, days away injury rate, normalized fatality rate, and normalized days away injury rate. Descriptive and interrupted time series analyses were conducted to examine impacts of the revision of the standard on the safety of structural iron and steel workers. The findings indicate that fatality and days away injury rates of the structural iron and steel workers declined by 22.2% and 53.7%, respectively, after the implementation of the standard revision. In addition, two normalized safety indicators revealed that the reductions of fatality and days away injuries of the structural iron and steel workers were greater than those from the overall construction workers. This study provides evidence for the effectiveness of the revised standard in preventing overall occupational injuries in structural iron and steel workers in the US construction industry. In addition, the findings of this study demonstrate that the revised standard was more effective on preventing days away injuries than fatalities, which can guide future directions for policy makers and researchers. Language: en
Introduction: Questioning What Makes the EU Viable

The sui generis interpretation dominant in mainstream European Union studies is often accompanied by a blithe assumption that the European Union (hereafter, the EU) has the political wherewithal and willpower to keep its show on the road.1 Hailed as unique among international treaty organizations, it has even been described by one recent commentator as the embodiment of a ‘new European Dream’ that ‘dares to suggest a new history, with an attention to quality of life, sustainability, and peace and harmony’ (Rifkin, 2004: 6).2 If deficiencies or deficits are identified in this polity, then it is usual to think there is an institutional solution: increasing the power of the European Parliament, turning the Council into a second parliamentary chamber, having a directly elected Commission president and so forth (Sidjanski, 1992: 436–8; Dehousse, 1997; van Gerven, 2005: 375–84). But whereas studies of the ‘democratic deficit’ reproduce these familiar, pious suggestions for improving the EU’s democratic credentials they shy away from discussing what impact they might have on the stability of EU politics. This book is precisely an attempt to assess the effects of institutional change, proposed for the sake of democratization, by identifying what makes the EU viable. In particular, the aim is to scrutinize how the EU political system has resolved various existential crises as the basis for examining what potential there is for greater centralization, in the name of democracy, of competences and representation at the EU-level. Furthermore, and more unusually, it is claimed that the best way of learning about EU viability is by contrast with the experience of political conflict between federal and state authority in the antebellum US.
Building a World of Frequent Readers: How Can Teachers Encourage All Students to Read?

Literacy is a fundamental social skill. Moreover, it is part of the way in which humans construct identities and develop psychologically; literacy is an ability that contributes to the overall health of a child. But how can teachers instil the value of reading in all young readers? In this article, Thomas and Burke discern and discuss the primary findings of Scholastic's Kids and Family Reading Report ; namely, to become frequent readers, children and young adults need access to a variety of books that represent their interests, freedom to choose which books to read, as well as encouragement and time to read. These conclusions corroborate findings from other studies in the field of literacy education and might seem obvious but, unfortunately, the literacy needs of many children are not met either at home or at school. Additionally, in this article they discuss why poor and minority youth are less likely to become frequent readers, and they provide practical advice for teachers that they can use to encourage all of their students to read.
Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care

Purpose: In 2015, the Centers for Medicare and Medicaid Services ruled that health organizations comply with additional requirements for electronic health records (EHRs), known as "Meaningful Use," and develop the capacity to collect gender identity data. Research has established effectiveness of a two-step gender identity question to collect these data. This study examines transgender patient perspectives on the use of a two-step question and experiences with privacy and sensitive disclosures in EHRs and healthcare settings. Methods: Four focus groups (N=30) were conducted in Chicago, Illinois in 2014-2015. Participants were asked to compare two intake forms-one with a two-step question and one with a single question-and discuss experiences with gender identity disclosure, privacy, and access to care. Narratives were transcribed verbatim to identify patterns and themes; the extended case method was used and grounded the data analysis process in the concept of intersectionality. Results: Participants expressed appreciation for improved reliability and competencies that the two-part question may afford. Narratives reveal concerns related to patient privacy, safety, and access because of the contexts in which these data are collected and transmitted. Virtually all participants described situations whereby sensitive gender identity information had been involuntarily disclosed, misinterpreted, or abused, and safety and care were compromised. Conclusion: Participants recognized the potential of the two-part question as a measurement and competency tool, but anticipated new privacy violations and involuntary disclosures. Narratives indicate that effects of sensitive disclosures may vary intersectionally, whereby white participants experienced lesser harms than their immigrant, HIV-positive, and black trans feminine counterparts. Discrimination and privacy violations may occur regardless of a two-part or one-part gender identity question, but increasing these sensitive disclosures within expanding EHR infrastructures may require a range of mechanisms that have flexibility across contexts to safeguard sensitive information and access to care.
Urine metabolomic analysis to detect metabolites associated with the development of contrast induced nephropathy.

