cssi/SciSciGPT-SciSciNet huggingface dataset:
P350 The quality of standards utilised in published audits between years 2007–2015

Background and aims Clinical audit is a process that has been defined as ’a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change’. This study was undertaken to evaluate the quality of explicit audit criteria in published paediatric audits. Methods The PUBMED, MEDLINE and CINAHL databases were searched for paediatric audits published in English using a combination of key words and MeSH headings between the years 2007–2015. Each article was reviewed by 2 authors and if a disagreement occurred the article was reviewed by at least 3 authors. The quality of the standards used in the audits was evaluated utilising the Oxford Centre for the Evidence-based Medicine Levels of Evidence (March 2009). Results Seven hundred and thirty-two articles were identified and 730 were retrieved. Two articles were excluded as they were ‘not healthcare related’ and did not deal with a predominant paediatric population. Ninety three percent (677 articles) were classified as ‘reviews of practice’. Of these 214 articles (29%) had a defined standard. Only 84 (11%) fulfilled the criteria of an audit (Fig.1). Fifty two percent of audits were from the UK. Thirty-four (40%) audits used standards of high quality of evidence (1a-1b). Those were mostly international or national guidelines. Thirty-seven percent standards were based on the ‘expert opinion’ (level 5). Conclusions Only 11 percent of studies described as ‘audits’ fulfilled the actual definition of an audit. Prior to undertaking audits clinicians should evaluate the quality of the standards that they intend to use. The increasing numbers of evidence based guidelines should make this process easier.
Liver-Targeted Gene Delivery Through Retrograde Intrabiliary Infusion

Retrograde intrabiliary infusion (RII) has recently been characterized as a safe and effective administration route for liver-targeted gene delivery. Efficient transgene expression in the liver has been achieved by infusing a variety of gene vectors including adenovirus, retrovirus, lipoplexes, polyplexes, and naked DNA through the common bile duct. Here, we describe the RII technique and key infusion parameters for delivering plasmid DNA and DNA nanoparticles to the rat liver. After RII of plasmid DNA, the level of transgene expression in rat liver is comparable to that achieved by hydrodynamic injection of plasmid DNA, which is considered to be "gold standard" for liver-targeted gene delivery. RII has also been shown to significantly enhance the gene delivery efficiency by polymer/DNA nanoparticles in comparison with intravenous and intraportal infusions. This method induces minimal level of cytotoxicity and damage to the liver and bile duct. Due to these advantages, RII has the potential to be used for delivering various gene vectors in clinical setting through the endoscopic retrograde cholangiopancreatography procedure.
Evidence Based Nutrition: knowledge and use among dietitians of Pakistan

Background: Evidence Based Practice, a relatively new term in Pakistan; is pivotal to achieve optimum patient care and satisfaction. Most of the healthcare providers, including dietitians are unaware of its importance. The objective of the study was to identify knowledge and use of Evidence Based Nutrition (EBN) among dietitians of Pakistan. Methods/subjects: A cross sectional survey was carried out and structured, pretested questionnaires were e-mailed to the dietitians working in Pakistan. The response rate was 45% (23/51). Mean age of the respondents was 29.134 years and mean years of practice were 4.347. 87% (n=20) were females and 52.2% (n=12) had 16 years of education.34.8% (n=8) were registered dietitians and 47.8% (n=11) were employed full time as dietitians across Pakistan. Results: 82.6% (n=19) reported to engage in research activities and 60.9% (n=14) stated to use EBN in their practice. 52.2% (n=12) sometimes encountered knowledge gaps; for 60.9% (n=14) these were related to MNT and 78.2% (n=18) performed their own literature search on internet. Almost half (48%) had access to evidence based libraries and 52.2% (n=12) reported to use them. Reported barriers to implement EBN were lack of skills for critical appraisal of articles (39.1%, n=9); lack of knowledge of EBN (43.5%, n=10); and lack of time (8.7%, n=2). Main source of information was internet 65.2% (n=15). All of them were of the view that EBN should be used in routine clinical practice. Conclusion: It can be concluded that there is a lack of knowledge and use of EBN among dietitians in Pakistan. Providing adequate on-job training to current dietitians and incorporating EBN in nutrition and dietetics curriculum will enable future practitioners to implement EBN.
Histologic Mimics of Basal Cell Carcinoma

Context.— Basal cell carcinoma (BCC) is the most common human malignant neoplasm and is a frequently encountered diagnosis in dermatopathology. Although BCC may be locally destructive, it rarely metastasizes. Many diagnostic entities display morphologic and immunophenotypic overlap with BCC, including nonneoplastic processes, such as follicular induction over dermatofibroma; benign follicular tumors, such as trichoblastoma, trichoepithelioma, or basaloid follicular hamartoma; and malignant tumors, such as sebaceous carcinoma or Merkel cell carcinoma. Thus, misdiagnosis has significant potential to result in overtreatment or undertreatment. Objective.— To review key features distinguishing BCC from histologic mimics, including current evidence regarding immunohistochemical markers useful for that distinction. Data Sources.— Review of pertinent literature on BCC immunohistochemistry and differential diagnosis. Conclusions.— In most cases, BCC can be reliably diagnosed by histopathologic features. Immunohist...
The Many Faces of Globalization

