cssi/SciSciGPT-SciSciNet huggingface dataset:
Combined hyperlipidemia in a single subject with tetraplegia: ineffective risk reduction after atorvastatin monotherapy.

AbstractBackground/Objective: Effects of atorvastatin (Lipitor) drug monotherapy (1 0 mg daily) on fasting blood Iipid profiles and cardiovascular disease (CVD) risks were examined for a single subject with C5-C6 tetraplegia. Routine fasting Iipid profiles were analyzed by standard biochemistry techniques for total cholesterol (TC) , triglycerides (TG) , low-density lipoprotein-cholesterol (LDL-C) , and high-density lipoprotein-cholesterol (HDL-C). Lipid profiles were analyzed on 3 occasions before drug therapy was initiated and 3 months after therapy commenced. The TC:HDL and LDL:HDL ratios were computed for all sampling times and used to assess pretreatment and post-treatment CVD risk.Results: Fasting TC, TG, and LDL-C were all significantly reduced by therapy. The pretreatment HDL-C of 3 5 mg/ dl was lowered to 21 mg/ dl. As a result, the TC:HDL risk ratiowas only marginally reduced from 6 .6 to 6.4, whereas the LDL:HDL risk ratio remained unchanged by treatment.Conclusions: In this man with tetraplegi...
Optical diffusion imaging with single and multiple sources

Recently, optical imaging in highly scattering biological media has been intensively investigated for applications such as safe, noninvasive imaging and spectroscopy.1,2 In diffusion imaging, a modulation is applied to the optical carrier, which propagates through the medium with typically low loss and high scatter. The diffusion model is then applied to the received modulation envelope to invert the desired image or spectroscopic data from the scattered data. Sensitivity and resolution depend greatly on many factors, including the measurement configuration and the quality of the forward-scatter model. For this reason, we have studied critical aspects of the forward model and the measurement configuration.
Lineage tracing of human B cells reveals the in vivo landscape of human antibody class switching

Antibody class switching is a feature of the adaptive immune system which enables diversification of the effector properties of antibodies. Even though class switching is essential for mounting a protective response to pathogens, the in vivo patterns and lineage characteristics of antibody class switching have remained uncharacterized in living humans. Here we comprehensively measured the landscape of antibody class switching in human adult twins using antibody repertoire sequencing. The map identifies how antibodies of every class are created and delineates a two-tiered hierarchy of class switch pathways. Using somatic hypermutations as a molecular clock, we discovered that closely related B cells often switch to the same class, but lose coherence as somatic mutations accumulate. Such correlations between closely related cells exist when purified B cells class switch in vitro, suggesting that class switch recombination is directed toward specific isotypes by a cell-autonomous imprinted state.
Properties of mesoporous carbon modified carbon felt for anode of all-vanadium redox flow battery

A novel anode material for all-vanadium redox flow battery was synthesized by dispersion coating of sol-gel processed (resorcinol-furaldehyde) mesoporous carbon (MPC) onto the surface of polyacrylonitrile carbon felt (CF). The coated samples were then annealed at 900°C and 1100°C and the subsequent morphology, surface chemistry, and electrochemical properties of the MPC coated CF were characterized and compared with an uncoated CF. Addition of the MPC coating is shown to dramatically increase surface area while also increasing the number of active surface oxygen groups particularly for samples annealed at 1100°C. MPC coating shows a mixed effect on electrochemical properties. Characterization with cyclic voltammetry reveals the introduction of MPC coating provides roughly 30% increase in peak current density for the oxidation and reduction reactions of the V(IV)/V(V) redox couple, which is attributed to the significantly increased number of active reaction sites. However, MPC coating seems to be accompanied by a reduction in conductivity as demonstrated by increased redox peak separation and charge transfer resistance. This negative effect on conductivity can be mitigated by heat treatment (at or above 1100°C) which improves surface graphitization reducing redox peak separation and charge transfer resistance such that it is comparable with uncoated samples.
Structured Input Improves Usability and Precision for Solving Geometry-based Algebraic Problems

Previous research has shown that sketch-based input is efficient and preferable in the context of algebraic equation solving. However, research has not been conducted to evaluate whether this holds true when involving geometry input to facilitate quantitative problem-solving. We developed a bimodal (graphing geometric shapes and writing algebraic expressions) user interface, in order to conduct a within-subject, controlled experiment with 24 college students and varied two types of geometry input: 1) sketch-based input and 2) structured input. The sketch-based input was significantly faster than the structured input, but there were no significant differences based on perception and cognition. However, after a post-hoc analysis, we found a significant interaction effect on perception between prior knowledge and geometry input. Novice students preferred the sketch-based input, but advanced students preferred the structured input. Our study implies that natural sketch-based input may be less preferable than structured input for geometry-based interfaces toward math problem-solving.
Distress Due to Prognostic Uncertainty in Palliative Care: Frequency, Distribution, and Outcomes among Hospitalized Patients with Advanced Cancer.

