cssi/SciSciGPT-SciSciNet huggingface dataset:
Baseband Volterra filters for implementing carrier based nonlinearities

A diagonal coordinate representation for Volterra filters is developed and exploited to derive efficient Volterra filter implementations for processing carrier based input signals. In the diagonal coordinate representation, the output is expressed as a sum of linear filters applied to modified input signals. Hence, linear filtering methods are employed to implement the nonlinear filter on a baseband version of the input. Downsampling is then used to reduce computational complexity. The same approach is employed to develop efficient implementations for processing continuous-time carrier-based signals, pulse amplitude-modulated signals, and frequency division multiplexed input signals.
Bladder cancer risk from occupational and environmental exposures

Approximately 50% of bladder cancer incidence in the United States has been attributed to known carcinogens, mainly from cigarette smoking. Following the identification of this important causative factor, many investigators have attempted to identify other major causes of bladder cancer in the environment. Genetic and epigenetic alterations related to carcinogenesis in the bladder have been linked to environmental and occupational factors unrelated to cigarette smoking and may account for a significant portion of bladder cancer cases in non-smokers. The interaction between genetics and exposures may modulate bladder cancer risk and influence the differing incidence, progression, and mortality of this disease in different genders and races. Comparative molecular studies are underway to measure the relative effects of environment and inheritance to account for observed differences in the epidemiology of bladder cancer. The use of geospatial tools and population-based data will offer further insight into the environmentally-linked causes of bladder cancer.
A remanent noise problem with the median filter

This paper is concerned with the noise suppression capabilities of the median filter. It finds that though the median filter is highly successful at removing noise from both 1-D and 2-D signals without causing undue blurring effects, it is bound to leave some noise on the final signal. In certain cases this noise can be substantial, when compared with the noise left by a mean or Gaussian filter. However, the effect is turned to good use when the median filter is employed in a particular type of (2-D) corner detector. Indeed, the remanent noise of the median filter provides a sound explanation of the excellent properties of this type of corner detector. >
New Python-based methods for data processing

Current pixel-array detectors produce diffraction images at extreme data rates (of up to 2 TB h−1) that make severe demands on computational resources. New multiprocessing frameworks are required to achieve rapid data analysis, as it is important to be able to inspect the data quickly in order to guide the experiment in real time. By utilizing readily available web-serving tools that interact with the Python scripting language, it was possible to implement a high-throughput Bragg-spot analyzer (cctbx.spotfinder) that is presently in use at numerous synchrotron-radiation beamlines. Similarly, Python interoperability enabled the production of a new data-reduction package (cctbx.xfel) for serial femto­second crystallography experiments at the Linac Coherent Light Source (LCLS). Future data-reduction efforts will need to focus on specialized problems such as the treatment of diffraction spots on interleaved lattices arising from multi-crystal specimens. In these challenging cases, accurate modeling of close-lying Bragg spots could benefit from the high-performance computing capabilities of graphics-processing units.
Policy Research and the Future: An Exemplar for a Critical Symbolic Interactionism

Abstract Policy research is inquiry that seeks to inform organizational decisions. As such, it is embroiled in the construction of whatever futures these effectuate. Symbolic Interactionism has untapped resources for the conduct of policy research in its basic assumption that human nature and its situations are human creations. Within that tradition, it is always possible to compare what has been produced with some “future,” and to do so “critically.” The most relevant contemporary exemplar for such a comparison may be found in the work of Hugh Duncan. His analysis of the sociodramas that individuals perform, and his examination of comedy and tragedy as competing forms of social order is discussed. Finally, his attempt to exhibit the comedic as the humane form of social order is presented as a “formal” exemplar for the conduct of policy research which entertains a variety of futures in the investigation of present situations.
FT-EPR study of photoinduced electron transfer in a micellar system

Abstract Photoinduced electron transfer from Zn-tetraphenylporphyrin (ZnTPP) to benzoquinone (BQ) in micelles of cetyltrimethylammonium chloride (CTAC) has been investigated by time-resolved Fourier-Transform Electron Paramagnetic Resonance (FT-EPR). An analysis of the time-evolution of the FT-EPR signal from the BQ anion radical following laser excitation of ZnTPP gives the values of the forward and back electron transfer rate constants and for the BQ− spin-lattice relaxation time. The data are compared with those obtained from ZnTPP/BQ in ethanol. The experimental data show that the forward reaction involves electron transfer from CTAC solubilized ZnTPP to BQ in the aqueous phase. Furthermore, attraction between the cationic headgroups of the surfactant molecules and BQ− apparently promotes back electron transfer.
Independent precursors for thymus dependent and thymus independent IgG memory B cells.

