cssi/SciSciGPT-SciSciNet huggingface dataset:
Meaning of infant feeding issues and mothers' use of help

Abstract This article explores the meaning of feeding issues for 17 primiparous and multiparous mothers of young infants and examines the relationship of these issues to the mothers' use of help. Meaning is studied in terms of the content of the issue, its importance to the infant's well-being and mother's actions in response. The feeding issues identified by the mothers are evaluated according to the infant's age and type of feeding. Three classes of feeding issues (technical, regulation, and personal experience of infant or mother) are studied; sources (lay and authority, including clinician and published information) and frequency of help used are assessed by means of a daily diary of feeding issues kept by mothers during the infant's first 90 days. The frequency with which the three classes of issues are reported vary with the infant's age and type of feeding method used (breast, bottle, or both breast and bottle for at least part of the study period). Requests for help and the type of help used vary ...
Case 26: An Unusual Cause of a Serious Cardiac Arrhythmia

A 17-year-old boy (American Society of Anesthesiologists physical status II [ASA 2]) with a diagnosis of a chronic pain syndrome involving his right chest as a result of a motorbike accident is scheduled for a dorsal root entry zone (DREZ) lesion placement at right T10, T11, and T12 with dermatomal evoked potential monitoring. The patient’s history includes several back surgical procedures. In the preoperative area, midazolam, 4mg intravenous (IV), is given for sedation. Monitors are placed on the patient in the operating room, and anesthesia is induced using thiopental, fentanyl, and vecuronium. After the airway is secured, the patient is turned prone onto a Wilson frame, and all pressure points are padded. Anesthesia is maintained with isoflurane, nitrous oxide, vecuronium, and meperidine. Anesthesia monitors consist of noninvasive blood pressure (BP), electrocardiogram (ECG), pulse oximetry, esophageal stethoscope, temperature probe, oxygen analyzer, and end-tidal CO2. The neurologist uses the Hewlett-Packard Component Monitoring System, model M10948 (Mountain View, CA). The ECG skin electrodes from 3M Health Care Red Dot, model 2238 (St. Paul, MN), are placed as follows: right arm lead (white) at the right posterior shoulder, left arm lead (black) at the left posterior shoulder, right leg lead (green) at the right midaxillary line at the sixth intercostal space, left leg lead (red) at the left midaxillary line at the eighth intercostal space, and the V5 lead (brown) at the left midaxillary line at the fifth intercostal space. Evoked potential stimulator skin electrodes are placed at the right T8, T10, T12, and the left T10 dermatomes by the neurologist. Using a Nicolet Viking IV (Madison, WI), the neurologist will monitor evoked potentials, after dermatomal electrical stimulation, to help evaluate the efficacy of the placement of the DREZ lesions by the surgeons.
A diagnostic of influential cases based on the information complexity criteria in generalized linear mixed models

ABSTRACTModeling diagnostics assess models by means of a variety of criteria. Each criterion typically performs its evaluation upon a specific inferential objective. For instance, the well-known DFBETAS in linear regression models are a modeling diagnostic which is applied to discover the influential cases in fitting a model. To facilitate the evaluation of generalized linear mixed models (GLMM), we develop a diagnostic for detecting influential cases based on the information complexity (ICOMP) criteria for detecting influential cases which substantially affect the model selection criterion ICOMP. In a given model, the diagnostic compares the ICOMP criterion between the full data set and a case-deleted data set. The computational formula of the ICOMP criterion is evaluated using the Fisher information matrix. A simulation study is accomplished and a real data set of cancer cells is analyzed using the logistic linear mixed model for illustrating the effectiveness of the proposed diagnostic in detecting the...
The Effects of Ecdysis on Feeding Frequency and Behavior of the Common Garter Snake (Thamnophis sirtalis)

Physiological changes associated with shedding might be expected to have direct or indirect effects on other aspects of physiology and behavior. In snakes, shedding frequency increases with increasing temperature and metabolic rate (Semlitsch, 1979; Appleby, 1980; Gibson et al., 1989). The rate of shedding is increased by injury (Neill, 1949; Kauffeld, 1969; Appleby, 1980), and varies by gender, reproductive state, body size, feeding frequency, diet, and color morph (Brown, 1988; Zug, 1993). Changes in snake feeding frequency and behavior associated with shedding have been described in qualitative terms (McDonald, 1976; Appleby, 1980; Lillywhite, 1989; Ford, 1995), but to our knowledge, quantitative analyses of such changes are lacking. The purpose of this study was to quantify the effects of shedding on feeding frequency and other behaviors.
A Comparison Between Customized and Premixed Parenteral Nutrition: Cost Really Matters

Background. Parenteral route is accepted for delivering nutrition when enteral feeding is not possible. Standardized premixed parenteral nutrition solution (SPNS) formulations are uniform in their ...
Hospitals and Communities, 1100–1960. Edited by Christopher Bonfield Jonathan Reinarz, and Teresa Huguet‐Termes. (Bern, Switzerland: Peter Lang, 2013. Pp. 430. $128.25.)

