cssi/SciSciGPT-SciSciNet huggingface dataset:
Using the Consolidated Framework for Implementation Research to Increase Provider Screening for Intimate Partner Violence in Rural Health Clinics.

Abstract Purpose To demonstrate the utility of the Consolidated Framework for Implementation Research as a tool for conceptualizing and overcoming obstacles to the implementation of universal screening practices for intimate partner violence (IPV), with a particular focus on rural family practice settings. This article uses data from a 2014 statewide survey of rural primary care providers to identify potential leverage points for policy and practice changes. Methods The Physician Readiness to Manage Intimate Partner Violence was administered to 134 physicians and nurses at rural health clinics in a Midwestern state. Six scales measuring knowledge, attitudes, and behaviors were computed and analyzed with bivariate and logistic regression models to ascertain links between knowledge/attitudes and screening/response behaviors. Findings Knowledge and attitudes did not predict screening; rather, the number of hours of previous training on abuse and the organizational protocols of the clinics where providers were employed significantly increased the likelihood of frequent IPV screening. Conclusions Guided by Consolidated Framework for Implementation Research principles, the author concludes that external factors, that is, state or national policies mandating IPV screening in clinics, may be an effective way to increase provider identification of a major public health problem affecting women. Rural women may benefit especially from IPV screening during health care encounters, because there are few other supportive services for abuse survivors in rural areas.
Did They Ever Stand a Chance? Understanding Police Interrogations of Juveniles

The Miranda v. Arizona (1966) decision was a pivotal case in the United States. It afforded rights to suspects and defendants against self-incrimination and representation during police interrogations. Miranda ensured police read individuals in custody their rights before interrogations. However, what happens when individuals being read their rights do not fully comprehend the significance of what the police are telling them, whether it is because of lack of comprehension due to brain development, or susceptibility to the influence of those questioning them? The courts have examined these direct issues when it comes to “voluntary” confessions made by juveniles. Several cases ( J.D.B. v. North Carolina, 2011; Yarborough v. Alvarado, 2004) have tackled elements of this issue in court, but studies show that a majority of youth do not fully comprehend what they are waiving when police read their Miranda warnings. This paper will examine the decision in Miranda and other key cases related to the interrogation of juveniles, explore the cognitive development of juveniles, and investigate how police handle interrogation of juveniles.
Laminated micro-machine: Design and fabrication of a flexure-based Delta robot

Abstract Mesoscale electromechanical systems find applications in fields such as medical instrumentation, soft robotics, microscopy, flexible electronics and imagining. This paper implements the printed circuit MEMS (PC-MEMS) process [1] for the fabrication of a ‘pop-up’ flexure-based mesoscale system that exploits the simplicity of 2-D manufacturing techniques such as sheet-metal operations and laser cutting to realize a 3-D mechanism. The fabrication of a laminated Delta robot with prismatic actuation is presented to exemplify this process. A working device with actuation and functional components such as linear guides, stepper motors and limit switches is designed and fully realized. Because the mechanism is popped out of the plane to achieve its 3D shape, we present a stiffness analysis to arrive at the out-of-plane (or ‘pop-out’) angles that the planar system must accommodate so that constraints/limits on actuator torque/force can be can satisfied while producing an operational system. The simplicity of the processes makes it a candidate for the use in the emerging open-source hardware technologies for fabricating low-cost, complex, electromechanical systems.
Theodore Karman, Paul Wigner, John Neumann, Leo Szilard, Edward Teller and their ideas of ultimate reality and meaning

L'A. propose une etude comparative entre les pensees philosophiques de Theodore Karman, Paul Wigner, John Neumann, Leo Szilard et Edward Teller. Tous ces philosophes ont en commun d'avoir fui l'Allemagne et la Hongrie pour les Etats-Unis apres l'accession d'Hitler au pouvoir. Il s'agit de faire ressortir leur conception respective sur les realites ultimes et sur leur signification. Les cinq auteurs en question sont passes en revue d'abord separement (cinq parties, une pour chacun). La conclusion fait ressortir les nombreux points communs de leur pensee
1-Hydrosilatrane: A Locomotive for Efficient Ketone Reductions

An efficient method for the reduction of ketones with 1-hydrosilatrane is described. In the presence of a Lewis base activator, the resulting secondary alcohols are rapidly formed in good to excellent yields (20 examples, 71–99 % yields). The relative bulkiness of 1-hydrosilatrane also enables the diastereoselective reduction of (–)-menthone to (+)-neomenthol, and the use of a chiral alkoxide activator can lead to the enantioselective reduction of prochiral ketones.
Using ontology-based semantic similarity to facilitate the article screening process for systematic reviews

