cssi/SciSciGPT-SciSciNet huggingface dataset:
Comparison of the influence of desflurane inhalation versus isoflurane inhalation on the morbidly obese patients undergoing laparoscopic gastric bypass surgery keeping adequate anesthetic depth and recovery

Objective To compare the efficacy and recovery profile of isoflurane and desflurane as the main anesthetics for morbidly obese patients under bispectral index(BIS) monitoring. Methods Forty morbidly obese patients (body mass index ≥35 kg·m -2) were randomly assigned into two groups. After intravenous induction of general anesthesia and tracheal intubation, anesthesia was maintained with either desflurane or isoflurane as the main anesthetics. The concentrations of the volatile drugs were adjusted to maintain BIS between 40 to 50 and hemodynamic stable. When the surgeon started the skin suture, the end-tidal concentration of the inhalational drug was reduced to keep BIS at 60. At the last skin suture,the inhalational drug was discontinued.During the postope- rative period the Adrete test was carried out to evaluate the intermediate recovery. Results No differences in anesthetic exposure and intraoperative adjuvants consumptions were found between the two groups. Eye opening, hand grip, extubation and orientation times of desflurane [(8.1±3.7),(9.8±4.1),(10.6±4.1),(14.1±5.5) min] were shorter than isoflurane[(13.2±4.9) ,(15.6±6.3),(16.9±6.9),(21.9±8.2) min] (P0.05). The time for Aldrete score reaching 9 was significantly shorter after desfurane than isoflurane(P0.05).Conclusion Under BIS monitoring,both desflurane and isoflurane can provide a safe and effective intraoperative control of hemodynamic stability and keep adequate anesthetic depth in morbidly obese patients. But desflurane has the advantage of a faster recovery and earlier discharge from the postanesthesia care unit than isoflurane.
Method of Measuring Scapula Glenoid Version Angle by Multiplanar Reformation of Multi-Slices Spiral CT

Objective:To evaluate the method of measuring the scapula glenoid version angle bymultiplanar reformation(MPR) of multi-slices spiral CT(MSCT).Methods:20 dry scapula specimens and 24 anticorrosive shoulder joint specimens were scanned with 16-slices spiral CT scanner,the scapula glenoid was reconstructed 11 slices on axial plane with MPR of MSCT from top to bottom.The scapula glenoid version angle was measured from NO.2 slice to NO.10 slice,the total slices for measurement was nine,NO.2 slice was the first slice for measurement.NO.10 slice was the ninth slice for measurement.The nine groups′ data of the glenoid version angle were analyzed by the Statistics.Results:The scapula glenoid version angle of nine groups were respectively-17.13°±11.22°,-7.42°±7.32°,-1.99°±5.37°,-1.65°±4.84°,-2.27°±4.83°,-1.82°±4.93°,-1.71°±5.10°,2.05°±5.11°,-2.20°±5.77° from the top slice of scapula glenoid to bottom slice.The Statistics showed that the scapula glenoid version angle of the first slice for measurement was the greatest variable:-34.60°～17.50°(the scapula glenoid retroversion was expressed as negative value,anteversion as positive value),the result had significant difference between the first slice for measurement and the second slice,the result of the first slice for measurement and the second slice had significant difference compared with the other 7 slices(P0.05),the result among the other 7 slices for measurement had no significant difference.Conclusion:The method of measuring the scapula glenoid version angle by(MPR) of MSCT is simple,fast and accurate.The glenoid fossa exhibits retroversion and a spiral twist in the horizontal plane,this anatomy property should be considered in the design of shoulder prosthesis.
Bleeding complications of triple antithrombotic therapy after percutaneous coronary interventions