Author(s): Diercks, Deborah B; Owen, Kelly P; Kline, Jeffrey A; Sutter, Mark E | Abstract: ObjectiveContrast induced nephropathy (CIN) is a result of injury to the proximal tubules. The incidence of CIN is around 11% for imaging done in the acute care setting. We aim to analyze the metabolic patterns in the urine, before and after dosing with intravenous contrast for computed tomography (CT) imaging of the chest, to determine if metabolomic changes exist in patients who develop CIN.MethodsA convenience sample of high risk patients undergoing a chest CT with intravenous contrast were eligible for enrollment. Urine samples were collected prior to imaging and 4 to 6 hours post imaging. Samples underwent gas chromatography/mass spectrometry profiling. Peak metabolite values were measured and data was log transformed. Significance analysis of microarrays and partial least squares was used to determine the most significant metabolites prior to CT imaging and within subject. Analysis of variance was used to rank metabolites associated with temporal change and CIN. CIN was defined as an increase in serum creatinine level of ≥ 0.5 mg/dL or ≥ 25% above baseline within 48 hours after contrast administration.ResultsWe sampled paired urine samples from 63 subjects. The incidence of CIN was 6/63 (9.5%). Patients without CIN had elevated urinary citric acid and taurine concentrations in the pre-CT urine. Xylulose increased in the post CT sample in patients who developed CIN.ConclusionDifferences in metabolomics patterns in patients who do and do not develop CIN exist. Metabolites may be potential early identifiers of CIN and identify patients at high-risk for developing this condition prior to imaging.
Evaluation of Platelet Dysfunction In Children: Improved Detection and Efficiency

Abstract 1446 Currently, there is no single assay that will detect platelet function abnormalities in all individuals. We prospectively studied 369 patients with a strong history of bruising and mucosal membrane bleeding for possible platelet dysfunction following documentation of normal Von Willebrand antigen and activity levels. In an effort to evaluate platelet function under more diverse conditions we chose to simultaneously evaluate 1) aggregation using platelet rich plasma and light transmission aggregometry (LTA), 2) adhesion under high shear using the Platelet Function Analyzer (PFA-100, ADP-collagen, and Epinephrine-collagen cartridges) and 3) platelet initiated clot formation using heparinized whole blood and the two standard mapping agonists, arachadonic acid (AA) and ADP (Hemascope Thromboelastograph Analyzer). Of the 369 platelet evaluations performed, 87 patients (24%) were found to be normal in all three assays with all agonists. On repeated assays with increased attention to medication and food history, an additional 152 patients were felt to have a transient or acquired dysfunction which improved or normalized on further testing. Leaving 130 patients with persistent bleeding and documented abnormalities on one or more of the assays used. There were no patients with only Collagen (CN) or arachadonic acid (AA) aggregation alone on LTA. Using LTA, there was one patient with combined CN and ADP aggregation defect only, another with AA and EPI absent aggregation only, and one with only AA and Thrombin receptor agonist peptide (TRAP) aggregation abnormalities. A summary of the remaining 127 patients are displayed in the table below: Summary: By using a combination of three assays, we were able to identify 25 additional patients with significant platelet dysfunction detected with abnormal platelet mapping or PFA-100 despite normal light transmission aggregometry. Patients with the most abnormalities on aggregation, also demonstrated abnormal adhesion and platelet initiated clot formation. However, the use of PFA-100 and/or platelet mapping alone would miss the majority of patients with aggregation defects. In the future, the unique combination of platelet function defects as measured by these assays, and future technologies, will not only improve detection, but also facilitate phenotype to genotype associations and expedite mutational analysis. Disclosures: Off Label Use: Rituximab to treat ITP.
Joint moment contributions to swing knee extension acceleration during gait in children with spastic hemiplegic cerebral palsy