Spleen cells from mice primed with the thymus dependent antigen trinitrophenyl keyhole limpet hemocyanin several months earlier can be cultured in vitro to give vigorous IgG antihapten PFC responses to thymus dependent and thymus independent forms of the hapten. The IgG memory precursors responding to these two forms of the hapten constitute functionally distinct subpopulations which we have designated as B1γ and B2γ to represent the precursor cells responding to the thymus independent and thymus dependent antigens respectively. Four types of evidence for these subpopulations are presented 1) the responses to the two types of antigen are additive when both forms are added to the same culture; 2) the precursor frequency for the thymus dependent and thymus independent populations is different although expansion over primary IgM precursor frequencies was not detectable;3) the avidities of the PFC elicited by each antigen are distinct; the thymus independent antigens elicit lower avidity PFC; 4) selective killing of one population can be accomplished by BUdR and light treatment without affecting the other population.
Quadrature phase shift keying direct sequence-spread spectrum code division multiple access with disparate quadrature chip and data rates

This research examines the performance of a QPSK DS-CDMA system with disparate chip and data rates (thus different processing gains) on the two quadrature channels for synchronous and asynchronous transmission using both orthogonal and random codes. In a CDMA setting, we investigate the effect on performance of unequal user signal energies and a variable number of interfering system users, in both AWGN and Rayleigh fading channels. With this disparate scheme we also obtain a moderate amount of shaping of the transmitted signal power spectrum. Our results show excellent agreement between analysis and simulations, and illustrate the additional degree of flexibility our disparate chip/data rate system provides.
The attic block syndrome

Although the true reason for pneumatization of the mastoid bone is not known, there are some theoretical benefits. As with the other pneumatized areas of the skull (ie, paranasal sinuses), aeration may be a benefit simply by decreasing the overall weight of the bony skull. Physiologically, the mastoid may be a way of increasing the effective volume of the middle ear. The greater the gaseous volume, the greater the compliance and the greater the ability to tolerate changes in middle ear pressure. Additionally, the volume of the middle ear/ mastoid complex affects the resonance properties of the ear. The larger the volume, the lower the resonance frequency. On the other hand, the honeycomb nature of the mastoid is felt to dampen the resonant peaks because the cavity is broken up into smaller individual air cells.1 The pneumatization of the middle ear is known to begin at approximately the eighth week of fetal life. The extension of aeration into the mastoid antrum area also begins at this time. Mastoid aeration progresses to its maximum by the age of 10 years in females and 15 years in males. Aeration of the pneumatized mastoid depends on a functioning eustachian tube and a patent middle ear space. Obstruction between the mastoid and the eustachian tube prevents normal air exchange and basic physiological function. The predominant venue of air flow between the middle ear and the mastoid is through the antrum and the epi tympanum (or attic) adjacent to the heads of the ossicles. In a sense, the heads of the ossicles partially obstruct the epitympanum. This narrow passage is further compromised by the numerous thin mucosal folds crisscrossing this area as described by Proctor. 2 Inflammatory processes such as infection can frequently lead to thickening of the normally thin mucous membrane of the middle ear and mastoid. If the thickening is severe enough, the mastoid antrum and/or epitympanum can be completely obstructed, leading to isolation of the mastoid air system. The ossicular heads and the many mucosal folds in the epitympanum put the attic at high risk for obstruction. This blockage is likely a frequent reversible occurrence, and temporary obstruction may create no significant or permanent problems. Treatment of the inflammatory process should lead to reversal of the mucosal thickening and resumption of aeration. At times the process reaches an irreversible state. There are several possible reasons for the lack of resolu-
Neighborhood socioeconomic status, Medicaid coverage and medical management of myocardial infarction: Atherosclerosis risk in communities (ARIC) community surveillance

Pharmacologic treatments are efficacious in reducing post-myocardial infarction (MI) morbidity and mortality. The potential influence of socioeconomic factors on the receipt of pharmacologic therapy has not been systematically examined, even though healthcare utilization likely influences morbidity and mortality post-MI. This study aims to investigate the association between socioeconomic factors and receipt of evidence-based treatments post-MI in a community surveillance setting. We evaluated the association of census tract-level neighborhood household income (nINC) and Medicaid coverage with pharmacologic treatments (aspirin, beta [β]-blockers and angiotensin converting enzyme [ACE] inhibitors; optimal therapy, defined as receipt of two or more treatments) received during hospitalization or at discharge among 9,608 MI events in the ARIC community surveillance study (1993-2002). Prevalence ratios (PR, 95% CI), adjusted for the clustering of hospitalized MI events within census tracts and within patients, were estimated using Poisson regression. Seventy-eight percent of patients received optimal therapy. Low nINC was associated with a lower likelihood of receiving β-blockers (0.93, 0.87-0.98) and a higher likelihood of receiving ACE inhibitors (1.13, 1.04-1.22), compared to high nINC. Patients with Medicaid coverage were less likely to receive aspirin (0.92, 0.87-0.98), compared to patients without Medicaid coverage. These findings were independent of other key covariates. nINC and Medicaid coverage may be two of several socioeconomic factors influencing the complexities of medical care practice patterns.
The influence of text characteristics on perceived and actual difficulty of health information