Background 5% of patients undergoing coronary stenting have an indication for anticoagulation. The aim of our study was to determine the bleeding rates and complications in patients on triple oral antithrombotic therapy (TOAT) after coronary stenting. Methods We studied patients who underwent coronary stenting in our institution between 2003-2013 and were started on TOAT. Bleeding was the primary outcome. Results Totally, 999 patients were treated with TOAT with a median follow up of 127 days. All patients were treated with warfarin as an anticoagulant. 267 patients (26.7%) developed a total of 331 bleeding events. 100 patients had bleeding during the first 30 days of therapy. Major bleeding, minor bleeding, bleeding requiring medical attention, and minimal bleeding developed in 2.9%, 3.3%, 17.2%, and 3.3% of the patients respectively as their most significant bleeding event. Patients with anticoagulation initiated at time of stenting had a significantly higher bleeding rate compared to those already on chronic anticoagulation [adjusted HR (95% CI): 1.37 (1.03–1.79), P = 0.03]. The bleeding likelihood was significantly higher for patients with drug-eluted stents (DES) compared to bare-metal stents (BMS) [adjusted OR (95% CI): 1.52 (1.14 − 2.04), P < 0.05]. Patients with atrial fibrillation had an increased rate of bleeding after 6 month of initiation of TOAT with significantly worse outcomes. Conclusions TOAT after coronary stenting is associated with high bleeding rates. Patients with AF had worse outcomes. Patients with newly initiated anticoagulation at time of stenting bleed significantly more than people already on chronic anticoagulation prior to stenting. © 2016 Wiley Periodicals, Inc.
Associations of neuroticism-impulsivity and coping with binge eating in a nationally representative sample of adolescents in the United States.

Abstract Objective Binge eating behavior is a public health concern due to its negative physical and mental health consequences. Little is known about the interplay of personality traits, coping styles, and binge eating in the general adolescent population. We examined the associations among the combination of neuroticism and impulsivity (NI), maladaptive coping styles (poor problem solving, distraction, and escape-avoidance), and lifetime prevalence of binge eating in a nationally representative sample of U.S. adolescents. We also explored coping as a moderator of the NI–lifetime binge eating association and gender as a moderator of the NI–coping associations and coping–lifetime binge eating associations. Methods We used data from the National Comorbidity Survey: Adolescent Supplement (NCS-A: 2001–2004), a cross-sectional nationally representative study of adolescents aged 13 to 18 years (n = 10,028). We studied the associations of NI and coping with lifetime binge eating using multivariate regression models. Results High NI was significantly associated with all three coping styles, especially escape-avoidance (β = 3.96, confidence interval [CI] = 3.62, 4.29, p Discussion Our findings indicate significant associations among high NI, increased escape-avoidance coping, and higher lifetime prevalence of binge eating in adolescents. Findings of our study have potential to inform development of interventions that target modification of maladaptive personality traits and coping styles to reduce problematic eating.
An overture to Così fan tutte: the poetics of the opera over two centuries

During the two centuries following its premiere, the news about Cosi fan tutte has generally not been good. Most of the nineteenth century and a good part of the twentieth condemned it, altered it beyond recognition, or, more frequently, simply ignored it. Today, the opera enjoys a more secure place in the repertory, yet opinion about and approaches to the work have shown remarkable stability over this span. In tracing a path back through the critical history of the opera, one spots a single perception above all others: that the opera's text seems to be incompatible with its music. This introduction will explore and assess this central issue in Cosi fan tutte 's reception with two particular historical/critical objectives in mind. First, it will show how present-day thinking about the opera comes out of critical approaches formulated in the nineteenth century. Then, it will offer a different way of conceiving the opera's handling of word and tone, one that finds agreement rather than incongruity between the two. A HISTORY OF WORD/MUSIC RELATIONS IN COSI FAN TUTTE Nineteenth-century roots to modern thought Although isolated complaints dot the beginnings of Cosi fan tutte 's reception, a more consistent animus toward the opera spread with the life-and-works studies that appeared from the close of the eighteenth century. Niemetschek's Leben of 1798 inaugurates the tradition with this oft-cited comment: “One wonders how [Mozart] could have condescended to squander his divine melodies on such a frivolous hodgepodge of a text.
Extracellular Hemin Auto-Amplification Intensifies Tissue Injury In Sickle Cell Disease