Abstract Objective Systematic Reviews (SRs) are utilized to summarize evidence from high quality studies and are considered the preferred source of evidence-based practice (EBP). However, conducting SRs can be time and labor intensive due to the high cost of article screening. In previous studies, we demonstrated utilizing established (lexical) article relationships to facilitate the identification of relevant articles in an efficient and effective manner. Here we propose to enhance article relationships with background semantic knowledge derived from Unified Medical Language System (UMLS) concepts and ontologies. Methods We developed a pipelined semantic concepts representation process to represent articles from an SR into an optimized and enriched semantic space of UMLS concepts. Throughout the process, we leveraged concepts and concept relations encoded in biomedical ontologies (SNOMED-CT and MeSH) within the UMLS framework to prompt concept features of each article. Article relationships (similarities) were established and represented as a semantic article network, which was readily applied to assist with the article screening process. We incorporated the concept of active learning to simulate an interactive article recommendation process, and evaluated the performance on 15 completed SRs. We used work saved over sampling at 95% recall (WSS95) as the performance measure. Results We compared the WSS95 performance of our ontology-based semantic approach to existing lexical feature approaches and corpus-based semantic approaches, and found that we had better WSS95 in most SRs. We also had the highest average WSS95 of 43.81% and the highest total WSS95 of 657.18%. Conclusion We demonstrated using ontology-based semantics to facilitate the identification of relevant articles for SRs. Effective concepts and concept relations derived from UMLS ontologies can be utilized to establish article semantic relationships. Our approach provided a promising performance and can easily apply to any SR topics in the biomedical domain with generalizability.
Abstract 468: Induction of Autophagy with Beclin-1 is not Sufficient to Reduce Atherosclerosis

Autophagy is a highly conserved cellular process designed to degrade long-lived and dysfunctional protein aggregates and organelles. Recent work has established an important role for macrophage aut...
A Closed-loop MEMS force sensor with adjustable stiffness

This paper presents the design, implementation, and control of a novel microelectromechanical system (MEMS) force sensor. The device features bidirectional electrostatic actuators and on-chip piezoresistive displacement sensors. For the fabrication, a standard silicon-on-insulator process is used. Due to the bidirectional geometry, the probe is able to perform force measurement in both push and pull directions. An electrostatic structure is also incorporated for in-situ tuning of the sensor's mechanical stiffness. This stiffness-adjusting mechanism offers an additional control parameter, enabling the sensor to be adaptable on various input force conditions. Exploiting the stiffness-adjusting mechanism, a variation in the resonant frequency from 3 kHz to about 4.4kHz is experimentally demonstrated which translates to a stiffness variation within a factor of two. By implementing a resonant controller together with an integral action, the adverse effect of flexural nonlinearities on the precision of the force measurement is mitigated. The performance of the closed-loop system is also evaluated by exerting a disturbance signal to the closed-loop system simulating an external input force. Finally, the resolution and the measurement range of the sensor in the open-loop and the closed-loop are compared and discussed.
Assessing Students' Conceptual Knowledge of Electricity and Magnetism.

Introducing the electricity and magnetism conceptual assessment as a new instrument that aligns well with typical course content in the second semester of a year-long college-level introductory physics course.
Physiological predictors of leptin vary during menses and ovulation in healthy women.

Abstract Although research has shown interactions between the reproductive system and energy homeostasis, it is not clear how environmental or behavioral factors may factor into these associations. Here we aimed to determine how changes in reproductive state (i.e., phase of the menstrual cycle) and other behavioral and physiological factors may influence leptin levels in healthy women, as well as how sexual activity may play a role in leptin modulation. We collected serum and saliva from 32 healthy women and measured leptin, estradiol, and progesterone. Participants also completed surveys of demographics, health and sexual behaviors, and physical activity. Leptin was predicted by meals per day and missed meals at both menses and ovulation. However, estradiol and physical activity were stronger predictors of leptin at menses, while sexual activity was a stronger predictor of leptin at ovulation. These findings suggest that predictors of serum leptin, and possibly energy storage and expenditure, vary across the menstrual cycle.
Bridging the Gaps in the Vaccine Development: Avant-Garde Vaccine Approach with Secreted Heat Shock Protein gp96-Ig

Design of highly pure and safe vaccines in post-genomic era unfortunately includes the inherent lack of immunostimulatory properties of proteins and peptides. Vaccine adjuvants are therefore considered key components in modern vaccinology since they provide the necessary help of enhancing the immune responses. Over the past two decades, Dr. Podack’s laboratory has developed an exciting and avant-garde reagent: a heat shock protein-based vaccine, chaperone gp96, that generates effective antitumor and anti-infectious immunity in vivo. State-of-the-art secreted gp96-Ig vaccine provides within one molecule strong adjuvant properties and antigen specificity for cross-priming CD8 T cells and activation of innate immunity. Gp96-peptide complexes were identified as an extremely efficient, femto-molar pathway of MHC I-mediated antigen cross-presentation, generating CD8 CTL responses detectable in the blood, spleen, liver, intestinal and reproductive tract lamina propria, and intraepithelial compartment, respectively. These studies provided the first evidence that cell-based gp96-Ig-secreting vaccines may serve as a potent modality to induce not only systemic but also mucosal immunity. The gp96-Ig vaccine strategy has been utilized in clinical trials for non-small cell lung cancer (NSCLC) patients and as prophylactic SIV vaccine to protect nonhuman primates from mucosal infection upon challenge with SIV, demonstrating the feasibility and benefits of this approach for both safety and efficacy.
Effect of Salt Water Exposure on Foam-Cored Polyurethane Sandwich Composites