Abstract Background: Prognostic uncertainty is common in advanced cancer and frequently addressed during palliative care consultation, yet we know little about its impact on quality of life (QOL). Objective: We describe the prevalence and distribution of distress due to prognostic uncertainty among hospitalized patients with advanced cancer before palliative care consultation. We evaluate the association between this type of distress and overall QOL before and after palliative care consultation. Design: Observational cohort study. Setting & Participants: Hospitalized patients with advanced cancer who receive a palliative care consultation at two geographically distant academic medical centers. Measurements: At the time of enrollment, before palliative care consultation, we asked participants: “Over the past two days, how much have you been bothered by uncertainty about what to expect from the course of your illness?” (Not at all/Slightly/Moderately/Quite a Bit/Extremely). We defined responses of “Quite a ...
Incorporation of Line Quantities in the Continuum Description for Multiphase, Multicomponent Bodies with Intersecting Dividing Surfaces III. Determination of Line Tension and Fluid-Solid Surface Tensions Using Small Sessile Drops

Abstract In this paper we analyze the sessile drop problem, starting from the governing equations for the static problem (part II of this series). We develop a singular perturbation solution, where the perturbation parameter characterizes the strength of the long-range intermolecular forces. We use this solution to develop a new method to determine line tension and solid–fluid surface tensions, using small sessile drops.
The pathophysiology, incidence, impact, and treatment of opioid-induced nausea and vomiting

Purpose Opioid medications are integral in managing acute moderate-to-severe pain. Opioid analgesics bind to μ (mu), κ (kappa), or δ (delta) opioid receptors in the brain, spinal cord, and digestive tract. However, opioids cause adverse effects that may interfere with their therapeutic use. Some adverse effects wane over time, but patients using opioids for acute pain struggle with opioid-induced nausea and vomiting (OINV) the entire time they take the opioid. This article discusses the underlying mechanisms, clinical implications, and treatment strategies of OINV. Data sources Systematic search and review of Medline, PubMed, and Google Scholar for articles relating to OINV. In addition, package inserts provided pharmacologic data and dose recommendations as needed. Conclusions Research suggests approximately 40% of patients may experience nausea and 15%–25% of patients may experience vomiting after opioid administration. Nausea often precedes vomiting, although they can occur separately. Many patients receiving opioids rate the nausea and vomiting as worse than their pain. Nausea and vomiting can lead to complications including electrolyte imbalances, malnutrition, and volume depletion, and can also negatively affect quality of life and postoperative recovery. Implications for practice There are several medications that can be used to treat OINV including serotonin receptor antagonists, dopamine receptor antagonists, and neurokinin-1 receptor antagonists. Healthcare providers should be proactive about discussing OINV with patients, as this may improve patient outcomes and pain relief.
An observational study of patient handover communications among nurses on an oncology critical care unit.

Background: Breakdown in communication is a common cause of errors in hospitals. Aim/Objectives: To evaluate the feasibility and utilization of evidence-based recommendations for nurse-to-nurse shi...
Association of testosterone and antimüllerian hormone with time to pregnancy and pregnancy loss in fecund women attempting pregnancy.

Objective To examine whether higher T and/or antimullerian hormone (AMH) was associated with anovulation, time to pregnancy (TTP), or pregnancy loss risk among healthy, fecund women without diagnosed polycystic ovary syndrome. Design Prospective cohort study conducted as a secondary analysis from the Effects of Aspirin in Gestation and Reproduction randomized trial. Setting University medical centers. Patient(s) A total of 1,198 healthy, eumenorrheic women aged 18–40 years attempting spontaneous pregnancy with one to two prior pregnancy losses were included. Women were categorized by baseline antimullerian hormone (AMH), as a surrogate marker of antral follicle count, and T concentrations; the highest quartile for each was "high," and below the top quartile (i.e., lower 75% of values) was "norm," forming four groups: norm T/norm AMH (n = 742), norm T/high AMH (n = 156), high T/norm AMH (n = 157), and high T/high AMH (n = 143). Intervention(s) Not applicable. Main Outcome Measure(s) Anovulation, pregnancy incidence, TTP, and pregnancy loss incidence. Result(s) Women with high T/high AMH had a greater anovulation risk (risk ratio 1.58, 95% confidence interval 1.13–2.22) compared with women with norm T/norm AMH, but with imprecise differences in incidence of pregnancy, TTP, or pregnancy loss. Conclusion(s) Women with higher T and AMH had more frequent anovulatory cycles but with marginal impacts on TTP or pregnancy loss. A continuum of mild inefficiency in reproductive function may be related to higher T and AMH, including in fecund women with normal menstrual cycles and no clinical diagnosis of polycystic ovary syndrome, but with unclear effects on fecundability and pregnancy loss. Clinical Trial Registration Number NCT00467363.
The formation of a medical student research committee and its impact on involvement in departmental research.