This collection of papers is a worthy successor to The Impact of Hospitals, 300–2000 (ed. Henderson, Horden, and Pastore), which appeared in 2007 by the same publisher. The current collection's cha...
Mimesis, Art, and Truth

Just as the influences of Heidegger’s mentors provide clues to his thought, so the observations of those he influenced—from Tillich to Gadamer, Rahner to Marcuse—prove equally enlightening. Tillich, who reformulated Heidegger’s concept of being to offer a new vision of the Protestant experience of God, provides a unique example. For in writing two dissertations on Schelling that consider myth and guilt respectively, Tillich displays an important cross fertilization within contemporary theology.1 Indeed, his theology suggests that Heidegger’s project is not monolithic, but instead unfolds across many historical fronts. Moreover, Tillich offers a point of detachment or distance in terms of which to evaluate the evolutionary path of Heidegger’s thought, to witness its breaks as well as its continuity.
Orientation of Organic Cations in Hybrid Inorganic–Organic Perovskite CH3NH3PbI3 from Subatomic Resolution Single Crystal Neutron Diffraction Structural Studies

We report the crystal growth of well-faceted single crystals of methylammonium lead iodide, CH3NH3PbI3, and detailed single crystal neutron diffraction structural studies aimed at elucidating the orientation of the methylammonium (CH3NH3+) cation in the tetragonal and cubic phases of the hybrid inorganic–organic perovskite. Room temperature experiments reveal a tetragonal structure where the protonated amine substituent (−NH3+) of the cation is disordered in four positions, each preferentially located near the neighboring iodine of the [PbI6] octahedra, while the methyl substituent (−CH3) is disordered in eight positions located near the body position of the unit cell. High temperature experiments show a cubic structure where the cation aligns along the [011] (edge), the [111] (diagonal), and the [100] (face) directions of the unit cell. The resulting site occupancy ratio suggests the CH3NH3+ cation resides primarily along the [011] direction, in agreement with reported DFT calculations. One important fea...
Effect of Fulvic Acid (FA) from Lignite Degraded on Germination Rate and Activities of Main Antioxidases in Soybean Seedlings

The antioxidase system can remove reactive oxygen and play an important role in the process of soybean germination.To study how fulvic acid(FA),produced by microbial degraded lignite,can improve the germination,Spectrophotometry and nitroblue tetrazolium test(NBT) ilumination method were taken to detect the activities of peroxidase(POD),catalase(CAT) and superoxide dismutase(SOD).The results showed when the concentration of FA was 100 mg·kg-1,the activities of CAT and SOD were improved by 32.15% and 24.5%,respectively.The germination ratio increased by 34.6% under a condition where the concentration of FA was 200 mg·kg-1,and the activity of POD was also increased by 19.92% under this FA concentration.In contrast with the promotion effect,solution with high FA concentration can restrain the activities of antioxidase.The study has shown that appropriate concentration of FA from lignite degraded by microorganism can improve the germination of soybean and increase the activities of POD,CAT and SOD significantly.FA is something like plant growth regulator,the appropriate concentration of FA can improve the germination ratio of soybean seed and improve its activities of antioxidase apparently.
Treatment of acne vulgaris. Guidelines for primary care physicians.

PreviewAcne is a challenging disease that does not usually respond well to haphazard or casual attempts at therapy. Fortunately, disfiguring scars can often be prevented by appropriate treatment. Dr Taylor describes a number of therapeutic approaches that may greatly change the natural course of the disease.
Gastric partitioning for morbid obesity: postoperative weight loss, technical complications, and protein status.

The study of 325 patients who underwent gastric partitioning (stapling) was undertaken to assess the complications and weight-loss records over a 5-year period. A subgroup of 15 patients was studied to determine protein status preoperatively and 2, 4, and 6 months after surgery. Laboratory tests, anthropometric measures, and food records were used to assess patient health and nutritional status. Four operative techniques have been used by a surgeon in Reno, NV, since 1979. The main postoperative complication in the first two procedures, a nonreinforced horizontal staple line (Groups 1 and 2), was staple line disruption and, therefore, poor weight-loss results. The staple line was reinforced in the next 193 patients (Group 3), and the patients followed a blenderized diet for 8 weeks postoperatively. Persistent vomiting was the most common problem in that group; 24% required dilatation of the stoma via gastroscopy. The vertical staple procedure was adopted for the next 48 patients (Group 4) to further minimize disruption and severe vomiting. Other operative complications were relatively few. At 48 and 18 months, respectively, Groups 3 and 4 showed an average weight loss of 27% of the preoperative weight. Eating patterns and food tolerances changed dramatically postoperatively, and protein intake dropped significantly. Mean protein intakes below standard recommended dietary allowance (RDA) were observed in a subgroup of Groups 3 and 4. However, the mean total lymphocyte count and albumin values demonstrated that patients were not compromising visceral proteins. The mean creatinine height indexes and arm muscle areas showed no significant difference in somatic protein status. Results indicate that improved gastric partitioning techniques can be effective in the treatment of morbid obesity. However, comprehensive follow-up care by an interdisciplinary team is important.
Implantation of SphinKeeper(TM): a new artificial anal sphincter