This study investigated the effect of moisture absorption on the mechanical performance of polyurethane sandwich composites. The core material was a closed cell polyurethane foam. Face sheets were ...
Management of HIV-Exposed Infants

The majority of new human immunodeficiency virus (HIV) infections in children are acquired perinatally, thus emphasizing the importance of effective management of this vulnerable group of infants born to mothers with HIV. Dramatic declines in new childhood HIV infections since 1995 are largely attributable to global efforts to prevent mother-to-child transmission. These efforts include HIV testing, providing antiretroviral treatment (ART) to pregnant and breastfeeding women living with HIV, antiretroviral (ARV) prophylaxis to infants born to mothers with HIV, intrapartum zidovudine when maternal viral load is not suppressed, and cesarean delivery. The recommendations for diagnosis, treatment, and prevention of HIV infection among pregnant women and their infants are constantly evolving, and the most current recommendations can always be found at https://aidsinfo.nih.gov.
Mild Obstructive Sleep Apnea Syndrome Should be Treated

What little I remember from high school concerning debating technique consists of the Jesuit adage, “define your terms.” Consequently, I will begin by reviewing the possible criteria by which obstructive sleep apnea (OSA) could be considered “mild” in degree. The various attributes attached to OSA include the presence of symptoms (most frequently, hypersomnia), as well as various metrics obtained from the overnight polysomnogram. The latter include degree of oxyhemoglobin desaturation, which might encompass saturation nadir, total sleep time (TST) below a certain saturation, or mean saturation; respiratory-associated arousal index; or apnea-hypopnea index (AHI). Although the definition of “mild” OSA could be the subject of its own debate, the American Academy of Sleep Medicine has, in fact, taken a position on this issue.1 Two criteria are used: sleepiness, which must be either absent or mild in degree (only occurring in sedentary situations), and AHI, which must fall between 5 and 15 events per hour of sleep. Unfortunately, mild OSA in clinical research has almost universally been defined only in terms of AHI, usually that in the range of 5–15. This definition must then suffice for purposes of this debate.
UNDERWATER SHOCK WAVE MEASUREMENTS USING PVDF TRANSDUCERS

Preliminary experiments have been performed to measure 2 to 4 GPa, time-resolved, pressure profiles of underwater shocks at solid/water interfaces. A transducer configuration has been developed that is based on a polyvinylidene fluoride polymer (PVDF) poled using the standardized technique developed at the Institut de Saint-Louis (ISL). It is known that PVDF is sensitive to both stress and strain. The NAVSWC PVDF transducer was designed to measure stress and strain by using a tandem-element arrangement and to compensate for the strain component in the stress record. Preliminary results will be presented showing progress with this transducer configuration.
The Development of Parallel GAMESS

This talk will describe the development of parallel capabilities with the quantum chemistry program GAMESS (General Atomic and Molecular Electronic Structure System) (Fletcher et al., 1998). The conversion of a large sequential Fortran package to parallel computation involves an interplay between four factors, the driving force of which is the need to run larger chemical applications and the availability of personnel interested in parallel programming, the hardware of the day, and the software tools of the day.
In vitro-in vivo evaluation of a controlled release buccal bioadhesive device for oral drug delivery.

Purpose. To investigate the use of buccal bioadhesive device in targeting controlled drug delivery to the gastrointestinal tract. Methods. A three-leg crossover study was designed to evaluate the application of buccal bioadhesive device for providing controlled drug delivery to the gastrointestinal tract of a model drug cyanocobalamin in four healthy adult male beagle dogs. Results. In vitro dissolution studies using deionized water as the medium indicated that 100% of the drug was released within 15 min from a immediate release oral capsule formulation, whereas 90% of the drug was released within a period of 18 hrs from a buccal bioadhesive device formulation. Drug release from the buccal bioadhesive devices appeared to follow Higuchi's square root of time dependent model. The terminal half-life of the drug following I.V. administration in four dogs was found to be 16.4 ± 2.4 hrs. Following immediate release oral capsule administration of the drug Cmax, tmax and bioavailability were 2333 ± 1469 ng/L, 2.5± 1.0 hrs and 14.1 ± 7.9%, respectively. Following buccal bioadhesive device administration of the drug Cmax, tmax and bioavailability were 4154 ± 1096 ng/L, 11 ± 1.2 hrs and 35.8 ± 4.1%, respectively. Significantly higher bioavailability of the drug was observed with the buccal bioadhesive device administration when compared to the immediate release oral capsule. Conclusions. The buccal bioadhesive device appears to improve the oral bioavailability of cyanocobalamin by providing controlled delivery of the drug to the gastrointestinal tract.
Metallo-Organic CVD (MOCVD)