ABSTRACTOver the past ten years, medical students have increased their research activity to be competitive for orthopaedic residency positions throughout the country. This increase may favor students at institutions with a strong history of research production and well-established research departments with supporting staff. To compete with these institutions, a Musculoskeletal Research Committee was developed at a southern academic institution to provide a mutually beneficial link between orthopaedic research faculty and medical students. This manuscript describes the formation of this committee and the resultant involvement of young medical students in departmental research over a one year period. Composed of students and faculty, the committee developed a Research Guide for Medical Students, Research Database and Student List, Medical Students’ Webpage, and Routing Form, and holds quarterly meetings for those students active in orthopaedic research. With this platform, the committee aimed to increase yo...
Manned-unmanned aircraft teaming

Unmanned aerial vehicles, due to their incredible development, relatively low cost, and low risk to human can become a prime candidate for the teaming with manned aircraft in performing complex/dangerous missions. There are various challenges and techniques for manned-unmanned aircraft collaboration. This paper introduces the concept of manned-unmanned aircraft teaming, as well as teaming categories. The technical differences between two team members; namely human pilot and autopilot are discussed. In addition, the teaming formulation, teaming laws, decision making process and communication between human pilot and autopilot is developed. An optimal control law for the state-space representation of the teaming is finally presented.
Dispersal of Fungal Spores from Three Types of Air Handling System Duct Material

Exposure to airborne microorganisms in indoor environments may result in infectious disease or elicit an allergic or irritant response. Air handling system components contaminated by fungi have been implicated in the dispersal of spores into the indoor environment, thereby serving as a route of exposure to occupants. This study was conducted to provide quantitative data on the dispersal of spores from fungal colonies growing on three types of duct material. Galvanized metal, rigid fibrous glass ductboard, and fiberglass duct liner were soiled and contaminated with a known concentration of Penicillium chrysogenum spores. The duct materials were incubated in humidity chambers to provide a matrix of growing, sporulating fungal colonies at a contamination level of 109 colony forming units (CFU) per duct section, consistent for all materials. For each experiment a contaminated duct section was inserted into the air handling system of an experimental room, and the air handling system was operated for three 5-minute cycles with an air flow of 4.2 m3 min−1. The duct air velocity was approximately 2.8 m sec−1. The airborne concentration of culturable P. chrysogenum spores (CFU m−3), total P. chrysogenum spores (spores m−3), and total P. chrysogenum-sized particles (particles m−3) were measured in the room using Andersen single-stage impactor samplers, Burkard slide impactor samplers, and an aerodynamic particle sizer, respectively. The highest airborne concentrations (104 CFU m−3; 105 spores m−3; 104 particles m−3) were measured during the first operating cycle of the air handling system for all duct materials with decreasing airborne concentrations measured during the second and third cycles. There was no significant difference in spore dispersal from the three contaminated duct materials. These data demonstrate the potential exposure for building occupants to high concentrations of spores dispersed from fungal colonies on air handling system duct materials during normal operation of the system.
Cis-Regulatory Enhancer Mutations are a Cause of Human Limb Malformations

Congenital limb malformations are the second most common class of human birth defects and can be caused both by environmental and genetic factors. While it is known that some limb malformations are the result of coding mutations that disrupt genes, identifying the causal mutation in a patient with an isolated limb malformation is often difficult. This may be due in part to the growing number of cases with isolated limb malformations that are shown to be the result of nucleotide changes in gene regulatory elements. These regulatory mutations affect gene expression in the developing limb and can cause dramatic changes to patterning, leading to congenital limb malformations. In this chapter, we will review characterized gene regulatory mutations leading to human limb malformations and also provide evidence that additional limb enhancers could be the cause of other human limb malformations.
Moral reasons not to breastfeed: a response to Woollard and Porter.

Woollard and Porter argue that mothers have no moral duty to breastfeed their babies. Rather, mothers simply have moral reason(s) to breastfeed, stemming from the benefits of breast feeding for babies. According to Woollard and Porter, doing what one has moral reason to do is often supererogatory, not obligatory. I agree that mothers have no moral duty to breastfeed. However, it is misleading to suggest that mothers in general have moral reason to breastfeed and to liken not breastfeeding to not performing some supererogatory action. I will suggest mothers in general have pro tanto, but not all-things-considered, moral reason to breastfeed. Moreover, I suggest many mothers also have pro tanto moral reasons not to breastfeed. Breastfeeding is not always supererogatory; indeed, sometimes not breastfeeding is morally better. This is important because it contradicts dangerous assumptions in public discourse. One way of characterising popular consensus about breastfeeding is as Woollard and Porter do: mothers have a duty to breastfeed. But we might also characterise popular consensus differently: all moral reasons for/against breastfeeding are on the ‘pro’ breastfeeding side of the issue, whereas if there are any (good) reasons not to breastfeed these are non-moral (prudential). Woollard and Porter’s argument is important and correct in concluding that mothers have no duty to breastfeed, but it leaves this other false and dangerous idea intact and even subtly reinforces it.
Just Who Needs Forgiveness? The Emotional Terrain of a Prison-Based Interview

