cssi/SciSciGPT-SciSciNet huggingface dataset:
Analyzing stakeholder's perceptions of uncertainty to advance collaborative sustainability science: case study of the watershed assessment of nutrient loads to the Detroit River project.

Abstract The topic of uncertainty is of growing interest in the impact assessment (IA) field, due to increases in contextual uncertainty and the awareness of the complexity of advanced analysis. IA practitioners can now draw on maturing theoretical frameworks to manage uncertainty, but questions remain about whether these frameworks align with stakeholder concerns and how their use can benefit IA projects. This article reports on an empirical application of the leading framework for organizing IA uncertainty proposed by Walker et al. in 2003. Twenty-two stakeholders involved in a large water quality modeling project in the U.S. Great Lakes region were interviewed, and their uncertainty-related statements were categorized according to the Walker dimensions. Overall, the framework's three primary dimensions performed well and allowed for the analysis of differences in uncertainty perceptions among the stakeholder groups. In addition, the analysis resulted in useful insights for the project, such as identifying top scenario uncertainties to use for modeling as well as highlighting specific concerns about the assumptions, data, and modeling approach for further exploration. In addition to encompassing the variety of uncertainty concerns raised in the case, the paper illustrates how the Walker framework can support IA practices like stakeholder collaboration and scenario construction which may improve IA outcomes.
Using Small Groups, Institutions, and Sociocultural Units

The wonderful African proverb, “It takes a village to raise a child,” unfortunately has been distorted in a recent political campaign. Initially, the proverb meant only that childrearing is a process that evolves within the context of a caring community, beginning with the family but extending to all members of the community who naturally have a stake in seeing that children become good citizens of that society. In terms of professional helping, it has long been recognized that we must view the person in his or her environmental context; the two are inseparable, with each affecting and being affected by the other. This series of transactions remains vital throughout the life course. An older person is equally involved with his or her families, which might include multiple generations of families, and with the “village,” that is, with other individuals, small groups, organizations, and the community itself, as well as the cultures (majority and minority, if any) and physical environment. The African proverb is simply another expression for the ecological-systems perspective that we have adopted in this book.
Algorithm for solution of state equation with sparse matrix

Abstract A sparse matrix technology is used in computing the solution of state space equation with a sparse matrix of coefficients in Max_Algebra. And a special iterative algorithm is developed for the convenience of application of sparse matrix technology.
Longitudinal examination of passenger characteristics among airline types in the US

Abstract We examine longitudinal changes (2005–2015) in the characteristics of passengers flying with two types of airlines in the United States: low-cost carriers (LCCs) and legacy carriers (or non-LCCs). In addition to the extant views on passenger similarities and dissimilarities across LCCs and NLCCs, we find that airline-type passenger segments are dynamic and constantly changing. Furthermore, we argue that such dynamics in passenger segments may have been escalated by the introduction of a new type of airline – ultra low-cost carriers (ULCCs). We assert that taking more caution in targeting air passengers is necessary, as we found a mixture of both convergence (e.g., airport access time, per diem) and divergence (e.g., number of checked bags, terminal wait time) in the key passenger characteristics across airline types.
Crystal structure of ethyl 4-[4-(di-methyl-amino)-phen-yl]-2,7,7-trimethyl-5-oxo-1,4,5,6,7,8-hexa-hydro-quinoline-3-carboxyl-ate.

In the title racemic compound, ethyl 4-(4-di­methyl­amino­phen­yl)-2,7,7-trimethyl-5-oxo-1,4,5,6,7,8-hexa­hydro­quinoline-3-carboxyl­ate, the common structural features in this type of compound, such as the flat-boat conformation of the 1,4-di­hydro­pyridine (1,4-DHP) ring, the envelope conformation of the fused cyclo­hexa­none, and the substituted phenyl ring at the pseudo-axial position and orthogonal to the 1,4-DHP ring, are present. In the crystal, mol­ecules are linked via N—H⋯O and C—H⋯O hydrogen bonds, forming layers parallel to the (10\overline1) plane.
Trivalent Europium Complexes Using Dendritic â-Diketone Ligands

A series of photon harvesting lanthanide complexes have been synthesized by chelating dendritic â-diketone ligands to Eu +3 . The ligands are modified benzoyltrifluoroacetone units (BTFA) with poly(aryl ether) dendron attachments. These ligands impose a very large asymmetric nature to the first coordination sphere of europium compared to previous dendritic compounds. These complexes exhibit europium emission with no residual emission from the ligands as the dendritic subunits increase from G-0 to G-3. This is due to both antenna and site isolation effects. These complexes mimic light harvesting organisms seen in Nature. When these intensities are compared throughout the series, an increase in intensity is seen where [(G 2 )BTFA]3Eu is the brightest, with [(G 3 )BTFA]3Eu being less intense than the G-2 complex. However, the lifetime data indicates that the G-3 complex is the longest lived species.
Structural and Biochemical Studies of Dihydrofolate Reductase from Streptococcus pyogenes as a Target for Antifolate Antibiotics

