cssi/SciSciGPT-SciSciNet huggingface dataset:
An Overview of Efforts to Bring Clinical Knowledge to the Point of Care

By bringing people the right information in the right format at the right time and place, state of the art clinical information systems with imbedded clinical knowledge can help people make the right clinical decisions. This chapter provides an overview of the efforts to develop systems capable of delivering such information at the point of care. The first section focuses on “library-type” applications that enable a clinician to lookup information in an electronic document. The second section describes a myriad of “real-time clinical decision support systems.” These systems generally deliver clinical guidance at the point of care within the clinical information system (CIS). The third section describes several “hybrid” systems, which combine aspects of real-time clinical decision support systems with library-type information. Finally, section four provides a brief look at various attempts to bring clinical knowledge, in the form of computable guidelines, to the point of care. “To be effective, (clinical decision support) tools need to be grounded in the patient’s record, must use standard medical vocabularies, should have clear semantics, must facilitate knowledge maintenance and sharing, and need to IDEA GROUP PUBLISHING 701 E. Chocolate Avenue, Suite 200, Hershey PA 17033-1240, USA Tel: 717/533-8845; Fax 717/533-8661; URL-http://ww .idea-group.com ITB11163 This chapter appears in the book, Clinical Knowledge Management: Opportunities and Challenges, by Rajeev K. Bali. © 2005, Idea Group Inc.
Eliminating All Nonepithelial Cells Using Colchicine

To eliminate the interstitial cell population of hydra using colchicine treatments (Campbell, 1976; Marcum and Campbell, 1978). The resulting viable animals consist only of two layers of epithelial cells plus the noncellular mesoglea. These animals are termed epithelial hydra.
Role of Rho kinase and Na+/H+ exchange in hypoxia‐induced pulmonary arterial smooth muscle cell proliferation and migration

Abnormal proliferation and migration of pulmonary arterial smooth muscle cells (PASMCs) are hallmark characteristics of vascular remodeling in pulmonary hypertension induced by chronic hypoxia. In this study, we investigated the role of the Na+/H+ exchanger (NHE) and alterations in intracellular pH (pHi) homeostasis in meditating increased proliferation and migration in PASMCs isolated from resistance‐sized pulmonary arteries from chronically hypoxic rats or from normoxic rats that were exposed to hypoxia ex vivo (1% or 4% O2, 24–96 h). We found that PASMCs exposed to either in vivo or ex vivo hypoxia exhibited greater proliferative and migratory capacity, elevated pHi, and enhanced NHE activity. The NHE inhibitor, ethyl isopropyl amiloride (EIPA), normalized pHi in hypoxic PASMCs and reduced migration by 73% and 45% in cells exposed to in vivo and in vitro hypoxia, respectively. Similarly, EIPA reduced proliferation by 97% and 78% in cells exposed to in vivo and in vitro hypoxia, respectively. We previously demonstrated that NHE isoform 1 (NHE1) is the predominant isoform expressed in PASMCs. The development of hypoxia‐induced pulmonary hypertension and alterations in PASMC pHi homeostasis were prevented in mice deficient for NHE1. We found that short‐term (24 h) ex vivo hypoxic exposure did not alter the expression of NHE1, so we tested the role of Rho kinase (ROCK) as a possible means of increasing NHE activity. In the presence of the ROCK inhibitor, Y‐27632, we found that pHi and NHE activity were normalized and migration and proliferation were reduced in PASMCs exposed to either in vivo (by 68% for migration and 22% for proliferation) or ex vivo (by 43% for migration and 17% for proliferation) hypoxia. From these results, we conclude that during hypoxia, activation of ROCK enhances NHE activity and promotes PASMC migration and proliferation.
Trends analysis on the morbidity and mortality of prostate cancer among residents in Pudong New Area of Shanghai,2002-2013

OBJECTIVE To analyze the morbidity and mortality of prostate cancer among residents in Pudong New Area of Shanghai.METHODS The residents of Pudong New Area in Shanghai were recruited in this study from 2002to2013.The mortalities of prostate cancer in different groups were calculated and these rates were standardized by the world population in 1985 and Chinese population in 1982.The trends of prostate cancer from 2002 to 2013and annual percent changes(APC)were analyzed by Join-point regression program.RESULTS Among the 3 235 prostate cancer cases occurred between 2002 and 2013,the world ASR(age-standardized rate)of incidence was 11.20 per 100 000person-year,and the China ASR was 7.01 per 100 000person-year.The morbidity had a significant upward trend(APC=6.14%,z=9.49,P0.001).There was an obvious upward trend in aged 45 to 59years old(APC=54.66%,z=2.73,P=0.02)and above 60 years old(APC=10.77%,z=3.79,P=0.003).In 1 570 prostate cancer patients dead between 2002 and 2013,the world ASR(age-standardized rate)of mortality was 4.66 per 100 000person-year,and the China ASR was 2.70per100 000person-year.The peak of incidence rate was above 85 years old(244.99 per 100 000person-year).The mortality had a significative upward trend(APC=5.99%,z=4.42,P=0.001).There was an obvious upward trend in aged 40 to 69years old(APC=27.12%,z=11.28,P0.001)and above 70 years old(APC=16.89%,z=5.19,P0.001).The peak of death rate was above 85 years old(322.31 per 100 000person-year).CONCLUSIONS It is evident that the incidence and mortality of prostate cancer have significant upward trend in Pudong new area.Therefore,an increased focus on etiological study of prostate cancer and early diagnosis technology application is necessary.
Modulation of IL-13 mRNA,TNF-α mRNA and IgE with Chinese herbal drugs in rats with bronchial asthma