This chapter discusses the metallo-organic chemical vapor deposition (MOCVD), which is a specialized area of CVD process. The deposition of indium phosphide and indium antimonide show that the deposition of critical semiconductor materials can be obtained at lower temperatures than conventional thermal CVD and that epitaxial growth can be easily achieved. Metallo-organics are the compounds in which the atom of an element is bound to one or more carbon atoms of an organic hydrocarbon group. Some of the elements used in MOCVD are nontransitional and are the metals of groups IIa, IIb, IIIb, IVb, Vb, and VIb. Thus the metallo-organics complement the halides and carbonyls, which are the precursors for the deposition of transition metals (Groups IVa, Va, and VIa) and their compounds. The MOCVD is used on a large scale, particularly in the semiconductor and opto-electronic applications, since the diversity and purity of the precursor chemicals have improved over the past several years.
Evidence of Handedness on Documented Skeletons

The collection of skeletal material at the University of Maryland School of Medicine now includes a small sample of scapulae and long bones of the upper extremities taken from cadavers of known handedness. This sample has been used to begin studies for determining the accuracy of methods currently used for diagnosing handedness. Measurements have been taken of the deflection angle that results from dorsal inclination of the glenoid fossa, humeral length and head diameter, bicondylar width, and radial and ulnar lengths. A radiohumeral index and the total combined length of the long bones for each extremity as well as side difference in total length were calculated. These data plus the presence or absence of an extensor facet on the dorsal margin of the glenoid fossa have been compared with the known hand preference. Thus far, the data indicate that the extensor facet, greater dorsal inclination of the glenoid fossa, greater total length of long bones, and greater bicondylar width correlate with the dominant side. Since the sample size is small, further work is needed before a valid statistical analysis can be made.
An approach to real-time adaptive decision making in dynamic distributed systems

Efficient operation of a dynamic system requires (near) optimal real-time control decisions. Those decisions depend on a set of control parameters that change over time. Very often, the optimal decision can be made only with the knowledge of future values of control parameters. As a consequence, the decision process is heuristic in nature. The optimal decision can be determined only after the fact, once the uncertainty is removed. For some types of dynamic systems, the heuristic approach can be very effective. The basic premise is that the future values of control parameters can be predicted with sufficient accuracy. We can either predict those value based on a good model of the system or based on historical data. In many cases, the good model is not available. In that case, prediction using historical data is the only option. It is necessary to detect similarities with the current situation and extrapolate future values. In other words, we need to (quickly) identify patterns in historical data that match the current data pattern. The low sensitivity of the optimal solution is critical. Small variations in data patterns should affect minimally the optimal solution. Resource allocation problems and other "discrete decision systems" are good examples of such systems. The main contribution of this work is a novel heuristic methodology that uses neural networks for classifying, learning and detecting changing patterns, as well as making (near) real-time decisions. We improve on existing approaches by providing a real-time adaptive approach that takes into account changes in system behavior with minimal operational delay without the need for an accurate model. The methodology is validated by extensive simulation and practical measurements. Two metrics are proposed to quantify the quality of control decisions as well as a comparison to the optimal solution.
Going with the Flow: Testing the Role of Habitat Isolation among Three Ecologically Divergent Darter Species

Variation in habitat across the landscape can limit dispersal between populations and influence the diversity and degree of genetic structure of populations. This effect may be larger in small aquatic species with low vagility, specific habitat requirements, and that inhabit lotic systems where dispersal may be biased by the unidirectional movement of water downstream. Darters offer a unique perspective to understand these influences because they have variable life histories and habitat requirements, and evidence suggests that certain life history characters may affect gene flow. Data were collected from a combination of microsatellite loci from 825 individuals to compare genetic structure and differentiation of three species of darters (Ammocrypta beanii, Etheostoma swaini, and Percina nigrofasciata) with differences in life histories and habitat requirements in the Pearl River basin. Our analyses reveal low, but interesting, patterns of population subdivision. Genetic subdivision among populations was highest for E. swaini, intermediate for P. nigrofasciata, and lowest for A. beanii. This pattern suggests a difference in dispersal, influenced by the variation in available habitat required for each species. Further investigations are warranted for small, benthic, and especially threatened species in the Pearl River basin as the main channel has undergone a significant shift in geomorphology and habitat diversity since the construction of reservoirs and low-head dams along its course.
Primary Care Integration

Prevention and early intervention efforts for both psychiatric and medical conditions are key to promoting the optimal development of children. Various strategies for integrated care, which include primary, secondary, and tertiary prevention efforts, have a global applicability. This chapter utilizes problem-based learning to illustrate the implementation of integrated service delivery structures. Through this learning modality, the global challenges related to a shortage of specialized child mental health providers and lack of access to care are discussed. Strategies to address these barriers include innovative service delivery models, collaborative partnerships, and tele-mental health services.
Jealousy, Consent, and Compersion Within Monogamous and Consensually Non-Monogamous Romantic Relationships.