Inadequate peak knee extension during the swing phase of gait is a major deficit in individuals with spastic cerebral palsy (CP). The biomechanical mechanisms responsible for knee extension have not been thoroughly examined in CP. The purpose of this study was to assess the contributions of joint moments and gravity to knee extension acceleration during swing in children with spastic hemiplegic CP. Six children with spastic hemiplegic CP were recruited (age=13.4+/-4.8 years). Gait data were collected using an eight-camera system. Induced acceleration analysis was performed for each limb during swing. Average joint moment and gravity contributions to swing knee extension acceleration were calculated. Total swing and stance joint moment contributions were compared between the hemiplegic and non-hemiplegic limbs using paired t-tests (p<0.05). Swing limb joint moment contributions from the hemiplegic limb decelerated swing knee extension significantly more than those of the non-hemiplegic limb and resulted in significantly reduced knee extension acceleration. Total stance limb joint moment contributions were not statistically different. Swing limb joint moment contributions that decelerated knee extension appeared to be the primary cause of inadequate knee extension acceleration during swing. Stance limb muscle strength did not appear to be the limiting factor in achieving adequate knee extension in children with CP. Recent research has shown that the ability to extend the knee during swing is dependent on the selective voluntary motor control of the limb. Data from individual participants support this concept.
Reducing Microwave Absorption with Chaotic Microwaves

We study the response of a two-level quantum system to a chaotic signal using numerical methods and compare it to the response to a sinusoidal signal. We expect the largest response for sinusoidal driving functions, because the Schrodinger equation is linear. The method is based on numerical solutions of the Schrodinger solution of the two-level system, and the chaotic signal used is that of a Chua oscillator. We find that when two-level systems are perturbed by a chaotic signal, the peak population of the initially unpopulated state is much lower than which is produced by a sinusoidal signal of small detuning. This is true even when the peak frequency of the chaotic signal, which is identified via a discrete fourier transform, is close to the resonant frequency. We also find that the response is weaker for a weaker signal, where the resonant peak for a sinusoidal signal would be narrower. We discuss potential applications of this result in the field of microwave power transmission, as it shows applying chaotic forcing functions to transmitted microwaves used for power transmission could decrease unintended absorption of microwaves by organic tissue.
Imaging out-of-plane polarized emission patterns on gap mode SERS substrates: from high molecular coverage to the single molecule regime

Gap mode surface-enhanced Raman scattering (SERS) substrates are created when a single nanoparticle is deposited on a thin metal film, creating a region of significant electromagnetic field enhancement in the gap between the nanoparticle and the film due to excitation of a vertically-oriented, out-of-plane dipole plasmon mode, e.g. the gap plasmon. When molecules are located in the gap and couple to the gap plasmon mode, the resulting emission is polarized perpendicular to the thin film, generating SERS emission patterns that have a characteristic donut shape. We analyze these SERS emission patterns using a dipole emission model and extract out-of-plane and in-plane emission angles associated with the gap plasmon mode. Fluctuations in both of these angles reveal dynamic heterogeneity due to molecular motion within the hot spot that changes as a function of molecular coverage. We also reveal static heterogeneity associated with structural defects in the thin film component of the gap mode substrates, indicating that even nanometer-scale surface roughness can impact the quality of gap mode emission.
From civil war to uncivil peace: The Vietnamese army and the early Nguyễn state (1802–1841)

This article examines the role and prominence of the military as the key institution of the new Nguyen dynasty in Vietnam at the beginning of the 19th century. The military had brought the new regi...
SNPCEQer: detecting SNPs in sequences generated by the Beckman CEQ2000 DNA Analysis System.

SNPCEQer identifies and reports SNPs in sequences obtained from the Beckman CEQTM2000 DNA Analysis System. SNPCEQer aligns sequences obtained using CEQ2000 heterozygote detection analysis and repor...
Regulation of superoxide dismutase synthesis in Candida albicans.