Prison-based interviews can provide unique insight into a social world from which most everyone is excluded. Because incarceration policies are socially significant, academic analysts arguably have an obligation to learn as much as possible about how punishment is practiced. One area of such inquiry lies with the increased number of life sentences in the United States. To learn more about this reality, I conducted a series of interviews of lifers in the state of Washington. These interviews necessary traversed emotionally difficult terrain. I use this essay to reflect on the benefits and complications of interviews that cover sensitive issues, particularly in a prison setting where the research subjects suffer from diminished agency.
Opening Remarks and Review of Selected Cognitive Aspects: 1971–1973

Publisher Summary Approaches continue to be made to problems of stimulus and/or response characteristics as they may influence the Contingent Negative Variation (CNV). Modality of stimulation, a characteristic which was dismissed as being of relatively little importance early on in CNV research, has appeared as a considerable variable as it influences the CNV and may determine reaction time (RT). Engaging the S in the task remains the most solid way of predictably manipulating his CNV. Within limits, as the S's involvement in subsequent stimuli and responses is increased up to a point, his CNV will likewise increase; the converse also tends to hold. Where the relationship between the CNV and S engagement becomes discontinuous, that discontinuity is very striking. The most striking demonstrations of these discontinuities have involved manipulation of constitutional anxiety, situational anxiety, sex, or all three.
Quality & safety in the literature: July 2019

The term ‘value-based purchasing’ describes programmes implemented by healthcare payers that require a modification of payment for medical care services based on the quality and safety of the care delivered. The overall goal of these programmes is to motivate improved outcomes for patients while also reducing healthcare spending. There has been a recent rapid introduction of value-based purchasing programmes in the USA1 and the UK2–4 in response to growing healthcare costs, increasing recognition of healthcare-associated complication frequency and morbidity and variation in quality and cost of healthcare delivery.5 6 Earlier versions of these programmes involved voluntary participation of facilities competing for additional incentive payments (the proverbial ‘carrot’). More recent versions have evolved to include mandatory participation, requiring data collection and public reporting of various metrics, with the motivating incentive being to avoid the ‘stick’ of substantial reductions in payment and public reputation shaming for poor quality of care. Value-based purchasing programmes are now common across all healthcare settings, from acute care in hospitals to post-acute care in facilities and at home. These programmes impact all ages of patients, and performance can be assessed and penalised at the level of the facility and/or individual physicians. Programmes have grown in scale through mandatory participation and increasing size of potential financial penalty, and several programmes impact Medicare beneficiaries in the USA.1 With this growth, they now function as large-scale interventions with potential for both positive and negative impacts for patients and healthcare providers. Unlike most other interventions reported in peer-reviewed journals, these value-based purchasing interventions are more commonly developed and implemented without undergoing the same types of institutional review board oversight, piloting and adverse event tracking that other clinical interventions would undergo before large-scale implementation. Instead, they are developed with input from legislature and its consultants as well as …
Comparison of deep learning and human observer performance for lesion detection and characterization

The detection and characterizations of abnormalities in clinical imaging is of the utmost importance for patient diagnosis and treatment. In this paper, we present a comparison of convolutional neural network (CNN) and human observer performance on a simulated lesion detection and characterization task. We apply both conventional performance metrics including accuracy and non-conventional metrics such as lift charts to perform qualitative and quantitative comparison of each type of observer. It is determined that the CNN generally outperforms the human observers, particularly at high noise levels. However, high noise correlation reduces the relative performance of the CNN, and human observer performance is comparable to CNN under these conditions. These findings extend into the field of diagnostic radiology, where the adoption of deep learning is starting to become widespread. The importance of considering the applications for which deep learning is most effective is of critical importance to this development.
Methodological considerations in pre- and post-emergency network identification and data collection for disaster risk reduction: Lessons from wildfire response networks in the American Northwest

Abstract While social network analysis continues to enjoy considerable attention, literature on social network data collection often lacks explicit attention to methods. This presents special challenges to approaching the problems of undertaking social network analysis and of studying disaster preparedness, planning, and, ultimately, risk reduction. In this paper, we address this issue by presenting our synthesis of several strategies for network analyses from our processes for network identification and data collection in a longitudinal study of multi-jurisdictional, inter-agency wildfire response networks in the American Northwest. In the course of this ongoing project, the process of detecting and collecting data on pre-existing and emergent networks in the real world was not a matter of one theoretical or empirical judgement, but rather several. We alternated between: (1) spatio-ecological detection of jurisdictions adjacent to areas at-risk for large wildfires; (2) a hybrid approach to selecting actors and agencies identified as common participants in wildfire response networks; and (3) event-based detections of parties to specific wildfire response networks. We conclude with steps for thinking through network identification and bounding, integrating networks, conceptualizing rosters and ties in initial and events-based phases, and how to manage longitudinal network data collection.
Impact of Hospital Readmissions Reduction Program Penalties on Hip and Knee Replacement Readmissions: Comparison of Hospitals at Risk of Varying Penalty Amounts.