A new artificial anal sphincter, SphinKeeperTM, was devised with the aim to treat fecal incontinence (FI) by implanting specifically designed self-expandable prostheses into the intersphincteric space. Preliminary data concerning the procedure feasibility and prosthesis localization at 3 months are presented. SphinKeeperTM prostheses in the native state are dehydrated, thin, solid cylinder (length 29 mm, diameter 3 mm), changing their state (shorter—length 23 mm, thicker—diameter 7 mm—and softer, with shape memory) within 48 h of contact with fluids. In this study, 10 prostheses were implanted in each patient with FI under local anesthesia and under endoanal ultrasound (EAUS) guidance, into the upper-middle intersphincteric space of the anal canal by a specifically designed delivery system. EAUS was used postoperatively to assess prostheses dislocation. Ten patients (5 females; median age 58 years, range 20–75) were enrolled and treated with SphinKeeperTM implantation. Median duration of procedure (performed by endoanal ultrasound guidance) was 40 min (range 30–45). Neither intraoperative nor postoperative complications were reported after a 3-month follow-up. In one patient, a partial dislocation of a single prosthesis was documented by EAUS, causing anal discomfort which resolved after 1 week. SphinKeeperTM can be safely implanted in patients with FI of different etiology. Implantation was well tolerated with no dislodgment of implants at 3-month follow-up.
Measurements of the mid-rapidity parity violating spin asymmetries for W± bosons at PHENIX

The parity violating W± single spin asymmetry, in longitudinally polarized p + p collisions, can give us a clean way to access the \(\Delta \bar u\) and \(\Delta \bar d\) polarized parton distribution functions. The current status of the analysis of the 2011 data set and future prospects will be presented.
Objective assessment of sleep and alertness in medical house staff and the impact of protected time for sleep

We studied 26 physicians in postgraduate medical training ("house staff") to objectively quantify their sleep, alertness, and psychomotor performance while working on call. This study provided precise data on the extent of sleep deprivation during a typical call night, the workload factors predictive of sleep loss, and the extent to which protected time for sleep within the call night can ameliorate sleep loss and consequent daytime sleepiness. We used ambulatory EEG recording equipment and a standardized computer-based performance test to monitor sleep and alertness over the course of a 36-hour call day. Comparisons were made between interns provided with 4 hours of protected time for sleep by a covering resident ("night-float") and interns without such coverage. As anticipated, we found evidence that hospital interns were severely sleep-deprived, to an extent even greater than prior behavioral observations have suggested. Interns in both conditions spent an average of less than 5 hours (295.4 minutes) in bed attempting to sleep and obtained an average of 3.67 hours (220.1 minutes) of sleep (range 37.4-358.4 minutes). Provision of the night-float for 4 hours did not significantly change total sleep time (TST) (212.8 minutes covered vs. 224.9 minutes uncovered), but sleep efficiency was significantly improved (86.5% vs. 70.3%; p = 0.001). Covered interns also obtained significantly more slow-wave sleep than the uncovered interns (65.4 minutes vs. 51.1 minutes; p = 0.05). However, measures of alertness and performance were not significantly different between the two groups and were only weakly related to TST. These data suggest that significant chronic sleep deprivation is relatively unaffected by sleep obtained in the hospital and that provision of protected time for sleep does not significantly improve TST. Language: en
The Romanianization Bureaucracy

To achieve its goals, the Antonescu government tasked the implementation of Romanianization to the SSRCI and its department, the CNR, who supervised the expropriation, administration, and distribution of properties; the MEN, including its Commissars Office, who was the driving force behind the Romanianization of businesses; and the OCR, belonging to the MMSOS, who promoted the Romanianization of employment. While many of these agencies’ employees were based in central and local offices (in every district) and served as Romanianization desk bureaucrats, others (field agents) were located “on the ground.” The latter were commissars of various types: inspectors, controllers, and building managers tasked with the surveillance of the Romanianization process in companies and buildings.
Parameter-Varying Aerodynamics Models for Aggressive Pitching-Response Prediction

Current low-dimensional aerodynamic-modeling capabilities are greatly challenged in the face of aggressive flight maneuvers, such as rapid pitching motions that lead to aerodynamic stall. Nonlinearities associated with leading-edge vortex development and flow separation push existing real-time-capable aerodynamics models beyond their predictive limits, which puts reliable real-time flight simulation and control out of reach. In the present development, a push toward realizing real-time-capable models with enhanced predictive performance for flight operations has been made by considering the simpler problem of modeling an aggressively pitching airfoil in a low-dimensional manner. A parameter-varying model, composed of three coupled quasi-linear sub-models, is proposed to approximate the lift, drag, and pitching-moment response of an airfoil to arbitrarily prescribed aggressive ramp–hold pitching kinematics. An output-error-minimization strategy is used to identify the low-dimensional quasi-linear parameter...
Critical Realism in Economics: Development and Debate

(2000). Critical Realism in Economics: Development and Debate. Journal of Economic Issues: Vol. 34, No. 1, pp. 245-247.
The role(s) of cysteine residues in redox regulation of Janus kinase 2