AIM: To assess the modulation of IL-13 mRNA, TNF-α mRNA and IgE with Chinese herbal drugs in rats with bronchial asthma. METHODS:Twenty-four Wistar rats were randomly divided into 3 groups: control group, asthma model group, therapeutic group. Rat model of asthma was made by ovalbumin (OVA) and AI(OH)3. In the period of challenge, a Chinese herbal solution comprised with bitter apricot seed, liquoric root etc was used in therapeutic group. While in other groups normal saline was inhalated. Differential count of cells in bronchoalveolar lavage fluid was performed. Quantification of IgE in serum and bronchoalveolar lavage fluids (BALF) and IL-13 mRNA and TNF-α mRNA levels in lung tissues were conducted by immunoradiometric assay (IRMA) and RT-PCR.RESULTS:Compared to the controls, the asthma model rats had significant increases of serum IgE level, eosinophils percentage, and expressions of IL-13 mRNA and TNF-α mRNA. Compared to the asthma model group, the rats in the therapeutic group showed significant reductions of serum IgE and expressions of IL-13 mRNA and TNF-α mRNA. CONCLUSION:The Chinese herbal solution we used in this research could inhibit the expressions of IL-13 mRNA and TNF-α mRNA and improve the inflammation of asthma.
Correlation of Caspase Activity and In Vitro Chemo-Response in Epithelial Ovarian Cancer Cell Lines

The immediate assessment of response to therapy is most beneficial to ovarian cancer patients. This study shows the correlation of drug-induced caspase activation determined by western blot analysis and by Caspase-Glotrade mark assay. Our findings demonstrate that the use of the Caspase-Glotrade mark assay allows a simple, fast, and sensitive alternative for the evaluation of in vitro response to chemotherapy.
Monitoring of Respiratory Function in Critical Care Patients

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled "Surgical Care of the Respiratory Patient." The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.
Sodium Pump Function

Publisher Summary This chapter discusses the functions of the sodium pump in relation to the development of biological membranes. As biological complexity increased, more elaborate transport activities evolved to improve the control of the organism over its environment. As early life forms became exposed to various ionic environments, a need to develop some means of regulating cellular volume and of maintaining cytosolic homeostasis arose. As water follows the movement of ions, and they are transported between compartments, it became imperative to develop mechanisms to control the flow of ions, such as Na + and K + through the plasma membrane. In eukaryotic cells, these processes are controlled by the “sodium pump.” The pumping of Na + out of the cell and K + into the cell, and hence, regulation of cytosolic ionic concentrations and cell volume, therefore requires sufficient energy (derived from the hydrolysis of ATP) to overcome these driving forces, which is by definition, known as the “sodium pump activity.” The chapter discusses Na + -K + transport, transport mechanism, Na + , K + -ATPase structure, cardiac glycosides. The enzyme that fuels the sodium pump is the Na + , K + -ATPase. The Na + , K + -ATPase is mentioned as a vital protein, present in animal cells, as demonstrated by the remarkable degree of conservation across evolutionary lines and the fact that it has been found in every animal cell type, which is researched. This enzyme places a high metabolic burden on the cell, using a substantial portion of the total cellular energy production in maintaining the osmotic balance and ionic gradients across the plasma membrane. This enzyme is crucial for the survival of animal cells, as demonstrated by the fact that transgenic knockout mice do not survive. The Na + , K + -ATPase is composed of two subunits in a one-to-one stoichiometry—the alpha (α) or catalytic subunit and the beta (β) or glycoprotein subunit. In addition to its role in maintaining homeostasis, inhibition of the pump has significant therapeutic relevance by virtue of the secondary increase in Ca 2+ concentration leading to an increase in cardiac contractility.
Ceramic Evidence for Community Reorganization and Change in East-Central Arizona

ABSTRACTWe present a brief synthesis of current ceramic research in the Grasshopper region of east-central Arizona. Through a detailed analysis of ceramic technology and composition, coupled with observations of archaeological formation processes, we argue that the late Pueblo III-Pueblo IV period ceramic assemblages in the region document an instance of rapid change in manufacture and circulation patterns. Intensification and diversification of ceramic production are linked with the migration of ethnically diverse people into the Grasshopper region. These changes correlate with the demographic and social reorganization that took place in the Southwest at the end of the thirteenth century.
INBREEDING AND THE MUTATIONAL AND BALANCED LOADS IN NATURAL POPULATIONS OF DROSOPHILA WILLISTONI.

