cssi/SciSciGPT-SciSciNet huggingface dataset:
Ethos, Pathos, and Logos of Chaucer and His Prioress

Rhetorical analyses of Geoffrey Chaucer’s works typically proceed from a medieval standpoint, with analysts often “combing through Chaucer’s works and tabulating the figures in them that are also listed and described in the manuals [from Chaucer’s time]” (Payne 270). However, Chaucer composed The Canterbury Tales at a time when rhetorical scholarship had all but lost its classical roots. Thus, Chaucer himself and his medieval audience were largely unaware of the rhetorical theories that grew out of ancient Rome and Greece. Nevertheless, their culture was inevitably touched by classical rhetorical theories since the theories found in the medieval rhetoric manuals are indebted to older theories. It is perhaps in this way that Aristotle’s rhetorical theories appear in The Canterbury Tales. Through his keen use of whatAristotle termed ethos, pathos, and logos, Chaucer the narrator not only persuades his audience of the problems with their hierarchical society, but he also explores the problems of rhetoric, revisiting the one issue that had plagued ancient rhetoricians like Aristotle for centuries: the morality of manipulating language to manipulate people. I suggest that whereas Aristotle advised the use of ethos, pathos, and logos to construct the most effective argument, Chaucer takes an unconventional approach, relying mainly on the more human appeal, pathos. Appeals to ethos and logos are certainly not lacking in The Canterbury Tales, yet they fail in a traditional sense—painting Chaucer the pilgrim-narrator (distinguished from Chaucer the poet)1 as a bumbling simpleton with no apparent grasp of common sense (ethos and logos). The feelings that this bumbling, seemingly brainless narrator manages to evoke revive his credibility as a speaker, though, and his credibility inevitably undermines the credibility of many of the characters within The Canterbury Tales, especially the Prioress. Further, I suggest that the narrator’s ability to dictate how persuasive, or not, the other characters will be signifies an important alteration that Chaucer made to Aristotle’s rhetorical principles. According to Aristotle, ethos should not be affected by any previous knowledge of the speaker. In The Canterbury Tales, however, “The Prioress’s Tale” fails because it comes from a character the audience already seems to know, as a result of the narrator’s detailed description of her in “The General Prologue.” Clearly, Chaucer the pilgrim’s descriptions of the pilgrims affect their later appeals to ethos, often hindering their ability to communicate their message with believability. Despite the success of other appeals, like emotional appeals in “The Prioress’s Tale,” the Prioress’s attempt at persuasion inevitably fails because of the interconnectedness of all three appeals. Chaucer the pilgrim is the main exception to failed attempts at persuasion in The Canterbury Tales; he manages to gain the trust of the audience, despite the semblance of unsuccessful appeals to ethos and logos. In the end, it is his characterization as a flawed, albeit honest, individual that leads to his unique appeal to pathos.
A Dynamic Study of Engine Valving Mechanisms: Determination of the Impulse Force Acting on the Valve

In resent years, dynamic studies of valve mechanisms in the internal combustion engine have dealt with peculiar phenomena such as valve jum or bounce which occurs at high speed operation. These studies have contributed to the reduction of valve mechanism problems. This paper describes how the five mass model can simulate the valve mechanisms dynamically, and express the impulse force rather than the valve motion or pushrod force used previously
Surgical Reconstruction of the Upper Extremity.

James H. Herndon, editor. Stamford, Connecticut: Appleton and Lange; 1999. 992 pages. $225.00. This multiauthored, single-volume text includes vignettes of all of the important skeletal and neuromuscular lesions affecting the upper extremity. For those who are learning and reviewing while on the move, a single, inclusive volume such as this is an advantage compared with several volumes. It also encourages a high level of serendipity; the clinician searching for information about a given topic is necessarily exposed to other interesting data. Haphazard learning has many advantages. The text reflects …
Ether derivatives of a progestin and estrogen in monthly dosage.

18 menopausal women were treated with 2.5 mg quingestanol acetate and 2 mg quinestrol in a single capsule (W5782) 3 weeks later and then once every 28 days for 12 months. 3 patients discontinued the monthly medication due to side effects. The vaginal cytology consistently showed an increase in the number of superficial cells and a decrease in the intermediate and parabasal types. Serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) decreased from menopausal levels before therapy to normal levels with therapy. Serum inorganic phosphorus and calcium dropped and remained low throughout therapy. Serum total triglycerides increased with therapy as did serum nonesterified fatty acids. T-4 levels were consistently elevated. It is suggested that smaller and more frequent dosages might eliminate the side effects. The changes seen were considered consistent with the recognized actions of estrogen and progesterone except for the effect on phosphorus and calcium; this latter effect may be due to the anabolic effect in estrogen-progesterone-deficient women.
Trifluoromethyl Derivatives of Insoluble Small-HOMO−LUMO-Gap Hollow Higher Fullerenes. NMR and DFT Structure Elucidation of C2-(C74-D3h)(CF3)12, Cs-(C76-Td(2))(CF3)12, C2-(C78-D3h(5))(CF3)12, Cs-(C80-C2v(5))(CF3)12, and C2-(C82-C2(5))(CF3)12