Proc Amer Assoc Cancer Res, Volume 47, 2006 3789 The redox regulation of JAK2 is poorly understood, and there are contradictory reports as to whether the enzyme’s activity is inhibited or stimulated by oxidizing conditions in the cell. Here we demonstrate that multiple cysteine residues within the JAK2 catalytic domain are essential for enzymatic activity. Upon oxidation, the enzyme is no longer catalytically active, although activity can be restored via reduction to the thiol state. A series of recombinant variants of JAK2 were overproduced via the baculoviral expression vector system. The catalytic activities of these mutant enzymes were evaluated by in vitro autokinase assays and in situ transphosphorylation assays employing a variety of recombinant substrate proteins. These mutant JAK2 variants provided evidence that the amino-terminal autoinhibitory domain of JAK2 was not essential for direct redox regulation. Cysteine-to-serine mutagenesis allowed us to examine the effect of individually and combinatorially altering nine cysteine residues in or near the catalytic domain. These mutations identified four cysteine residues (Cys866, Cys917, Cys1094 and Cys1105) that cooperatively maintain JAK2’s catalytic competency. Cysteine-to-alanine mutagenesis corroborated the importance of these four residues, and provided additional evidence about the role(s) that they might play in regulating catalysis. Our data are consistent with a direct mechanism for redox regulation of JAK2 activity via oxidation and reduction of critical cysteine residues. Seemingly contradictory reports of oxidative stimulation of JAK2 activity might be best explained through indirect mechanisms, such as the oxidative inhibition of phosphotyrosine phosphatase involved in the negative regulation of JAK2 activity. When considered in light of the recently published structure of the JAK2 catalytic domain, the identification of these critical cysteine residues may be useful in the design of novel JAK2-targeted inhibitors for the treatment of myeloproliferative diseases.
The Language of Trust: Four Strategies of Self-Restraint in Patent Markets

Firms exchanging technology using the patent system as a trade system (through licensing, cross-licensing, transfer, and other mechanisms) appear to face uncertainty that cannot be resolved by information alone; trust in each others actions appears to be needed. Information is needed to resolve risk (a probability distribution can be constructed) but uncertainty (where no distribution can be made) requires trust in each others actions to be resolved and allow for rational decisions to be made. This article explores, based on interviews with some (about 14) of the most active patent licensing and patenting firms in the world, what strategies firms use to create such trust in each others actions, which allows for exchange in (uncertain) extant and new technical ideas based on the patent system. In the case of patents, the rights and their economic value are particularly risky and uncertain, as new inventions may be in pipeline that can be held private (as trade secrets), creating hold-up and other non-cooperative behavior, and the right to sue (enforce) have uncertain outcome. A distinction is thus made between uncertainty in state of the art (new technology) and the process of managing the uncertainty using diverse strategies, and treatment of risk based on state of nature and probabilities, hoping to expand on Arrow’s and other’s work, to provide a treatment of uncertainty in economic theory.
Cosmic Brownie

Whether you are new to the world of game development or a veteran of the field, you have most likely heard of, perhaps even taken part in, a game jam. An issue many teams face is "how do I accomplish everything I want with so little time?" This paper delves into the techniques and methods used by my team, Null Interactive, during Global Game Jam 2017. Furthermore, we discuss the product we created, strategies for using the limited time we were given, and the progression of our game jam experience.
Medical Family Therapy in Pediatrics

Pediatric medicine—or “pediatrics” as an umbrella term—promotes the physical, mental, and social well-being of infants, children, adolescents, and young adults (American Academy of Pediatrics, 2011). Pediatric practices are generally situated within primary and specialty care/tertiary care settings. Primary care settings—also called pediatric patient-centered medical homes (PPMH; Ader et al., 2015)—include those where annual well-baby and well-child visits, sick visits, and routine physical exams take place. They are usually led by generalist pediatricians. Specialty/tertiary care settings require additional training tailored to a specific content areas, such as pediatric endocrinology and/or obesity, pediatric pulmonary, pediatric oncology, pediatric hematology, pediatric orthopedics, pediatric intensive care, neonatology, neonatal intensive care, pediatric palliative care, pediatric nephrology, pediatric audiology and speech pathology, pediatric rheumatology, pediatric urology, pediatric gastroenterology, and other health conditions/presentations (see glossary for term definitions). Healthcare providers—and the roles that they serve—in pediatric specialty care teams are tailored to the specialty itself (e.g., a registered dietician in a pediatric endocrinology and obesity clinic).
One Introduction to Mathematical Research

(2006). One Introduction to Mathematical Research. Math Horizons: Vol. 14, No. 2, pp. 16-38.
School as a Social System

A social system is a set of related elements that work together to attain a goal. Conceptualizing a social institution or group as a social system is a useful heuristic device for describing how the unit functions in society. Social scientists have analyzed both the school class and the school itself as a social system and have described how they operate in society. Schools and their components are designed to meet two goals: the socialization of students to internalize the values needed to play a useful role in society; and the allocation or sorting of students to prepare them to attain an occupational position in society commensurate with their capabilities. Researchers have also depicted society itself as a social system and the school as one of its primary institutions. Structural functionalism and conflict theories have been helpful in explaining the interdependencies and interactions between the school and society. Structural functionalists argue that a social system must perform a set of functions in order to exist in a state of equilibrium. Conflict theorists claim that competition is the major force driving development in a social system. Coleman's recent work on social theory underscores the importance of a social-system approach to the study of schools.
An Efficient Black-box Technique for Defeating Web Application Attacks.