Evolutionary psychological research has studied romantic jealousy extensively within monogamous relationships, but has largely ignored jealousy among partners who mutually consent to forming extra-pair relationships (i.e., consensual non-monogamy; CNM). We examined monogamous (n = 529) and CNM (n = 159) individuals’ reactions to imagining their romantic partner(s)’s extra-pair involvement. For each romantic partner, men and women completed measures of relationship jealousy and reacted to scenarios of their partner’s extra-pair emotional and sexual involvement. Scenarios prompted participants to indicate which type of involvement would be more distressing and more enjoyable. They also described whether or not participants had consented to their partner’s extradyadic relationship. Monogamous men were more distressed by a partner’s extradyadic sexual versus emotional involvement (and a partner’s emotional involvement was more enjoyable) whether the scenario was consensual or not. Monogamous women were more distressed by a partner’s emotional versus sexual involvement (and a partner’s sexual involvement was more enjoyable) for consensual, but not non-consensual, scenarios. There were no gender differences among CNM participants. Monogamous individuals reported greater emotional distress toward a partner’s imagined extradyadic involvement, whereas CNM individuals reported thinking about their partner’s extra-pair relationships more frequently. Monogamous (vs. CNM) individuals reported greater confidence that their partner would never cheat on them (i.e., enter another relationship without their consent), and CNM participants were more confident that their primary versus secondary partner would never cheat, although this effect was stronger among CNM women. Moreover, CNM participants rated that it was more important that their primary versus secondary partner did not cheat, and reported greater distress imagining that their primary versus secondary partner had cheated. Women in CNM relationships rated it more important that their partner did not cheat sexually than emotionally. Finally, we replicated previous research showing that monogamous individuals mate guard more than CNM individuals, who mate guard their primary versus secondary partner more frequently. Future directions for developing evolutionary and romantic relationship research on CNM are discussed.
Nuclear Focal Adhesion Kinase Controls Vascular Smooth Muscle Cell Proliferation and Neointimal Hyperplasia Through GATA4-Mediated Cyclin D1 Transcription.

Rationale: Neointimal hyperplasia is characterized by excessive accumulation of vascular smooth muscle cells (SMCs) leading to occlusive disorders, such as atherosclerosis and stenosis. Blood vesse...
Defining and predicting transdiagnostic categories of neurodegenerative disease (800)

Objective: To develop biomarkers for neurodegenerative disease that accommodate the co-occurrence of multiple pathological protein species. Background: Neurodegenerative diseases are defined by the presence of one or two pathogenic protein species on autopsy. Yet, patients frequently meet criteria for multiple diseases. The prevalence of concomitant diagnoses and the inability to infer an underlying neuropathological syndrome from clinical variables hinders the identification of patients who might be good candidates for a particular intervention. Design/Methods: We used graph-based clustering on post-mortem histopathological data from 1389 patients with degeneration in the central nervous system to generate 4 non-overlapping, data-driven disease categories that simultaneously account for amyloid-β plaques, tau neurofibrillary tangles, α-synuclein inclusions, neuritic plaques, TDP-43 inclusions, angiopathy, neuron loss, and gliosis. Next, we use cross-validated multiple logistic regression to predict disease labels from in vivo data. Results: We identified histopathology-based transdiagnostic disease clusters that naturally separated patients in terms of cognitive phenotypes, cerebrospinal fluid (CSF) protein levels, and genotype. This phenotypic separation was not trivially explained by the representation of individual diseases within each cluster. Using multiple logistic regression, we accurately predicted (AUC > 0.9) membership to both existing disease categories and transdiagnostic clusters based on CSF protein levels and genotype. Conclusions: Broadly, our approach parses phenotypic and genotypic heterogeneity in neurodegenerative disease, and represents a general framework for identifying otherwise-fuzzy disease subtypes in other areas of medicine, such as epilepsy, vascular disease, and cancer. In clinical neurology, our predictive models may be useful for repurposing drugs by comparing efficacy to probabilistic estimates of disease cluster membership, as well as for targeting future drug trials towards an algorithmically defined family of diseases. Disclosure: Dr. Cornblath has nothing to disclose. Dr. Robinson has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Trojanowski has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Johnson a Johnson. Dr. Bassett has nothing to disclose.
A Multimodal Sepsis Quality-Improvement Initiative Including 24/7 Screening and a Dedicated Sepsis Response Team-Reduced Readmissions and Mortality.