Reaction of a mixture of insoluble higher fullerenes with CF3I at 500 °C produced a single abundant isomer of C74(CF3)12, C76(CF3)12, and C80(CF3)12, two abundant isomers of C78(CF3)12 and C82(CF3)12, and an indeterminant number of isomers of C84(CF3)12. Using a combination of 19F NMR spectroscopy, DFT calculations, and the structures and spectra of previously reported fullerene(CF3)n compounds, the most-probable structures of six of the seven isolated compounds were determined to be specific isomers of C2-(C74-D3h)(CF3)12, Cs-(C76-Td(2))(CF3)12), C2-(C78-D3h(5))(CF3)12), Cs-(C80-C2v(5))(CF3)12), C2-(C82-C2(5))(CF3)12), and C2-(C82-C2(3))(CF3)12) containing ribbons and/or loops of edge-sharing para-C6(CF3)2 hexagons. The seventh isolated compound is a C1 isomer of C78(CF3)12 containing two such ribbons. This set of compounds represents only the second reported isolable compound with the hollow C74-D3h cage and the first experimental evidence for the existence of the hollow fullerenes C76-Td(2), C78-D3h(5)...
KIN-MEDIATED MORPHOGENESIS IN FACULTATIVELY CANNIBALISTIC TADPOLES.

Inclusive fitness theory predicts that organisms can increase their fitness by helping or not harming relatives, and many animals modify their behavior toward kin in a manner consistent with this prediction. Morphogenesis also may be sensitive to kinship environment, particularly in species where certain individuals facultatively develop structures that can be used against conspecifics as weaponry. We tested this hypothesis by examining whether and how consanguinity affected the probability that a structurally distinctive carnivore phenotype, which is opportunistically cannibalistic, would be produced in plains spadefoot toad tadpoles (Spea bombifrons) and southern spadefoot toad tadpoles (S. multiplicata). For tadpoles of S. multiplicata, individuals were significantly more likely to express the carnivore phenotype in mixed sibship groups than in pure sibship groups. For tadpoles of S. bombifrons, individuals were significantly more likely to express the carnivore phenotype when reared alone than in pure sibship groups. Both outcomes were independent of food availability or sibship specific differences in size or growth rate, and waterborne chemical signals from nonkin were sufficient to trigger expression of the carnivore phenotype. Our results suggest that morphogenesis may be responsive to kinship environment in any species or population that occurs as multiple, environmentally induced forms (polyphenism) that differ in their ability to help or to harm others.
Measuring cocaine use by hair analysis among criminally-involved youth

The study examined the utility of hair analysis for determining the prevalence of cocaine use in a high-risk population. Personal interviews and scalp hair specimens were obtained from 121 male you...
Co-immunoprecipitation for interactions of three human septin proteins

AIM: To study the interactions of three human septin proteins, septin 1, 2 and 6, and to investigate the working model of the septins in the hepatic carcinoma. METHODS: Full length septin 1, 2 and 6 gene were cloned into the pCMV Myc and pCMV HA vector respectively and co immunoprecipitation experiment in human 293 was used to investigate the interactions of the three septin proteins. RESULTS: Interactions in the septin family were confirmed, including the interactions between septin 1 and septin 2 or septin 6, and the interactions within themselves. CONCLUSION: Septin proteins as a complex may play an important role in the carcinogenesis by regulating cell cycles.
Distribution of Retroperitoneal Metastases After Chemotherapy in Patients With Nonseminomatous Germ Cell Tumors

AbstractFor patients with advanced nonseminomatous germ cell tumors a retroperitoneal lymph node dissection is routinely performed following chemotherapy if the serum tumor markers have returned to normal. Bilateral retroperitoneal lymph node dissection has been recommended because metastatic deposits may be widespread. The aim of this study was to describe the distribution of retroperitoneal metastases following chemotherapy in patients with nonseminomatous germ cell tumor and determine if the extent of the retroperitoneal lymph node dissection can be modified. We studied 113 patients who had initially bulky retroperitoneal disease and underwent retroperitoneal lymph node dissection following chemotherapy. For the purposes of this study teratoma and malignant germ cell tumor are referred to as tumor. The most common location of tumor was the para-aortic area (91%) in patients with a left primary tumor and the interaortocaval area (78%) in those with a right tumor. Tumor was located outside the boundaries...
Influence of musical groove on postural sway.

Timescales of postural fluctuation reflect underlying neuromuscular processes in balance control that are influenced by sensory information and the performance of concurrent cognitive and motor tasks. An open question is how postural fluctuations entrain to complex environmental rhythms, such as in music, which also vary on multiple timescales. Musical groove describes the property of music that encourages auditory-motor synchronization and is used to study voluntary motor entrainment to rhythmic sounds. The influence of groove on balance control mechanisms remains unexplored. We recorded fluctuations in center of pressure (CoP) of standing participants (N = 40) listening to low and high groove music and during quiet stance. We found an effect of musical groove on radial sway variability, with the least amount of variability in the high groove condition. In addition, we observed that groove influenced postural sway entrainment at various temporal scales. For example, with increasing levels of groove, we observed more entrainment to shorter, local timescale rhythmic musical occurrences. In contrast, we observed more entrainment to longer, global timescale features of the music, such as periodicity, with decreasing levels of groove. Finally, musical experience influenced the amount of postural variability and entrainment at local and global timescales. We conclude that groove in music and musical experience can influence the neural mechanisms that govern balance control, and discuss implications of our findings in terms of multiscale sensorimotor coupling. (PsycINFO Database Record.
Quantifying uncertainties in first-principles alloy thermodynamics using cluster expansions