DOBZHANSKY, SPASSKY and TIDWELL ( 1963) have reported experiments on the effects of inbreeding on the egg to adult viability in progenies of Drosophila pseudoobscura females collected in several places in Arizona and California. As expected, the inbred progenies were less viable than the outbred ones, and the greater degree of inbreeding (brother-sister mating) gave a greater reduction of the viability than the lesser inbreeding (approximately equivalent to half-sib mating). Attempts were then made to estimate the genetic loads, in the populations examined, in terms of the A and B statistics suggested by MORTON, CROW, and MULLER (1956). Similar experiments, giving closely similar estimates of the A and B values, were reported by STONE, WILSON and GERSTENBERG (1963). DOBZHANSKY, SPASSKY and TIDWELL (1963) also approached the problem of the magnitude of the inbreeding effects by another method, previously used for studies on genetic loads in several species of Drosophila. This method consists in obtaining individuals homozygous for certain chromosomes, by means of a series of crosses using genetic markers and suppressors of recombination in the chromosomes under investigation. The estimates of the genetic load found by this method proved to be considerably higher than those obtained by studies of the viabilities of the inbred progenies. This discrepancy reinforced doubts previously expressed about the validity of the methods proposed for the evaluation of the magnitude of the genetic loads, and about the usefulness of these methods for discrimination between the mutational and the balanced components of these loads. These doubts in no way diminish the interest and importance of inbreeding studies. The experiments reported in the present article are made using Drosophila willistoni, a species in many respects different from Drosophila pseudoobscura. D. willistoni is a species very common in tropical America, and the previous work of PAVAN and associates ( 1951 ) has indicated that the populations carry very heavy genetic loads. As will be shown in the following pages, the results obtained are indeed different from those in D. pseudoobscura.
Toward greater insights on pharmacokinetics and exposure‐response relationships for therapeutic biologics in oncology drug development

There has been increased interest in optimizing dosing regimens for oncology products over the past decade. Investigations to refine dosing regimens often occur after new drug approval. There is growing focus on the use of exposure-response (ER) approaches to identify optimal dosing regimens for therapeutic biologics. Herein, we describe several recent observations that have informed our thinking on the use of ER analyses in the dose regimen optimization of therapeutic biologics developed to treat cancer.
MPL Mutation Profile in JAK2 Mutation-Negative Patients with Myeloproliferative Neoplasms.

Abstract Abstract 1891 Poster Board I-914 Myeloproliferative neoplasms (MPNs) are multipotent hematopoietic stem cell neoplasms characterized by excess production of various blood cells. Mutations in the thrombopoietin receptor gene (MPL) have been reported in JAK2 V617F-negative patients with MPNs. We evaluated the prevalence of MPL mutations relative to those of JAK2 mutations at V617 or in exons 12 through 15 in a large number of patients with suspected MPNs. A total of 2790 patients with suspected MPNs referred to our institution were first screened for JAK2 V617F and exon 12–15 mutations. Patients with no JAK2 mutations detected were then tested for MPL mutations in exons 10 and 11 by means of a sensitive MPL reverse-transcription-PCR-based assay with direct bidirectional sequencing. All JAK2 and MPL mutation assays were performed on plasma RNA, rather than DNA isolated from blood or bone marrow cells. Of the 2790 patients, 529 (18.96%) had a V617F mutation; 12 (0.43%) had small insertion/deletions in exon 12; and 7 (0.25%) had other JAK2 mutations, including point mutations in exons 13–15 and an exon 14 splice mutation. MPL mutations were identified in 66 of the 2242 (2.94%) JAK2 mutation-negative patients (2.37% of all tested patients). W515L was the dominant MPL mutant detected in 46 patients (70%) including two patients with homozygous W515L mutation. The other W515 variants (W515K, W515R, W515S, W515G, W515A, W515*) comprised 16% (N=11) of the MPL mutations. The remaining MPL mutations (n =9, 14%) were detected at other locations in exon 10 and 11. Two of these were novel exon 10 deletion/insertion mutations and two were unreported exon 11 point mutations. The exon 10 T496-A497ALVI (4AA) homozygous insertion was detected in one patient with a confirmed diagnosis of idiopathic myelofibrosis and the W515-P518 del/ins (KT) mutation was detected in another patient with unspecified MPN. The two novel MPL exon 11 point mutations were D545G and D545N. The S505N mutation (n=2) and V507I (n=1), R514K (n=1), and A519V (n=1) were also detected. Furthermore, three unreported silent polymorphisms/mutations (T496, L543, and D534) were detected. In conclusion, our results demonstrate that for every 100 V617F mutations detected in patients with MPNs, there are 2.3 JAK2 exon 12 mutations, 1.3 JAK2 exon 13–15 mutations, and 12.5 MPL mutations. Thus, MPL mutation detection should be performed on all JAK2 V617F-negative patients with suspected MPNs. In addition, our findings indicate that >20% of MPL mutations would have been missed if only W515L and W515K were analyzed; thus, sequencing of both exon 10 and 11 may be beneficial. Disclosures: No relevant conflicts of interest to declare.
Diffusion of Lithium Ions in Amorphous and Crystalline Poly(ethylene oxide)3:LiCF3SO3 Polymer Electrolytes