Globalization is a process. It is difficult to pinpoint a particular event or year as a starting point. Various aspects of it affect countries and communities at different speeds and at different times. Earlier chapters have noted the increasing integration of developing countries in the world trading system and the large private and public capital flows that permitted financing of the huge deficits resulting from the first oil crisis in the 1970s. By 1990 globalization in various forms was happening and spreading all over the world. Its impact on various countries and, within countries, on various income groups was diverse. This chapter will review the experience with growth and poverty alleviation of the main regional groupings of developing coutnries in the 1990s. This is followed by a discussion of the results of a number of studies which have attempted to link globalization with particular outcomes in terms of growth and poverty alleviation. The final two sections examine the impact of two key globalizing policies on developing countries poverty alleviation: the policies on international trade and capital flows, including both official assistance and private capital. The latter is important to review as it has played a far more greater role in development than in the 1990s and in the years since.
SARCOPLASMIC RETICULUM AND OTHER MEMBRANES IN THE REGULATION OF SKELETAL MUSCLE CONTRACTION AND RELAXATION, A MULTILEVEL APPROACH

Publisher Summary The skeletal muscle fiber is a giant multinucleate cell, extending centimeters in length, and up to 100μ in diameter. The bulk of the mass of the fast twitch skeletal muscle fiber is occupied by myofibrils that run the length of fiber. There can be hundreds of myofibrils in a single muscle fiber. The myofibril consists of a linear array of sarcomeres (approximately 2.5 μ long and 1 μ in diameter), the structural units that carry out muscle contraction and relaxation. The number of sarcomeres in a fibril depends on the length of the fiber. Muscle contraction and relaxation are controlled by the intra-fiber free Ca++ concentration, [Ca++]i, in the myoplasm that bathes the muscle filaments of the sarcomeres. In turn, the [Ca++]i is controlled by a network of membranes that regulate and coordinate the process in time and space. This chapter illustrates the structure of a mammalian striated-muscle fiber. It also illustrates a longitudinal section of a rabbit's skeletal muscle fiber. The chapter presents molecular biology approach for the study of sarcoplasmic reticulum (SR). It discusses the reconstitution approach to correlate membrane composition with structure and function and to characterize the nature of lipid–protein interactions in the SR membrane.
Dynamic Response of Neuronal Activity to Mean Arterial Pressure and Neurocritical Interventions Measured by Intracranial EEG following Subarachnoid Hemorrhage (P2.280)

Objective: We examine the relationship between physiologic parameters continuously recorded in a neurocritical care setting and quantitative EEG intracranially recorded following high-grade subarachnoid hemorrhage (SAH). We assess the impact of neurocritical interventions (sedation and vasopressor administration) by examining the anecdotally identified intracranial EEG (iEEG) responses considered clinically meaningful. Background: SAH patients may experience supply-demand mismatch of cerebral metabolism from seizures, vasospasm, cortical spreading depolarization, hydrocephalus, or cerebral edema. Previous studies have focused on non-neuronal measures of cerebral autoregulation. Design/Methods: SAH patients of Hunt-Hess grade 3–5 underwent 1) clinical multimodality neuromonitoring utilizing Spencer depth electrode, brain tissue oxygen cerebral oximetry, cerebral blood flow, and fiberoptic ICP through a quad-lumen bolt, and/or 2) neurosurgical placement of a subdural electrode strip following informed consent using time-synchronized monitoring (CNS-210, Moberg Research). We averaged physiologic data and artifact reduced spectral plots over 10-s epochs, binned within increments of the physiologic parameter. We removed outliers in the physiologic range (0.5 %ile). We stratified patients into DCI (Delayed Cerebral Ischemia) vs. non-DCI group based on clinical adjudication. We displayed data as an EEG frequency spectrogram across the physiologic parameter, blood pressure, over the ICU admission. We computed quantitative EEG (qEEG) features such as power in the alpha and delta band for comparison purposes. Results: 16 high-grade SAH patients had available post-SAH iEEG data over 21 months. MAP- dependent spectral features are noted in specific patients. 5 patients visually demonstrated a positive correlation of power in the alpha and delta bands with increasing blood pressure; 4 showed negative correlation. In two DCI patients, this relationship changed over time (pre-DCI vs. post-DCI). Conclusions: Neuronal function in the setting of SAH may be modifiable across the range of blood pressure changes. The EEG biomarker of DCI may also be modifiable in a critical period allowing interventions before irreversible injury occurs. Study Supported by: A. David Heitman Foundation for Neurovascular Research Disclosure: Dr. Shenoy has nothing to disclose. Dr. Fleuren has nothing to disclose. Dr. Biswal has nothing to disclose. Dr. Boyle has nothing to disclose. Dr. Zafar has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Westover has nothing to disclose. Dr. Rosenthal has nothing to disclose.
ENHANCED LIBERATION OF MINERAL AND PYRITE THROUGH LOW TEMPERATURE TREATMENT OF HERRIN IL. NO. 6 COAL