The cluster expansion is a popular surrogate model for alloy modeling to avoid costly quantum mechanical simulations. As its practical implementations require approximations, its use trades efficiency for accuracy. Furthermore, the coefficients of the model need to be determined from some known data set (training set). These two sources of error, if not quantified, decrease the confidence we can put in the results obtained from the surrogate model. This paper presents a framework for the determination of the cluster expansion coefficients using a Bayesian approach, which allows for the quantification of uncertainties in the predictions. In particular, a relevance vector machine is used to automatically select the most relevant terms of the model while retaining an analytical expression for the predictive distribution. This methodology is applied to two binary alloys, SiGe and MgLi, including the temperature dependence in their effective cluster interactions. The resulting cluster expansions are used to calculate the uncertainty in several thermodynamic quantities: ground state line, including the uncertainty in which structures are thermodynamically stable at 0 źK , phase diagrams and phase transitions. The uncertainty in the ground state line is found to be of the order of meV/atom, showing that the cluster expansion is reliable to ab initio level accuracy even with limited data. We found that the uncertainty in the predicted phase transition temperature increases when including the temperature dependence of the effective cluster interactions. Also, the use of the bond stiffness versus bond length approximation to calculate temperature dependent properties from a reduced set of alloy configurations showed similar uncertainty to the approach where all training configurations are considered but at a much reduced computational cost.
Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction

Tissue liquefaction technology (TLT) delivers warmed saline from the liposuction cannula tip at low pressure pulses to disaggregate adipocytes. This technology differs significantly from that used in other liposuction devices including water jet-assisted liposuction. Here we introduce our early experience with this technology in the setting of fat transfer for revision breast reconstruction. A retrospective chart review of 136 consecutive patients who underwent fat harvest with TLT and subsequent transfer into 237 breast reconstructions was conducted at a single institution. This two-surgeon series examined donor and recipient site complication rates over a median follow-up of 143 days [87–233]. The overall complication rate was 28.7 %, of which the majority (22.1 %) was fat necrosis at the recipient site as documented by any clinical, imaging, or pathologic evidence. The abdomen served as the donor site for half of the cases. Donor site complications were limited to widespread ecchymosis of the donor site notable in 10.4 % of cases. Twenty-five percent of patients had received postmastectomy radiotherapy prior to fat transfer. Prior to revision with fat transfer, implant-based breast reconstruction was used in 75.5 % of cases, and autologous flaps in the remainder. Fat transfer was combined with other reconstructive procedures 94.1 % of the time. TLT can be used to harvest adipocytes for fat transfer with donor site morbidity and recipient site complications comparable to other modalities. The efficiency and quality of harvested fat makes this technology appealing for wide spread adoption during fat transfer. This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
America Is from Venus, France Is from Mars: Pinups, Policing, and Gender Equality

Professor Tristin Green shows in this Essay that current portrayals of differences between American and French harassment law are incomplete. They overlook important history of harassment law in the United States and miss the extent to which American law has been and continues to be shaped by concerns very similar to those articulated by the French in devising their harassment law. To reveal the common thread of concern, Professor Green uncovers the seeds of the limits placed on employer liability for harassment by the United States Supreme Court in the 1980s and 1990s, and digs beneath the doctrinal cover of “because of sex” in Title VII cases today. She shows judges in the United States relying on the “because of sex” requirement to prevent Title VII from disrupting exclusionary and subordinating work cultures for the very same reasons that French law was originally narrowly conceived. American judges in these cases see harassment as a problem of interpersonal intrusion (if not violence) first and of workplace discrimination second. Most fundamentally, they see employers as mere police officers of individuals who engage in harassment, and they resist a construction of the law that would require employers to alter male-dominated work cultures.Seeing this similar thread of concern and how it restricts the reach of harassment law in the United States is important to understanding the equality project in both countries. France and the United States both face significant hurdles to developing a harassment law that will alter workplace cultures in ways that further integration and equality. If equality advocates cannot disrupt the pervasive sense that workplace harassment is a matter solely of interpersonal behavior to be policed, whether by employers or by the state, then the harassment laws of neither country are likely to be effective.
Financial Performance of Health Insurers: State-Run Versus Federal-Run Exchanges

Many insurers incurred financial losses in individual markets for health insurance during 2014, the first year of Affordable Care Act mandated changes. This analysis looks at key financial ratios of insurers to compare profitability in 2014 and 2013, identify factors driving financial performance, and contrast the financial performance of health insurers operating in state-run exchanges versus the federal exchange. Overall, the median loss of sampled insurers was -3.9%, no greater than their loss in 2013. Reduced administrative costs offset increases in medical losses. Insurers performed better in states with state-run exchanges than insurers in states using the federal exchange in 2014. Medical loss ratios are the underlying driver more than administrative costs in the difference in performance between states with federal versus state-run exchanges. Policy makers looking to improve the financial performance of the individual market should focus on features that differentiate the markets associated with state-run versus federal exchanges.
Risk factors for transactional sex among young females in post-conflict Liberia : original research article