Abstract The PEO 3 :LiCF 3 SO 3 polymer electrolyte has attracted significant research due to high conductivity and enhanced stability in lithium polymer batteries. Most experimental studies have shown that amorphous PEO lithium salt electrolytes have higher conductivity than the crystalline ones. Other studies, however, have shown that crystalline PEO salt complexes can conduct ions. As a result, further theoretical investigations are warranted to help clarify the issue. In this work, we use density functional theory with the climbing image nudged elastic band method to investigate the atomic-scale mechanism of lithium ion transport in the polymer electrolytes. We also use density functional theory and ab initio molecular dynamics simulations to obtain the amorphous structure of PEO 3 :LiCF 3 SO 3 . The diffusion pathways and activation energies of lithium ions in both crystalline and amorphous PEO 3 :LiCF 3 SO 3 are determined. In crystalline PEO 3 :LiCF 3 SO 3 , the activation energy for the low-barrier diffusion pathway is approximately 1.0 eV. In the amorphous phase, the value is 0.6 eV. This result would support the experimental observation that amorphous PEO 3 :LiCF 3 SO 3 has higher ionic conductivity than the crystalline phase.
CSF lactate alone is not a reliable indicator of bacterial ventriculitis in patients with ventriculostomies.

Abstract Introduction In a febrile patient with a ventriculostomy, diagnosing or excluding bacterial or microbial ventriculitis is difficult, as conventional markers in analysis of cerebrospinal fluid (CSF) are not applicable due to presence of blood and inflammation. CSF lactate has been shown to be a useful indicator of bacterial meningitis in CSF obtained via lumbar puncture, but little and heterogenous data exist on patients with ventriculostomies. Methods We reviewed all CSF analyses obtained via ventriculostomy in patients admitted to our tertiary medical center between 2008 and 2013, and constructed receiver operating characteristic (ROC) curves to evaluate the accuracy of CSF lactate concentration in discriminating a positive CSF culture from a negative one in setting of ventriculostomy and prophylactic antibiosis. Results Among 467 CSF lactate values, there were 22 corresponding CSF cultures with bacterial growth. Sensitivities and specificities for CSF lactate at threshold values 3, 4, 5 and 6 mmol/L showed sensitivity and specificity greater than 70% for CSF lactate threshold 4 mmol/L. The lowest threshold value of 3 mmol/L resulted in higher sensitivity of 81.8%, and the highest chosen threshold value resulted in high specificity of 94.2%, but these values had poor corresponding specificity and sensitivity, respectively. The area under the curve was 0.82 (95% CI 0.72, 0.91). Conclusion Our data from a large sample of CSF studies in patients with ventriculostomy indicate that no single value of CSF lactate provided both sensitivity and specificity high enough to be regarded as reliable test.
Impact of small prosthesis size on transcatheter or surgical aortic valve replacement outcomes.

Objectives Determine the comparative impact of small prosthesis size on transcatheter and surgical aortic valve replacement (SAVR) outcomes. Background Patients with small aortic annuli tend to have worse postoperative outcomes and hemodynamics. We sought to describe surgical outcomes in patients with very small aortic annuli and then compare early hemodynamic and clinical outcomes in patients undergoing surgical or transcatheter aortic valve replacement (TAVR) with the smallest available valves to assist in optimal prosthesis selection for this challenging patient population. Methods A retrospective single-center study comparing patient data from 2143 patients undergoing SAVR with valves having a true internal diameter (ID) of ≥19 mm with 130 patients receiving surgical valves with true ID's <19 mm (SmSAVR). Outcomes of SmSAVR patients were then compared with 40 patients undergoing TAVR receiving small valves (SmTAVR). A representative SmSAVR cohort was then compared with the SmTAVR patients for post-operative hemodynamics. Results Receiving a small surgical valve may significantly increase 1-year mortality compared with standard-sized surgical valves (HR 1.93; 95% confidence interval 1.03–3.61). SmTAVR patients had significantly shorter lengths of stay than SmSAVR (median 5 vs. 9 days), and significantly better postoperative hemodynamic profiles (mean gradient 13.4 ± 7.8 vs. 18.1 ± 8.4 mm Hg, P = 0.006, peak velocity of 2.5 ± 0.6 vs. 2.9 ± 0.6 m/s, P = 0.003). Conclusions TAVR is a safe and reasonable option for patients with small aortic annuli and is associated with shorter hospital stays and more favorable postoperative hemodynamic outcomes compared with SAVR. © 2017 Wiley Periodicals, Inc.
Lagrangian Mesh Model with Regridding for Planar Poiseuille Flow

Many biological settings involve complex fluids that have non-Newtonian mechanical responses that arise from suspended microstructures. In contrast, Newtonian fluids are liquids or mixtures of a simple molecular structure that exhibit a linear relationship between the shear stress and the rate of deformation. In modeling complex fluids, the extra stress from the non-Newtonian contribution must be included in the governing equations. In this study we compare Lagrangian mesh and Oldroyd-B formulations of fluid-structure interaction in an immersed boundary framework. The start-up phase of planar Poiseuille flow between two parallel plates is used as a test case for the fluid models. For Newtonian and Oldroyd-B fluids there exist analytical solutions which are used in the comparison of simulation and theoretical results. The Lagrangian mesh results are compared with Oldroyd-B using comparable parameters. A regridding algorithm is introduced for the Lagrangian mesh model. We show that the Lagrangian mesh model simulations with regridding produce results in close agreement with the Oldfoyd-B model.
Measuring urban tree loss dynamics across residential landscapes