Publisher Summary This chapter describes the enhanced liberation of mineral and pyrite through low-temperature treatment of Herrin Illinois No. 6 coal. In a study described in the chapter, a Fritsch centrifugal ball mill was used to reduce particle size and to liberate minerals from the coal matrix. Knoop microhardness testing was employed to examine brittleness of coal and an effect of cryogenic temperature on its microhardness. An automated image analyzer connected with an optical microscope was used to obtain pyrite liberation and particle size distributions for samples ground by the centrifugal ball mill. Surface artifacts of the coal were characterized using scanning electron microscopy before and after cryogenic treatments. The chapter describes the effect of temperature on the microhardness of coal is shown. Microhardness number is decreased by lowering temperature. In other words, the brittleness of coal increases with decreasing temperature treatment. It has also been found from Knoop test that microhardness is decreased with increasing exposure time at 130 K. The various grinding time was employed to examine pyrite liberation. It is seen that both increased grinding time and decreased exposure temperature result in increased pyrite liberation.
Recommended Practices and Parent Perspectives regarding AT Use in Early Intervention

It frequently is suggested that parents underutilize assistive technology (AT) for their young children with disabilities despite wide spread recommended practices for providing optimal AT interventions (i.e., devices and services). However, neither parent perspectives of AT underutilization or families' experiences with AT have been reported in the literature. The purpose of this article is to provide information about families' experiences with AT for their infants and toddlers who are receiving early intervention services. Computer assisted telephone interviews were conducted with a sample of 924 parents or other family members of children receiving Part C early intervention services. Participants were asked about various aspects of their experiences with AT, including devices, success rates, and resources. Results indicate that for the most part, families identifying, using, and paying for various devices do so without professional assistance. Further, most devices they have tried, or are trying, are ...
Lectures on Random Matrix Models

This is a review of the Riemann–Hilbert approach to the large N asymptotics in random matrix models and its applications. We discuss the following topics: random matrix models and orthogonal polynomials, the Riemann–Hilbert approach to the large N asymptotics of orthogonal polynomials and its applications to the problem of universality in random matrix models, the double scaling limits, the large N asymptotics of the partition function, and random matrix models with external source.
Microdialysis/Mass Spectrometry

Elucidation of the biochemistry of neurochemicals in the live animal has traditionally involved the sampling of blood, cerebrospinal fluid (CSF), and tissue from brain biopsy. Many other experimental studies of brain chemistry have been conducted with postmortem tissue, giving a poor representation of the dynamic chemistry that exists between cells and the interchange of compounds between cells and extracellular fluid. Total tissue levels may easily mask small but important neurochemical changes in specific brain regions. For these reasons, investigators have turned to techniques that directly sample the extracellular compartment of nervous tissue in living animals.
Examining Lending Discrimination Practices and Foreclosure Abuses

The incidence of fraud in stated income loans is 90 percent. It is overwhelmingly the lenders and their agents that prompted these frauds. Over two million fraudulent mortgage loans were made in 2006 alone. It was overwhelmingly fraudulent loans to borrowers who lacked any ability to repay their loans out of their income that caused the housing bubble to hyper-inflate. Endemic accounting control fraud in the origination of mortgages led to creation of 'echo' fraud epidemics in other contexts, including widespread appraisal fraud, endemic fraud in the sale of mortgages and mortgage derivatives, widespread predatory lending targeting Latinos, blacks and the elderly, and endemic foreclosure fraud. Fraudulent lenders use compensation to create perverse incentives in which bad ethics drives good ethics out of the marketplace. Fraud begets fraud. The federal government, California, and dozens of financial firms have sued the largest banks for fraud, yet the Justice Department refuses to even conduct a meaningful criminal investigation of the largest banks. Absent vigorous financial regulators that understand control fraud and make reducing and sanctioning such frauds their top priority the prosecutors cannot succeed against an epidemic of accounting control fraud. Financial regulators who make the necessary criminal referrals and provide the FBI with the expertise to identify and investigate accounting control fraud mechanisms are essential if we are to prevent or prosecute an epidemic of such frauds. Effective financial 'regulatory cops on the beat' are essential to our ability to prosecute elite white-collar criminals.
Data-driven approach to Early Warning Score-based alert management.

Background Increasing adoption of electronic health records (EHRs) with integrated alerting systems is a key initiative for improving patient safety. Considering the variety of dynamically changing clinical information, it remains a challenge to design EHR-driven alerting systems that notify the right providers for the right patient at the right time while managing alert burden. The objective of this study is to proactively develop and evaluate a systematic alert-generating approach as part of the implementation of an Early Warning Score (EWS) at the study hospitals. Methods We quantified the impact of an EWS-based clinical alert system on quantity and frequency of alerts using three different alert algorithms consisting of a set of criteria for triggering and muting alerts when certain criteria are satisfied. We used retrospectively collected EHRs data from December 2015 to July 2016 in three units at the study hospitals including general medical, acute care for the elderly and patients with heart failure. Results We compared the alert-generating algorithms by opportunity of early recognition of clinical deterioration while proactively estimating alert burden at a unit and patient level. Results highlighted the dependency of the number and frequency of alerts generated on the care location severity and patient characteristics. Conclusion EWS-based alert algorithms have the potential to facilitate appropriate alert management prior to integration into clinical practice. By comparing different algorithms with regard to the alert frequency and potential early detection of physiological deterioration as key patient safety opportunities, findings from this study highlight the need for alert systems tailored to patient and care location needs, and inform alternative EWS-based alert deployment strategies to enhance patient safety.
A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer.