Background Little is known about the impact of the U.S. Centers for Medicare & Medicaid Services' Hospital Readmissions Reduction Program (HRRP) expansion to include readmissions following elective primary total hip and knee replacements; the expansion was finalized in 2013 and was implemented in 2014. We examined whether hospitals at risk of relatively large penalties from this expansion experienced greater declines in joint replacement readmissions compared with hospitals at risk of smaller penalties. Methods We used Medicare's 2009 to 2016 Hospital Compare data sets to examine the impact of the HRRP's expansion in the July 2013 to June 2016 period (post-expansion) compared with the July 2009 to June 2012 period (pre-expansion). The primary outcome was the hospital-level, 30-day, risk-standardized readmission rate (hereafter called the readmission rate) following joint replacement surgical procedures. We used the percentage of a hospital's total inpatient revenue attributed to Medicare (categorized into quartiles) to represent the risk of penalties. We used hierarchical linear regression models to examine the adjusted impact of the HRRP's expansion. Results Our study cohort included 2,326 acute care hospitals. In the pre-HRRP expansion phase, the mean readmission rate was 5.36% among hospitals with the highest proportion of Medicare revenues (quartile 4) and 5.46% among hospitals with the lowest proportion of Medicare revenues (quartile 1). With the HRRP expansion, the readmission rate declined by 18.92% (1.01 percentage points) among quartile-4 hospitals and by 17.97% (0.98 percentage point) among quartile-1 hospitals (p = 0.45). This nonsignificant difference in readmission rate declines between quartiles persisted in multivariable analysis (a decline of 18.41% [0.98 percentage point] in quartile 4 and a decline of 17.35% [0.94 percentage point] in quartile 1; p = 0.35). Conclusions The HRRP's expansion to include joint replacements did not lead to greater reductions in postoperative readmissions among hospitals at risk of larger penalties in comparison with hospitals at risk of smaller penalties. Readmission rates were declining at similar rates among all hospitals, before and after the HRRP's expansion. Clinical relevance Readmissions and complications following joint replacements are measures of the quality of surgical care. These events have important clinical and economic implications for patients and providers. This study is clinically relevant because it examines whether policy interventions, such as the HRRP, have the potential to reduce these unintended consequences of surgical care.
Importance of Communication and Relationships: Addressing Disparities in Hospitalizations for African-American Patients in Academic Primary Care.

There are many interventions to facilitate seamless continuity of care for patients in transition from hospital back to primary care; however, disparities remain in readmission rates for vulnerable populations, especially African-Americans. We set out to investigate the association of race and ethnicity with 30-day readmission in our urban academic setting and to identify factors that could be leveraged in primary care to address disparities in hospitalizations. Using data originally collected for quality improvement purposes, we evaluated 30-day readmission rates for our primary care patients (January 1, 2013–September 30, 2014) by race and ethnicity, adjusting for demographic and clinical characteristics. Then, using inductive and deductive methods, we coded semi-structured interviews with 24 African-American primary care patients who were discharged from the Medicine or Cardiology service at our tertiary care hospital during the study period. African-Americans had the highest readmission rate (21.7%) and a higher adjusted odds of readmission (1.37; 95% CI 1.04–1.81) compared to Whites. Five major themes emerged as having potential to be leveraged in primary care to help prevent multiple hospitalizations: (1) dependable patient-physician relationships, (2) healthcare coordination across settings, (3) continuity with one primary care provider (PCP), (4) disease self-management, and (5) trust in resident physicians. Participants also made several recommendations to keep patients like themselves from returning to the hospital: increased time to tell their story during their primary care visit, more direct patient-physician communication during the visit, and improved access between visits. While African-American patients in our practice experience higher rates of hospital readmissions than their White counterparts, they emphasize the significance of their PCP relationship and communication to enhance disease management and prevent hospitalizations. Ongoing efforts are needed to establish and implement best practice communication trainings for patients at increased risk of hospitalization, particularly for resident physicians.
Angular dependence of strong field sequential double ionization for neon and acetylene simulated with time-dependent configuration interaction using CIS and CISD-IP.