Abstract Acute organ failure is a major clinical concern in sickle cell disease (SCD). However, the mechanism responsible for this potentially lethal complication is poorly understood. We tested the hypothesis that extracellular hemin liberates an intracellular danger molecule that promotes acute organ failure in SCD. Transgenic homozygous SCD (SS), sickle-trait (AS) and normal human hemoglobin (Hb) AA mice were infused with purified hemin (35 µmoles/kg), which raised total plasma hemin by ∼0.45 mM (equivalent to 0.72 g/dl Hb) within 5 min in all three groups of mice. In agreement with our previous results, SS but not AA and AS mice (n= 6 for each genotype) developed cardiopulmonary depression at 30 min evident by reductions in oxygen saturation (99.88±0.23% to 92.1±1.3%, p Disclosures: No relevant conflicts of interest to declare.
A New Approach to Human Cognition and its Significance for the Philosophy of Science

I will return to our focal topics of truth, objectivity, and scientific realism toward the last third of this essay. Those issues are usually discussed within a framework of unquestioned beliefs about the basic nature of cognition, and I want to set the stage by outlining an alternative conception of what cognition is. It is a conception of cognition — both perceptual and theoretical cognition — that derives from recent work in computational neurobiology, connectionist artificial intelligence (AI), and parallel distributed processing research in psychology.
The Impact of Peer Substance Use and Polygenic Risk on Trajectories of Heavy Episodic Drinking Across Adolescence and Emerging Adulthood

Background: Heavy episodic drinking is developmentally normative among adolescents and young adults, but is linked to adverse consequences in later life, such as drug and alcohol dependence. Genetic and peer influences are robust predictors of heavy episodic drinking in youth, but little is known about the interplay between polygenic risk and peer influences as they impact developmental patterns of heavy episodic drinking. Methods: Data were from a multisite prospective study of alcohol use among adolescents and young adults with genome-wide association data (n = 412). Generalized linear mixed models were used to characterize the initial status and slopes of heavy episodic drinking between age 15 and 28. Polygenic risk scores (PRS) were derived from a separate genome-wide association study for alcohol dependence and examined for their interaction with substance use among the adolescents’ closest friends in predicting the initial status and slopes of heavy episodic drinking. Results: Close friend substance use was a robust predictor of adolescent heavy episodic drinking, even after controlling for parental knowledge and peer substance use in the school. PRS were predictive of the initial status and early patterns of heavy episodic drinking in males, but not in females. No interaction was detected between PRS and close friend substance use for heavy episodic drinking trajectories in either males or females. Conclusions: Although substance use among close friends and genetic influences play an important role in predicting heavy episodic drinking trajectories, particularly during the late adolescent to early adult years, we found no evidence of interaction between these influences after controlling for other social processes, such as parental knowledge and broader substance use among other peers outside of close friends. The use of longitudinal models and accounting for multiple social influences may be crucial for future studies focused on uncovering gene–environment interplay. Clinical implications are also discussed.
Hybrid precoding for millimeter wave systems with a constraint on user electromagnetic radiation exposure

The rapid growth of wireless technology worldwide has prompted interest in the underutilized millimeter-wave band from 30 to 100 GHz. Regulation agencies set limits on the amount of electromagnetic radiation absorbed by users, measuring dosimetric quantities such as specific absorption rate (SAR) to assess compliance. The increased rate of energy deposition in human tissue at high frequencies remains a growing concern as wireless cellular networks begin to incorporate millimeter wave technologies. In this paper, we present a baseband model for SAR-aware wireless communication and a strategy for optimal hybrid precoding in millimeter wave systems with SAR constraints.
Cardiovascular Pharmacology: An Update and Anesthesia Considerations

Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. The development of therapeutic agents for the treatment of cardiovascular diseases has always been a priority because of the huge potential market for these drugs. These medications should be part of the anesthesiologist's armamentarium because the typical surgical patient is older and has more comorbidities than in the past. This article reviews commonly used cardiovascular medications that are important in managing patients with unstable hemodynamics.
Reactivity of autoantibodies from patients with defined subepidermal bullous diseases against 1 mol/L salt-split skin: Specificity, sensitivity, and practical considerations