The synthesis of superoxide dismutase [SOD: EC 1.15.1.1] in response to various cultural conditions was examined in Candida albicans, an opportunistic yeast which causes candidiasis in immunosuppressed patients. SOD plays an important role in protecting cells from the oxidative damage of superoxide radicals. Maximum SOD activity was found after 72 hrs of yeast growth. The optimum pH and temperature for the SOD activity were 7 and 40 °, respectively. The major SOD activity was found in the cytosol fraction and the level of extracellular SOD was very low. The enzyme was stimulated to varying degrees by cholic acid, procaine and tocopherol. On the basis of inhibitor studies and other enzyme properties, the isolated enzyme from C. albicans is identified as copper and zinc superoxide dismutase.
Sex differences in the traumatic stress response: PTSD symptoms in women recapitulated in female rats

Post-traumatic stress disorder (PTSD) affects men and women differently. Not only are women twice as likely as men to develop PTSD, they experience different symptoms and comorbidities associated with PTSD. Yet the dearth of preclinical research on females leaves a notable gap in understanding the underlying neuropathology of this sex difference. Using two standard measures of PTSD-like responses in rats, the acoustic startle response (ASR) and dexamethasone suppression test (DST), we tested the effects of traumatic stress in adult male and female rats using two rodent models of PTSD, single prolonged stress and predator exposure. We then examined the neural correlates underlying these responses with cFos and glucocorticoid receptor immunohistochemistry in brain regions implicated in the traumatic stress response. We now report that adult male and female rats across two models of PTSD show consistent sex-specific responses that recapitulate fundamental differences of PTSD in men and women. Trauma-exposed males showed the well-established hyper-responsive phenotype of enhanced ASR and exaggerated negative feedback control of the hypothalamic-pituitary-adrenal axis, while the same traumatic event had little effect on these same measures in females. Dramatic sex differences in how trauma affected cFos and glucocorticoid receptor expression in the brain lend further support to the idea that the trauma response of male and female rats is fundamentally different. Two standard measures, ASR and DST, might suggest that females are resilient to the effects of traumatic stress, but other measures make it clear that females are not resilient, but simply respond differently to trauma. The next important question to answer is why. We conclude that males and females show fundamentally different responses to trauma that do not simply reflect differences in resilience. The divergent effects of trauma in the brains of males and females begin to shed light on the neurobiological underpinnings of these sex differences, paving the way for improved diagnostics and therapeutics that effectively treat both men and women.
A swarm intelligence approach to counting stacked symmetric objects

In a manufacturing environment it is often necessary to perform a manual inventory of finished goods and raw materials. These raw materials might be wood, plastic or metal and often represent a large investment of capital to procure and store. While the economic value of an accurate inventory is high, the process of obtaining a good count is tedious and fraught with human error. As a precursor to counting an inventory of tubular steel bar stock from digital images, we present a hybrid algorithm inspired by ant colony and particle swarm technology. This algorithm defines an environmental habitat for interacting particles to competitively cluster into segmented colonies. By forming colonies at bar stock end profile locations the algorithm provides potentially countable high-level information.
The moral pitfalls of leadership

This chapter explores that ethical challenges involved in leadership roles. It examines the notion of an ideal leader. The chapter discusses the 'dirty hands' problem. It also discusses the way that leadership scholars and researchers study the rosier terrain of what they think a 'good', meaning an ethical, leader should be like. Dean Ludwig and Clinton Longenecker use the story to illustrate a variety of moral pitfalls of successful leaders. While the Bathsheba Syndrome describes the personal challenges of success, Plato and Niccolo Machiavelli each describes some of the difficulties of being an ethical leader. Management scholar Bernard Bass based his theory of transformational leadership on Burns' theory. However, Bass's theory of transformational leadership does not incorporate Burns' emphasis on conflict and the dialogue between leaders and followers about values, nor does it include moral considerations about values. The dirty hands argument raises questions about whether leaders have to split up their approach to morality into morality as a leader morality.
100.65 Abnormal Coronary Reactivity is Associated With Atrial Fibrillation Development: Is Atrial Fibrillation a Vascular Disease?