Purpose: Willingness and ability to learn from health information in text are crucial for people to be informed and make better medical decisions. These two user characteristics are influenced by the perceived and actual difficulty of text. Our goal is to find text features that are indicative of perceived and actual difficulty so that barriers to reading can be lowered and understanding of information increased. Methods: We systematically manipulated three text characteristics, – overall sentence structure (active, passive, extraposed-subject, or sentential-subject), noun phrases complexity (simple or complex), and function word density (high or low), – which are more fine-grained metrics to evaluate text than the commonly used readability formulas. We measured perceived difficulty with individual sentences by asking consumers to choose the easiest and most difficult version of a sentence. We measured actual difficulty with entire paragraphs by posing multiple-choice questions to measure understanding and retention of information in easy and difficult versions of the paragraphs. Results: Based on a study with 86 participants, we found that low noun phrase complexity and high function words density lead to sentences being perceived as simpler. In the sentences with passive, sentential-subject, or extraposed-subject sentences, both main and interaction effects were significant (all p < .05). In active sentences, only noun phrase complexity mattered (p < .001). For the same group of participants, simplification of entire paragraphs based on these three linguistic features had only a small effect on understanding (p = .99) and no effect on retention of information. Conclusions: Using grammatical text features, we could measure and improve the perceived difficulty of text. In contrast to expectations based on readability formulas, these grammatical manipulations had limited effects on actual difficulty and so were insufficient to simplify the text and improve understanding. Future work will include semantic measures and overall text composition and their effects on perceived and actual difficulty. Limitations: These results are limited to grammatical features of text. The studies also used
Now You See It, Now You Don’t: Ethnography and Selective Visibility in the Technology Sector

As ethnographers practicing within an engineering driven industry, we often struggle with visibility and its effects. Exposing the methodological and technical underpinnings of ethnographic practice can bring us closer to the teams we work with, but it can also draw attention to the ways that engineering and anthropology clash. In this brief paper we describe the rationale for deliberate and highly selective visibility in our engineering-driven workplace. We will draw on our experience as anthropologists “embedded” in teams of engineers to discuss our own claims to authority and examine how legitimacy is conferred upon ideas and actions in a technology-driven environment.
Effectiveness of Micro-Blowing Technique in Adverse Pressure Gradients

The impact of the micro-blowing technique (MBT) on the skin friction and total drag of a strut in a turbulent, strong adverse-pressure-gradient flow is assessed experimentally over a range of subsonic Mach numbers (0.3 less than M less than 0.7) and reduced blowing fractions (0 less than or equal to 2F/C (sub f,o) less than or equal to 1.75). The MBT-treated strut is situated along the centerline of a symmetric 2-D diffuser with a static pressure rise coefficient of 0.6. In agreement with presented theory and earlier experiments in zero-pressure-gradient flows, the effusion of blowing air reduces skin friction significantly (e.g., by 60% at reduced blowing fractions near 1.75). The total drag of the treated strut with blowing is significantly lower than that of the treated strut in the limit of zero-blowing; further, the total drag is reduced below that of the baseline (solid-plate) strut, provided that the reduced blowing fractions are sufficiently high. The micro-blowing air is, however, deficient in streamwise momentum and the blowing leads to increased boundary-layer and wake thicknesses and shape factors. Diffuser performance metrics and wake surveys are used to discuss the impact of various levels of micro-blowing on the aerodynamic blockage and loss.
Lessons from the Press Box: What Sports Writers can Teach Academics

Sports writing and academic writing might initially seem to be strange bedfellows. They have different structures--the inverted pyramid with emphasis on the lead versus, for example, the four-part format (introduction/literature review, method, results, and discussion) of the typical research paper. Their audiences also differthe broad Mr./Ms. Every person of sports writing as opposed to the specialized highly educated audience of academia. However, upon closer examination, they have more in common than might first appear, with sports writing providing lessons that academic writers could profitably draw upon.
Alterations in cardiac adrenergic terminal function and β-adrenoceptor density in pacing-induced heart failure

Congestive heart failure is associated with cardiac adrenergic nerve terminal changes and β-adrenoceptor density downregulation. To study the temporal sequence of these changes, we performed studie...
Industrial Reuse of Urban Stormwater

Rainfall runoff becomes contaminated as it passes over urban land. Billions of gallons of water can be recovered for beneficial uses if urban stormwater is properly controlled and treated. The Storm and Combined Sewer Program of the United States Environmental Protection Agency Office of Research and Development has continuously supported the development and demonstration of stormwater control systems and treatment processes. Water quality of the treated storm runoff can meet the required standards for subpotable usage. Current urban stormwater control and treatment technology are discussed, leading to the feasibility of urban stormwater reuse for various purposes in industry, irrigation and recreation. A hypothetical case study illustrating the cost effectiveness of reclaiming urban stormwater for complete industrial supply is presented.
Unconventional systems

For the bulk of the past decade, the computer manufacturer has maintained the "party line" that their successive models of high-end machines possessed all the performance that would be required for the foreseeable future. (This "party line" alternated with abortive attempts to, in fact, build high performance, compatible extensions of the product line which turned out to be neither high performance nor compatible.) While it appears to be true that currently available equipment will for a while continue to be adequate to permit plumbing supply houses to do inventory control, it has always been outrageously false that this equipment come evens close to meeting our scientific or military needs. In these areas, we have witnessed the oft noted paradox of technological advances spurring scientific needs in such a fashion that the disparity between what is needed and what is available continues to grow. In the case at hand, this is no paradox at all in that it is only now that we can realistically envision computers of sufficient speed and capability to make it possible to start using them to solve problems with a nontrivial intellectual content.
Understanding and modeling removal of anionic organic contaminants (AOCs) by anion exchange resins.