Strong field ionization is fundamentally important for attosecond spectroscopy and coherence control. However, the modeling beyond the single active electron approximation is still difficult. Time-dependent configuration interaction with singly excited configurations and a complex absorbing potential (TDCIS-CAP), can be used to simulate single and double ionization by intense laser fields. When the monocation does not have degenerate states, TDCIS-CAP starting from a Hartree–Fock calculation of the cation is suitable for simulating the second ionization step. When the monocation has two or more degenerate states, the simulations should treat these degenerate states equivalently. CISD-IP (single and double excitation configuration interaction with ionization) can be used to treat degenerate states of the cation on an equal footing by representing the cation wavefunctions with ionizing single (1 hole) and double (2 holes/1 particle) excitations from the neutral molecule. Since CISD-IP includes single excitations for each of the monocation states, time dependent CISD-IP with a complex absorbing potential (TDCISDIP-CAP) can also be used to simulate ionization to the dications states. In this work, TDCIS-CAP and TDCISDIP-CAP have been used to simulate the angular dependence of ionization of the neon cation and acetylene cation. In both cases, the second electron is ionized predominantly from an orbital perpendicular to the orbital involved in the first ionization. The TDCISDIP-CAP simulations show some features involving interactions between the monocation states that are not seen in the TDCIS-CAP simulations.Strong field ionization is fundamentally important for attosecond spectroscopy and coherence control. However, the modeling beyond the single active electron approximation is still difficult. Time-dependent configuration interaction with singly excited configurations and a complex absorbing potential (TDCIS-CAP), can be used to simulate single and double ionization by intense laser fields. When the monocation does not have degenerate states, TDCIS-CAP starting from a Hartree–Fock calculation of the cation is suitable for simulating the second ionization step. When the monocation has two or more degenerate states, the simulations should treat these degenerate states equivalently. CISD-IP (single and double excitation configuration interaction with ionization) can be used to treat degenerate states of the cation on an equal footing by representing the cation wavefunctions with ionizing single (1 hole) and double (2 holes/1 particle) excitations from the neutral molecule. Since CISD-IP includes single excita...
The Reality of the Dream: Present Status of a Sample of 98 Totally Blind Adults:

This study of 98 totally blind adults analyzes nine characteristics of sample members (i.e., sex, race, age, education, vocational rehabilitation, marital status, onset of blindness, type of school...
Novel targeted therapies for metastatic breast cancer

Metastatic breast cancer (mBC) continues to be a leading cause of cancer-related death in women. Even though mortality rates have improved over recent years, the 5-year survival rate of advanced BC is still at only 27%. As researchers and clinicians attempt to tackle this challenge, there has been extensive research and many trials studying treatment options for BC patients with metastatic disease, with numerous new therapies being discovered as a result. We review the most pertinent novel agents to enter the scope of BC treatment, including CDK4/6 inhibitors, PI3K inhibitors, mTOR inhibitors, immunotherapy, PARP inhibitors, and more.
Chapter 3 – Material properties

Publisher Summary This chapter explains properties of materials used in structures. Wood, steel, and concrete are usually the materials used in building. Of the properties of these materials, the reader's focus is drawn to those that have some bearing on the structural behavior of the elements under consideration. The most obvious and important, structural properties are those relating force to deformation or stress to strain. Ductility is important in a structural member because it allows concentrations of high stress to be absorbed and redistributed without causing sudden, catastrophic failure. Wood, the oldest of construction material, is cut cured/seasoned and made ready. Load fatigue and species are taken into consideration when choosing wood. Steel is subject to corrosion if not protected and loss of strength and stiffness at high temperatures if not fireproofed. Steel has a distinct elastic region in which stresses are proportional to strains and a plastic region that begins with the yielding of the material and continues until a so-called strain-hardening region is reached. Related products such as cold formed steel, hollow structural sections, and open-web steel joists are discussed.
Accelerating Auxiliary-Field Quantum Monte Carlo Simulations of Solids with Graphical Processing Units.

We outline how auxiliary-field quantum Monte Carlo (AFQMC) can leverage graphical processing units (GPUs) to accelerate the simulation of solid state systems. By exploiting conservation of crystal ...
Students teaching students: A survey of a medical student led surgical skills workshop - A prospective cohort study.

Abstract Background Surgical skills training is a recognized vital component of medical education, yet a standardized curriculum does not exist. Early opportunities for skills development and mentorship may increase student interest in pursuing surgery. We evaluated the effects of a student-led, faculty-supervised suture clinic on student comfort level with basic surgical skills and interest in surgery. Methods A cohort survey study of 103 second-year medical students participating in a surgical skills course was performed between the years 2016–2018. Upon completion of the course, we assessed their comfort level with performing six basic skills as well as their interest in pursuing surgery based on pre- and post-course surveys. Results Mean age was 25 years and 50.5% were female. Most students (61.2%) had no prior suturing experience. Upon completion of the course, there was a significant improvement (p = Conclusions Early implementation of a basic skills workshop can augment student comfort level and promote an interest in surgery. Peer student mentors can effectively lead the workshop and minimize the time commitment needed by surgical faculty. This can serve as a new direction in medical education and an avenue for further studies to analyze the longitudinal effects of the curriculum on career choice and success in surgical residency.
Strain-free disulfide bridge and stabilization of β-ribbon structures in short peptides