Streptococcus pyogenes, a beta-hemolytic bacterium, causes a wide spectrum of infections in human including pharyngitis, tonsillitis, scarlet fever, rheumatic fever, and necrotizing fasciitis. Streptococcal infections can also exist as co-infection with methicillin resistant Staphylococcus aureus (MRSA). Trimethoprim-sulfamethoxazole (TMP-SMX) combination has been used for treatment of S. pyogenes and MRSA co-infection. However, resistance to TMP, an inhibitor of dihydrofolate reductase enzyme (DHFR), has challenged the efficacy of TMP-SMX combination. We explored the activity of a series of novel DHFR inhibitors against S. pyogenes. This study identified potent inhibitors of DHFR enzyme from S. pyogenes with excellent inhibitory activity against the growth of the live bacteria. We determined, for the first time, the crystal structure of S. pyogenes DHFR which provides structural insights into design and development of antifolate agents against this global pathogen.
Lung Lavage Granulocyte Patterns and Clinical Phenotypes in Children with Severe, Therapy-Resistant Asthma

Background Children with severe asthma have frequent exacerbations despite guidelines-based treatment with high-dose corticosteroids. The importance of refractory lung inflammation and infectious species as factors contributing to poorly controlled asthma in children is poorly understood. Objective To identify prevalent granulocyte patterns and potential pathogens as targets for revised treatment, 126 children with severe asthma underwent clinically indicated bronchoscopy. Methods Diagnostic tests included bronchoalveolar lavage (BAL) for cell count and differential, bacterial and viral studies, spirometry, and measurements of blood eosinophils, total IgE, and allergen-specific IgE. Outcomes were compared among 4 BAL granulocyte patterns. Results Pauci-granulocytic BAL was the most prevalent granulocyte category (52%), and children with pauci-granulocytic BAL had less postbronchodilator airflow limitation, less blood eosinophilia, and less detection of BAL enterovirus compared with children with mixed granulocytic BAL. Children with isolated neutrophilia BAL were differentiated by less blood eosinophilia than those with mixed granulocytic BAL, but greater prevalence of potential bacterial pathogens compared with those with pauci-granulocytic BAL. Children with isolated eosinophilia BAL had features similar to those with mixed granulocytic BAL. Children with mixed granulocytic BAL took more maintenance prednisone, and had greater blood eosinophilia and allergen sensitization compared with those with pauci-granulocytic BAL. Conclusions In children with severe, therapy-resistant asthma, BAL granulocyte patterns and infectious species are associated with novel phenotypic features that can inform pathway-specific revisions in treatment. In 32% of children evaluated, BAL revealed corticosteroid-refractory eosinophilic infiltration amenable to anti-TH2 biological therapies, and in 12%, a treatable bacterial pathogen.
Scent marks of rodents can provide information to conspecifics.

For a scent mark to be informative it must provide a reliable, honest signal that allows individuals that detect it to predict fitness tradeoffs if they choose or not choose to respond to it. I argue that scent marks provide a great deal of information about the sender to receivers. The manner in which an animal uses this information to make decisions will depend on the context and manner in which it encounters these scent marks. Receivers can use the information found in the scent marks and odors to locate the donor, learn its identity, determine the donor’s phenotype or genotype, and assess whether the scent marks were encountered earlier by conspecifics. For receivers to make potentially informed decisions, when they encounter the scent marks of conspecifics with whom they have had different experiences across a variety of contexts higher level cognitive processing involving procedural memory, episodic memory, autobiographical memory and making judgements of numerical discrimination would be required. Senders should have some insight into the receivers to increase the likelihood that the targets respond appropriately to the scent mark by reducing uncertainty. The sender’s state or the current state of the environment and the context will affect when and where the scent marks were deposited. Decisions to deposit scent marks and respond to them must represent a tradeoff in the benefits and costs to the sender and receivers in terms of their fitness and survival. The actual tradeoff should be context dependent and reflect the experience, physiology, and life history constraints affecting the receiver. Calculating these tradeoffs likely involves some cognitive processing and requires some sort of information transfer between the sender and the receiver.
Rapid response of tattoo-associated cutaneous sarcoidosis to minocycline: case report and review of the literature.

Importance: Cutaneous sarcoidosis can present in pre-existing tattoos. Previous reports suggest modest improvement with systemic or topical corticosteroids or other immunomodulating medications. Tetracyclines have anti-inflammatory properties and have been shown to be efficacious in non-tattoo associated cutaneous sarcoidosis. The pharmacology of minocycline suggests that its higher concentration in the skin may improve its efficacy in the treatment of cutaneous granulomas.Case Report: We present a case of a 35-year-old man with a history of pulmonary sarcoidosis who developed raised plaques within tattoos present for over 10 years. Skin biopsy findings revealed non-caseating granulomas consistent with cutaneous sarcoidosis. The patient was started on minocycline 100mg twice daily and had resolution of pruritus in four days and improvement of sarcoidal plaques within one week.Conclusions: To our knowledge, this is the first report of cutaneous sarcoidosis in tattoos treated with minocycline. Our patient’s rapid response to minocycline suggests that minocycline may be a quickly effective medication for cutaneous sarcoidosis and should be considered as a therapeutic option given its favorable side-effect profile.
Enhanced immunogenicity and protective efficacy of a tetravalent dengue DNA vaccine using electroporation and intradermal delivery.