Abstract The spatial arrangement of urban vegetation depends on urban morphology and socio-economic settings. Urban vegetation changes over time because of human management. Urban trees are removed due to hazard prevention or aesthetic preferences. Previous research attributed tree loss to decreases in canopy cover. However, this provides little information about location and structural characteristics of trees lost, as well as environmental and social factors affecting tree loss dynamics. This is particularly relevant in residential landscapes where access to residential parcels for field surveys is limited. We tested whether multi-temporal airborne LiDAR and multi-spectral imagery collected at a 5-year interval can be used to investigate urban tree loss dynamics across residential landscapes in Denver, CO and Milwaukee, WI, covering 400,705 residential parcels in 444 census tracts. Position and stem height of trees lost were extracted from canopy height models calculated as the difference between final (year 5) and initial (year 0) vegetation height derived from LiDAR. Multivariate regression models were used to predict number and height of tree stems lost in residential parcels in each census tract based on urban morphological and socio-economic variables. A total of 28,427 stems were lost from residential parcels in Denver and Milwaukee over 5 years. Overall, 7% of residential parcels lost one stem, averaging 90.87 stems per km 2 . Average stem height was 10.16 m, though trees lost in Denver were taller compared to Milwaukee. The number of stems lost was higher in neighborhoods with higher canopy cover and developed before the 1970s. However, socio-economic characteristics had little effect on tree loss dynamics. The study provides a simple method for measuring urban tree loss dynamics within and across entire cities, and represents a further step toward high resolution assessments of the three-dimensional change of urban vegetation at large spatial scales.
Evaluation of Tropical Cyclone Structure Forecasts in a High-Resolution Version of the Multiscale GFDL fvGFS Model

AbstractA nested version of the cubed-sphere finite-volume dynamical core (FV3) with GFS physics (fvGFS) is capable of tropical cyclone (TC) prediction across multiple space and time scales, from s...
Representation of obese participants in obesity-related cancer randomized trials.

Abstract Background Obesity is a risk factor for numerous cancer types, and may influence cancer treatment outcomes. Underrepresentation of obese patients in obesity-related cancer randomized controlled trials (RCTs) may affect generalizability of results. We aimed to assess the reporting of information about eligibility and enrollment of obese participants in obesity-related cancer RCTs. Methods We conducted a systematic review of RCTs of 10 obesity-related cancer types (esophagus, colon/rectum, liver, gallbladder, pancreas, postmenopausal breast, endometrium, ovary, kidney, and thyroid cancer). We selected RCTs published between 2013 and 2016 in five major journals. For each trial, we examined the article, the protocol, and the registration record. We assessed if eligibility criteria limiting the enrollment of obese participants were reported, the proportion of obese participants that were enrolled, and if a subgroup analysis according to obesity status was reported. We systematically contacted corresponding authors and asked for information about eligibility of obese participants and the proportion of obese participants. Results We included 76 RCTs. Colon/rectum (n = 20), postmenopausal breast (n = 11), and kidney (n = 11) cancers were the most frequent types. Based on publicly available sources, information on the eligibility of obese participants was available in 5 (7%) trials. The proportion of obese participants could be estimated in 9 (12%) trials only. We found a subgroup analysis in only one RCT. When considering unpublished information, the eligibility of obese participants was explicitly stated in 31 (41%) trials but it was unclear if the remaining 59% trials considered obese participants as eligible and what proportion of obese participants was included. Across 22 trials, the median proportion of obese participants included was 18% (Q1–Q3 11–23). Conclusion Information on the eligibility and enrollment of obese participants in cancer RCTs is dramatically underreported. More transparency is needed to understand the applicability of obesity-related cancer RCT results to obese patients with cancer.
Ultrasound Imaging for the Surgical Intensivist

Ultrasound imaging technology and techniques have rapidly advanced over the past decade and are now at the point where they should be considered a standard and critical component of critical care practice. All current and future intensivists should be thoroughly familiar with the myriad of applications of point-of-care ultrasound (POCUS) for assisting in the assessment, diagnostic workup, and therapeutic interventions in the intensive care unit (ICU) setting. POCUS differs from comprehensive ultrasound (US) in its intent and use. POCUS is performed bedside by a clinician, employed to detect acute and often life-threatening conditions to facilitate treatment or to guide performance of an invasive procedure. It is quick and usually only focuses on a single or limited set of organs. Its clinical applications can be viewed as procedural guidance, diagnostics, monitoring, or resuscitation, with guidelines for the appropriate use of bedside ultrasound in the ICU set forth by the Society of Critical Care Medicine. By following evidence-based recommendations regarding the appropriate use of ultrasound in the ICU, clinicians can provide selected patients with effective and efficient care. This chapter will review the key points and strategies for ICU physicians to incorporate POCUS into their day-to-day practice.
Introduction of Fluorine into Organic Compounds

The large number of methods for introducing fluorine into organic compounds may be subdivided into addition of hydrogen fluoride, addition of fluorine, addition of halogen fluorides across double and triple bonds, and substitution of fluorine for hydrogen, halogen, oxygen, and nitrogen.
NEW EMPIRICAL RELATION BETWEEN COHESION ENERGY DENSITY AND ONSACER REACTION FIELD FOR SEVERAL CLASSES OF ORGANIC COMPOUNDS