Over the past few years, injection vulnerabilities have become the primary target for remote exploits. SQL injection, command injection, and cross-site scripting are some of the popular attacks that exploit these vulnerabilities. Taint-tracking has emerged as one of the most promising approaches for defending against these exploits, as it supports accurate detection (and prevention) of popular injection attacks. However, practical deployment of tainttracking defenses has been hampered by a number of factors, including: (a) high performance overheads (often over 100%), (b) the need for deep instrumentation, which has the potential to impact application robustness and stability, and (c) specificity to the language in which an application is written. In order to overcome these limitations, we present a new technique in this paper called taint inference. This technique does not require any source-code or binary instrumentation of the application to be protected; instead, it operates by intercepting requests and responses from this application. For most web applications, this interception may be achieved using network layer interposition or library interposition. We then develop a class of policies called syntaxand taint-aware policies that can accurately detect and/or block most injection attacks. An experimental evaluation shows that our techniques are effective in detecting a broad range of attacks on applications written in multiple languages (including PHP, Java and C), and impose low performance overheads (below 5%).
Sun Yat-sen as Guofu: Competition over Nationalist Party Orthodoxy in the Second Sino-Japanese War:

This article explores the significance of the cult of Sun Yat-sen, often referred to as “Father of the [modern Chinese] Nation” 國父 (Guofu), for Nationalist state-building in China. Although Sun Yat...
Study of reversible motion of 101¯2 tensile twin boundaries in a magnesium alloy during strain path changes

Abstract Twinning process involving reversible motion of twin boundaries was examined and quantified in a rolled Mg-3Al-1Zn magnesium alloy compressed along two perpendicular directions. The evolution of twinning is analyzed by quasi in-situ electron backscatter diffraction technique, and the detailed structure of the twin boundary is analyzed using high-resolution transmission electron microscopy technique. The results suggest that both twinning and detwinning are attributed to the mobility of twin boundaries. Low-angle boundaries were identified at the prior twin boundaries after detwinning due to the effect of alloying elements, and these low-angle boundaries will affect subsequent deformation. Twin boundary is serrated and consists of 10 1 ¯ 2 coherent twin boundaries and prism-basal boundaries that control twin boundary migration.
Fenestrated endovascular aneurysm repair-induced acute kidney injury does not result in chronic renal dysfunction

Abstract Objective Acute kidney injury (AKI) is a common physiologic complication after fenestrated endovascular aneurysm repair (FEVAR). This investigation was initiated to determine the unknown impact of post-FEVAR AKI on long-term renal function after index hospital discharge. Methods A retrospective review was performed of an institutional FEVAR database capturing preoperative, intraoperative, and postoperative variables related to the implantation of consecutive Zenith Fenestrated endografts (ZFEN; Cook Medical, Bloomington, Ind) between October 2012 and April 2018. AKI in this study was bimodally defined as qualification by either Risk, Injury, Failure, Loss of kidney function, and End-stage (RIFLE) criteria or a postoperative serum creatinine (sCr) concentration increase of 0.5 mg/dL from baseline. Glomerular filtration rate (GFR) was calculated using the validated Modification of Diet in Renal Disease (MDRD) study equation. Results During the study period, 120 FEVARs were performed at our institution. Twenty-four (20%) patients exhibited postoperative AKI by our established definitions. Two in-hospital deaths occurred in the AKI cohort compared with none in the remaining FEVARs (P = .04). Four (16.7%) AKI patients required perioperative ( Conclusions AKI is common after FEVAR but rarely results in permanent renal dysfunction as both sCr concentration and GFR return to baseline by 6 months after the procedure.
Behind Enemy Lines: Exploring Trusted Data Stream Processing on Untrusted Systems

Data Stream Processing Systems (DSPSs) execute long-running, continuous queries over transient streaming data, often making use of outsourced, third-party computational platforms. However, third-party outsourcing can lead to unwanted violations of data providers' access controls or privacy policies, as data potentially flows through untrusted infrastructure. To address these types of violations, data providers can elect to use stream processing techniques based upon computation-enabling encryption. Unfortunately, this class of solutions can leak information about underlying plaintext values, reduce the possible set of queries that can be executed, and come with detrimental performance overheads. To alleviate the concerns with cryptographically-enforced access controls in DSPSs, we have developed \system, a DSPS that makes use of Intel's Software Guard Extensions (SGX) to protect data being processed on untrusted infrastructure. We show that \system can execute arbitrary queries while leaking no more information than an idealized \baseline system. At the same time, an extensive evaluation shows that the overheads associated with stream processing in \system are comparable to its computation-enabling encryption counterparts for many queries.
Primary Posterior Sagittal Anorectoplasty Outcomes for Rectovestibular and Perineal Fistulas Using an Accelerated Pathway: a Single Institution Study.