Objectives To evaluate if a hospitalwide sepsis performance improvement initiative improves compliance with the Centers for Medicare and Medicaid Services-mandated sepsis bundle interventions and patient outcomes. Study Design Retrospective analysis comparing 6 months before and 14 months after intervention. Setting Tertiary teaching hospital in Washington, DC. Subjects Patients admitted with a diagnosis of sepsis to a tertiary hospital. Interventions Implementation of a multimodal quality-improvement initiative. Measurements and Main Results A total of 4,102 patients were diagnosed with sepsis, severe sepsis, or septic shock during the study period, 861 patients (21%) were diagnosed during a 6-month preintervention period, and 3,241 (79%) were diagnosed in a 13-month postintervention period. Adjusted for patient case-mix, the prevalence of simple sepsis increased by 12%, but it decreased for severe sepsis and septic shock by 5.3% and 6.9%, respectively. Compliance with all sepsis bundle interventions increased by 31.1 percentage points (p < 0.01). All-cause hospital readmission and readmission due to infection were both reduced by 1.6% and 1.7 percentage points (p < 0.05). Death from any sepsis diagnosis was reduced 4.5% (p < 0.01). Death from severe sepsis and septic shock both was reduced by 5% (p < 0.01) and 6.5% (p < 0.01), respectively. Conclusions After the implementation of multimodal sepsis performance initiatives, we observed a higher prevalence of sepsis secondary to screening but a lower prevalence of severe sepsis and septic shock, an improvement in compliance with the sepsis bundle interventions bundle, as well as reduction in hospital readmission and all- cause mortality rate.
Caracterización de la migración y los determinantes sociales de la salud en el Continente Americano.

Objectives: To relate the types of migration considering social determinants of health in the American Continent; and characterize the migrant population by sex. Methods: A search was done at PubMed, Scielo, Lilacs, EBSCO, and Google Scholar using MeSH terms. For the inclusion criteria, the title and abstract were analyzed considering: being linked to migration in the American continent, related to the social determinants of health and language (Spanish or English). Articles that mentioned migratory processes or migrants from Asia, Africa, Europe, Oceania, migrations in the same country, investigations where migration was linked to specific pathologies, critical reviews of the literature, and letters to the editor were excluded. Results: titles and abstracts of 1,488 articles were accessed, inclusion and exclusion criteria were applied, obtaining 25 articles. 4 duplicate articles were eliminated, reaching 21 final articles. Conclusion: Regardless of the type of migration, there is a greater female migratory flow. The determinants that affect health are similar in general within the American continent. However, when we talk about access to the health system, it was observed that there is a difference, depending on the type of migration
Stem Cell Transplantation Efficacy in Cerebral Palsy: A Case Report from a Physical Therapist Perspective

Children with spastic cerebral palsy usually display an elevationin muscle tone,a decline in gross motor functional abilities,feeding problems and visual problems.Studies on stem cell treatment are in their early stages concerningitsefficacy forcerebral palsy. The purpose of the current study was to evaluate the efficacy of stem cell transplantation forgross motor functions, fine motor functions, feeding, visionandspasticity in achild with cerebral palsy(CP). A child with spastic CPon Level Vofthe Gross Motor Function Classification System(GMFCS)was selectedforthe transplantation of autologous Bone Marrow-derived Mononuclear Cells(BMMNCs). Muscle tone, grossmotor abilities, finemotor abilities, feeding abilities and visual abilities were assessed on 4 occasionsincluding1)beforethe transplantation,2) immediately after the transplantation,3) sixmonths after the transplantation,and 4) oneyearafter the transplantation.No effect of stem cell transplantation was observedinthe childconcerning gross motor functions, fine motor functions,feeding, vision and the degree of spasticity. Furtherstudies should be carried out on the subject using a different population rather than the one comprising children on Level V of the GMFCS. Copyright (c) Alaa Noureldeen Kora
The Macroevolutionary Consequences of Niche Construction in Microbial Metabolism.

Microorganisms display a stunning metabolic diversity. Understanding the origin of this diversity requires understanding how macroevolutionary processes such as innovation and diversification play out in the microbial world. Metabolic networks, which govern microbial resource use, can evolve through different mechanisms, e.g. horizontal gene transfer or de novo evolution of enzymes and pathways. This process is governed by a combination of environmental factors, selective pressures, and the constraints imposed by the complex genetic architecture of metabolic networks. In addition, many independent results hint that the process of niche construction, by which organisms actively modify their own and each other’s niches and selective pressures, could play a major role in microbial innovation and diversification. Yet, the general principles by which niche construction shapes microbial macroevolutionary patterns remain largely unexplored. Here, we discuss several new hypotheses and directions, and suggest metabolic modeling methods that could allow us to explore large-scale empirical genotype-phenotype-environment spaces in order to study the macroevolutionary effects of niche construction. We hope that this short piece will further stimulate a systematic and quantitative characterization of macroevolutionary patterns and processes in microbial metabolism.
Maternal immune response and placental antibody transfer after COVID-19 vaccination across trimester and platforms