Phase 1 clinical trials with a DNA vaccine for dengue demonstrated that the vaccine is safe and well tolerated, however it produced less than optimal humoral immune responses. To determine if the immunogenicity of the tetravalent dengue DNA vaccine could be enhanced, we explored alternate, yet to be tested, methods of vaccine administration in non-human primates. Animals were vaccinated on days 0, 28 and 91 with either a low (1 mg) or high (5 mg) dose of vaccine by the intradermal or intramuscular route, using either needle-free injection or electroporation devices. Neutralizing antibody, IFN-γ T cell and memory B cell responses were compared to a high dose group vaccinated with a needle-free intramuscular injection delivery device similar to what had been used in previous preclinical and clinical studies. All previously untested vaccination methodologies elicited improved immune responses compared to the high dose needle-free intramuscular injection delivery group. The highest neutralizing antibody responses were observed in the group that was vaccinated with the high dose formulation via intradermal electroporation. The highest IFN-γ T cell responses were also observed in the high dose intradermal electroporation group and the CD8+ T cells were the dominant contributors for the IFNγ response. Memory B cells were detected for all four serotypes. More than a year after vaccination, groups were challenged with dengue-1 virus. Both the low and high dose intradermal electroporation groups had significantly fewer days of dengue-1 virus RNAemia compared to the control group. The results from this study demonstrate that using either an electroporation device and/or the intradermal route of delivery increases the immune response generated by this vaccine in non-human primates and should be explored in humans.
First do No harm: Medical legal violence and immigrant health in Coral County, USA.

Abstract Contemporary U.S. health and immigration policies exclude millions of noncitizens from healthcare coverage. Growing scholarship emphasizes legal status as a technology of social exclusion and determinant of health, but few studies capture the effects of recent policy uncertainty on noncitizen health. By examining the case of Coral County (a pseudonym), I highlight the challenges facing safety-net clinics and their noncitizen patients making life and death decisions amidst uncertainty before and after the 2016 presidential election. Observational and interview data with patients, clinic workers, and community partners (n = 27) revealed that growing anxiety over federal immigration policies altered clinical risk calculations through a process I refer to as “medical legal violence” (MLV). Whereas previous risk negotiation strategies leveraged bureaucratic routines to elevate imminent threats of illness and/or injury in health decisions, heightened immigration enforcement under the Trump administration shifted the balance in clinical risk calculations toward social risks of detention, deportation, and family separation. This transformed clinical care in Coral County by turning trusted medical-legal bureaucracies into potential tools for federal biopolitical surveillance of immigrant patients, blocking healthcare pathways and increasing patients’ fear and anxiety.
Effects of Vietnam’s two-child policy on fertility, son preference, and female labor supply

In 1988, facing a total fertility rate of over four births per woman, the Vietnamese government introduced a new policy that required parents to have no more than two children. Using data from the Vietnam Population and Housing Censuses from 1989, 1999, and 2009, I apply a differences-in-differences framework to assess the effects of this policy on family size, son preference, and maternal employment. I find that the policy decreased the probability that a woman has more than two children by 15 percentage points for younger women and by 7 percentage points for middle-aged women. The policy reduced the average number of living children by 0.2 births per woman. Low-education women and women in rural areas were more affected by the policy. The policy had no effects on mothers’ age at first birth and gender of mothers’ last birth. The reduction in fertility caused by the policy was associated with a 1.2 percentage point decrease in the proportion of sons in each family. The policy increased maternal employment by 1.3 percentage points. Instrumental variables estimates of the effects of fertility on maternal employment and child education suggest a negative relationship between the number of children and female labor supply and a trade-off between child quantity and child quality in Vietnam.
The lymph node stromal laminin α5 shapes alloimmunity

Lymph node stromal cells (LNSCs) regulate immunity through constructing lymphocyte niches. LNSC-produced laminin α5 (Lama5) regulates CD4+ T cells but the underlying mechanisms of its functions are poorly understood. Here we show that depleting Lama5 in LNSCs resulted in decreased Lama5 protein in the LN cortical ridge (CR) and around high endothelial venules (HEVs). Lama5 depletion affected LN structure with increased HEVs, upregulated chemokines, and cell adhesion molecules, and led to greater numbers of Tregs in the T cell zone. Mouse and human T cell transendothelial migration and T cell entry into LNs were suppressed by Lama5 through the receptors α6 integrin and α-dystroglycan. During immune responses and allograft transplantation, depleting Lama5 promoted antigen-specific CD4+ T cell entry into the CR through HEVs, suppressed T cell activation, and altered T cell differentiation to suppressive regulatory phenotypes. Enhanced allograft acceptance resulted from depleting Lama5 or blockade of T cell Lama5 receptors. Lama5 and Lama4/Lama5 ratios in allografts were associated with the rejection severity. Overall, our results demonstrated that stromal Lama5 regulated immune responses through altering LN structures and T cell behaviors. This study delineated a stromal Lama5-T cell receptor axis that can be targeted for immune tolerance modulation.
Oral ethinyl estradiol treatment in women with cystic fibrosis is associated with lower bone mineral density.