Ionic organic contaminants (OCs) are a growing concern for water treatment and the environment and are removed inefficiently by many existing technologies. This study examined removal of anionic OCs by anion exchange resins (AXRs) as a promising alternative. Results indicate that two polystyrene AXRs (IRA910 and IRA96) have higher sorption capacities and selectivity than a polyacrylate resin (A860). For the polystyrene resins, selectivity follows: phenolates ≥ aromatic dicarboxylates > aromatic monocarboxylates > benzenesulfonate > aliphatic carboxylates. This trend can be explained based on hydration energy, the number of exchange groups, and aromaticity and hydrophobicity of the nonpolar moiety (NPM) of the anions. For A860, selectivity only varies within a narrow range (0.13–1.64). Despite the importance of the NPM of the anions, neutral solutes were sorbed much less, indicating synergistic combinations of electrostatic and nonelectrostatic interactions in the overall sorption. By conducting multiple l...
Comparative Study of Mouthparts of the Phlebotomine Sand Flies Lutzomyia longipalpis, L. shannoni, and Phlebotomus papatasi (Diptera: Psychodidae)

Mouthparts of adult male and female Lutzomyia longipalpis (Lutz & Neiva), L. shannoni (Dyar), and Phlebotomus papatasi Scopoli were examined by light and scanning electron microscopy. Parameters compared include length and width of mandible, hypopharynx, labrum, maxillary palp (length only), lacinia (length and number of lateral and medial teeth); and number of teeth or spicules and length of tooth or spicule row on mandible, hypopharynx, and labrum. Female P. papatasi possess significantly longer mandibles, labrum, hypopharynx, laciniae, and maxillary palps than either L. longipalpis or L. shannoni . Significantly more teeth were present on mandibles and hypopharynx of female L. shannoni than on those of female L. longipalpis or P. papatasi . The hypopharynx and maxillary palps were significantly shorter in male L. shannoni than in male L. longipalpis or P. papatasi . Females of each species had significantly more medial teeth on the lacinia than did males of the same species.
Of Dialectics and Goat's Blood in an Anecdote by Montaigne

In his essay ‘De la ressemblance des enfants aux peres’ (II, 37) Montaigne tells two stories, the second of which is the curious account of how, after hearing that goat's blood was good for one's health, he raised a billy goat and had it slaughtered in the hope of procuring for himself some of this marvelous elixir. Only after the animal had been killed did he begin to have doubts about the medicinal virtues of goat's blood. Amused by his earlier credulousness, Montaigne relates this anecdote in a tone so personal, so affable and self-deprecatory that the reader, won over by the amiability of the speaker, is likely to be sensitive to the human quality of the narrator but unlikely to be attentive to the subtle way in which the text determines his responses or to the author's ulterior motives for eliciting those very responses.
Simple technique for culture of highly differentiated cells from dog tracheal epithelium

Cultures of dog tracheal epithelium have proved very useful in studies of ion transport. Their short-circuit current (Isc), however, is usually much less than the original tissue. We have tested a ...
Transcriptional Regulation of T Cell Lineage Commitment

Through most of life, multilineage precursor cells undergo commitment to the T cell lineage only after immigrating to the thymus. These cells undergo a stepwise process through which they give up potential to become B cells, myeloid cells, dendritic cells, natural killer cells, or innate lymphoid cells. The commitment process involves separate mechanisms to deal with each of these options, with environmental Notch signaling deferring access to the alternative pathways through multiple rounds of cell division until permanent, intrinsic mechanisms of alternative fate exclusion can be established. The basis for measuring alternative lineage potential, the roles of environmental signals in promoting different fates, the transcriptional machinery that provides access to them, and the T cell–specific factors that eventually eliminate them are described in this article.
Culture Under Cross-Examination: White man's justice? Sierra Leone and the expanding project of international law