Coronary artery disease (CAD) risk factors are associated with atrial fibrillation (AF) and impaired endothelial function. We hypothesized that an abnormal coronary reactivity test (Abn-CRT) is associated with AF in patients with non-obstructive CAD. Three hundred patients with chest pain, non-
Fever of Unknown Origin

The evaluation of an FUO is a significant test of all a physician's clinical skills. The ultimate goal of the physician is to reach a diagnosis and to cure the patient in the best possible situation. Despite such pressure both externally and self-imposed, a physician needs to meticulously follow the patient and logically pursue the available diagnostic tests. To "shotgun" the process, except in the most urgent situation, is to ultimately create more frustration, confusion, and despair among the physician and his patient.
Xylem conductivities in grasses

Abstract Grasses are a main source of carbohydrates for the human populations worldwide. Grasses grow in a variety of environments, from wet rice paddies in Asia to deserts with limited water. Research on water distribution characteristics of grass culms to leaves is important because grasses occur in many habitats and circumstances. The purpose of this study is to understand the characteristics of xylem cells (water-transporting cells), xylem cells within vascular bundles, and xylem conductivity. Xylem conductivity is used to estimate the ability of cells to transport water from culms (stems) to leaf lamina. Data from 12 species of C3 grasses, species mostly confined to temperate climates, and 13 species of C4 grass, species found in tropical climates, were obtained with standard histological procedures. C4 grass culms had twice as many vascular bundles as C3 grasses. Xylem conductivities in culms were two to three times greater for C4 than C3 grasses. Xylem conductivities in leaves were five to six times greater for C4 than C3 grasses. Xylem conductivities of culms to leaf lamina of C4 and C3 grasses species were compared. Leaf conductivities per bundle, relative to culm conductivities per bundle, were almost five times greater for C4 than for C3 grasses. In a similar manner, xylem conductivities in entire leaves, relative to xylem conductivities of entire culms, were two times greater for C4 than for C3 grasses. Overall, the data show that xylem conductivities were higher in both leaves and culms of C4 grasses compared with C3 grasses, and that the contribution of xylem conductivities from culms to leaves were greater for C4 than for C3 grasses. The higher conductivities in C4 grasses was attributed to higher numbers of bundles per culm/ per leaf and not to vessel radii or numbers of vessels per bundle.
Practicing Clinicians’ Recommendations to Reduce Burden from the Electronic Health Record Inbox: a Mixed-Methods Study

Workload from electronic health record (EHR) inbox notifications leads to information overload and contributes to job dissatisfaction and physician burnout. Better understanding of physicians’ inbox requirements and workflows could optimize inbox designs, enhance efficiency, and reduce safety risks from information overload. We conducted a mixed-methods study to identify strategies to enhance EHR inbox design and workflow. First, we performed a secondary analysis of national survey data of all Department of Veterans Affairs (VA) primary care practitioners (PCP) to identify major themes in responses to a free-text question soliciting suggestions to improve EHR inbox design and workflows. We then conducted expert interviews of clinicians at five health care systems (1 VA and 4 non-VA settings using 4 different EHRs) to understand existing optimal strategies to improve efficiency and situational awareness related to EHR inbox use. Themes from survey data were cross-validated with interview findings. We analyzed responses from 2104 PCPs who completed the free-text inbox question (of 5001 PCPs who responded to survey) and used an inductive approach to identify five themes: (1) Inbox notification content should be actionable for patient care and relevant to recipient clinician, (2) Inboxes should reduce risk of losing messages, (3) Inbox functionality should be optimized to improve efficiency of processing notifications, (4) Team support should be leveraged to help with EHR inbox notification burden, (5) Sufficient time should be provided to all clinicians to process EHR inbox notifications. We subsequently interviewed 15 VA and non-VA clinicians and identified 11 unique strategies, each corresponding directly with one of these five themes. Feedback from practicing end-user clinicians provides robust evidence to improve content and design of the EHR inbox and related clinical workflows and organizational policies. Several strategies we identified could improve clinicians’ EHR efficiency and satisfaction as well as empower them to work with their local administrators, health IT personnel, and EHR developers to improve these systems.
Diminished Risk-Taking

Strained mental resources inhibit the capacity for clear analysis and sound judgment. Adaptation to an environment swirling with winds of technological upheaval requires agility, resourcefulness and resilience. In short, mental effort. In the face of uncertainty, decision-making involves a creative assessment of outcomes and their probabilities, a specification of relationships between resources and outcomes and, importantly, an imagination capable of out-of-the-box thinking. Available cognitive bandwidth cannot meet this challenge. As a consequence, there is resistance to change, a reluctance to adapt and cautious conservatism prevails. Conventional outcomes are observed and groundbreaking entrepreneurial activity shrinks, more from compromised bandwidth than innate preference changes.
Uranium tetrafluoride (UF4) powder analyzed by XPS