This study aimed to examine the risk factors for engaging in transactional sex among young females in Montserrado County, Liberia. Data from an HIV behavioral survey conducted among young people aged 14 - 25 years were used. The analytical sample included 493 sexually-experienced females. Bivariate and multivariate analyses were conducted. We found that 72% of our sample had ever engaged in transactional sex. Engagement in transactional sex was associated with education (OR: 0.5); reporting no earned income (OR: 1.9); longer duration of sexual activity (OR: 3.5); early sexual debut (OR: 2.5); history of sexual violence (OR: 2.1) and multiple sexual partnerships (OR: 4.0). Respondents' age, residence, and drug/alcohol use were not associated with engagement in transactional sex. HIV interventions should incorporate educational strategies to reduce the prevalence of transactional sex among young people. These strategies should include economic opportunities to offset financial need as well as efforts to eradicate sexual violence. Cette etude vise a examiner les facteurs de risque associes au rapport sexuel transactionnel chez les jeunes femmes dans le comte de Montserrado, Liberia. Nous avons utilise les donnees d'une enquete sur le comportement des jeunes gens âges de 14 - 25 ans face au VIH. L'echantillon d'analyse comprenait 493 femmes sexuellement experimentees. Des analyses bivariees et multivariees ont ete effectuees. Nous avons constate que 72% de notre echantillon avait deja eu des rapports sexuels transactionnels. L'engagement dans le rapport sexuel transactionnel a ete associe a l'education (OR: 0,5); celles qui declarent qu'elles n'ont gagne aucun revenu (OR: 1,9); une plus longue duree de l'activite sexuelle (OR: 3,5); le debut precoce du rapport sexuel (OR: 2,5); des antecedents de violence sexuelle (OR: 2,1) et les partenariats sexuels multiples (OR: 4,0). L'âge, le domicile des interviewees et l'usage de la drogue ou l'alcool n'etaient pas associes a l'engagement a des rapports sexuels transactionnels. Les interventions contre le VIH devraient integrer les strategies educatives pour reduire la prevalence des rapports sexuels transactionnels chez les jeunes. Ces strategies devraient inclure des possibilites economiques pour compenser les besoins financiers ainsi que les efforts qui visent a eradiquer la violence sexuelle.
Energy Management and Singular Perturbations in Flight Mechanics

Abstract This paper discusses the application of singular perturbation methods to problems in flight mechanics. Emphasis is given to the selection of slow and fast states and to an approach for obtaining nonlinear optimal control solutions in feedback form. Energy state transformations play a useful role in preconditioning the state dynamics for singular perturbation analysis; however, multiple boundary layer methods and new approaches to boundary layer matching are required to obtain closed-loop solutions. Weighted minimum time/fuel solutions for aircraft and missile applications are discussed.
Simultaneous Estimation of Legal and Illegal Supply and Demand: The Case of Motion Pictures

ABSTRACTPrior research into illegal goods has typically looked at one-way effects, such as illegal demand on legal demand. This research investigates a previously unexamined component of the market...
Factors Affecting the Accuracy of Korean Parsing

We investigate parsing accuracy on the Korean Treebank 2.0 with a number of different grammars. Comparisons among these grammars and to their English counterparts suggest different aspects of Korean that contribute to parsing difficulty. Our results indicate that the coarseness of the Treebank's nonterminal set is a even greater problem than in the English Treebank. We also find that Korean's relatively free word order does not impact parsing results as much as one might expect, but in fact the prevalence of zero pronouns accounts for a large portion of the difference between Korean and English parsing scores.
SELECTED THERMODYNAMIC AND FLUID FLOW DATA FROM THE SPACE SHUTTLE LIQUID OXYGEN SERVICING SYSTEM

This paper presents some thermal/flow data from the Space Shuttle liquid oxygen servicing system which consists of a 3408 m3 storage tank and a 15.24-centimeter vacuum-jacketed transfer line of about 500 meters long. The flowrate, pressure, and temperature data cover the system chill down and the stable flow. The pressure spike data are due to liquid column separation and vapor cavity collapse. Procedures associated with these data are given in details such that computer models for cryogenic system performance and waterhammer analyses can be validated.
Alternative possibilities and moral responsibility: The flicker of freedom

Some defenders of the principle of alternative possibilities (PAP) have responded to the challenge of Frankfurt-style counterexamples (FSCs) to PAP by arguing that there remains a “flicker of freedom” -- that is, an alternative possibility for action -- left to the agent in FSCs. I argue that the flicker of freedom strategy is unsuccessful. The strategy requires the supposition that doing an act-on-one's-own is itself an action of sorts. I argue that either this supposition is confused and leads to counter-intuitive results; or, if the supposition is acceptable, then it is possible to use it to construct a FSC in which there is no flicker of freedom at all. Either way, the flicker of freedom strategy is ineffective against FSCs. Since the flicker of freedom strategy is arguably the best defense of PAP, I conclude that FSCs are successful in showing that PAP is false. An agent can act with moral responsibility without having alternative possibilities available to her.
Forensic Analysis of Android Steganography Apps