The Special Court for Sierra Leone stands on a sprawling site in central Freetown, shielded from the rest of the country by imposing grey walls. An outer wall, ranging between five and eight feet in height, displays signs warning people that to park or even stand in the court's vicinity is forbidden; an inner one, about fifteen feet tall, is crowned by coils of razor wire. A policeman brandishing an AK-47, accompanied by other security personnel, guards the entrance from a sentry post; above it, a sand-bagged gun turret takes aim at the main road. Visitors who pass through the court's steel gate are obliged to acquire a security pass from a razor-wired concrete reception area in the shape of a pill box, then walk through a car park area and into the court's inner compound through two sliding, steel doors; vehicles, meanwhile, are subjected to bomb checks. Inside, to the left, stand the prefabricated huts of the Office of the Prosecutor, reminiscent of a military barracks or prisoner of war camp, ringed by razor wire and a six-feet high fence carrying signs that read ‘ID Cards Must be Shown at All Times’, ‘Restricted Access’, ‘Authorised Personnel Only’, ‘Visitors Must Be Escorted’. At various junctures guntoting Nigerian soldiers stand guard, wearing dark sunglasses, blue helmets and military fatigues; sometimes they conduct drills and simulate combat situations. Past the Office of the Prosecutor and up a path stands the gleaming structure of the courthouse itself, architecturally designed, apparently, to evoke an impression of the scales of justice.
That “Most Real Gift from One Generation to the Next”

The system of higher education in the United States is both remarkably resilient and elastic. There is no denying, however, that those of us in higher education have faced and will continue to face tough challenges, as we seek to improve access and navigate a rapidly altering technological and fiscal landscape. I am presently an administrator at a remarkably well endowed non-profit (private) four year institution, a nationally ranked liberal arts university.
A prospective randomized comparison of two distinct allogenic tissue constructs for anterior cruciate ligament reconstruction.

Abstract Background Conduct a prospective randomized study to compare clinical outcomes of anterior cruciate ligament (ACL) reconstruction using quadrupled hamstring tendon (HT) allograft or doubled tibialis anterior (TA) allograft. Limited level 1 data exist comparing outcomes of different soft tissue allograft constructs for ACL reconstruction. We hypothesized no difference would exist in the patient reported outcomes (PRO), arthrometric testing, or rate of re-rupture between the two constructs. Methods Ninety eight subjects undergoing primary ACL reconstruction were randomized to HT (n = 47) or TA (n = 51) allograft. Subjects completed validated (PRO) measures pre-operatively, and six months and two years post-operatively. Arthrometric testing was performed at six months to assess integrity of the reconstruction. Results Fifty-eight percent of subjects (57/98) completed a two-year follow up. Allograft re-tear rates were similar between groups (6.2% HT vs. 4.0% TA, respectively, p = 1.0). The relative risk of re-tear in the HT group was 1.5 compared to the TA group (p = 0.7). The TA group improved significantly more on the physical portion of the VR-12 (p = 0.046) and Lysholm score (p = 0.014) compared to the HT group. There was no difference in the change from baseline for the other PRO scores at two years. Conclusions Our data indicate no difference in graft failure rate and similar improvement from baseline in most PRO scores between treatment groups after two years. Based on these findings, TA allograft appears to provide a reliable and satisfactory option for patients who elect to undergo allograft ACL reconstruction.
Integration in Disasters of Different Types, Severity, and Location

Abstract The authors use disaster experiences that range from quite localized incidents to catastrophes around the world to illustrate how integration can work on many levels. From the disaster behavioral health (DBH) perspective, the response draws upon a highly variable collection of persons (primarily volunteers) whose makeup varies by state and jurisdiction. At the international level, evidence-based guidelines for Mental Health and Psychosocial Support (MHPSS) in emergency settings have been widely ratified and used effectively in responses to natural disasters, armed conflict, and humanitarian emergencies. This is a phrase equivalent to DBH in the US Future directions highlight the advantages of developing a more systematic, science-based, and professionalized DBH response within the United States, and incorporating the international MHPSS guidelines to enhance DBH within the United States and to streamline integration when the United States participates in an international response. From an emergency management (EM) perspective, the scale of the disaster is a primary determinant of the levels of response that must be activated to manage the event. The chapter includes four case studies that focus on best practices, lessons learned, and provides a planning matrix to improve integration.
Video Analysis of Factors Associated With Response Time to Physiologic Monitor Alarms in a Children's Hospital.