Designing water soluble peptides which adopt -ribbon structures in aqueous solution is a challenging problem in modern bioorganic chemistry [1,2]. We had shown earlier that a disulfide cross link formed between the side-chains of -amino-mercaptohexanoic acid residues in peptides is a lot more effective in enhancing the stability of -ribbon structure of the peptide as compared to the disulfide bridge formed between cysteine residues [3]. We observed similar stabilization when the disulfide bridge is made up of six atoms [4]. In order to evaluate the effect of the disulfide bridge length on -ribbon conformation, we synthesized short peptides containing cysteine, homocysteine, (S)-amino-mercaptopentanoic acid (Amp) and (S)-amino-mercaptohexanoic acid (Amh) and converted them into disulfide bridged dimers. Peptides with longer disulfide bridge show more pronounced -ribbon character in comparison to the cystine peptide.
Structural Defects Of T-Even Bacteriophages

Publisher Summary This chapter discusses on some of the bacteriophages of Escherichia coli designated T- (for type): T1, T2, T3, T4, T5, T6, and T7; in particular, the serologically related bacteriophages T2, T4, and T6. It is shown that T-even bacteriophage is tadpole-shaped particles and the DNA appears to be confined within the head structure by using electron microscopy. These viruses are indeed complex, composed of many substructural components linked together to form the complete particle. Emphasis is given on the structure and composition of the head. The chapter describes the various models, which elucidate the assembly of both normal and aberrant heads. It investigates the effects of a variety of compounds on the maturation of bacteriophages. A table is provided, which represents a summary of the compounds and the aberrations they induce. Triazolealanine, thiazolealanine, putrescine, proflavin, and actinomycin all affect the production of short-headed phage. Canavanine, guanidine, arid dimethyl sulfoxide all affect the production of polyheads. With the diversity of compounds involved, the incorporation of the compound is required to produce these aberrant substructures.
Building an Evidence Base for Survivors of Critical Illness

On rounds in the long-term acute care hospital, I am surprised to see a familiar name on my list — a patient with respiratory failure whom I had initially admitted to our intensive care unit (ICU)....
Epigenetic fine-mapping: identification of causal mechanisms for autoimmunity

Genome-wide association studies (GWAS) have identified genetic susceptibility loci for a variety of autoimmune and inflammatory diseases. These studies confirm the fundamental genetic basis of individual autoimmune diseases, and also point to shared etiological mechanisms across the spectrum of autoimmunity. While hundreds of genetic loci have been implicated in autoimmune diseases, the translation of individual susceptibility loci into specific molecular mechanisms for individual diseases remains difficult. This review highlights recent advances in the genetics of autoimmune disease, and the emerging use of epigenetic techniques to identify pathogenic cell types and causal molecular mechanisms of autoimmunity.
College professors' perceptions of students who stutter and the impact on comfort approaching professors.

Abstract Purpose Previous literature has documented that college professors view hypothetical students who stutter more negatively than their fluent peers. The purpose of the present study was to investigate whether individuals who stutter report they experience more negative perceptions in the college classroom, and the impact of those perceptions on their comfort approaching professors. Methods Two hundred forty-six adults who do and do not stutter, matched for age, participated in this study. Participants were presented with 16 positive and negative personality traits and asked to rate how strongly they believed their professor viewed them along each trait. All participants were asked whether they felt comfortable approaching their professors to discuss their performance. Adults who stutter were asked additional questions to investigate their college experience more comprehensively. Results Adults who stutter reported they experienced significantly more negative perceptions from their professors than adults who do not stutter, and were significantly less likely to feel comfortable approaching their professors. These reported negative perceptions, specifically being perceived as less self-assured, predicted comfort approaching professors to receive performance feedback for adults who stutter. Finally, amongst adults who stutter, perception of how they were evaluated compared to their peers was significantly related to comfort approaching professors. Conclusions Results support that the negative perceptions towards hypothetical students who stutter reported in previous literature are experienced by individuals who stutter, and that these perceptions drive comfort approaching professors for performative feedback. Results suggest professors may increase students’ comfort by clearly outlining equality in evaluation procedures.
Acceptability of Neuroscientific Interventions in Education.