Background The glycolytic nature of cancer cells presents a potential treatment target that may be addressed by a ketogenic diet (KD). Objective We hypothesized that a KD would improve body composition and lower serum insulin and insulin-like growth factor-I (IGF-I) in women with ovarian or endometrial cancer. Methods In this randomized controlled trial, women with ovarian or endometrial cancer [age: ≥19 y; body mass index (kg/m2): ≥18.5] were randomly assigned to a KD (70:25:5 energy from fat, protein, and carbohydrate) or the American Cancer Society diet (ACS; high-fiber, low-fat). Body composition (DXA) and fasting serum insulin, IGF-I, and β-hydroxybutyrate were obtained at baseline and at 12 wk; urinary ketones were also measured throughout the intervention. We assessed differences between the diets with ANCOVA and independent t tests. We used correlation analyses to estimate associations between changes in serum analytes and body composition. Results After 12 wk, the KD (compared with ACS) group had lower adjusted total (35.3 compared with 38.0 kg, P < 0.05) and android (3.0 compared with 3.3 kg, P < 0.05) fat mass. Percentage of change in visceral fat was greater in the KD group (compared with the ACS group; -21.2% compared with -4.6%, P < 0.05). Adjusted total lean mass did not differ between the groups. The KD (compared with ACS) group had lower adjusted fasting serum insulin (7.6 compared with 11.2 µU/mL, P < 0.01). There was a significant inverse association between the changes in serum β-hydroxybutyrate and IGF-I concentrations (r = -0.57; P < 0.0001). Conclusions In women with ovarian or endometrial cancer, a KD results in selective loss of fat mass and retention of lean mass. Visceral fat mass and fasting serum insulin also are reduced by the KD, perhaps owing to enhanced insulin sensitivity. Elevated serum β-hydroxybutyrate may reflect a metabolic environment inhospitable to cancer proliferation. This trial was registered at www.clinicaltrials.gov as NCT03171506.
Integrating coalescent species delimitation with analysis of host specificity reveals extensive cryptic diversity despite minimal mitochondrial divergence in the malaria parasite genus Leucocytozoon

Coalescent methods that use multi-locus sequence data are powerful tools for identifying putatively reproductively isolated lineages, though this approach has rarely been used for the study of microbial groups that are likely to harbor many unrecognized species. Among microbial symbionts, integrating genetic species delimitation methods with trait data that could indicate reproductive isolation, such as host specificity data, has rarely been used despite its potential to inform species limits. Here we test the ability of an integrative approach combining genetic and host specificity data to delimit species within the avian malaria parasite genus Leucocytozoon in central Alaska. We sequenced seven nuclear loci for 69 Leucocytozoon samples and used multiple species delimitation methods (GMYC and BPP models), tested for differences in host infection patterns among putative species based on 406 individual infections, and characterized parasite morphology. We found that cryptic morphology has masked a highly diverse Leucocytozoon assemblage, with most species delimitation methods recovering support for at least 21 separate species that occur sympatrically and have divergent host infection patterns. Reproductive isolation among putative species appears to have evolved despite low mtDNA divergence, and in one instance two Leucocytozoon cytb haplotypes that differed by a single base pair (~ 0.2% divergence) were supported as separate species. However, there was no consistent association between mtDNA divergence and species limits. Among cytb haplotypes that differed by one to three base pairs we observed idiosyncratic patterns of nuclear and ecological divergence, with cytb haplotype pairs found to be either conspecific, reproductively isolated with no divergence in host specificity, or reproductively isolated with divergent patterns of host specialization. Integrating multi-locus genetic species delimitation methods and non-traditional ecological data types such as host specificity provide a novel view of the diversity of avian malaria parasites that has been missed previously using morphology and mtDNA barcodes. Species delimitation methods show that Leucocytozoon is highly species-rich in Alaska, and the genus is likely to harbor extraordinary species-level diversity worldwide. Integrating genetic and ecological data will be an important approach for understanding the diversity and evolutionary history of microbial symbionts moving forward.
No neuron is an island: Homeostatic plasticity and over-constraint in a neural circuit

To support computation the activity of neurons must vary within a useful range, which highlights one potential value of homeostatic plasticity. The interconnectedness of the brain, however, introduces the possibility that combinations of homeostatic mechanisms can produce over-constraint in which not all set points can be satisfied. We use a simulation of the cerebellum to investigate the potential for such conflict and its consequences. In this instance the conflict produces perpetual drift and eventual saturation of synaptic weights. We show that these problems can be resolved for this network by a particular combination of sites and rules for plasticity. We also show that simulations that implement these rules for homeostatic plasticity are more resistant to forgetting. These results illustrate the general principle that homeostatic plasticity within a system must not set up conflicts in which mutually exclusive set points exist and that one consequence can be perpetual induction of plasticity.
Theoretical Foundations: Bakhtin and Feminism