Importance Bedside monitor alarms alert nurses to life-threatening physiologic changes among patients, but the response times of nurses are slow. Objective To identify factors associated with physiologic monitor alarm response time. Design, Setting, and Participants This prospective cohort study used 551 hours of video-recorded care administered by 38 nurses to 100 children in a children’s hospital medical unit between July 22, 2014, and November 11, 2015. Exposures Patient, nurse, and alarm-level factors hypothesized to predict response time. Main Outcomes and Measures We used multivariable accelerated failure-time models stratified by each nurse and adjusted for clustering within patients to evaluate associations between exposures and response time to alarms that occurred while the nurse was outside the room. Results The study participants included 38 nurses, 100% (n = 38) of whom were white and 92% (n = 35) of whom were female, and 100 children, 51% (n = 51) of whom were male. The race/ethnicity of the child participants was 45% (n = 45) black or African American, 33% (n = 33) white, 4% (n = 4) Asian, and 18% (n = 18) other. Of 11 745 alarms among 100 children, 50 (0.5%) were actionable. The adjusted median response time among nurses was 10.4 minutes (95% CI, 5.0-15.8) and varied based on the following variables: if the patient was on complex care service (5.3 minutes [95% CI, 1.4-9.3] vs 11.1 minutes [95% CI, 5.6-16.6] among general pediatrics patients), whether family members were absent from the patient’s bedside (6.3 minutes [95% CI, 2.2-10.4] vs 11.7 minutes [95% CI, 5.9-17.4] when family present), whether a nurse had less than 1 year of experience (4.4 minutes [95% CI, 3.4-5.5] vs 8.8 minutes [95% CI, 7.2-10.5] for nurses with 1 or more years of experience), if there was a 1 to 1 nursing assignment (3.5 minutes [95% CI, 1.3-5.7] vs 10.6 minutes [95% CI, 5.3-16.0] for nurses caring for 2 or more patients), if there were prior alarms requiring intervention (5.5 minutes [95% CI, 1.5-9.5] vs 10.7 minutes [5.2-16.2] for patients without intervention), and if there was a lethal arrhythmia alarm (1.2 minutes [95% CI, −0.6 to 2.9] vs 10.4 minutes [95% CI, 5.1-15.8] for alarms for other conditions). Each hour that elapsed during a nurse’s shift was associated with a 15% longer response time (6.1 minutes [95% CI, 2.8-9.3] in hour 2 vs 14.1 minutes [95% CI, 6.4-21.7] in hour 8). The number of nonactionable alarms to which the nurse was exposed in the preceding 120 minutes was not associated with response time. Conclusions and Relevance Response time was associated with factors that likely represent the heuristics nurses use to assess whether an alarm represents a life-threatening condition. The nurse to patient ratio and physical and mental fatigue (measured by the number of hours into a shift) represent modifiable factors associated with response time. Chronic alarm fatigue resulting from long-term exposure to nonactionable alarms may be a more important determinant of response time than short-term exposure.
Characteristics of an effective nursing clinical instructor: The state of the science.

Aim and Objectives The aim of this paper is to analyze the perceived characteristics of an effective nursing clinical instructor and methods for measure instructor effectiveness. This review also examined importance of characteristics based on student age. Background The clinical instructor has a vital role in clinical education. While the role may be well defined, the characteristics these instructors need to do their jobs effectively are not. Design An integrative review from 1985 to present using four key terms: nursing, clinical, teaching, and effectiveness. This review revealed 37 articles that met the inclusion criteria for analysis. Results A synthesis of current research revealed three dominant themes: competency, the ability to develop interpersonal relationships, and certain personality traits. The analysis of the literature suggests the ability to develop interpersonal relationships is the most valued skill. Overall, approachability emerged as the most important personality trait needed to be an effective clinical instructor. The analysis also revealed a difference regarding the priority of characteristics based on age of the student. Conclusion The analysis of the literature suggests the ability to develop interpersonal relationships is the most valued skill for clinical instructors. Overall, approachability emerged as the most important personality trait needed to be an effective clinical instructor. Relevance to clinical practice Future studies should continue to evaluate the extent of the dominant themes especially considering the rise of the millennial student generation. This article is protected by copyright. All rights reserved.
Novel technique to avoid diaphragmatic paralysis during focal ablation of a non-pulmonary vein trigger mapped to the crista terminalis.

Almost 90% of triggers for atrial fibrillation (AF) are believed to originate from the pulmonary veins,1 and pulmonary vein isolation is the mainstay of therapy for patients with paroxysmal AF.2 Patients who demonstrate recurrent AF despite pulmonary vein isolation highlight the challenge and need of identifying non–pulmonary vein triggers. Reproducibility and inherent risk of the location of these foci may limit the success.
Lowest-order mode transmission in multimode dielectric S-bends

This paper focuses on the problem of lowest-order mode (LOM) transmission in multimode S-bends given LOM input. Total loss calculations in S-bends using the finite difference beam propagation method (FDBPM) are compared with analytical results. Sine and cosine shaped slab S-bend geometries are studied to determine if mode conversion (to higher-order modes) can be controlled and/or suppressed altogether. Reduction of bending losses for the overall structure is also sought. It is also shown that loss rates for a fixed radius of curvature and total loss in an S-bend are not sensitive to the substrate index. Thus results determined in this paper are applicable to a range of substrate indices. Specifically, it is shown that the results are applicable to ion-exchange glass waveguides.
Non-Axisymmetric Chimney Convection in a Mushy Layer Under a High Gravity Environment