Abstract Objective The purpose of this study was to determine whether estrogen supplementation primarily from oral contraceptive pills compared to no estrogen supplementation is associated with differences in mean bone mineral density (BMD) measured by DXA in a cross-sectional study of women with cystic fibrosis (CF). Methods In this cross-sectional study of women with CF followed at a single center, we analyzed 49 women with CF ages 18–50 years with a documented DXA. BMD of women with CF taking estrogen supplementation was compared to BMD of women with CF not taking estrogen supplementation. Results Twelve women with CF were taking estrogen supplementation with mean dose of 23.3 mcg/day (SD 6.9 mcg/day) of ethinyl estradiol. There were no statistically significant differences between demographics of the 12 women with CF taking estrogen supplementation compared to the 37 women with CF not taking estrogen supplementation. Women taking estrogen had lower mean lumbar spine Z-score: −0.7 ± 0.7, compared to women not taking estrogen, Z-score: −0.04 ± 1.0 (p-value 0.046). Women taking estrogen had lower mean BMD at the lumbar spine: 0.952 ± 0.086 g/cm2, compared to women not taking estrogen: 1.023 ± 0.105 g/cm2 (p-value 0.038). Similar trends were seen at the total hip and femoral neck. Conclusion Low-dose estrogen supplementation in premenopausal women with CF was associated with lower BMD compared to no estrogen supplementation in a similar group of premenopausal young women with CF. Future studies are needed to investigate the optimal formulation, route of administration, and dose to accrue and preserve bone mass in premenopausal women with CF.
Variant Interpretation for Dilated Cardiomyopathy: Refinement of the American College of Medical Genetics and Genomics/ClinGen Guidelines for the DCM Precision Medicine Study.

Background The hypothesis of the Dilated Cardiomyopathy Precision Medicine Study is that most dilated cardiomyopathy has a genetic basis. The study returns results to probands and, when indicated, to relatives. While both the American College of Medical Genetics and Genomics/Association for Molecular Pathology and ClinGen's MYH7-cardiomyopathy specifications provide relevant guidance for variant interpretation, further gene- and disease-specific considerations were required for dilated cardiomyopathy. To this end, we tailored the ClinGen MYH7-cardiomyopathy variant interpretation framework; the specifications implemented for the study are presented here. Methods Modifications were created and approved by an external Variant Adjudication Oversight Committee. After a pilot using 81 probands, further adjustments were made, resulting in 27 criteria (9 modifications of the ClinGen MYH7 framework and reintroduction of 2 American College of Medical Genetics and Genomics/Association of Molecular Pathology criteria that were deemed not applicable by the ClinGen MYH7 working group). Results These criteria were applied to 2059 variants in a test set of 97 probands. Variants were classified as benign (n=1702), likely benign (n=33), uncertain significance (n=71), likely pathogenic (likely pathogenic; n=12), and pathogenic (P; n=3). Only 2/15 likely pathogenic/P variants were identified in Non-Hispanic African ancestry probands. Conclusions We tailored the ClinGen MYH7 criteria for our study. Our preliminary data show that 15/97 (15.5%) probands have likely pathogenic/P variants, most of which were identified in probands of Non-Hispanic European ancestry. We anticipate continued evolution of our approach, one that will be informed by new insights on variant interpretation and a greater understanding of the genetic architecture of dilated cardiomyopathy. Clinical trial registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03037632.
Study of the Synergistic Effect of the Nanoparticle-Surfactant-Polymer System on CO2 Foam Apparent Viscosity and Stability at High Pressure and Temperature

The goal of this study is to experimentally investigate the stability and rheological behavior of supercritical CO2 foam in the presence of nanosilica, a surfactant, and a polymer. First, three typ...
Use of an Internet-of-Things Smart Home System for Healthy Aging in Older Adults in Residential Settings: Pilot Feasibility Study