This chapter provides an overview of the theoretical lenses employed in this project, including Bakhtinian theory, intertextuality, and feminist reading strategies. After exploring the Bakhtinian idea of truth, Cobb provides explanations and examples of the theoretical concepts of menippea, the novel, outsidedness, polyphony, dialogism, and carnivalesque. Alongside these terms, when appropriate, Cobb incorporates ideas formulated through the field of narratology, in particular, focalization and focalizor, which are connected to Bakhtin’s concept of outsidedness. The theory of intertextuality as outlined by Julia Kristeva is discussed as readings of other ancient narratives are placed in dialogue with Luke-Acts. Finally, Cobb outlines the ways that feminist scholars have utilized Bakhtin in their methodology and reading strategies, specifically, the concepts of dialogism and carnivalesque.
Overcoming Our Crisis-Recoil Response

In order to seriously consider whether or not to enter parenthood, a girl needs help choosing the most advantageous course by understanding that her baby is not her possession and is a human being with a separate life. She needs help envisioning her future and the future of her baby in order to distinguish her self-interests from her baby’s interests. Choosing not to enter parenthood and to make an adoption plan allows young people to develop as responsible, caring individuals. They can act in the best interests of their babies and mature by planning ahead and making painful decisions. They gain satisfaction by creating a better future for themselves and their babies.
An Osteopathic Approach to Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome is a common office complaint in primary care. It encompasses a constellation of clinical conditions, including greater trochanteric bursitis, teninopathies affecting the gluteus medius and gluteus minimus, inflammation of the iliotibial band and abductor-adductor imbalance. Common treatments include supportive care such as rest, ice, and compression as well as corticosteroid injections, Extracoproreal shockwave therapy and home exercise programs. Surgical interventions are reserved for refractory cases. Emerging therapies include OMM utilizing muscle energy, as well as regenerative medicine such as PRP or prolotherapy.
TGF-β signaling is critical for maintenance of the tendon cell fate

Studies of cell fate focus on specification, but little is known about maintenance of the differentiated state. We find that TGF{beta} signaling plays an essential role in maintenance of the tendon cell fate. To examine the role TGF{beta} signaling in tenocytes TGF{beta} type II receptor was targeted in the Scleraxis cell lineage. Tendon development was not disrupted in mutant embryos, but shortly after birth tenocytes lost differentiation markers and reverted to a more stem/progenitor state. Targeting of Tgfbr2 using other Cre drivers did not cause tenocyte dedifferentiation suggesting a critical significance for the spatio-temporal activity of ScxCre. Viral reintroduction of Tgfbr2 to mutants was sufficient to prevent and even rescue mutant tenocytes suggesting a continuous and cell-autonomous role for TGF{beta} signaling in cell fate maintenance. These results uncover the critical importance of molecular pathways that maintain the differentiated cell fate and a key role for TGF{beta} signaling in these processes.
Transthyretin-stabilising mutation T119M is not associated with protection against vascular disease or death in the UK Biobank

Background: Destabilised transthyretin (TTR) can result in the progressive, fatal disease transthyretin-mediated (ATTR) amyloidosis. A stabilising TTR mutation, T119M, is the basis for a therapeuti...
Approaching Target and Targetoid Eruptions in Inpatient Dermatology

To summarize the differential diagnosis and describe a clinical approach for the evaluation of target and targetoid lesions in hospitalized patients. Important diagnostic considerations for target and targetoid lesions in an inpatient setting include erythema multiforme, Stevens-Johnson syndrome/toxic epidermal necrolysis, mycoplasma-associated rash and mucositis, fixed drug eruption, urticaria multiforme, subacute cutaneous lupus erythematosus, and Rowell syndrome. Less frequent diagnoses may include erythema migrans, arthropod bite, erythema gyratum repens, erythema annulare centrifugum, tinea concentricum, tinea corporis, Granuloma annulare, elastolytic giant cell granuloma, cutaneous T cell lymphoma, linear IgA syndrome, pigmented purpuric dermatosis of Majocchi, hobnail hemangioma, and acute hemorrhagic edema of infancy. Morphology can be a key in initially discriminating among these entities. Classic target lesions should be distinguished from targetoid, gyrate, and annular lesions. The differential diagnosis of target and targetoid lesions in hospitalized patients is broad; however, attention to additional morphologic features, location, concomitant symptoms, mucosal involvement, histopathology, location, and progression can aid in diagnosis. Clinical evaluation should also consider patient demographics and associated systemic symptoms to elucidate the correct diagnosis.
Estimating Migration Impacts of Wildfire: California’s 2017 North Bay Fires