XPS was performed on as-received and Ar+-sputtered uranium tetrafluoride (UF4) powder. The as-received powder surface exhibits stoichiometric UF4 with hydrocarbon contamination and surface impurities of uranium dioxide (UO2) and uranyl fluoride (UO2F2). Sputtering removes a majority of surface contamination and impurities, while also partially reduces the powder surface to uranium trifluoride (UF3).XPS was performed on as-received and Ar+-sputtered uranium tetrafluoride (UF4) powder. The as-received powder surface exhibits stoichiometric UF4 with hydrocarbon contamination and surface impurities of uranium dioxide (UO2) and uranyl fluoride (UO2F2). Sputtering removes a majority of surface contamination and impurities, while also partially reduces the powder surface to uranium trifluoride (UF3).
Enhancing the American College of Surgeons NSQIP Surgical Risk Calculator to Predict Geriatric Outcomes

Background The American College of Surgeons (ACS) NSQIP Surgical Risk Calculator (SRC) plays an important role in risk prediction and decision-making. We sought to enhance the existing ACS NSQIP SRC with functionality to predict geriatric-specific outcomes and assess the predictive value of geriatric-specific risk factors by comparing performance in outcomes prediction using the traditional ACS NSQIP SRC with models that also included geriatric risk factors. Study Design Data were collected from 21 ACS NSQIP Geriatric Surgery Pilot Project hospitals between 2014 and 2017. Hierarchical regression models predicted 4 postoperative geriatric outcomes (ie pressure ulcer, delirium, new mobility aid use, and functional decline) using the traditional 21-variable ACS NSQIP SRC models and 27-variable models that included 6 geriatric risk factors (ie living situation, fall history, mobility aid use, cognitive impairment, surrogate-signed consent, and palliative care on admission). Results Data from 38,048 patients 65 years or older undergoing 197 unique operations across 10 surgical subspecialties were used. Stable model discrimination and calibration between developmental and validation datasets confirmed predictive validity. Models with and without geriatric risk factors demonstrated excellent performance (C statistic >0.8) with inclusion of geriatric risk factors improving performance. Of the 21 ACS NSQIP variables, CPT code, COPD, age, functional dependence, sex, disseminated cancer, diabetes, and sepsis were the strongest risk predictors, and impaired cognition, fall history, and mobility aid use were the strongest geriatric predictors. Conclusions The ACS NSQIP SRC can predict 4 unique outcomes germane to geriatric surgical patients, with improvement of predictive capability after accounting for geriatric risk factors. Augmentation of ACS NSQIP SRC can enhance shared decision-making to improve the quality of surgical care in older adults.
Generativity and Interactional Effects: an Overview.

We propose a means to relate properties of an interconnected system to its separate component systems in the presence of cascade-like phenomena. Building on a theory of interconnection reminiscent of the behavioral approach to systems theory, we introduce the notion of generativity, and its byproduct, generative effects. Cascade effects, enclosing contagion phenomena and cascading failures, are seen as instances of generative effects. The latter are precisely the instances where properties of interest are not preserved or behave very badly when systems interact. The goal is to overcome that obstruction. We will show how to extract mathematical objects from the systems, that encode their generativity: their potential to generate new phenomena upon interaction. Those objects may then be used to link the properties of the interconnected system to its separate systems. Such a link will be executed through the use of exact sequences from commutative algebra.
Types and Timing of Teaching During Clinical Shifts in an Academic Emergency Department.