Background: The Internet-of-Things (IoT) technologies can create smart residences that integrate technology within the home to enhance residents’ safety as well as monitor their health and wellness. However, there has been little research on real-world testing of IoT smart home devices with older adults, and the feasibility and acceptance of such tools have not been systematically examined. Objective: This study aims to conduct a pilot study to investigate the feasibility of using IoT smart home devices in the actual residences of older adults to facilitate healthy aging. Methods: We conducted a 2-month feasibility study on community-dwelling older adults. Participants chose among different IoT devices to be installed and deployed within their homes. The IoT devices tested varied depending on the participant’s preference: a door and window sensor, a multipurpose sensor (motion, temperature, luminosity, and humidity), a voice-operated smart speaker, and an internet protocol (IP) video camera. Results: We recruited a total of 37 older adults for this study, with 35 (95%) successfully completing all procedures in the 2-month study. The average age of the sample was 78 (SD 9) years and primarily comprised women (29/37, 78%), those who were educated (31/37, 86%; bachelor’s degree or higher), and those affected by chronic conditions (33/37, 89%). The most widely chosen devices among the participants were multipurpose sensors and smart speakers. An IP camera was a significantly unpopular choice among participants in both phases. The participant feedback suggests that perceived privacy concerns, perceived usefulness, and curiosity to technology were strong factors when considering which device to have installed in their home. Conclusions: Overall, our deployment results revealed that the use of IoT smart home devices is feasible in actual residences of older adults. These findings may inform the follow-up assessment of IoT technologies and their impact on health-related outcomes and advance our understanding of the role of IoT home-based monitoring technologies to promote successful aging-in-place for older adults. Future trials should consider older adults’ preferences for the different types of smart home devices to be installed in real-world residential settings.
"God Doesn't Make Mistakes": Memorable Messages, Adjustment, and Grief following Family Death

Communicating in the wake of family death is complicated. Family members can vary in their expectations for support, their understandings of appropriate topics, and their approaches to coping. Using data collected from 172 individuals who experienced a family death in the last five years, this study explored family communication about loss with an eye toward identifying connections between specific communicative moments and reports of grief and adjustment. Framed within the theory of memorable messages (ToMM), five distinct memorable message types were identified and findings revealed that the type of message a bereaved individual received had direct implications for their reported amount of grief and adjustment. Messages centered on justifying or explaining the death were linked to greater grief, as compared to those that offered advice, shared a memory, or provided a sense of availability. Moderation analyses revealed that attendance to religious service impacted the relationship between message type and reports of grief and adjustment, particularly for rationale-based messages, which were more positively received by participants who attended religious service regularly. This piece supports the ToMM and extends knowledge of family communication about death, ultimately providing solace to those struggling to find the appropriate words to say to a grieving loved one.
The Role of Theranostics in Prostate Cancer

Theranostics in men with metastatic castration-resistant prostate cancer (mCRPC) has been developed to target bone and the tumor itself. Currently, bone-directed targeted alpha therapy with radium-223 (223Ra) is the only theranostic agent proven to prolong survival in men with mCRPC who have symptomatic bone metastases and no known visceral metastases. The clinical utility and therapeutic success of 223Ra has encouraged the development of other tumor-targeting theranostic agents in mCRPC, primarily targeting prostate-specific membrane antigen (PSMA) with radioligand therapy (RLT). There is increasing evidence of promising response rates and a low toxicity profile with 177Lu-labeled PSMA RLT in patients with mCRPC. A phase III randomized study of 177Lu-labeled PSMA RLT has completed accrual and is awaiting results as to whether the drug improves radiographic progression-free survival and overall survival in men with mCRPC receiving standard of care treatments. Additional early clinical trials are investigating the role of tumor-directed targeted alpha therapy with radiotracers such as 225Ac. In this article, we review the current status of theranostics in prostate cancer, discussing the challenges and opportunities of combination therapies with more conventional agents such as androgen receptor inhibitors, cytotoxic chemotherapy, and immunotherapy.
Metastatic melanoma of the spleen without known primary.

We present the case of a patient who underwent a laparoscopic splenectomy for splenomegaly associated with anemia and thrombocytopenia thought to be secondary to lymphoma and was found to have metastatic melanoma without a primary source. This is a rare entity in that the patient falls into an atypical population group with conflicting opinions about management that has been scarcely reported in the literature.
OTX2 regulates CFTR expression during endoderm differentiation and occupies 3′ cis-regulatory elements

Background Cell-specific and developmental mechanisms contribute to expression of the cystic fibrosis transmembrane conductance regulator (CFTR) gene, however, its developmental regulation is poorly understood. Here we use human induced pluripotent stem cells (hiPSCs) differentiated into pseudostratified airway epithelial cells to study these mechanisms. Results Changes in gene expression and open chromatin profiles were investigated by RNA-seq and ATAC-seq, and revealed that alterations in CFTR expression are associated with differences in stage-specific open chromatin. Additionally, 2 novel open chromatin regions, at +19.6kb and +22.6kb 3' to the CFTR translational stop signal, were observed in definitive endoderm (DE) cells, prior to an increase in CFTR expression in anterior foregut endoderm (AFE) cells. Chromatin studies in DE and AFE cells revealed enrichment of active enhancer marks and occupancy of OTX2 at these sites in DE cells. Loss of OTX2 in DE cells alters histone modifications across the CFTR locus and results in a 2.5-fold to 5-fold increase in CFTR expression. However, deletion of the +22.6kb site alone does not affect CFTR expression in DE or AFE cells. Conclusions These results suggest that a network of interacting cis-regulatory elements recruit OTX2 to the locus to impact CFTR expression during early endoderm differentiation. This article is protected by copyright. All rights reserved.
Norwood Operation With Partial Left Ventriculectomy For Neonatal Dilated Cardiomyopathy.