Nonlinear buoyancy-driven chimney convection in arbitrary Prandtl number melts within mushy layers during alloy solidification is considered under a high-gravity environment, where the rotation axis is inclined at an angle γ to the high-gravity vector. The chimneys within the mushy layer produce undesirable freckles in the final form of the solidified material. These are imperfections that reduce the quality of the material. Methods of control aiming at eliminating or reducing significantly the convective flows in the chimneys also serve to eliminate or reduce significantly the existence and presence of the chimneys in the mushy layer, resulting in higher quality castings. Asymptotic and scaling examinations of the governing system for a non-axisymmetric and weakly unsteady mode of chimney convection resulted in new analytical expressions for the leading order magnitudes of the basic flow quantities as functions of the basic flow parameters. These results indicate that chimney convection can be reduced significantly in certain ranges of the parameter values under certain high gravity conditions and for prescribed and independent values of the radius of the chimneys.
Pilot randomized controlled trial of a Mediterranean diet or diet supplemented with fish oil, walnuts, and grape juice in overweight or obese US adults

The 2015–2020 Dietary Guidelines for Americans recommend a Mediterranean-type diet as one of three healthful eating patterns. However, only one previous trial has evaluated the effects of a Mediterranean diet intervention in a US sample population. To address this gap, we conducted a pilot, non-blinded, 8-week randomized controlled trial on the comparative efficacy of consumption of a Mediterranean diet or a diet supplemented with fish oil, walnuts, and grape juice versus controls. Participants (overweight or obese US adults; 73% female and mean age 51 years) were randomly assigned to one of three groups: (1) Mediterranean diet; (2) habitual high-fat American-type diet supplemented with fish oil, walnuts, and grape juice; or (3) habitual high-fat American-type diet (controls). Intent-to-treat analysis of within-subject differences (Student’s paired t-test or Wilcoxon sign ranks test) and between-subject differences (mixed-effects models with a group-by-time interaction term, adjusted for baseline health outcome) was conducted. Participants in the Mediterranean diet arm (n = 11) had significantly greater weight loss despite no significant change in total caloric intake, and lower plasma cystine, indicative of decreased oxidative stress, compared to controls (n = 9) at both 4 and 8 weeks. Compared to controls, they also had significantly lower total cholesterol and low-density lipoprotein cholesterol levels at 4 weeks. Participants in the supplement arm (n = 10) had significantly lower adiponectin levels compared to controls at 4 weeks. No significant improvements in endothelial function or inflammatory biomarkers were observed in either intervention group compared to controls. These results suggest that adopting a dietary pattern reflecting a Mediterranean diet improves weight and cardio-metabolic health among overweight or obese US adults, and may be more beneficial than supplementing habitual American diets with fish oil, walnuts, and grape juice. ClinicalTrials.gov NCT00166088 . Registered 14 September 2005.
An adaptive Monte Carlo method for uncertainty forecasting in perturbed two-body dynamics

Abstract A key objective of space situational awareness is to provide an accurate characterization of state uncertainty of space objects (SOs) in order to support predictive analytics, such as assessments of the probability of collision with other SOs. Due to a large number of SOs in comparison with the limited number of sensors available for tracking them, physics based uncertainty forecasting is often required for long periods, during which state uncertainty can become highly non-Gaussian. In this paper, we consider the problem of uncertainty forecasting in perturbed two-body dynamics via adaptive Monte Carlo simulations (MCS). While widely used, the standard Monte Carlo approach is limited by two main challenges: i.) its slow rate of convergence, which is especially detrimental to its application in complex systems where each simulation is computationally expensive; and ii.) ambiguity in the ensemble's capability to “accurately” characterize the true state-pdf over time with a fixed ensemble size, given the fact that the propagated state uncertainty is time-varying and unknown in advance. We employ a newly developed adaptive Monte Carlo method that aims to characterize the propagated state-pdf within user defined accuracy bounds in the perturbed two-body dynamics. In the adaptive Monte Carlo algorithm, the transient performance of MCS is quantified in terms of the standard deviation of its approximation error, which is estimated via bootstrapping. A particle addition scheme is activated when the approximation error exceeds the user-defined upper bound at the current time and new particles are introduced sequentially, one at a time. These are selected through a two-layered algorithm that (a.) enforces optimal inter-particle projective distance, and (b.) minimizes sample discrepancy with respect to the true initial state-pdf in terms of the space-filling and non-collapsing properties. On the other hand, particles are removed (halted) for future propagation when current MCS error is estimated to be lower than the user defined threshold, in the interest of reducing computational load. Particle removal is dependent on their own evolved probability-density values which are obtained by solving the corresponding stochastic Liouville equation (SLE) numerically. As a result, the proposed approach is expected to generate a “minimal” ensemble of particles to characterize the propagated state-pdf within user defined accuracy bounds at all future times. Numerical simulations are shown to demonstrate the effectiveness of the proposed forecasting method.
Drones in Construction

Drones are a quick and cost friendly option for construction companies wanting to increase productivity and efficiency in their day-to-day operations. With increased technological capabilities and newfound affordability, drones are rapidly influencing commercial industries; but regulations found in 14 C.R.F. § 107 must be relaxed before drones can provide both true efficiency in the construction industry and significantly impact the economy. Drones fly above a construction site, gathering images and collecting data that can be used to reduce the risk of personal accident, reconstruct work schedules, and identify construction defects. While drones provide inherent benefit to the construction industry, inexperienced operators, faulty mechanics, and limited insurance policies combine to create some risk. However, this risk does not outweigh the benefit that drones provide.
Marketing Exposure Recall is Associated With Past 30-Day Single, Dual, Polytobacco Use Among US Adolescents.