The processing power of smartphones supports steganographic algorithms that were considered to be too computationally intensive for handheld devices. Several steganography apps are now available on mobile phones to support covert communications using digital photographs.
A Prospective Assessment of Optimal Mechanical Ventilation Parameters for Pediatric Catheter Ablation

Catheter stability, an important factor in ablation success, is affected by ventilation. Optimal ventilation strategies for pediatric catheter ablation are not known. We hypothesized that small tidal volume and positive end-expiratory pressure are associated with reduced ablation catheter movement at annular positions. Subjects aged 5–25 years undergoing ablation for supraventricular tachycardia (SVT) or WPW at two centers from March 2015 to September 2016 were prospectively enrolled and randomized to receive mechanical ventilation with either positive end-expiratory pressure of 5 cm H2O (PEEP) or 0 cm H2O (ZEEP). Movement of the ablation catheter tip at standard annular positions was measured using 3D electroanatomic mapping systems under two conditions: small tidal volume (STV) (3–5 mL/kg) or large TV (LTV) (6–8 mL/kg). 58 subjects (mean age 13.8 years) were enrolled for a total of 266 separate observations of catheter movement. STV ventilation was associated with significantly reduced catheter movement, compared to LTV at all positions (right posteroseptal: 2.5 ± 1.4 vs. 5.2 ± 3.1 mm, p < 0.0001; right lateral: 2.7 ± 1.6 vs. 6.3 ± 3.5 mm, p < 0.0001; left lateral: 1.8 ± 1.0 vs. 4.3 ± 1.9 mm, p < 0.0001). The presence or absence of PEEP had no effect on catheter movement. In multivariable analysis, STV was associated with a 3.1-mm reduction in movement (95% CI 2.6–3.5, p < 0.0001), adjusting for end-expiratory pressure, annular location, and patient size. We conclude that STV ventilation is associated with reduced ablation catheter movement compared to a LTV strategy, independent of PEEP and annular position.
Rumen metabolism and absorption of a 14C-labelled elastomeric copolymer and its value as a roughage substitute for cattle.

Several synthetic elastomeric and plastomeric polymers were tested for suitability as artificial roughages. They were fed to rumenfistulated cattle fed grain only. Several of the polymers were regurgitated, remasticated and reswallowed, and they formed thin strands of intermeshed fiber that produced a large, loosely woven hay-like mass that floated on the rumen contents. An elastomeric polymer consisting of copolymers of 80 to 90% ethylene and 10 to 20% propylene, with a tensile strength at yield of 45.7 kg/cm2, a hardness of 30 units (Shore D hardness scale) and a tensile strength at 300% elongation of 51.0 kg/cm2, was selected for further testing. The copolymer was fed at about 90 g/head daily for 127 days to cattle fed grain only. At slaughter, rumens contained an average of 8.0 kg copolymer (dry basis). Cattle fed the copolymer had healthier rumen papillae and epithelia of the abomasum and small intestines than did control animals fed grain only. Using /sup 14/C-labeled copolymer, we found that the copolymer was not degraded by rumen microorganisms or acid-pepsin solution. When /sup 14/C-labeled copolymer was fed to milking cows, no /sup 14/C activity was found in milk, blood or urine. Upon slaughter, about 100% of the /sup 14/Cmore » activity was recovered from digesta and feces. We concluded that the copolymer was not absorbed from the digestive tract.« less
Hegemonic Femininities and Intersectional Domination

We examine how two sociological traditions account for the role of femininities in social domination. The masculinities tradition theorizes gender as an independent structure of domination; consequ...
Paper-based isothermal DNA amplification and real-time analysis

This work reports a paper-based sensor technology for point-of-care nucleic acid amplification tests. The technology integrates a sensor chip and an Arduino-compatible fluorescence detector. The paper-based sensor provides the functions of reagent storage, sample transportation, and DNA amplification. The compact and low-cost fluorescence detector can quantify the amplicons in real time. The results show that the paper-based sensor can detect genomic DNA extracted from Escherichia coli with the concentration as low as 2 × 104 copies/ µL. As a diagnosis tool, the sensor has the potential to measure multiple target genes simultaneously.
The Safety and Efficacy of Transnasal Humidified Rapid‐Insufflation Ventilatory Exchange for Laryngologic Surgery