The combination of severe fetal mitral regurgitation diagnosed in-utero, aortic stenosis, left ventricular dilatation and dysfunction is associated with extremely poor prognosis. We report a neonate who underwent Norwood operation and left ventricular exclusion using partial left ventriculotomy and Alfieri mitral valve stitch. Left ventricular exclusion eliminated right ventricular compression and allowed survival and progression to subsequent second-stage palliation.
Advance Directives Completion among Older American Couples: A Dyadic Perspective on the Role of Cognitive Function and Other Factors.

OBJECTIVE Dyadic perspective is scarce in existing advance directive (AD) literature. Particularly, the significance of one's own and/or one's partner's cognitive function on AD remains unknown. This study investigates the relationship of cognitive function and other factors with AD completion within the spousal context. METHODS Data from the Health and Retirement Study (2014-2015) were used. Older heterosexual couples (age ≥65) married for 10+ years were asked if they had a living will and/or appointed a durable power of attorney for healthcare (DPAHC). Structural Equation Models examined the actor and partner effects of sociodemographic, health, and couple-level characteristics on wife's and husband's AD, respectively. RESULTS Moderate spousal interdependence was observed in living will (Kappa coefficient, k =0.60) and DPAHC (k=0.53). Older age and higher education were related to both spouses having AD. Less household wealth and being racial/ethnic minority were associated with a lower probability of having AD. Notable gender contrasts in actor and partner effects were found. Wife's higher level of cognitive function was associated with husband's AD completion. Contrarily, husband's lower level of cognitive function was associated with wife's AD completion. Retirement status had primarily actor effects for both husbands and wives. More chronic conditions were linked to husband's AD completion. DISCUSSION The spousal interdependence of AD warrants practitioner efforts to facilitate family-oriented end-of-life planning. Wives and husbands may have different thoughts regarding their spouse's cognitive capacity to surrogate. Facilitating couple-based discussions may be a feasible approach to promote engagement with AD among older adults.
Working with Experts from Non-clinical Fields

Simulation programs can benefit greatly from inter-disciplinary collaboration, especially with specialists outside of clinical fields. A working knowledge of relevant non-clinical fields can help simulation program directors by enriching the diversity of lessons learned, enhanceing the impact and maximizing the value derived from simulation. Such knowledge also provides a resource for finding and working with experts in these fields. We outline top non-clinical fields that have played important roles in various aspects of simulation in healthcare. These fields include professional education, human factors, safety science, quality improvement, gaming, psychometrics, biostatistics, and sensor technology. Expertise in some of these fields, such as patient safety and professional education, may be readily available in a clinical setting. Other fields will require working with local and regional organizations, such as nearby universities. It is necessary to develop common ground with non-clinician experts, such as orientation on health care priorities and culture. Non-clinicians may find it useful to shadow in clinical settings, attend case discussions and project meetings. It may also be feasible for healthcare simulation specialists to attend introductory training in certain fields, such as professional education, so that they can bridge the language gaps when working with experts from non-clinical fields.
Characterization of Outcomes by Surgical Management of Lung Neuroendocrine Tumors Associated With Cushing Syndrome

Importance Ectopic adrenocorticotropic hormone secretion from lung tumors causing Cushing syndrome are associated with high rates of morbidity. Optimal management remains obscure because knowledge is based on rare reports with few patients. Objective To characterize the outcomes of lung neuroendocrine tumors associated with Cushing syndrome. Design, setting, and participants An observational case series review from 1982 to 2020 was conducted in a single institution referral center. Kaplan-Meier analysis estimated disease-free survival (DFS). Participants underwent curative-intent surgery for a lung neuroendocrine tumor causing Cushing syndrome. Exposures Lobectomy or pneumonectomy vs sublobar resection. Main outcomes and measures Disease-free survival, disease persistence/recurrence. Results Of the 68 patients, the median age was 41 years (range, 17-80 years), 42.6% (29 of 68) were male, 81.8% (54 of 66) were White, with a mean follow-up after surgery was 16 months (range, 0.1-341 months). Lobectomy was the most common procedure (48 of 68 [70.6%]), followed by wedge resection (16 of 68 [23.5%]) and segmentectomy (3 of 68 [4.4%]). Video-assisted thoracoscopic surgery was performed in 19 of 68 (27.9%) of patients. Surgical morbidity was 19.1% (13 of 68), and perioperative mortality was 1.5% (1 of 68). Lymph node positivity was 37% (22 of 59) when evaluable. The overall incidence of persistence/recurrence was 16.2% (11 of 68) with a median time to recurrence of 55 months (range, 18-152 months). The median DFS was reached in 12.7 years (0.1-334 months). There were no statistical differences in DFS based on tumor size, stage (8th edition TNM), whether full systematic lymphadenectomy was performed or not, nodal status, or surgical approach. Conclusions and relevance In this case series study, neuroendocrine pulmonary tumors associated with Cushing syndrome had increased nodal metastasis, higher recurrence, and lower DFS than quiescent bronchopulmonary carcinoid tumors, but many patients experienced favorable outcomes. This observation is underscored by the discordance of TNM-stage classifications vs prognosis. Observing no difference in surgical techniques, the implication may be that a lung-sparing approach could suffice. These results may reflect the intrinsic importance of the hormone physiology instead of the carcinoid biologic factors.
Strength and Conditioning: A Concise Introduction