This chapter examines a cluster of wildfire conflagrations that hit northern California during October 2017, which resulted in significant loss of housing units (6874 residential structures destroyed or damaged). To assess the magnitude of the migration response and network of destinations, a method to estimate migration drawing from a proxy universe of households with students enrolled in public schools was proposed, using data on school exits and re-enrollments from a longitudinal student database. The analysis finds that a small minority of households affected by the fires moved out of the area. Out of nearly 7800 persons displaced by the central fire complex in one city, this study estimated fewer than 1000 changed neighborhoods; of those, fewer than 500 moved out of Sonoma County. These findings are applicable to other wildfires and localized disasters where a substantial portion of housing is lost but public infrastructure in the region remains intact.
Biomarker sST2 in Adults with Transposition of the Great Arteries Palliated by Mustard Procedure

Background: Transposition of the great arteries (TGA) is a congenital heart defect (CHD) in which the aorta and pulmonary artery are transposed; it requires urgent surgical intervention. The Mustard procedure was an early surgery allowing survival into adulthood. However, this procedure is associated with long-term adverse effects including arrhythmias and heart failure (HF). A key factor impairing HF management in adults with CHD is lack of biomarkers to predict outcome. Soluble ST2 (sST2) is a protein secreted by myocytes in response to mechanical strain and fibrosis. No studies have focused specifically on sST2 in TGA individuals that underwent a Mustard procedure. In this study, we hypothesized adults with TGA palliated with a Mustard procedure would have higher levels of sST2 than healthy individuals, and this would correlate with functional class status. Methods: We screened the Pediatric Cardiology database for D-TGA subjects and Mustard operation. Healthy controls were recruited from clinic and the community. Patients were matched by age to a control group of 21 healthy individuals. Severity of symptoms was assessed by NYHA functional classification. sST2 levels were obtained using Critical Diagnostics Presage ST2 Assay kit. Additionally, cTnI, BNP, lipid panel, insulin, glucose, and EKG and echocardiography (TGA) were obtained at IUSM clinical laboratories. Results: We identified 45 patients with D-TGA and Mustard operation. 19 patients were included in analysis: 12 male and 7 female subjects aged 18 to 46, mean of 34.9 years. In the Mustard group, 9 subjects were assigned to NYHA class II, and 9 to class III. The control group was asymptomatic. sST2 levels in the Mustard group were elevated in 53%, while only 29% in the controls. Of the Mustard subjects with elevated sST2, 67% had elevated cTnI, 80% arrhythmias, 70% EKG T-wave abnormalities, and 80% took cardiac medications. 90% of these patients had low HDL, 40% high LDL, and 40% low insulin. Conclusion: This study demonstrates patients with Mustard operation averaged higher sST2 levels than healthy subjects. Importantly, of the patients with elevated levels, there was a significant association of sST2 with biomarker abnormalities and clinical heart failure signs. This suggests in patients with D-TGA palliated with Mustard procedure, sST2 may add predictive value to cardiac related morbidity and mortality.
Re-analysis of Abutment Angle Method for Moderate and Deep Cover Retreat Room and Pillar Mines and Investigation of Loading Mechanics Using Finite Volume Modeling

Mining-induced stresses in underground coal mines play a significant role in pillar and ground support design, hence in the safety of mining operations. In the US, Analysis of Longwall Pillar Stability (ALPS) and in Australia, Analysis of Longwall Tailgate Serviceability (ALTS) software are used for designing Longwall coal mine layouts; and in the US, Analysis of Retreat Mining Pillar Stability (ARMPS) software is used to design retreat room-and-pillar mine layouts. All these software determine the adequacy of the design by comparing the estimated loads to the load-bearing capacity of the pillars and they use the “abutment angle” concept and a square decay stress distribution function to calculate the magnitude and distribution of the mining-induced loads. The abutment angle concept has been successfully applied to US longwall coal mines with the use of ALPS and ALTS in Australia. ARMPS uses the same concept for retreat room and pillar coal mine design in the US. The suggested abutment angle for coal mines in the US was derived as 21° by the back analysis of underground stress measurements from the 1990s and implemented in ALPS and ARMPS. The ALPS methodology was re-examined and calibrated for Australian conditions with additional Australian stress measurements and resulted in the original ALTS methodology which has been continually improved and expanded with additional cases. In this paper, some recent stress measurements are back-analyzed, and the abutment angles are investigated to verify the applicability of using 21° in retreat room and pillar mines with different depths and mining dimensions. For shallow mines, the derivation of the 21° abutment angle is supported by the new case histories. However, at depths greater than 200 m, the abutment angle was found to be decreasing with increasing depth. In this study, a new equation for the calculation of abutment angle for moderate and deep cover cases was constructed and tested for its applicability in retreat room and pillar mines. The differences in the mechanism of complete side abutment loads in shallow and deep cover mines are further analyzed by applying the finite volume modeling (FVM) approach to two case study mines, one shallow, and one deep cover. A 2D model of each mine is created and one-side and two-side abutment loads of consecutive panels are analyzed. Analysis of the deep cover mine indicated that the prior panel gobs provide a considerable amount of support to the overburden strata. These higher gob loads prevent a higher percentage of overburden loads from being transferred to the active panel workings, and this is in agreement with the lower abutment angles observed for deep cover mines. The findings of this study should only be used for retreat room-and-pillar mines’ production pillar loads since these are calculated geometrically using the abutment angle concept.
Extreme Cinema: Affective Strategies in Transnational Media