ABSTRACT For some organic compounds cohesive energy density, CED, within a homologous series is found to change linearly with a single material parameter, g 2 = [(n 2 − 1)/ (2n 2 + 1)] 2 , reflecting the intensity of the Onsager reaction field; n is the refractive index of the compound. This correlation has been found for n-alkanes, 1-nalkenes and n-alkyl benzenes (exhibiting only dispersive interactions), for methyln-alkyl ketones (with dipolar interactions) and for linear alcohols (forming hydrogen bonds). Correlation for n-alkanes, extrapolated to corresponding g 2 is in good agreement with CED for polyethylene. Substituent changes both g 2 and CED, of the compound, relative to the corresponding n-alkane. Change of g 2 reflects the effect of the substituent on purely dispersive interaction. The contribution of the specific interactions (dipolar or hydrogen bonds) causes the difference between CED for a substituted n-alkane and an imaginary n-alkane of equal g 2 . For methyl-n-alkyl ketones this contribution is in good agreement with previously reported values.
Teaching Quality Improvement and Health Care Systems at Dartmouth's Geisel School of Medicine

The Geisel School of Medicine at Dartmouth College has integrated health care delivery science, which includes quality improvement and leadership training, into its medical school curriculum.
Urbanization, Nutrition Transition, and Obesity: Evidence from China

This paper explores the effects of urbanization on nutrition transition and obesity. Taking adult individuals from the China Health and Nutrition Survey (CHNS), from the year 1989 to 2009, this study confirms the hypothesis that rising urbanization has positive effects on the obesity level. Also, the results reveal a nutrition transition towards a dietary pattern of more fat and protein intake in China. Particularly, evidence from the gender difference indicates that the effect of urbanization, along with the factors as education and income, on obesity is more pronounced for females than males.
An average case analysis of planning

I present an average case analysis of propositional STRIPS planning. The analysis assumes that each possible precondition (likewise postcondition) is equally likely too appear within an operator. Under this assumption, I derive bounds for when it is highly likely that a planning instanee can be efficiently solved, either by finding a plan or proving that no plan exists. Roughly, if planning instances have no conditions (ground atoms), g goals, and O(n9√δ) operators, then a simple, efficient algorithm can prove that no plan exists for at least 1 - 8 of the instances. If instances have Ω(n(ln g)(ln g/δ)) operators, then a simple, efficient algorithm can find a plan for at least 1-δ of the instances. A similar result holds for plan modification, i.e., solving a planning instance that is close too another planning instance with a known plan. Thus it would appear that propositional STRIPS planning, a PSPACE-complete problem, is hard only for narrow parameter ranges, which complements previous average-case analyses for NP-complete problems. Future work is needed to narrow the gap between the bounds and to Consider more realistic distributional assumptions and more sophisticated algorithms.
The Impact of Freedom of Information Laws on Foreign Direct Investment in Developing Countries

Freedom of Information (FOI) laws, which guarantee access to government information, have been hailed for strengthening democratic accountability. By 2008 they had been passed by over seventy countries, including over forty in the developing world. This paper finds that FOI laws also have an economic impact, increasing FDI inflows in developing countries. FOI laws can impact FDI by leading to increased transparency and greater policy credibility. Using a panel study of developing countries from 1985 to 2008, I find that FOI laws increase FDI inflows, but only once in effect for three or more years. I also find that existing institutional quality is an important scope condition: the effect of FOI laws holds only where the rule of law is high. Instrumental variables models confirm the results are not an artifact of endogeneity. These results show that transparency and access to information can have an impact on economic outcomes.
Sustainability assessment of agricultural rainwater harvesting: Evaluation of alternative crop types and irrigation practices.

Rainwater harvesting (RWH) has been used globally to address water scarcity for various ecosystem uses, including crop irrigation requirements, and to meet the water resource needs of a growing world population. However, the costs, benefits and impacts of alternative crop types and irrigation practices is challenging to evaluate comprehensively. We present an assessment methodology to evaluate the sustainability of agricultural systems as applied to a southeastern U.S. river basin. We utilized detailed, crop-level cultivation information to calculate sustainability indicators (relative to well-water irrigation) at the basin scale (6-digit Hydrologic Unit Codes). 40 design configurations comprising crop types and irrigation practices were evaluated to demonstrate the methodology’s robustness. Four RWH designs and four major crops (pasture-grass, soybeans, corn, and cotton) resembling current practices were evaluated, as well as six combined systems (combined RWH and well-water systems) with four globally representative crops (corn, soybeans, wheat, and quinoa). Sustainability scores were calculated by integrating seven life cycle impact indicators (cumulative energy demand, CO2 emission, blue water use, ecotoxicity, eutrophication, human health-cancer, and life cycle costs). At a basin-wide RWH adoption rate of 25%, the benefits, relative to 100% well-water, of the RWH systems irrigating soybeans and supported with well-water (0.4 well-water: 0.6 RWH) provided cumulative energy savings of 39 Peta Joule and reductions in CO2 emission, blue water use, ecotoxicity, eutrophication, and human health-cancer at 1.9 Mt CO2 eq., 6.9 Gm3, 5.7 MCTU, 6.6 kt N eq., and 0.07 CTU, respectively. These benefits increased linearly with RWH scaling variables including the adoption rates, system service life, crop area, and water needs. Our methodology integrates the three pillars of agricultural sustainability specific to rainwater harvesting into a single score. It is applicable to other locations worldwide facing water scarcity by modifying the RWH system design, selecting other crop types, and obtaining appropriate data.
CO 2 Elimination (V̇ CO2 )