Abstract Background: Circulating IgG anti-basement membrane autoantibodies from patients with subepidermal bullous diseases can be categorized on the basis of their pattern of reactivity against 1 mol/L sodium chloride (NaCl)-split skin. Objective: The purpose of this study was to define by immunochemical techniques the specific antigen(s) targeted by IgG autoantibodies from a group of patients with subepidermal blistering diseases and then (1) prospectively determine which side(s) of 1 mol/L NaCl-split skin is (are) bound by these patients' autoantibodies, (2) compare the sensitivity of intact and 1 mol/L NaCl-split skin for the detection of these autoantibodies; and (3) devise a practical method to distinguish patients with antiepiligrin cicatricial pemphigoid from those with other subepidermal blistering diseases. Methods: Investigative techniques included direct and indirect immunofluorescence microscopy, immunoprecipitation studies, and immunoblotting. Results: These studies identified 14 patients whose sera immunoprecipitate bullous pemphigoid antigens 1, 2, or both. These patients' circulating IgG anti-basement membrane autoantibodies bind the epidermal ( n = 11), epidermal and dermal ( n = 2), or dermal ( n = 1) sides of 1 mol/L NaCl-split skin by indirect immunofluorescence microscopy. In contrast, IgG from all patients with autoantibodies directed against type VII collagen ( n = 5) or epiligrin ( n = 6) bind only the dermal side of 1 mol/L NaCl-split skin. In all but one patient in this series, 1 mol/L NaCl-split skin proved to be a more sensitive test substrate than intact human skin for detection of circulating IgG anti-basement membrane autoantibodies. Patients with antiepiligrin cicatricial pemphigoid were distinguished from other patients in that their circulating autoantibodies bound epidermal basement membrane in the skin of primates but not small mammals. Conclusion: NaCl-split skin (1 mol/L) of various species is a sensitive and practical indirect immunofluorescence microscopy test substrate for the evaluation of patients with IgG anti-basement membrane autoantibodies and evaluation of subepidermal bullous diseases.
National Crisis and Democratic Consolidation in South Korea

When a ferry, Sewol, sank, killing hundreds of its passengers, South Koreans turned to the state for emergency responses—rescuing survivors, investigating the disaster, and bringing justice to the responsible. However, the state completely failed, and its failures raised questions about not only the competency of the current government but also the legitimacy of South Korea's democratic institutions in general. For students of political science, the Sewol tragedy provides an opportune opportunity to evaluate the South Korean democracy. Is it functioning as it should? Has it been consolidated? If not, what is holding it back? This chapter finds answers in the political institutions of South Korea—including the typical attributes of a semi-presidential system, which allow the president to claim and exercise authority excessively. Such institutional attributes include subordinate prime ministers, singular presidential term, parliamentary elections out of sync with presidential ones, and single-member district plurality elections of lawmakers. They permit the president, if (s)he decides, to act and speak like a monarch, as in the case of president Park Guen-hye. This study concludes by suggesting that a proportional representation system could be an institutional remedy for authoritarianism of South Korea.
Oral health-related concerns, behavior, and communication with health care providers of patients with breast cancer: impact of different treatments.

AIM The objectives are to compare responses of breast cancer (BCa) treatment groups (chemotherapy, tamoxifen, and aromatase inhibitors (AIs) to each other and a control regarding (a) subjective oral health, (b) oral health-related behaviors, (c) oral health-related concerns, and (d) communication with health care providers. METHODS Survey data were collected from 140 postmenopausal BCa patients and 41 healthy postmenopausal control respondents. RESULTS BCa patients reported on average more frequent mouth sores/mucositis (5-point scale with 1 = never: 1.63 vs. 1.14; p < .01), glossadynia (1.60 vs. 1.07; p < .01), xerostomia (2.48 vs. 1.40; p < .01), and dysgeusia (2.10 vs. 1.46; p < .01) than the control respondents. Patients undergoing chemotherapy were more aware that cancer treatment can affect their oral health than patients on tamoxifen/AI (93% vs. 55%/56%; p < .001). BCa patients reported being more frequently informed by oncologists about oral health-related effects of cancer treatment than by dentists. Oncologists/nurses were more likely to communicate about oral health-related treatment effects with patients undergoing chemotherapy than patients on tamoxifen or AIs. Few BCa patients perceived dentists as knowledgeable about cancer treatment-related oral concerns and trusted them less than oncologists. CONCLUSIONS BCa treatments impact oral health. Low percentages of BCa patients had received specific information about impacts of BCa treatments on oral health from their dentists.
Psycho-Spiritual Dreams in the Nineteenth Century, Part II: Metaphysics and Immortality:

The author focuses on metaphysical issues as explored in the nineteenth century periodical dream literature. The relationship between dreams of death and myths of immorality is examined first, followed by illustrations of the use of death dreams in the expositions of both realist and idealist philosophies. Specific philosophies buttressed by these dream phenomena (as argued by the nineteenth century authors) are (a) the wandering soul, (b) spiritualism and Swedenborgianism (with the subcategories of dreams and fiction and fantastic dreams, (c) Naturphilosophie, (d) atomist theory, (e) ancestral memories, (f) naive realism, and (g) idealism. Further integration of dream phenomena in Christian psychotherapies and theology is recommended.
Using Activity Theory to Examine How Teachers' Lesson Plans Meet Students' Learning Needs

How is lesson planning useful? This research study used Cultural Historical Activity Theory and intersubjectivity to answer this questions. This research explored to what extent teacher candidates'...
What Is "Natural"? Consumer Responses to Selected Ingredients.

Interest in “natural” food has grown enormously over the last decade. Because the United States government has not set a legal definition for the term “natural”, customers have formed their own sensory perceptions and opinions on what constitutes natural. In this study, we examined 20 ingredients to determine what consumers consider to be natural. Using a national database, 630 consumers were sampled (50% male and 50% female) online, and the results were analyzed using percentages and chi-square tests. No ingredient was considered natural by more than 69% of respondents. We found evidence that familiarity may play a major role in consumers’ determination of naturalness. We also found evidence that chemical sounding names and the age of the consumer have an effect on whether an ingredient and potentially a food is considered natural. Interestingly, a preference towards selecting GMO (genetically modified organisms) foods had no significant impact on perceptions of natural.
MRI-Guided Intravenous Alteplase for Stroke - Still Stuck in Time.

Time is a critical determinant of patient eligibility for intravenous thrombolysis in acute stroke. In such patients, intravenous alteplase is routinely administered up to 4.5 hours after the onset of symptoms, but even within this window, earlier treatment leads to better outcomes. Restriction of treatment to fixed times has limitations, since the time of symptom onset often cannot be ascertained, particularly in patients who wake up from sleep with a neurologic deficit. Furthermore, most patients arrive at the hospital more than 4.5 hours after symptom onset, which renders only a minority of patients eligible for treatment. The duration of symptoms . . .
Continuous Intravenous 5-Fluorouracil with Hydroxyurea and Concomitant Radiotherapy for Advanced Head and Neck Cancer

Head and neck cancer affects approximately 40000 patients each year in the United States (Cancer Statistics 1988). About one-third of these will present with early stage disease that can usually be cured with surgery or radiotherapy used as single treatment modalities. However, the majority of patients will present with regionally advanced disease. These patients can also be treated with curative intent; however, most will experience disease recurrence despite aggressive treatment combining surgery and radiotherapy.
Absence of Brain Edema After Reversible Osmotic Opening of the Blood-Brain Barrier

The blood-brain barrier in the rhesus monkey was opened reversibly by perfusing 2.2 mol/kg recrystallized DL-lactamide solution into the internal carotid artery. Gross neurologic sequelae did not occur and no changes were observed in brain water, sodium or potassium content 48 h after osmotic opening, demonstrating the nondestructive nature of such reversible opening. Prolonged barrier opening caused by perfusion of unrecrystallized lactamide, on the other hand, resulted in brain edema and electrolyte changes that were maximal 24–48 h later, consistent with entry of plasma water and salt into the brain. Barrier damage in this case was due presumably to a cytotoxic factor that could be removed by recrystallization. The results support the suggestion that a threshold intensity and duration of barrier opening is required to produce brain edema. Measurable edema may have been absent after reversible opening because interstitial albumin was excreted or metabolized by 48 h, or because a low brain compliance prevented significant water accumulation.
The Mother-Infant Transaction Program. The content and implications of an intervention for the mothers of low-birthweight infants.