Extreme Cinema examines the highly stylized treatment of sex and violence in post-millennial transnational cinema, where the governing convention is not the narrative but the spectacle.
Fracture location impacts opioid demand in upper extremity fracture surgery

Abstract Introduction Opioid sparing protocols should be formulated with appropriate demand. Specific fracture location has been hypothesized as an important predictor of post-operative pain. The purpose of this study is to evaluate the impact of fracture location on perioperative opioid demand after surgery with the hypothesis that this factor would be significantly associated with perioperative opioid demand in upper extremity fracture surgery. Methods A national database was used to identify1-month pre-operative to 1-year postdischarge opioid demand in oxycodone 5-mg equivalents in 336,493 patients undergoing fracture fixation of the clavicle through distal radius between 2010 and 2020. Three timeframes were evaluated: 1-month pre-op to 90-days post-discharge, 3 months post-discharge to 1-year post-discharge, and 1-month pre-op to 1-year postdischarge. Multivariable main effects linear and logistic regression models were constructed to evaluate the changes in opioids filled, opioid prescriptions, and odds of two or more opioid prescriptions in these timeframes based on fracture location with adjustment for age, sex, obesity, pre-operative opioid usage, and polytrauma. Results Compared to distal radius fracture fixation, fixation of elbow, distal humerus, humeral shaft, and proximal humerus fractures were associated with large, significant increases in 1-month pre-op to 1-year post-discharge opioid filling (33.5 – 63.4 additional oxycodone 5-mg equivalents, all p Discussion Fracture location was a significant predictor of perioperative opioid demand. Elbow, distal humerus, humeral shaft, and proximal humerus fracture fixation was associated with the largest increases in opioid demand after upper extremity fracture fixation. Patients with these injuries may be at highest risk of extensive opioid consumption. Level of evidence Level III, retrospective, observational cohort study
Validation of a Crisis Standards of Care Model for Prioritization of Limited Resources During the Coronavirus Disease 2019 Crisis in an Urban, Safety-Net, Academic Medical Center.

OBJECTIVES: The coronavirus disease 2019 pandemic has overwhelmed healthcare resources even in wealthy nations, necessitating rationing of limited resources without previously established crisis standards of care protocols. In Massachusetts, triage guidelines were designed based on acute illness and chronic life-limiting conditions. In this study, we sought to retrospectively validate this protocol to cohorts of critically ill patients from our hospital. DESIGN: We applied our hospital-adopted guidelines, which defined severe and major chronic conditions as those associated with a greater than 50% likelihood of 1- and 5-year mortality, respectively, to a critically ill patient population. We investigated mortality for the same intervals. SETTING: An urban safety-net hospital ICU. PATIENTS: All adults hospitalized during April of 2015 and April 2019 identified through a clinical database search. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 365 admitted patients, 15.89% had one or more defined chronic life-limiting conditions. These patients had higher 1-year (46.55% vs 13.68%; p < 0.01) and 5-year (50.00% vs 17.22%; p < 0.01) mortality rates than those without underlying conditions. Irrespective of classification of disease severity, patients with metastatic cancer, congestive heart failure, end-stage renal disease, and neurodegenerative disease had greater than 50% 1-year mortality, whereas patients with chronic lung disease and cirrhosis had less than 50% 1-year mortality. Observed 1- and 5-year mortality for cirrhosis, heart failure, and metastatic cancer were more variable when subdivided into severe and major categories. CONCLUSIONS: Patients with major and severe chronic medical conditions overall had 46.55% and 50.00% mortality at 1 and 5 years, respectively. However, mortality varied between conditions. Our findings appear to support a crisis standards protocol which focuses on acute illness severity and only considers underlying conditions carrying a greater than 50% predicted likelihood of 1-year mortality. Modifications to the chronic lung disease, congestive heart failure, and cirrhosis criteria should be refined if they are to be included in future models.
Irrigated trap crops impact key hemipteran pests in organic pistachio orchard

Using sown groundcovers as trap crops to protect a cash crop is a traditional pest management tool. Pistachio is a major crop in California’s Central Valley, where high summer temperatures and little to no precipitation between May and November lead to summer dry-down of annual groundcover. Hemipteran pests that consist of ‘small bugs’ and ‘large bugs’ are a major contributor to nut damage, especially in organic production. In this 2-year field study, we tested the use of irrigated trap crop mixtures, sown between tree rows, to reduce those hemipteran pests’ abundance or damage. Biweekly beat samples of the tree canopy and sweep samples of the sown groundcovers in trap crop plots and resident weedy vegetation in control plots were taken over two consecutive growing seasons. Arthropod richness and abundance were highest in the groundcover and tree canopy in the trap crop plots. Small and large bug pest populations were higher and lower, respectively, in the tree canopy in trap crop plots, indicating a mixed response of these hemipterans to the presence of the trap crops. Additionally, natural enemy populations were more abundant in the tree canopy in trap crop plots than in control plots. There was no difference in nut damage between plots with and without the trap crop. These findings suggest that populations of hemipteran pests and beneficials can be manipulated successfully with irrigated trap crops, but future studies will need to focus on doing so in a way that decreases hemipteran pistachio damage.
Congenital Defects Or Adverse Developmental Effects In Vertebrate Wildlife: The Wildlife-Human Connection