The availability of three COVID-19 vaccines in the United States provides an unprecedented opportunity to examine how vaccine platforms and timing of vaccination in pregnancy impact maternal and neonatal immunity. Here, we characterized the antibody profile after Ad26.COV2.S, mRNA-1273 or BNT162b2 vaccination in 158 pregnant individuals, and evaluated transplacental antibody transfer by profiling maternal and umbilical cord blood in 175 maternal-neonatal dyads. These analyses revealed lower vaccine-induced functions and Fc-receptor binding after Ad26.COV2.S compared to mRNA vaccination, and subtle advantages in titer and function with mRNA-1273 versus BN162b2. mRNA vaccinees had higher titers and functions against SARS-CoV-2 variants of concern. First and third trimester vaccination resulted in enhanced maternal immune responses relative to second trimester. Higher cord:maternal transfer ratios following first and second trimester vaccination reflect placental compensation for waning maternal titers. These results support vaccination early in pregnancy to maximize maternal protection throughout gestation, without compromising neonatal antibody protection.
Pain in Parkinson’s Disease: Pathophysiology, Classification, and Clinical Approach

Pain is a frequent yet underrecognized symptom of Parkinson’s disease (PD). Although routine clinical neurological examination generally does not reveal any abnormality of sensation in persons with PD, objective abnormalities of proprioceptive function and sensorimotor integration have been demonstrated with sophisticated testing. Painful symptoms pose a considerable diagnostic and therapeutic challenge to the clinician. For diagnostic purposes, it is helpful to classify painful or unpleasant sensory symptoms into one or more of the following five categories: musculoskeletal pain, radicular or neuropathic pain, dystonia-related pain, akathitic discomfort, or primary, central parkinsonian pain. The identification of parkinsonian pain is vitally important for the effective diagnosis and treatment of pain in PD.
Children's reasoning about traits.

Publisher Summary Children develop trait conceptions, which extend beyond mere descriptions or evaluations of observable behavior, before reaching school age. These trait conceptions help guide children as they make inferences about the mental states of others and reason about their social world. There is evidence that trait conceptions undergo some important changes during the elementary school years. In some cases, children interpret information about traits as though it indicates what individuals are like in general across time and contexts, which is a form of psychological essentialism. This way of conceptualizing traits is associated with an increased risk of maladaptive responses to academic and social challenges and a tendency to interpret negative social and academic outcomes as diagnostic of underlying traits. Across the elementary school years, children develop more coherent essentialist belief systems that correspond to aspects of their emerging understanding of the biological domain.
Ecology of African Pastoralist Societies

2008, James Currey Publishers, Box 242, 266 Banbury Road, Oxford OX2 7DL, UK 312 pages, softcover and hardcover ISBN 978-0-85255-990-1 (softcover), 978-0-85255-991-8 (hardcover). Price £17.95 (softcover), £50.00 (hardcover)
A Study of School Organizational Climate Variables Associated with Teacher Morale.

(1986). A Study of School Organizational Climate Variables Associated with Teacher Morale. The Clearing House: A Journal of Educational Strategies, Issues and Ideas: Vol. 60, No. 4, pp. 189-191.
Financial influences and scale-free networks

We consider the problem of analyzing influences in financial networks by studying correlations in stock price movements of companies in the S&P 500 index and measures of influence that can be attributed to each company. We demonstrate that under a novel and natural measure of influence involving cross-correlations of stock market returns and market capitalization, the resulting network of financial influences is Scale Free. This is further corroborated by the existence of an intuitive set of highly influential hub nodes in the network. Finally, it is also shown that companies that have been deleted from the S&P 500 index had low values of influence.
Capstone design course in chemical engineering

The capstone course in chemical engineering at Widener University is divided into two semesters. In the fall semester, students experience the application of chemical engineering principles to the development, design, operation and evaluation of all major process equipment. Two in-class examinations are given during the term and a common project is assigned to all students. Students are allowed to work in small teams, although each student must submit a separate project report. In doing so, students also gain exposure to industrial computing tools. The course is taught in a state-of-the-art computer classroom in which each student has his or her own computer station which is part of a LAN that serves the school of engineering. In the second semester, students randomly pick a technology out of an envelope. The course requirements are for students to provide a process design package for a world scale manufacturing facility by the end of the semester. Such a document is often called a "black book" in industry. Students are also required to present and defend their design. Feedback from the students has been positive and they exhibit pride and ownership in their work. There are no tests given. Some suggestions on milestones are provided in the course syllabus and the professor works closely with students as they proceed with the design. About midway through the semester, the students give a short, five slide presentation on the status of their process design to the full faculty and fellow students. A final presentation is due at the end of the course in which the students describe their results.
The Euro Area Crises, Shifting Power Relations and Institutional Change in the European Union1