Strength and Conditioning: A Concise Introduction offers a concise but comprehensive overview of training for athletic performance. Introducing essential theory and practical techniques in all of the core areas of athletic training, the book clearly demonstrates how to apply fundamental principles in putting together effective real-world training programs. This book encourages students and professionals to think critically about their work and to adopt an evidence-based approach. It explains the inter-dependence of aspects of training such as needs analysis, assessment, injury, competition level, athlete age, and program design, and it fully explains how those aspects should be integrated. Strength and Conditioning is an accessible, engaging, and reflective introduction to the theory and application of strength and conditioning programs. Including clear step-by-step guidance, suggestions for further reading, and detailed sport-specific examples, this is the perfect primer for any strength and conditioning course or for any professional trainer or coach looking to refresh their professional practice. Included in the second edition are in-depth descriptions of free weights, kettlebells, heavy ropes, speed, agility, horizontal force production training, as well as updated research from the strength and conditioning field. Programming chapters and real-world programs provide examples of how to incorporate all the modern strength and conditioning tools. This is the perfect primer for any strength and conditioning course or for any professional trainer or coach looking to refresh their professional practice.
Tense and aspect (in)compatibility in Serbian matrix and subordinate clauses

This paper proposes a compositional temporal analysis of restrictions on perfective aspect in morphological present tense contexts in matrix and (certain) embedded clauses in Serbian. The main idea is that the availability of perfective aspect depends on the duration of the time interval with respect to which the event is ordered. This time interval is further determined by the interplay of temporal and aspectual components higher in the structure. Moreover, it is shown that the observed restrictions on perfective aspect in Serbian are, to a large extent, parallel to restrictions on non-progressive, episodic, non-stative, non-generic predicates in English. Following the assumption that these predicates contain a perfective component (Kamp and Reyle, 1993; Smith, 1991; Cowper, 1998; Wurmbrand, 2014, inter alia), the proposed analysis allows for the unification of Aspect in Serbian and the abovementioned predicates in English.
Qualitative analysis for social scientists: Memos and memo writing

In this chapter, a number of theoretical memos written by researchers during their various studies are reproduced. Before reading and studying them, it is requisite to at least scan the earlier discussion in Chapter 1 about memos and their indispensable functions in discovering, developing, and formulating a grounded theory. In the previous chapter on the student seminars as well in later chapters, one can frequently sense the hovering presence of memos which arise out of codes and ideas generated in seminar, consultation, and team sessions. In fact, one explicit rule of thumb is that such sessions must soon be followed by a jotting down or typing out of the summary or the thoughts stimulated, just as individual researchers need to interrupt their data collecting and coding to write memos. Furthermore, recollect that waiting for the muse to appear is not the model here. Although there are periods of intense memo writing, grounded theorists are trained to write memos regularly – often from the first days of a research project – and in close conjunction with the data collecting and coding. (See discussion of the triad, Chapter 1. See also Glaser 1978, pp. 83–92.) The initial memos tend to look a little like those written by novices at this general style of memo writing: at first, a high proportion of them may be operational (what data to collect, where to go to do this), or reminder notes (don't forget to …, or don't forget this point), or scattered “bright ideas,” or fumbling around with a flood of undifferentiated products of coding, or just thinking aloud on paper for purposes of stimulation in order to see where that thinking will lead, and so on.
Federal Aid-to-State Programs Top 1,100

The federal government has a large and growing presence in state and local policy activities. This rising intervention has been facilitated by “grants-in-aid,” which are programs that combine federal subsidies with topdown regulations to micromanage state and local affairs. A new analysis finds that the number of federal aid programs for state and local governments totaled 1,122 in 2010, or more than triple the number 25 years ago. Some of the most expensive federal aid programs are in the areas of education, housing, health care, and transportation. With today’s massive deficits, the federal government can no longer afford to fund all of these state and local activities. Federal lawmakers would better serve the nation by focusing on national issues rather than trying to fix potholes and run the schools. Furthermore, aid ties up the states in bureaucratic knots and reduces state policy innovation. The $646 billion aid system should be cut.
Experimentally Determined Stresses Associated with Elliptical Holes Using Polar Coordinates

: This paper determines the individual components of stress experimentally in a finite tensile plate containing an elliptical hole using a series representation of an Airy stress function in terms of polar coordinates. The Airy coefficients are evaluated from measured temperature information. As well as satisfying force equilibrium, the thermoelastic results are substantiated independently using strain gages and finite element analysis. Employing real, rather than the commonly used complex, variables can be easier for such problems, avoids inconveniences associated with conformal mapping and the concept is applicable to experimental analysis of arbitrarily shaped and/or loaded cut-outs.
Comparison of Bos Taurus-Bos Indicus Breed Crosses with Straightbred Bos Indicus Breeds of Cattle for Maternal and Individual Traits