Introduction This study assesses the relationship between tobacco/e-cigarette marketing exposure and single, dual, and polytobacco product use, among adolescents. Given the increased use of noncigarette tobacco products (eg, cigars, e-cigarettes, hookah) among youth, it is imperative to understand if marketing exposure is associated with dual and polytobacco product use. Methods Data were obtained from the 2014 National Youth Tobacco Survey and weighted to be representative of US middle and high school students. Multivariable multinomial logistic regression models were used to assess the relationships between product marketing (via internet, print, retail, and TV/movies) and past 30-day single, dual, and poly (three or more) tobacco product use. Three analyses were conducted using different categories as referent groups to allow for comprehensive examination of the relationships between all groups. Results Marketing exposure was significantly correlated with a greater risk of single, dual, and polytobacco product use relative to nonusers. Relative to single product users, product marketing exposure was significantly correlated with a greater relative risk of dual and polytobacco use. There was no statistical difference in the association of marketing exposure between dual and polytobacco use, in any model. Conclusion A positive relationship between tobacco product marketing exposure and number of tobacco products used was observed. The magnitude of the relationship grew from single product to dual/poly use. Restrictions of marketing of all tobacco products, similar to cigarettes, particularly in the retail setting, should be considered. Implications This study has two primary public health implications. First, self-reported exposure to tobacco/e-cigarette marketing is widespread among adolescents of all tobacco product categories. Second, this widespread exposure to tobacco/e-cigarette marketing appears to not only be correlated with use of a single tobacco product (eg, cigarettes, e-cigarettes), but also multiple tobacco products. While longitudinal studies are needed to further investigate the relationships observed in this study, findings justify further study given the known relationship between tobacco marketing exposure and subsequent cigarette use.
The Intermediate Value Theorem is NOT Obvious---and I am Going to Prove It to You.

The Intermediate Value Theorem is not often proved in Calculus I classes because many teachers and students see the theorem as obvious and its proof as impenetrable. This article addresses those tw...
Porosity production in weathered rock: Where volumetric strain dominates over chemical mass loss

Weathering in the critical zone causes volumetric strain and mass loss, thereby creating subsurface porosity that is vital to overlying ecosystems. We used geochemical and geophysical measurements to quantify the relative importance of volumetric strain and mass loss---the physical and chemical components of porosity---in weathering of granitic saprolite of the southern Sierra Nevada, California, USA. Porosity and strain decrease with depth and imply that saprolite more than doubles in volume during exhumation to the surface by erosion. Chemical depletion is relatively uniform, indicating that changes in porosity are dominated by processes that cause strain with little mass loss. Strain-induced porosity production at our site may arise from root wedging, biotite weathering, frost cracking, and the opening of fractures under ambient topographic stresses. Our analysis challenges the conventional view that volumetric strain can be assumed to be negligible as a porosity-producing mechanism in saprolite.
Transgender, Transexual, and Gender Variant Individuals

Abstract Gender identity refers to an individual's experience or identity in relation to gender. Transgender, transsexual, and gender variant individuals (often considered under the umbrella term of transgender or trans∗) have gender identities that are not congruent with the gender assigned to them at birth. Trans∗ identity and experiences are framed with regard to medical perspectives, social and legal perspectives, and community perspectives.
Salivary stress hormone response and performance in full competition after linear or undulating periodization training in elite powerlifters.

BACKGROUND The purposes of this study were to determine differences in training loads and stress hormones among national level powerlifting competitors and the effect on performance. METHODS Thirteen experienced male powerlifters provided detailed training logs during the 8 weeks prior to a national competition. Participants were divided into linear (LP, N.=6) and undulating periodization (UP, N.=7) training groups. Following weigh-ins and after successfully completing the competition, participants provided saliva samples. RESULTS LP resulted in lower levels of salivary cortisol (sC) (LP 4.27±0.71 nmols/L; UP 5.53±0.78 nmols/L) and higher testosterone-to-cortisol ratio (T:C) (LP 8.03±0.84 nmols/L; UP 5.23±1.41 nmols/L) compared to UP prior to competition. Following competition, both LP and UP groups had significant increases in salivary testosterone (sT) (LP 383.70±34.96 nmols/L; UP 376.62±38.17 nmols/L) and sC (LP 17.67±1.39 nmols/L; UP 18.17±1.46 nmols/L) and significant reductions in T:C (LP 8.03±0.80 to 6.67±0.83; UP 5.23±1.41 to 4.95±1.00). Finally, the UP group had a significantly higher Wilks coefficient following the competition compared to the LP group (LP 440.7±31.83 vs. UP 480.29±24.13). CONCLUSIONS It appears that the higher volume loads undertaken by UP have a larger perturbation on resting stress hormones; however, this does not seem to negatively influence powerlifting performance.