This article summarizes the Mother-Infant Transaction Program (MITP). A plan of intervention that forestalls the downward spiral of unfavorable transactions. This intervention would take place before an adverse pattern had become established, yet not so soon after childbirth that the mother would not be in a fit psychologic condition to profit from it, and be economically feasible, neither unduly protracted nor extravagant in staff requirements.
Emerson's Telescope: Jones Very and Romantic Individualism

Ralph Waldo Emerson described the poet Jones Very as a “telescope,” the kind of intensely focused idealist who challenges the commitments of those he encounters. Very can be compared to Herman Melville's Bartleby as a test case that reveals the limits of nineteenth-century individualism and late romanticism.
Flexpoint: Predictive Numerics for Deep Learning

Deep learning has been undergoing rapid growth in recent years thanks to its state-of-the-art performance across a wide range of real-world applications. Traditionally neural networks were trained in IEEE-754 binary64 or binary32 format, a common practice in general scientific computing. However, the unique computational requirements of deep neural network training workloads allow for much more efficient and inexpensive alternatives, unleashing a new wave of numerical innovations powering specialized computing hardware. We previously presented Flexpoint, a blocked fixed-point data type combined with a novel predictive exponent management algorithm designed to support training of deep networks without modifications, aiming at a seamless replacement of the binary32 widely in practice today. We showed that Flexpoint with 16-bit mantissa and 5-bit shared exponent (flex16+S) achieved numerical parity to binary32 in training a number of convolutional neural networks. In the current paper we review the continuing trend of predictive numerics enhancing deep neural network training in specialized computing devices such as the Intel®N ervana ™ Neural Network Processor.
Preliminary Results in the Immunization of Irus Monkeys Against Dental Caries

Studies utilizing gnotobiotic rodents have clearly shown that certain bacteria including Streptococcus mutans can induce dental caries (1–3). Since caries is an infectious disease, it is not surprising that recent efforts have been made to control this disease, especially in light of successful vaccines developed for other infectious diseases caused by bacteria (for a survey, see 4). Most studies of caries immunity have been performed in rodents.
Defining the Northeast Monsoon of India

AbstractThis study introduces an objective definition for onset and demise of the northeast Indian monsoon (NEM). The definition is based on the land surface temperature analysis over the Indian su...
A molecular picture of surface interactions of organic compounds on prevalent indoor surfaces: limonene adsorption on SiO2

Indoor surfaces are often coated with organic compounds yet a molecular understanding of what drives these interactions is poorly understood. Herein, the adsorption and desorption of limonene, an organic compound found in indoor environments, on hydroxylated silica (SiO2) surfaces, used to mimic indoor glass surfaces, is investigated by combining vibrational spectroscopy, atomistic computer simulations and kinetic modeling. Infrared spectroscopy shows the interaction involves hydrogen-bonding between limonene and surface O–H groups. Atomistic molecular dynamics (MD) simulations confirm the existence of π-hydrogen bonding interactions, with one or two hydrogen bonds between the silica O–H groups and the carbon–carbon double bonds, roughly one third of the time. The concentration and temperature dependent adsorption/desorption kinetics as measured by infrared spectroscopy were reproduced with a kinetic model, yielding the adsorption enthalpy of ∼55 kJ mol−1, which is consistent with the value derived from the MD simulations. Importantly, this integrated experimental, theoretical and kinetic modeling study constitutes a conceptual framework for understanding the interaction of organic compounds with indoor relevant surfaces and thus provides important insights into our understanding of indoor air chemistry and indoor air quality.
Enhancing charge mobilities in selectively fluorinated oligophenyl organic semiconductors: a design approach based on experimental and computational perspectives