This paper provides a review of defects reported in vertebrate wildlife, particularly including those present or already programmed at birth, which are known or suspected to be associated with pollutants. Species from each of the main classes of animals in the vertebrate sub-phylum (including bony fish, amphibians, reptiles, birds, and mammals) are now known to have been affected by endocrine disrupting chemicals (EDCs) in the environment.
A class of nonlinear game-theoretic filters and controllers using a dissipative approach

For a class of nonlinear time-varying systems, a stable nonlinear game-theoretic filter (GTF), which solves the disturbance attenuation problem, is obtained with a dissipative approach. For such nonlinear functions (modifiable nonlinearities), the estimation error propagates almost linearly. A sufficient condition to render the dissipative inequality satisfied for the GTF with respect to the worst strategy for the process and sensor disturbances is derived. The filter gain is obtained from a Riccati differential equation (RDE) which results from bounding the dissipative inequality. The design parameters are then scaling coefficients multiplying the weighting matrices in the RDE. Then, a sufficient condition for the GTF to be asymptotically stable is derived and shown to be sufficient for the GTF to be dissipative. The disturbance attenuation property is implied by the dissipativity of the GTF. Next, for a class of dynamical system with modifiable nonlinear measurement functions but linear dynamics, an implementable stabilizing time-varying, nonlinear game-theoretic controller (GTC) is derived by bounding the dissipative inequality of the feedback control. Its structure is assumed from a natural modification, to accommodate the modifiable nonlinearity, of the corresponding linear quadratic game problem. Sufficient conditions for dissipativity and internal stability are obtained provided two coupled RDE are satisfied. These RDEs are somewhat modified from those obtained from the corresponding linear quadratic problem. >
Incidence and effects of vascular disease in 1,000 consecutive pregnancies in private practice.

Abstract In a recent paper 1 entitled "Interpretation of Blood Pressure Behavior in Pregnancy and the Puerperium", the principal differentiating features between vascular disease and true toxemia of pregnancy were presented, and the value of ophthalmoscopic examination in the recognition of these outstanding causes of hypertension in pregnancy was emphasized. The present paper is based on an analysis of hypertension in 1,000 consecutive pregnancies in private practice, from seven months to term and to the end of the puerperium. Retinal examination was done routinely early in pregnancy and constituted the sole means by which a diagnosis of latent or existing vascular disease was made. The criterion of hypertension was based on a diastolic blood pressure of 80 or more mm. Hg. The analysis serves to emphasize many of the differential characteristics of vascular disease and true toxemia as presented in the paper above mentioned.
Switchable 2-port Aluminum Nitride MEMS resonator using monolithically integrated 3.6 THz cut-off frequency phase-change switches

This work presents the first experimental demonstration of an intrinsically switchable Aluminum Nitride (AlN) 2-port MEMS resonator using 3 monolithically integrated chalcogenide phase change material (PCM) switches.
A Proposal for Dealing with Deontic Dilemmas

In this paper I propose a simple modification of standard deontic logic that will enable the system to accommodate deontic dilemmas without inconsistency and without deontic explosion, while at the same time preserving the range of genuinely valid inferences. The proposal applies both to monadic deontic logic and to a dyadic logic of conditional obligation. In the Appendix these systems are proved to be sound and complete with respect to an appropriate semantics and also to be decidable.
Adam Smith's Impartial Spectator: His Reliance on Societal Values, Limits in Inspiring Altruism, and Application in Today's Context

In his comprehensive overview of moral philosophy, The Theory of Moral Sentiments (1759), Adam Smith made a key contribution through the concept of the “impartial spectator”—an imagined third party who allows an individual to objectively judge the ethical status of his or her actions. Also called the “man within the breast,” the impartial spectator is a tool through which individuals divide themselves into the “judge” and “the judged” to examine their own conduct in an unbiased manner. While Smith conceptualizes this imaginary figure as an embodiment of universal morality, and hence not limited to the values of one’s immediate community, I argue that this is largely impossible due to the character’s society-reliant nature. The impartial spectator is inevitably a local figure, a judge who, while objective, adjudicates based on the context of one’s immediate social milieu. Furthermore, due to his dependence on community norms, the impartial spectator is unable to motivate individuals to care for those outside conventional society’s concerns, and is ultimately restricted in his capacity to inspire moral improvement. Interestingly, however, the “man within the breast’s” society-driven nature seem less problematic and debilitating to Smith’s overall self-evaluation method in the context of today’s globalized, equality-driven world. His reliance on community norms does not serve as a key hindrance factor for inspiring altruism today, which demonstrates that Smith’s introspective technique may be better-suit for application in the present than in the philosopher’s time.