OBJECTIVES Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is an intraoperative ventilatory technique that allows avoidance of tracheal intubation (TI) or jet ventilation (JV) in selected laryngologic surgical cases. Unimpeded access to all parts of the glottis may improve surgical precision, decrease operative time, and potentially improve patient outcomes. The objective of this prospective, randomized, patient-blinded, 2-arm parallel pilot trial was to investigate the safety and efficacy of THRIVE use for adult patients undergoing nonlaser laryngologic surgery of short-to-intermediate duration. METHODS Twenty adult, American society of anesthesiology class 1-3 patients with body mass index (BMI) < 35 kg/m2 were randomly assigned to either an experimental THRIVE group or active comparator conventional ventilation group (TI or supraglottic high-frequency JV [SHFJV]). Primary outcomes included intraoperative oxygenation, anesthesia awakening/extubation time, time to laryngoscopic suspension, number of intraoperative suspension adjustments, and operative time. Secondary patient outcomes including postanesthesia and functional patient recovery were investigated. RESULTS Compared to TI/SHFJV, THRIVE use was associated with significantly lower intraoperative oxygenation (SpO2 93.0 ± 5.6% vs. 98.7 ± 1.6%), shorter time to suspension (1.8 ± 1.1 minutes vs. 4.3 ± 2.1 minutes), fewer suspension adjustments (0.4 ± 0.5 vs. 1.7 ± 0.9), and lower postoperative pain scores on recovery room admission (1.3 ± 1.9 vs. 3.7 ± 2.9) and discharge (0.9 ± 1.3 vs. 2.7 ± 1.8). The study was underpowered to detect other possible outcome differences. CONCLUSION We confirm the safe intraoperative oxygenation profile of THRIVE for selected patients undergoing nonlaser laryngologic surgery of short-to-intermediate duration. THRIVE facilitated surgical exposure and improved early patient recovery, suggesting a potential economic benefit for outpatient laryngologic procedures. The results of this exploratory study provide a framework for designing future adequately powered THRIVE trials. TRIAL REGISTER ClinicalTrials.gov (NCT03091179). LEVEL OF EVIDENCE II Laryngoscope, 2020.
Cannulation Strategies for Minimally Invasive Cardiac Surgery.

ObjectiveOperative techniques for minimally invasive cardiac surgery (MICS) have evolved dramatically over the past decade to include a wide demographic of patients. Mastering a variety of cannulat...
Value of Immediate Post-Kidney Biopsy Ultrasound in Excluding Late Hemorrhagic Complications

Background: Hemorrhage is the most serious potential complication of percutaneous kidney biopsy. Patients are typically observed for at least 6-8 hours after a kidney biopsy, with serial measurements of vital signs and hemoglobin to monitor for major hemorrhage. This study assessed whether an immediate post-biopsy ultrasound can reliably exclude delayed major hemorrhage. Methods: We retrospectively evaluated the clinical outcomes in 147 patients undergoing an outpatient native kidney biopsy with an 18-gauge needle at a large medical center during a 2.5 year period (January 2017 to June 2019). All patients underwent a standardized post-biopsy ultrasound to assess for active extravasation of blood. We extracted from the medical records vital signs and hemoglobin values obtained before the biopsy and at 2, 4, and 6 hours after the procedure. We ascertained whether any patients with a negative post-biopsy ultrasound developed a delayed major hemorrhage. Results: Each patient underwent 2 or 3 biopsy passes. The mean patient age was 48±17 years, 49% were female, 37% were black, 53% had hypertension and 16% had diabetes. Of the 142 patients without evidence of active extravasation on ultrasound, the blood pressure, heart rate, and hemoglobin remained stable during 6 hours of observation. All were discharged after 6 hours, and none had a late bleeding complication. Conclusions: If the immediate post-kidney biopsy ultrasound does not show active bleeding, the patient is extremely unlikely to develop a late major hemorrhagic complication (negative predictive value, 100%). Such patients can be discharged home safely after a 2-hour observation, thereby simplifying their management.
Cognition and Daily Functioning: Results from the Hispanic Community Health Study/Study of Latinos (SOL) and Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA).

Background Among older adults, poorer cognitive functioning has been associated with impairments in instrumental activities of daily living (IADLs). However, IADL impairments among older Hispanics/Latinos is poorly understood. Objective To characterize the relationships between cognition and risk for IADL impairment among diverse Hispanics/Latinos. Methods Participants included 6,292 community-dwelling adults from the Study of Latinos - Investigation of Neurocognitive Aging, an ancillary study of 45+ year-olds in the Hispanic Community Health Study/Study of Latinos. Cognitive data (learning, memory, executive functioning, processing speed, and a Global cognitive composite) were collected at Visit 1. IADL functioning was self-reported 7 years later, and treated as a categorical (i.e., risk) and continuous (i.e., degree) measures of impairment. Survey two-part models (mixture of logit and generalized linear model with Gaussian distribution) and ordered logistic regression tested the associations of cognitive performance (individual tests and composite z-score) with IADL impairment. Additionally, we investigated the moderating role of age, sex, and Hispanic/Latino background on the association between cognition and IADL impairment. Results Across all cognitive measures, poorer performance was associated with higher odds of IADL impairment 7 years later. Associations were generally stronger for the oldest group (70+ years) relative to the youngest group (50-59 years). Sex and Hispanic/Latino background did not modify the associations. Across the full sample, lower scores on learning, memory, and the Global cognitive composite were also associated with higher degree of IADL impairment. Conclusion Across diverse Hispanics/Latinos, cognitive health is an important predictor of everyday functioning 7 years later, especially in older adulthood.
A Survey of Patterns for Adapting Smartphone App UIs to Smart Watches