Abstract Background Posterior sagittal anorectoplasty (PSARP) is the most common surgical treatment for patients with anorectal malformations. Such patients are often subjected to prolonged nil per os (NPO), antibiotic use, and use of parenteral nutrition. Our aim was to review our institutional experience with patients undergoing PSARP using an accelerated standardized postoperative pathway. Methods Our hospital database was queried from 2004 to 2016 for patients diagnosed with imperforate anus who underwent a surgical procedure. Short term outcomes, hospital length of stay (LOS), and cost were evaluated. Results Sixty-three patients were identified during the study period. Of these patients, 34 (54.0%) had a fistula to the urogenital tract or had no demonstrable fistula and one cloaca and 29 (46.0%) had a fistula in the perineum. Approximately half of patients underwent primary PSARP, including 8 patients with fistulas located in the vestibule and vagina in girls and two with no apparent fistulas (12.7% of total cohort). Only two postoperative complications occurred: one superficial surgical site infection and one perineal wound dehiscence. Among the whole cohort, median LOS was 3 days. Median time to PO intake was 2 days, and median cost was $11,532. No complications occurred among the subset of 8 patients undergoing primary PSARP. Conclusion Patients undergoing PSARP experienced similar outcomes compared to historical series, suggesting that the accelerated pathway for early refeeding and reduced use of antibiotics may be beneficial in appropriately selected patients. Type of study Case series with no comparison group Level of evidence Level IV.
The left lateral occipital cortex exhibits decreased thickness in children with sensorineural hearing loss

Abstract Patients with sensorineural hearing loss (SNHL) tend to show language delay, executive functioning deficits, and visual cognitive impairment, even after intervention with hearing amplification and cochlear implants, which suggest altered brain structures and functions in SNHL patients. In this study, we investigated structural brain MRI in 30 children with SNHL (18 mild to moderate [M-M] SNHL and 12 moderately severe to profound [M–P] SNHL) by comparing gender- and age-matched normal controls (NC). Region-based analyses did not show statistically significant differences in volumes of the cerebrum, basal ganglia, cerebellum, and the ventricles between SNHL and NC. On surface-based analyses, the global and lobar cortical surface area, thickness, and volumes were not statistically significantly different between SNHL and NC participants. Regional surface areas, cortical thicknesses, and cortical volumes were statistically significantly smaller in M–P SNHL compared to NC in the left middle occipital cortex, and left inferior occipital cortex after a correction for multiple comparisons using random field theory (p
Accelerated imaging with segmented 2D pulses using parallel imaging and virtual coils.

Abstract Large magnetic field inhomogeneity can be a significant cause of spatial flip-angle variation when using ordinary, limited-bandwidth RF pulses. Multidimensional RF pulses are particularly sensitive to inhomogeneity due to their extended pulse length, which decreases their bandwidth. Previously, it was shown that, by breaking a 2D pulse into multiple undersampled k-space segments, the excitation bandwidth can be increased at the expense of increased imaging time. The present study shows how this increased imaging time can be offset by undersampling acquisition k-space in a phase-encoded dimension that is in the direction of excitation segmentation. Data from each segment are viewed as originating from “virtual receive coils” rather than multiple physical coils. The undersampled data are reconstructed using parallel imaging techniques (e.g. as in GRAPPA). The method was tested in vivo with brain imaging at both 3 T and 4 T, and used in conjunction with a 32-channel head coil and conventional GRAPPA on the 3 T data. Relationships with existing techniques and future applications are discussed.
Functional Magnetic Resonance Imaging Detects Between-Group Differences in Neural Activation Among Men with Delayed Orgasm Compared with Normal Controls: Preliminary Report