Author(s): Baugh, Joshua J.; Monette, Derek L.; Takayesu, James K.; Raja, Ali S.; Yun, Brian J. | Abstract: Objectives: Academic emergency physicians must find ways to teach residents, medical students, and advanced practice providers amidst the myriad demands on their time during clinical shifts. In this study, we sought to characterize in detail what types of teaching occurred, how often they occurred, and how attending teaching styles differed at one academic emergency department (ED).Methods: We conducted this observational study in a large, urban, quaternary care, academic Level I trauma center with an emergency medicine (EM) residency. The on-shift activities of EM attending physicians (attendings) were observed and recorded over 42 hours by a fourth-year EM resident with co-observations by an EM education fellow. Teaching categories were identified, developed iteratively, and validated by the study team. We then characterized the distribution of teaching activities during shifts through the coding of attending activities every 30 seconds during observations. Teaching archetypes were then developed through the synthesis of notes taken during observations.Results: Attendings spent a mean of 25% (standard deviation 7%) of their time engaging in teaching activities during shifts. Of this teaching time 36% consisted of explicit instruction, while the remaining 64% of teaching occurred implicitly through the discussion of cases with learners. The time distribution of on-shift activities varied greatly between attendings, but three archetypes emerged for how attendings coupled patient care and teaching: “in-series”; “in-parallel modeling”; and “in-parallel supervision.”Conclusions: Teaching in this academic ED took many forms, most of which arose organically from patient care. The majority of on-shift teaching occurred through implicit means, rather than explicit instruction. Attendings also spent their time in markedly different ways and embodied distinct teaching archetypes. The impact of this variability on both educational and patient care outcomes warrants further study.
The Virtues of Unvirtuous Spaces

Websites that facilitate sexual commerce have, in recent years, become pet enemies of some self-styled anti-trafficking advocates. However, this war on intermediaries should not be confused with an actual fight against human trafficking. The same pathways that may give rise to exploitation are no less available to law enforcement seeking to recover victims - a fact that recommends against shuttering these spaces.
Calathea gentryi and C. yawankama (Marantaceae), new species endemic to Amazonian Peru

Calathea gentryi H. Kenn., and C. yawankama H. Kenn., both endemic to Amazonian Peru, are described as new. Calathea gentryi occurs in Department Loreto in both Maynas and Alto Amazonas Provinces. Calathea gentryi is characterized by all basal leaves, a single, relatively small (4.5–7 × 1–2.5 cm) narrowly ellipsoid to subcylindric inflorescence of 12 to 19 spirally arranged small (1.1–1.5 × 0.9–1.2 cm) bracts, and three bracteoles per flower pair, two lateral, membranous, and a medial, claviculate, one. Calathea gentryi shares a similar habit and inflorescence morphology with C. barbata Peters. and C. schunkei H. Kenn. Calathea yawankama, known only from the type locality in Department Amazonas, is characterized by the relatively broad (length: width ratio 1.15–2.23:1), all basal leaves, leaves with the blades patterned with a light green band along the midrib adaxially, purple abaxially, and small (2–2.5 × 2–2.7 cm), globose, inflorescence of 12 to18 spirally arranged bracts, the presence of claviculate bracteoles and white flowers. Calathea yawankama shares a similar inflorescence morphology with C. compacta S. Suarez & Galeano and C. pearcei Rusby.
Prospectus: An Online Polymorphic Attack Detection Model for Intelligent Transportation Systems

Cooperative Intelligent Transportation Systems (cITSs) is one of the Internet of Things (IoT) applications whose purpose is to improve road safety and traffic efficiency. Within this system, vehicles can communicate with one another by establishing a Vehicular Ad-Hoc Network (VANET) along the road section. Although such connectivity facilitates the exchange of information related to road safety and traffic efficiency, it puts the vehicles at risk in that an attacker could compromise one or more vehicles and use them to share false information causing congestions and/or life-threatening accidents. Although several studies tried to address this issue, they assume that the network topology and/or attack behaviour is stationary, which is not realistic as the cITS is dynamic in nature and the attackers may have the ability and resources to change their behaviour continuously. Therefore, these assumptions are not suitable and lead to low detection accuracy and high false alarms. To this end, this paper proposes a misbehaviour detection model that can cope with the dynamicity of both cITS topology and attack behaviour. The model starts by addressing the issue of missing data that happen at the early stages of the model formation after a topology change. Then, the deep learning approach is used to select the discriminative features used to train. We expect that the proposed model will help to overcome the limitations of related solutions by detecting attacks that change their behaviour continuously.
Glycan-dependent corneocyte adherence of staphylococcus epidermidis mediated by the lectin subdomain of aap