Abstract This article studies recent governance dynamics in the euro area under the pressure of the sovereign debt crisis from 2009 to the end of 2011 from an institutionalist perspective. It investigates five cases of implicit or explicit institutional change which reveal the pace and the scope of explicit and implicit institutional change in the monetary union under crisis conditions. It argues that key steps of crisis management have actually created path dependencies for further institutional change. It also argues that incoherent responses from multiple actors in the face of immediate crisis management needs, new policy challenges and coordination difficulties in the crisis have strengthened the case for more substantial institutional change. An institutional set-up that continues to adapt only incrementally to the inner and outer challenges by not impacting more strongly on national sovereignty and by not strengthening supranational policy-making based on its own sources of legitimacy will not be able to solve the collective action problems inherent in the European Monetary Union (EMU)’s architecture with a centralized monetary policy and insufficient integration in the fields of economic, budgetary and financial policy coordination. Policy Implications • The adaptability of the institutional framework of the euro area should not be underestimated. • Substantial adjustment to its governance have occured and will happen below the level of Treaty change. • In the medium-term, a more fundamental reform may be required in order to account for problems of governance efficiency and, increasingly, problems of legitimacy. • An institutional set-up that continues to adapt only incrementally to the inner and outer challenges by not impacting more strongly on national sovereignty and by not strengthening supranational policy-making based on its own sources of legitimacy will not be able to solve the collective action problems inherent in the Euro area’s asymmetry; namely, a centralized monetary policy and insufficient integration in the fields of economic, budgetary and financial policy coordination.
After Receiving Financing, Do INC. 500 Companies Continue to Utilize Their Business Plan?

Small, successful companies included on the INC. 500 list were surveyed to determine whether these companies use a business plan once financing has been obtained. The responding CEOs indicated that the business plan is a document of substantial importance in obtaining funding and in managing operations. Additionally, these CEOs were questioned regarding the importance of specific sections of their business plan when using the business plan to: (1) obtain funding and (2) manage their business. When it comes to obtaining funding, INC. 500 CEOs rank the Executive Summary and the Financial Section as the top two most important sections of the business plan. When it comes to managing the company, the Finance Section of a business plan was ranked first in importance over all other sections. CEOs and top management of small companies should take appropriate steps to craft an effective business plan, revise it periodically to reflect a changing environment, and refer to it often to assist their company in achieving even greater success in their operations.
Blood loss in vaginal operations and the use of preoperative intravenous estrogen.

Abstract A study was undertaken for the purpose of determining the effect of intravenous estrogen on blood loss during gynecological operations. One hundred women preoperatively received 20 mg. of intravenous estrogen, while 100 were used as controls. A slight decrease in blood loss following estrogenic preparation was noted, particularly in the menopausal and postmenopausal age periods during vaginal hysterectomy and vaginal hysterectomy with anterior and posterior repair.
Tribological Characteristics of CVD Nanocrystalline Diamond Film Grown by Bias Enhanced Nucleation Process

Nanocrystalline diamond (NCD) films on titanium alloys are of importance for tribology and biomedical implants. However, due to the different thermal expansion coefficients of the two materials, the complex nature of the interlayer formed during diamond deposition, and the difficulty in achieving high nucleation density, it is difficult to deposit adherent NCD films on titanium and its alloys. The aim of this research work is to successfully produce smooth, low roughness and well adherent NCD film on a pure Ti substrate by bias enhanced nucleation (BEN) process using microwave plasma chemical vapor deposition (MWPCVD) method. The friction coefficient was estimated to be around 0.06 in dry air using ball on disk tribometer with reciprocating sliding against a cemented carbide ball of 10 mm diameter at a high contact load of 20 N in dry air. The friction coefficient of bare Ti was between 0.55-06.
Distributed cosegmentation via submodular optimization on anisotropic diffusion

The saliency of regions or objects in an image can be significantly boosted if they recur in multiple images. Leveraging this idea, cosegmentation jointly segments common regions from multiple images. In this paper, we propose CoSand, a distributed cosegmentation approach for a highly variable large-scale image collection. The segmentation task is modeled by temperature maximization on anisotropic heat diffusion, of which the temperature maximization with finite K heat sources corresponds to a K-way segmentation that maximizes the segmentation confidence of every pixel in an image. We show that our method takes advantage of a strong theoretic property in that the temperature under linear anisotropic diffusion is a submodular function; therefore, a greedy algorithm guarantees at least a constant factor approximation to the optimal solution for temperature maximization. Our theoretic result is successfully applied to scalable cosegmentation as well as diversity ranking and single-image segmentation. We evaluate CoSand on MSRC and ImageNet datasets, and show its competence both in competitive performance over previous work, and in much superior scalability.