Abstract Background Mechanisms underlying delayed orgasm (DO) are poorly understood; however, known effects of psychotropic medications on sexual function provides a rationale for aberrant central nervous system signaling as a cause. Aim To compare brain activation between men with normal orgasm and those with lifelong DO during sexual stimulation using brain fMRI algorithms. Methods 3 subjects with self-reported life-long DO and 6 normal controls were included in this study. The International Index of Erectile Function, Male Sexual Health Questionnaire, and self-reported time to orgasm were used to assess sexual function. Subjects underwent a 3-T fMRI study while viewing 3 video clips: a neutral control (NC), a positive emotional control (EC), and a sexual condition (SC). Each video sequence was repeated 5 times, with 50-second clips presented in a randomized fashion. fMRI data were analyzed in a block design manner to determine areas of differential brain activation between groups. The Allen Brain Atlas of gene expression in the human brain was used to identify signaling pathways in the areas of differential fMRI activation between the DO and control groups. Outcomes The primary outcome was differential activation of fMRI neural activation between groups. Results Analysis of differential activation in the SC compared with the NC and EC revealed increased activation in the right frontal operculum (P = .003), right prefrontal gyrus (P = .003), and inferior occipital gyrus (P = .003). Increased activation in the right fusiform gyrus of the occipital lobe and the right hippocampus (P = .0004) was seen in the DO group compared with controls. Using the Allen Atlas of Human Brain Expression, we identified corresponding neurotransmitter receptors to this region, including adenosine receptors, muscarinic and nicotinic cholinergic receptors, cannabinoid receptors, and dopamine receptors, among others. Clinical Implications Lifelong DO in men may be due to abnormal neurotransmitter signaling leading to poor progression of arousal due to aberrant processing of sexual cues. Identification of neurotransmitter pathways by fMRI will aid the development of pharmacotherapeutic agents. Strengths & Limitations Strengths of this study include the novel application of functional neuroimaging to investigate the pathogenesis of DO. Limitations include the small sample size, making this study exploratory in nature. Conclusion This study revealed differences in brain activation on visualization of sexual stimuli in men with a history of DO compared with controls. Identified regions are rich in numerous neurotransmitter receptor subtypes and may be amenable to pharmacologic targeting to identify novel therapies for these men. Flannigan R, Heier L, Voss H, et al. Functional Magnetic Resonance Imaging Detects Between-Group Differences in Neural Activation Among Men with Delayed Orgasm Compared with Normal Controls: Preliminary Report. J Sex Med 2019:16;1246–1254.
Chromosomal Basis of Inheritance

In this chapter, we first discuss the structural and functional aspects of human chromosomes. The human genome is packaged into a set of chromosomes, which are derived in equal numbers from the mother and father. Each ovum and sperm contains a set of 23 different chromosomes, which is the haploid number of chromosomes in humans. The diploid fertilized egg and virtually every cell of the body arising from it has two haploid sets of chromosomes, resulting in the diploid human chromosome number of 46. The haploid human genome consists of approximately 3 × 109 base pairs of DNA. This DNA is compacted in a hierarchy of levels into chromosomes of manageable size. We then discuss the two types of cell division, namely mitosis and meiosis. In somatic cells, nuclear division takes place by mitosis. During mitosis each chromosome divides into two daughter chromosomes, one of which segregates into each daughter cell, thus producing daughter cells with identical chromosome constitutions. Meiosis, however, is a specialized cell division in germ cells that generates gametes with the haploid set of 23 chromosomes. The final gametic set includes single representatives of each of the 23 chromosome pairs selected at random. Next, we discuss the methods used to study human chromosomes, including both conventional chromosome banding and molecular cytogenetic techniques. We then touch on the concept of genomic imprinting and its role in human genetic disease. Finally, we briefly review the various types of human chromosomal abnormalities.
Legal Scholarship and Digital Publishing

SUMMARY Scholarship, including legal scholarship, depends on the reliability of sources used so that subsequent scholars can build upon the work. Reliability is here defined as including accurate access to sources that reproduce faithfully the original source. Legal scholarship depends on the existence and reliability of accessible materials to verify the accuracy and validity of the ideas advanced in the source. The growth of digital publishing,1 which includes both distributing information directly in electronic format and the conversion of paper materials into electronic format, threatens the established reliability of source materials. The current legal literature has failed to address this issue; the author's examination of 20 law review articles, all containing at least four citations to the Internet, found that 12 of the 20 contained an online source which could no longer be accessed within a year of the online source's publication. The author suggests that librarians and scholars be aware of the r...
Assessing the Utility and Accuracy of ICD10-CM Nontraumatic Subarachnoid Hemorrhage Codes for Intracranial Aneurysm Research

Background: The 10th revision of International Classification of Disease, Clinical Modification (ICD10CM) increased the number of codes to identify nontraumatic subarachnoid hemorrhage from one to twenty-two. ICD10CM codes are able to specify the location of aneurysms causing subarachnoid hemorrhage (aSAH), however it is not clear how frequently or accurately these codes are being used in practice. Objective: To systematically evaluate the usage and accuracy of location-specific ICD10CM codes for aSAH. Methods: We extracted all uses of ICD10CM codes for nontraumatic subarachnoid hemorrhage (I60.x) during the first three years following the implementation of ICD10CM from the billing module of the EHR for UCHealth. For those codes that specified aSAH location (I60.0-I60.6), EHR documentation was reviewed to determine whether there was an active aSAH, any patient history of aSAH, or unruptured intracranial aneurysm/s and the locations of those outcomes. Results: Between October 1, 2015 and September 30, 2018, there were 3,119 instances of nontraumatic subarachnoid hemorrhage ICD10CM codes (I60.00-I60.9), of which 297 (9.5%) code instances identified aSAH location (I60.0-I60.6). These codes accurately identified current aSAH (64%), any patient history of aSAH (84%), and any patient history of intracranial aneurysm (87%). The accuracy of identified outcome location was 53% in current aSAH, 72% for any history of aSAH, and 76% for any history of an intracranial artery. Conclusions: Researchers should use ICD10CM codes with caution when attempting to detect active aSAH and/or aneurysm location.
Reuse of Human Excreta in Developing Countries: Agricultural Fertilization Optimization