Data were analyzed to compare crossbred females produced by crossing exotic Angus and Red Poll males to indigenous Ankole, Boran and Small East African Zebu (Zebu) females with straightbred females of the Ankole, Boran and Zebu breeds at the Ruhengere Field Station in the Ankole District of Southwestern Uganda. Progeny of the straightbred and crossbred dams were by Friesian, Brown Swiss and Simmental sires. Crossbred exotic X indigenous dams were favored over straightbred indigenous dams by 13.7% (P less than .01) in calf birth weight and by 14.8% (P less than .01) in calf weaning weight. Cross-bred cows exceeded (P less than .01) straightbred cows by 61.9% (48.5 kg) in calf weight weaned per cow exposed to breeding. Crossbred cows weighed 37, 46 and 42 kg more (P less than .01) than straightbred cows at parturition, weaning and cow mean weight, respectively. Angus X Boran and Red Poll X Boran crossbred dams were compared specifically with straightbred Boran dams. Exotic (Angus, Red Poll) X Boran crossbred dams exceeded straightbred Boran dams by 27.0% (P less than .05) in calf crop born, by 8.3% (P less than .05) in progeny birth weight and by 14.7% (P less than .01) in progeny weaning weight. Weight of calf weaned per cow exposed to breeding favored (P less than .01) the Angus X Boran and Red Poll X Boran crossbred dams over the straightbred Boran dams by 50.5% (50 kg).(ABSTRACT TRUNCATED AT 250 WORDS)
Metabolic Changes in Nicotinamide Adenine Dinucleotide in Response to Anthrax Toxin

Abstract Bacillus anthracis produces a toxin both in vitro and in vivo which, when injected intravenously into rats, brings about the death of the animals accompanied by gross pulmonary edema. Lung tissue removed prior to death showed, in vitro, a 30% reduction in overall oxidative metabolism (Qo2), whereas the nicotinamide adenine dinucleotide (NAD)-independent succinic dehydrogenase remained unaffected. The NAD concentration in the lungs of injected animals was reduced by 50%. Upon addition of NAD, the Qo2 of lung tissue from injected animals rose to control values. At 45 min after toxin injection, the serum lactate concentration began to rise, showing about a 3.5-fold increase over controls after 75 min. No changes occurred in the pyruvate concentration. These changes may be explained by increased use of the pyruvate for glycolytic energy production with further loss of NAD. Additional experiments with liver, spleen, kidney, and brain tissues showed that the toxin-induced reduction of Qo2 is an effect specific for lung tissue. Brain tissue showed a significant increase in oxidative metabolism upon the addition of the toxin, whereas the other tissues remained unaffected. It is suggested that a principal effect of the toxin is to inhibit, in lung tissue, the regeneration of NAD in the respiratory chain.
Normal-state optical conductivity of YBa2Cu3O6+x.

The optical conductivity in the normal state of ${\mathrm{YBa}}_{2}$${\mathrm{Cu}}_{3}$${\mathrm{O}}_{6+\mathit{x}}$ is calculated within the framework of the memory-function formalism. We assume that the carriers are constrained to the ${\mathrm{CuO}}_{2}$ planes and are scattered by spin fluctuations of the Cu spins. First, the calculation is done using the phenomenological form of the spin susceptibility proposed in the antiferromagnetic-Fermi-liquid theory. In a second step, we choose two different forms of the spin susceptibility to improve the high-frequency dependence of the optical conductivity. It is found that fitting the experimental data requires more than one form of the spin susceptibility. It is also found that the relaxation rate varies roughly linearly with the frequency and that the mass enhancement is weakly frequency dependent.
Cervical range of motion and dynamic response and strength of cervical muscles

Basic physical characteristics of the neck have been defined which have application to the design of biomechanical models, anthropometric dummies, and occupant crash protection devices. The study was performed using a group of 180 volunteers chosen on the basis of sex, age (18-74 years), and stature. Measurements from each subject included anthropometry, cervical range-of-motion (observed with both x-rays and photographs), the dynamic response of the cervical flexor and extensor muscles to a controlled jerk, and the maximum voluntary strength of the cervical muscles. Data are presented in tabular and graphic form for total range-of-motion, cervical muscle reflex time, decelerations of the head, muscle activation time, and cervical muscle strength. The range-of-motion of females was found to average 1-12 deg greater than that of men, depending upon age, and a definite degradation in range-of-motion was observed with increasing age. Average neck muscle reflex times range from 56-92 ms for flexors and 54-87 ms for extensors, with males being generally slower-reacting. This finding means that the cervical muscles generally cannot be activated in sufficient time to mitigate the hyperextension effects of a surprise rear-end collision. Reflex time becomes significantly longer after middle c.g. in the range of 0.3-0.5 g. The time required to stop the head after initial detection of the muscle reflex was slightly longer for neck extensors. Strength tests revealed that males are on average stronger than females in both flexor and extensor strengths. Males and females also exhibit different aging characteristics, and a slight stature effect was noted for the younger and shorter portions of the population. Age and sex were found to be important factors in cervical flexibility and response characteristics, and they should be included whenever accurate representation of neck parameters is desired.