Wearable devices, such as smart watches and fitness trackers are growing in popularity, creating a need for application developers to adapt or extend a UI, typically from a smartphone, onto these devices. Wearables generally have a smaller form factor than a phone; thus, porting an app to the watch necessarily involves reworking the UI. An open problem is identifying best practices for adapting UIs to wearable devices. This paper contributes a study and data set of the state of practice in UI adaptation for wearables. We automatically extract UI designs from a set of 101 popular Android apps that have both a phone and watch version, and manually label how each UI element, as well as how screens in the app, are translated from the phone to the wearable. The paper identifies trends in adaptation strategies and presents design guidelines. We expect that the UI adaptation strategies identified in this paper can have wide-ranging impacts for future research and identifying best practices in this space, such as grounding future user studies that evaluate which strategies improve user satisfaction or automatically adapting UIs.
Thermo-Mechanical Response of an Additively Manufactured Energetic Material Simulant to Dynamic Loading

The mesoscale thermo-mechanical behavior of an additively manufactured energetic material (AMEM) simulant under dynamic loading is studied. The material is unidirectionally printed using direct ink writing (DIW) of a high solid-loaded photopolymer and cured under ultraviolet (UV) light exposure. Experiments and multi-physics computations are performed to relate localized deformation, dissipation mechanisms, and temperature rises to the print structure. Simultaneous high-speed visible light and infrared imaging is used to obtain deformation and temperature fields over the same area of samples with micrometer spatial and microsecond temporal resolutions. Loading along different directions relative to the print structure of the material is achieved using a split-Hopkinson pressure bar (SHPB) or Kolsky bar at the average strain rate of ~ 310 s−1. Shear banding and shear failure are observed. Simulations accounting for the geometry and print structure of the samples are performed. The microstructural heterogeneities are found to significantly affect the orientation-dependent deformation, damage, and heating, with the damage and heating most pronounced when the loading direction and print orientation are non-collinear. The heating is attributed to both constituent inelastic dissipation and internal friction. Depending upon the strain rate level and the loading orientation, the contribution of frictional dissipation to the overall heating is 0.9–4.5%. Despite this relatively low fraction in the overall heating, friction is localized at fracture sites and plays an important role in the development of local temperature spikes called hotspots which are of great interest for energetic materials.
Recommendation to reality: Closing the transcranial Doppler screening gap for children with sickle cell anemia.

Background Although annual transcranial Doppler (TCD) screening is recommended for children with sickle cell anemia (SCA), compliance is low and variable. Our objective was to utilize an electronic health record (EHR)-based registry to improve TCD adherence among children with SCA, 2-16 years of age, at our institution. Methods We developed an in-EPIC real time registry for children with sickle cell disease in year 2016. Since end of year 2016, we have been extracting data quarterly to examine TCD rates and share the list of children who have not received a TCD screen in the past 18 months with the clinical team. The registry also includes a TCD risk score to enhance point of care. We also added Child Life support to increase TCD compliance among children Results At baseline, prior to and start of quarterly data audit and feedback, 63% of children received the recommended annual TCD screen. TCD rates steadily increased to 80% by the third quarter of 2017. We observed a dip in TCD rates, driven by failure of screening young children. Since the initiation of Child Life support for children 70%. Overall, our data meet criteria for special cause variation, indicating improvement in TCD rates since 2015. Conclusions Regular tracking and identification of patients overdue for a TCD screen using an EHR-based registry resulted in sustained improvement in TCD screening rates. Involvement of Child Life support further improved TCD rates.
Decision Making and Interventions During Interfacility Transport of High-Acuity Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Abstract Objective There are limited data regarding the typical characteristics of coronavirus disease 2019 (COVID-19) patients requiring interfacility transport or the clinical capabilities of the out-of-hospital transport clinicians required to provide safe transport. The objective of this study is to provide epidemiologic data and highlight the clinical skill set and decision making needed to transport critically ill COVID-19 patients. Methods A retrospective chart review of persons under investigation for COVID-19 transported during the first 6 months of the pandemic by Johns Hopkins Lifeline was performed. Patients who required interfacility transport and tested positive for severe acute respiratory syndrome coronavirus 2 by polymerase chain reaction assay were included in the analysis. Results Sixty-eight patients (25.4%) required vasopressor support, 35 patients (13.1%) were pharmacologically paralyzed, 15 (5.60%) were prone, and 1 (0.75%) received an inhaled pulmonary vasodilator. At least 1 ventilator setting change occurred for 59 patients (22.0%), and ventilation mode was changed for 11 patients (4.10%) during transport. Conclusion The safe transport of critically ill patients with COVID-19 requires experience with vasopressors, paralytic medications, inhaled vasodilators, prone positioning, and ventilator management. The frequency of initiated critical interventions and ventilator adjustments underscores the tenuous nature of these patients and highlights the importance of transport clinician reassessment, critical thinking, and decision making.
Long-Term Outcomes From a Phase 2 Trial of Radiofrequency Ablation Combined With External Beam Radiation Therapy for Patients With Inoperable Non-Small Cell Lung Cancer

Purpose Long-term outcomes after external beam radiation therapy (EBRT) and radiofrequency ablation (RFA) for medically inoperable early-stage non-small cell lung cancer (NSCLC) are not well known. Methods and Materials Patients with medically inoperable early-stage NSCLC were enrolled in a prospective single-arm, phase 2 study between June 2007 and October 2008 and were treated with RFA followed by EBRT. Radiation was delivered using hypofractionated radiation therapy (HFRT; 70.2 Gy in 26 fractions) or stereotactic body radiation therapy (54 Gy in 3 fractions). Results Twelve patients were evaluable; 10 patients were treated with HFRT. The cumulative incidence of local progression at 5 years was 16.7% (95% confidence interval [CI], 0-37.8). Median progression-free survival was 37.8 months (95% CI, 11.1 to not reached) and median overall survival was 53.6 months (95% CI, 21.0 to not reached). There were no mortalities within 30 days after RFA and no grade ≥4 toxicity. Conclusions The combination of RFA with EBRT appears feasible with favorable long-term local control. However, because SBRT alone has similar or better rates of control, we do not recommend routine combined RFA and EBRT.
Biventricular conversion after Fontan completion: A preliminary experience.