In developing nations, 1.2 billion people suffer from a lack of a basic sanitation system and fecal sludge manage- ment challenges, despite many efforts to combat this issue. Fecal sludge is a mixture of waste, including human excreta, soil, and water. Human excreta contains a significant amount of nutrients that can be used in agricultural fertilizers. The use of human excreta in agricultural fertilizers would reduce the need for artificial fertilizers and improve human excreta disposal through the use of composting and vermicomposting toilet systems. In developing nations where soil conditions are poor and fresh water is unavailable, the use of human excreta in fertilizer can ameliorate two problems: low food productivity and lack of sanitation service. Among the seventeen Sustainable Development Goals (SDGs) established by the United Nations (UN), ensuring a sani- tation system for everyone addresses the Goal 6, securing food for everyone. Additionally, enhancing low food productivity addresses the second goal of the SDGs, improving low food productivity. Thus, more efficient use of human excreta can help achieve two SDGs at the same time.
Cauterization as a Simple Method for Regeneration Studies in the Zebrafish Heart

In the last two decades, the zebrafish has emerged as an important model species for heart regeneration studies. Various approaches to model loss of cardiac myocytes and myocardial infarction in the zebrafish have been devised, and have included resection, genetic ablation, and cryoinjury. However, to date, the response of the zebrafish ventricle to cautery injury has not been reported. Here, we describe a simple and reproducible method using cautery injury via a modified nichrome inoculating needle as a probe to model myocardial infarction in the zebrafish ventricle. Using light and electron microscopy, we show that cardiac cautery injury is attended by significant inflammatory cell infiltration, accumulation of collagen in the injured area, and the reconstitution of the ventricular myocardium. Additionally, we document the ablation of cardiac nerve fibers, and report that the re-innervation of the injured zebrafish ventricle is protracted, compared to other repair processes that accompany the regeneration of the cauterized ventricle. Taken together, our study demonstrates that cautery injury is a simple and effective means for generating necrotic tissue and eliciting a remodeling and regenerative response in the zebrafish heart. This approach may serve as an important tool in the methods toolbox for regeneration studies in the zebrafish.
Unlocking the Power of State Constitutions with Equal Protection: The First Step Toward Education as a Federally Protected Right

This Article analyzes the intersection of state constitutional law with federal equal protection, revealing how federal equal protection, by relying on state constitutional education standards, can force states to further equalize and increase the resources available to struggling schools. It begins by exploring the extent of inequality and inadequacy in our public schools and the remedies that are necessary to address them. State-based litigation has produced gains in these areas, but lingering problems persist. Scholars have proposed several measures to address these problems, but most require either extraordinary changes at the federal level or modest changes that would do little to guarantee results. This Article proposes a middle road that builds upon the successes in state courts but makes the changes in state law relevant to federal litigation and enforcement. Of course, the traditional obstacle to such proposals has been the Supreme Court’s holding in San Antonio Independent School District v. Rodriguez, but this Article demonstrates a strategy that would not require the Supreme Court to overturn its precedent but simply apply equal protection in a manner that accounts for developments in state law. In particular, this Article posits that an educational revolution in the states has fundamentally changed the nature of the education right at stake and the responsibility for enforcing it. Thus, the scrutiny of this right under federal equal protection would be far different than it was just a few decades ago. Given the states’ weakened ability to enforce these rights, the future of education equity depends on federal intervention.
Kinematic and Kinetic Predictors of Y-Balance Test Performance

# Background The Y-Balance Test (YBT) assesses dynamic stability and neuromuscular control of the lower extremity. Several authors have analyzed kinematic predictors of YBT performance with conflicting results, but the influence of kinetic factors is not well understood. # Purpose To examine kinematic predictors of YBT performance and determine the joint kinetics which predict YBT performance. # Study Design Cross-sectional study. # Methods Thirty-one physically active individuals performed YBT trials on a force plate while whole body kinematics were recorded using a motion capture system. Sagittal, frontal, and transverse plane joint kinematics and joint moments were calculated at maximum reach in each YBT reach direction. Variables correlated with reach distances at the *p* \< 0.2 level were entered into a stepwise linear regression. # Results In the anterior direction, knee flexion and torso rotation (*R^2^*=0.458, *p*\<0.001) and knee extensor and hip abductor moments (*R^2^*=0.461, *p*\<0.001) were the best kinematic and kinetic predictors of reach distance. In the posterior medial direction, hip flexion, ankle dorsiflexion, and ankle rotation accounted for 45.8% of the variance in reach direction (*p*\<0.001) while hip and knee extensor, and hip abductor moments explained 72.6% of the variance in reach distance (*p*\<0.001). In the posterior lateral direction, hip flexion and pelvic rotation (*R^2^*=0.696, *p*\<.001) and hip extensor moments (*R^2^*=0.433, *p*=0.001) were the best kinematic and kinetic predictors of reach distance. # Conclusion The ability to generate large hip and knee joint moments in the sagittal and frontal plane are critical for YBT performance. # Level of Evidence 3\.