Researchers are increasingly applying neuroscience technologies that probe or manipulate the brain to improve educational outcomes. However, their use remains fraught with ethical controversies. Here, we investigate the acceptability of neuroscience applications to educational practice in two groups of young adults: those studying bioscience who will be driving future basic neuroscience research and technology transfer, and those studying education who will be choosing among neuroscience-derived applications for their students. Respondents rated the acceptability of six scenarios describing neuroscience applications to education spanning multiple methodologies, from neuroimaging to neuroactive drugs to brain stimulation. They did so from two perspectives (student, teacher) and for three recipient populations (low-achieving, high-achieving students, students with learning disabilities). Overall, the biosciences students were more favorable to all neuroscience applications than the education students. Scenarios that measured brain activity (i.e., EEG or fMRI) to assess or predict intellectual abilities were deemed more acceptable than manipulations of mental activity by drug use or stimulation techniques, which may violate body integrity. Enhancement up to the norm for low-achieving students and especially students with learning disabilities was more favorably viewed than enhancement beyond the norm for high-achieving students. Finally, respondents rated neuroscientific applications to be less acceptable when adopting the perspective of a teacher than that of a student. Future studies should go beyond the acceptability ratings collected here to delineate the role that concepts of access, equity, authenticity, agency and personal choice play in guiding respondents’ reasoning.
Vitamin D: Skin, sunshine, and beyond

Vitamin D is a steroid hormone of importance to the field of dermatology. Skin is unique in that it is the site of vitamin D synthesis upon sun exposure and a target organ for its activity. We explore the physiology and metabolic mechanism of action of vitamin D, as well as its effects on the skin. We also discuss the current evidence of the efficacy and safety of oral and topical vitamin D analogues on skin conditions such as psoriasis, atopic dermatitis, vitiligo, sunburn, actinic keratosis, and fibrosing skin disorders. Based on currently available scientific evidence, the National Academy of Medicine's recommended dietary allowance for vitamin D ranges from 400 IU to 800 IU daily based on age categories.
Bayesian adaptive trial design for a continuous biomarker with possibly non-linear or non-monotone prognostic or predictive effects

As diseases like cancer are increasingly understood on a molecular level, clinical trials are being designed to reveal or validate subpopulations in which an experimental therapy has enhanced benefit. Such biomarker-driven designs, particularly "adaptive enrichment" designs that initially enroll an unselected population and then allow for later restriction of accrual to "marker-positive" patients based on interim results, are increasingly popular. Many biomarkers of interest are naturally continuous, however, and most existing design approaches either require upfront dichotomization or force monotonicity through algorithmic searches for a single marker threshold, thereby excluding the possibility that the continuous biomarker has a non-disjoint and truly non-linear or non-monotone prognostic relationship with outcome or predictive relationship with treatment effect. To address this, we propose a novel trial design that leverages both the actual shapes of any continuous marker effects (both prognostic and predictive) and their corresponding posterior uncertainty in an adaptive decision-making framework. At interim analyses, this marker knowledge is updated and overall or marker-driven decisions are reached such as continuing enrollment to the next interim analysis or terminating early for efficacy or futility. Using simulations and patient-level data from a multi-center Children's Oncology Group trial in Acute Lymphoblastic Leukemia, we derive the operating characteristics of our design and compare its performance to a traditional approach that identifies and applies a dichotomizing marker threshold.
Application of global models to various scenarios related to international conflict resolution

Abstract A new generation FUGI model classifies the world into 140 countries/regions and provides global information on the world economy under alternative policy scenarios. The FUGI model is currently being used by the United Nations, Department of International Economic and Social Affairs for the purpose of long-term projections of the world economy and policy simulatons of the UN international development strategies for the 1990's. It seems likely to play a significant role in envisaging their policy impacts on the future of global intrdependence and corraborating the needs for global cooperation toward international conflict resolutions.
Impairment of Memory after Prolonged Alcohol Consumption in Mice

The association of chronic excessive ethanol consumption with anatomical and functional brain impairment has long been observed by clinicians. It is controversial whether this association in some or all patients is merely an unrelated coexistence of alcoholism with other degenerative brain disorders or whether an actual cause-effect relationship exists. If chronic alcohol consumption were truly related to mental impairment, the question arises if impaired brain function is a cause or a result of chronic excessive alcohol consumption (Goodwin and Hill, 1974). Assuming that chronic ethanol consumption is indeed the cause of CNS impairment, it can be postulated that malnutrition that may accompany chronic alcoholism, rather than alcohol per se, is the cause (Victor, Adams, and Collins, 1971). Alternatively, ethanol itself, alone or in conjunction with malnutrition, could cause CNS impairment (Freund, 1973).
Unternehmensstrategie: Konzept und Trends der Anwendung

In der Zeit von 1962 bis 1972 verdoppelte das Unternehmen W.T. Grant seine Grose, gemessen in Quadratmetern, und erhohte seinen Gewinn von 9 Millionen Dollar auf 37 Millionen Dollar. Vier Jahre spater ging die Firma in Konkurs. Ihre Vermogenswerte wurden liquidiert. In den 30er Jahren waren Sears und Montgomery Ward ungefahr gleich hinsichtlich Umsatz, Gewinn, Fahigkeiten und Potential. Zwei Jahrzehnte spater war Sears rund dreimal so gros wie Ward.1 Eindeutig war die Strategieauswahl fur diese Ergebnisse verantwortlich. Obwohl diese Beispiele extrem sind, ist doch jede Organisation von ihren strategischen Entscheidungen oder — manchmal — unterbliebenen Entscheidungen beeinflust.