Abstract Objective To assess the feasibility and outcomes of biventricular conversion following takedown of Fontan circulation. Methods Retrospective analysis of patients who had takedown of Fontan circulation and conversion to biventricular circulation at a single center from September 2007 to April 2020. Failing Fontan physiology was defined as Fontan circulation pressure >15 mm Hg and/or the presence of associated complications. Results Biventricular conversion was performed in 23 patients at a median age of 10.0 (7.5-13.0) years. Indications included failing Fontan physiology in 15 (65%) and elective takedown in 8 (35%) patients. A subset of patients (n = 6) underwent procedures for staged recruitment of the nondominant ventricle before conversion. Median z score of end-diastolic volume of borderline ventricle before takedown was –2.3 (–3.3, –1.3). Hypoplastic left heart syndrome (P Conclusions A primary as well as a staged biventricular conversion is feasible in patients who have had previous Fontan procedure. Although this provides an alternative to transplantation in patients with failing Fontan, outcomes are worse in those with failing Fontan compared with elective takedown of Fontan circulation. Optimal timing needs further evaluation.
Comparative Outcomes by Surgical Approach in Patients with Malignant Sinonasal Disease

Objective There is a paucity of data on comparative outcomes for open versus endoscopic surgery for patients with malignant sinonasal pathology. Most of the available studies are limited by a sample size Design This is a retrospective cohort study. Setting The findings of this study come from a single-institution tertiary care center from 2008 to 2019. Participants In total, 199 patients who underwent surgery for malignant sinonasal disease participated in this study. Main Outcome Measures The main outcome measures were perioperative complications and reoperation. Results Patients in our sample had a mean age of 59.7 years (SD, 20.4). In total, 62% were male and 72% were white. An endoscopic-only approach was used in 41% of patients and an open or combined approach in 59% of patients. Squamous cell carcinoma was the most common pathology (43.0%), followed by sarcoma (9.5%), skin cancer (6.5%), sinonasal undifferentiated carcinoma (6.5%), and adenocarcinoma (5.5%). The all-cause complication rate was 14.6%. Patients with an open resection had a higher rate of intraoperative complications (5.9 vs. 0%; p = 0.043), postoperative complications (19.5 vs. 3.7%; p = 0.001), and all-cause complications (21.0 vs. 3.7%; p 6 months) did not significantly differ by surgical approach (p = 1.000 and 0.741, respectively). Conclusion The endoscopic approach for resection of malignant sinonasal disease is viable for select patients and may be associated with a favorable complication rate compared with the open approach.
Elastic gas/water interface for highly stable foams with modified anionic silica nanoparticles and a like-charged surfactant.

Abstract Hypothesis. Surface active anionic nanoparticles (NPs) with strategically designed covalent ligands may be combined with a liked-charged surfactant to form a highly elastic gas-water interface leading to highly stable gas/water foams. Experiments. The colloidal stability of the NPs was determined by dynamic light scattering, and the surface elastic dilational modulus E’ of the interface by sinusoidal oscillation of a pendant droplet at 0.1 Hz, which was superimposed on large-amplitude compression-expansion cycles. The foam stability was measured with optical microscopy of the bubble size distribution and from the macroscopic foam height. Findings. The NPs played the key role the formation of a highly elastic air-water interface with a high E’ despite a surfactant level well above the critical micelle concentration. Unlike the case for most previous studies, the NP amphiphilicity was essentially independent of the surfactant given the very low adsorption of the surfactant on the like-charged NP surfaces. With high E’ values, both coalescence and coarsening were reduced leading to highly foam up to 80 °C. However, the surfactant facilitated foam generation at much lower shear rates than with NPs alone. The tuning of NP surfaces with ligands for colloidal stability in brine and simultaneously high amphiphilicity at the gas-water interface, over a wide range in surfactant concentration, is of broad interest for enabling the design of highly stable foams.
Project-Think and the Fragmentation and Defragmentation of Civil Society in Egypt, Palestine, and Turkey:

By drawing from authors’ fieldwork in Egypt, Palestine, and Turkey, this article critically examines perceptions of project-think among civic organizations in the Middle East. As a managerial ratio...
Sanitary Engineering and Reactor Waste Disposal

General nature of reactor wastes, their effect on nature and treatment; radioactive wastes directly associated with reactors; use of standards to determine health criteria; methods of assessment; effects of water treatment processes; effects of natural environment.
Critical Assumptions in the Stern Review on Climate Change

The Stern Review's analysis of global-warming economics depends on an extreme view of economic discounting.