Staphylococcus epidermidis and other coagulase-negative staphylococci (CoNS) that colonize skin are known to promote skin immunity and inhibit colonization of pathogens that cause skin and soft tissue infections, including Staphylococcus aureus. However, S. epidermidis adherence to corneocytes, the cells that constitute the uppermost layer of the skin epidermis, remains poorly understood. Our study documents that S. epidermidis corneocyte adherence is dependent upon the accumulation-associated protein (Aap). Aap is composed of two distinct A and B domains. The A domain is comprised of a repeat region and a conserved L-type lectin domain, whereas the fibrillar B domain, which is comprised of G5 and E repeats, is linked to the cell wall in a sortase-dependent manner. Our studies revealed that adherence to corneocytes is dependent upon the lectin subdomain within the A domain. However, significant adherence was only observed when the lectin domain was expressed with both the A repeat and the B domain, suggesting further interactions between these three domains. Our data also suggest that the A repeat domain is important for stability or expression of Aap. Deglycosylation treatment suggested that glycans expressed in the host stratum corneum serve as potential binding partners for Aap-mediated corneocyte adherence. Last, bioinformatic analyses of the predominant commensal species of CoNS identified open reading frames (ORFs) homologous to aap, thus suggesting that Aap orthologues containing lectin-like domains may provide the basis for staphylococcal colonization of skin. Corroborating these observations, adherence to corneocytes in an S. aureus mgrA mutant was dependent upon SasG, the Aap orthologue in S. aureus. IMPORTANCE Staphylococcus aureus is the most significant cause of skin and soft tissue infections yet it rarely colonizes the skin of healthy individuals. This is believed to be due, in part, to inhibition of colonization via toxic substances produced by normal skin flora, including by S. epidermidis. Furthermore, we surmise that S. aureus colonization inhibition may also be due to competition for binding sites on host corneocytes. To understand these potential interactions between S. aureus and S. epidermidis and, potentially, other coagulase-negative staphylococci, we must first understand how staphylococci adhere to corneocytes. This work documents that S. epidermidis adherence to corneocytes is dependent upon the fibrillar cell wall-associated protein Aap. Our work further documents that Aap binds to glycans exposed on the corneocyte surface, which are commonly exploited by bacteria to facilitate adherence to host cells. Furthermore, we find that Aap orthologues may be responsible for corneocyte adherence in other staphylococci, including in S. aureus.
HPE1, an Effector from Zebra Chip Pathogen Interacts with Tomato Proteins and Perturbs Ubiquitinated Protein Accumulation

The gram-negative bacterial genus Liberibacter includes economically important pathogens, such as 'Candidatus Liberibacter asiaticus' that cause citrus greening disease (or Huanglongbing, HLB) and 'Ca. Liberibacter solanacearum' (Lso) that cause zebra chip disease in potato. Liberibacter pathogens are fastidious bacteria transmitted by psyllids. Pathogen manipulation of the host' and vector's immune system for successful colonization is hypothesized to be achieved by Sec translocon-dependent effectors (SDE). In previous work, we identified hypothetical protein effector 1 (HPE1), an SDE from Lso, that acts as a suppressor of the plant's effector-triggered immunity (ETI)-like response. In this study, using a yeast two-hybrid system, we identify binding interactions between tomato RAD23 proteins and HPE1. We further show that HPE1 interacts with RAD23 in both nuclear and cytoplasmic compartments in planta. Immunoblot assays show that HPE1 is not ubiquitinated in the plant cell, but rather the expression of HPE1 induced the accumulation of other ubiquitinated proteins. A similar accumulation of ubiquitinated proteins is also observed in Lso infected tomato plants. Finally, earlier colonization and symptom development following Lso haplotype B infection are observed in HPE1 overexpressing plants compared to wild-type plants. Overall, our results suggest that HPE1 plays a role in virulence in Lso pathogenesis, possibly by perturbing the ubiquitin-proteasome system via direct interaction with the ubiquitin-like domain of RAD23 proteins.
Regulation of Reptilian Reproductive Behavior

By studying the behavioral physiology of closely related species, we can reconstruct the probable evolutionary history of a behavior and of the mechanisms that control it. By then comparing the ecologies of the species, we gain insight into the ultimate factors that may have given rise to these adaptations. This is the essence of the comparative method.