During exercise, CO2 production by the muscles increases dramatically. The CO2 is transported from the muscles to the lungs via the bloodstream. Two mechanisms permit the efficient transport of the increased quantities of CO2: (1) cardiac output may increase more than fivefold during exercise; and (2) venous CO2 content rises during exercise. Unlike oxygen, CO2 is very soluble in blood. In the physiologic range, the CO2 content is approximately proportional to the partial pressure of CO2 (pCO2). Mixed venous pCO2 levels may increase from 42–45 mm Hg at rest to as much as 60 mm Hg (or more) at peak exercise.
The impact of obesity on gait stability in older adults.

Abstract Obesity increases fall risk, and fall-related injuries in older adults. While prior work suggests obesity influences postural stability during standing, little is known about how obesity affects walking stability. Therefore, this study compared walking stability in older adults with and without obesity. Exploratory analyses were also conducted to evaluate the associations between measures of body habitus and gait stability as well as the association between prospective stumbles and falls and gait stability. A total of 34 older adults (17 with obesity, 17 with normal weight) walked on a treadmill at a self-selected speed. Walking stability was quantified as the local dynamic stability of the trunk in all three planes of motion. Participants also performed a series of functional tests, and were followed for a one-year period during which they reported falls and stumbles. Although participants with obesity performed significantly worse than participants without obesity on most functional tests, there were no differences in stability between groups in any direction (p = 0.18–0.78; η2 = 0.003–0.056), nor between those with and without a prospective fall or stumble (p = 0.18–0.93; η2 = 0.003–0.054). There were significant, albeit weak, correlations between BMI, waist circumference, and waist-to-height ratio and walking instability (p = 0.027–0.042; ρ = 0.36–0.39). Increased body mass, in absence of other obesity-related comorbidities, may have minimum impact on walking stability and in turn fall risk in older adults.
Silver-Catalyzed Enantioselective Propargylic C-H Bond Amination through Rational Ligand Design.

Asymmetric C–H amination via nitrene transfer is a powerful tool to prepare enantioenriched amine precursors from abundant C–H bonds. Herein, we report a regio- and enantioselective synthesis of γ-...
Photon-in Electron-out Spectroscopies

A variety of X-ray spectroscopies can be classified as “photon-in electron-out” techniques. Analogous to the “photon-in photon-out” methods discussed in Chap. 8, these electron-based methods involve measuring both the incident photon energy and the outgoing electron energy and in some cases the electron momentum and/or spin. Depending on the energy of the incoming photon, the type of electron analysis, and the experimental conditions, an inevitable slew of acronyms has been applied:
Fluid moments of the nonlinear Landau collision operator

An important problem in plasma physics is the lack of an accurate and complete description of Coulomb collisions in associated fluid models. To shed light on the problem, this Letter introduces an integral identity involving the multivariate Hermite tensor polynomials and presents a method for computing exact expressions for the fluid moments of the nonlinear Landau collision operator. The proposed methodology provides a systematic and rigorous means of extending the validity of fluid models that have an underlying inverse-square force particle dynamics to arbitrary collisionality and flow.
The impact of time spent on the electronic health record after work and of clerical work on burnout among clinical faculty.

Objective To identify specific thresholds of daily electronic health record (EHR) time after work and daily clerical time burden associated with burnout in clinical faculty. Materials and methods We administered an institution-wide survey to faculty in all departments at Mount Sinai Health System from November 2018 to February 2019. The Maslach Burnout Inventory and Mayo Well-Being Index assessed burnout. Demographics, possible confounding variables, and time spent on EHR work/clerical burden were assessed. Results Of 4156 eligible faculty members, 1781(42.9%) participated in the survey. After adjustment for background factors, EHR frustration (odds ratio [OR]=1.64-1.66), spending >90 minutes on EHR-outside the workday by self-report (OR = 1.41-1.90) and >1 hour of self-reported clerical work/day (OR = 1.39) were associated with burnout. Reporting that one's practice unloads clerical burden (OR = 0.50-0.66) and higher resilience scores (OR = 0.77-0.84) were negatively associated with burnout.Spending >90 minutes/day on EHR-outside work (OR = 0.66-0.67) and >60 minutes/day on clerical work (OR = 0.54-0.58) was associated with decreased likelihood of satisfactory work-life integration (WLI) and professional satisfaction (PS). Greater meaning in work was associated with an increased. Likelihood of achieving WLI (OR = 2.51) and PS (OR = 21.67). Conclusion Results suggest there are thresholds of excessive time on the EHR-outside the workday (>90 minutes) and overall clerical tasks (>60 minutes), above which clinical faculty may be at increased risk for burnout, as well as reduced WLI and PS, independent of demographic characteristics and clinical work hours. These thresholds of EHR and clerical burden may inform interventions aimed at mitigating this burden to reduce physician burnout.
A 480Gb/s/mm 1.7pJ/b Short-Reach Wireline Transceiver Using Single-Ended NRZ for Die-to-Die Applications

With recent AI and big data developments, quickly moving massive amounts of data is paramount to future technologies. Scalable solutions that can sustain higher performance systems that consume ever-increasing amounts of data are necessary. Low power, low latency, and aggregation are essential in highly scalable data-distribution solutions [2].
Effect of EAM on Quality Factor and Noise in MEMS Vibratory Gyroscopes

This paper reports a study on contribution of electromechanical amplitude modulation (EAM) on performance of MEMS Coriolis vibratory gyroscopes (CVGs). We theoretically predicted and experimentally demonstrated the impact of EAM on both quality factor and output noise in MEMS CVGs operating in the open-loop rate mode. We demonstrated the effect on a dynamically amplified dual-mass gyroscope (DAG) improving the gyroscope performance from 0.04 deg/rt-hr in Angular Random Walk (ARW) and 0.52 deg/hr in bias instability to 0.0065 deg/rt-hr in ARW and 0.08 deg/hr in bias instability by changed the EAM setting from 3.5 to 1.2 V in amplitude and from 75 to 225 kHz in frequency. The optimized EAM parameters were derived by the noise prediction model presented in the paper.
Traditional risk and cultural protection: Correlates of alcohol and cannabis co-use among African-American adolescents.

OBJECTIVE Previous work indicates that African-American adolescents are at high risk for concurrent alcohol and cannabis use. The present study examines the associations of traditional ecological predictors of substance use with concurrent alcohol and cannabis use among African-American adolescents. It also examines whether racial identity, a culturally relevant factor, is associated with concurrent use beyond the influence of traditional factors. METHOD Secondary analyses were conducted based on a large survey of high school adolescents. Responses on self-report measures of substance use and psychosocial determinants of health were examined for those respondents in grades 9-12 who identified as African American (N = 465; 59.8% female). RESULTS Findings demonstrated that traditional risk and resilience factors, including externalizing symptoms and substance use beliefs, were related to alcohol and cannabis co-use relative to other patterns of use among African-American adolescents. Racial identity dimensions were also associated with alcohol and cannabis co-use beyond the influence of traditional factors. However, the direction of these associations varied by dimension. CONCLUSIONS Findings from the present study assist in advancing the current knowledge base by identifying potential risk and protective factors for alcohol and cannabis co-use among African-American youth, who face increasing rates of this substance use pattern. They also underscore the importance of accounting for cultural variability in models of adolescent substance use among this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
H-H, C-H, and Related Sigma-Bonded Groups as Ligands

Publisher Summary This chapter discusses H–H, C–H, and sigma-bonded related groups as ligands. Ligands that act by donation of lone pairs (e.g., NH3) or of π-bonding electrons (e.g., C2H4) are common in transition-metal chemistry. Two-electron, three-center bonds seem to form most readily when at least one of the three centers is H. Dihydrogen complexes are the simplest transition-metal species isolobal with H3+, but they have been recognized only in the past three years. Solid-state nuclear magnetic resonance (NMR) spectroscopy has provided further insights into the properties of H2 complexes. The simplest reaction of an H2 complex is dissociation. There is clear evidence in many cases that H2 ligands can undergo rapid exchange with terminal M–H groups. Interactions between a C–H bond, and coordinatively unsaturated metal fragments were first observed in the 1960s by Ibers and by Maitlis. A particularly significant series of agostic complexes is Cp*Co(PR3)-(alkyl). There are a number of cases in which essentially planar methyl groups bridge between two metals. In a recent development, it has been shown that the [HW2(CO)10] anion has a bent W–H–W bridge; previous data had been collected on disordered salts and so were less reliable.
Developmental stereo: topographic iconic-abstract map from top-down connection

Engineering approaches to stereo typically use explicit search for the best matching between left and right sub-windows, which involves a high cost of search and unstable performance in the presence of binocular inconsistency and weak texture. The brain does not seem to conduct explicit search in the V1 and V2 cortex. But the mechanisms that the brain employs to integrate binocular disparity into 3-D perception is still largely a mystery. The work presented in this paper focuses on an important issue of integrated stereo: How the same cortex can perform recognition and perception by generating a topographic disparity-tuning map using top-down connections. As top-down connections with objectclass supervisory signals result in topographic class maps, the model presented here clarifies that stereo can be processed by a unified in-place learning framework in the neural layers, and can generate iconic-abstract internal representation.
Testicular Histology in the Adolescent With a Varicocele

A varicocele is a common cause of adult male infertility, and surgical ligation is a generally accepted mode of therapy. However, the guidelines for management of the adolescent with a varicocele are not clearly defined. Herein, we describe histologic abnormalities noted on testis biopsy in nine of 24 boys with moderate to large varicoceles. Surgical ligation of the varicocele is recommended when there is volume loss of the testis ipsilateral to the varicocele. All others should be reexamined periodically, and an attempt should be made to obtain a baseline semen analysis.