Fluorination can be used to tune optoelectronic properties at the molecular level. A series of oligophenyls with various difluorinations of the phenyl rings has been synthesized, crystalized, structurally resolved and computationally analyzed for charge mobility. We find that difluorination of the phenyl rings at para positions leads to oligophenyls that are stacked in symmetrical overlap with significantly enhanced hole mobility as well as the highest electron mobility of the molecules considered. Other difluorinations lead to relatively shifted molecular units in the π-stacked crystal and therefore to lower mobilities. The selectively fluorinated oligophenyls were synthesized using the Suzuki–Miyaura cross coupling reaction. The structures of the products were characterized by X-ray diffraction (XRD), 1H, 13C, 19F NMR spectroscopy and gas chromatography (GC)/mass spectroscopy (MS) measurements. Computational analysis of the materials based on state-of-the-art tools are used to predict their charge transport properties in the crystal phase. In short, we establish a molecular design approach based on fluorination of oligophenyls to achieve enhanced hole mobilities and relatively high electron mobilities.
Thomas Jefferson: A Modern Prometheus

In Thomas Jefferson: A Modern Prometheus, Wilson Jeremiah Moses provides a critical assessment of Thomas Jefferson and the Jeffersonian influence. Scholars of American history have long debated the legacy of Thomas Jefferson. However, Moses deviates from other interpretations by positioning himself within an older, 'Federalist' historiographic tradition, offering vigorous and insightful commentary on Jefferson, the man and the myth. Moses specifically focuses on Jefferson's complexities and contradictions. Measuring Jefferson's political accomplishments, intellectual contributions, moral character, and other distinguishing traits against contemporaries like George Washington and Benjamin Franklin but also figures like Machiavelli and Frederick the Great, Moses contends that Jefferson fell short of the greatness of others. Yet amid his criticism of Jefferson, Moses paints him as a cunning strategist, an impressive intellectual, and a consummate pragmatist who continually reformulated his ideas in a universe that he accurately recognized to be unstable, capricious, and treacherous.
Ecosystem Services: Is a Planet Servicing One Species Likely to Function?

Human wellbeing is more likely to be secured if we work in the service of nature rather than attempt to force nature to work in the service of humanity. The success of ecology and evolution is attributable to subscription to the philosophical principles of naturalism and pragmatism, neither of which admit romantic, spiritual, moral, or other humanist constructs. Currently, however, environmental science is investing heavily in the idea of ecosystem services which mixes naturalism and pragmatism with humanism. It imagines that we can select those ecological and evolutionary processes that fit humanist ideals while eliminating all others. I suggest that this immiscible blend of philosophies is untenable. Natural science has revealed a biosphere that is governed by nothing that maps well onto humanist ideals. The biosphere is not designed to serve a single species and will collapse if we force it to do so. The way forward is to think less about ecosystems servicing or disserving humanity, and to think more about humanity living in the service of nature as all species do. This idea should not be confused with pantheism, enslavement to dark Malthusian fears, or cold-hearted adherence to evolutionary principles like survival of the fittest – such primitive thinking is as much a formula for planetary demise as blind faith in ecosystem services. Rather, I propose that living in the service of nature yields a biosphere in which all of life prospers and, in so doing, achieves the environmental sustainability that is a necessary precursor to attaining humanist ideals.
Characterizing the Parent Role in School-Based Interventions for Autism: A Systematic Literature Review.

Parent-focused intervention for children with autism spectrum disorder (ASD) has garnered considerable evidence of effectiveness for treating core symptoms of the disorder. However, these programs often teach parents discrete skills that may or may not align with school-based interventions. Family-school partnerships (FSPs) are essential for children with ASD given the complex presentation of symptoms characteristic of this disorder. It is unclear how and to what degree current school-based interventions for children with ASD include parents and whether their inclusion is consistent with definitions of parent involvement or FSPs established in the literature. A systematic review of the school-based intervention literature for children with ASD was conducted on studies published between 2002 and 2017. Thirty-six articles met inclusion criteria. Results indicated interventions included parents in ways consistent with both parent involvement and FSPs, though the former model was more common. Findings suggest a need for greater focus on measuring parent behavioral outcomes when evaluating intervention effectiveness and developing or refining interventions to include meaningful family-school partnering. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Untreated Stroke as Collateral Damage of COVID-19: “Time Is Brain” Versus “Stay at Home”

For decades, neurologists have been advocating that anyone with acute focal deficits report immediately to the closest hospital's emergency room. Major advancements in the hyperacute diagnosis and treatment of stroke have justified our call-to-action slogan of "Time is Brain"-faster therapy leads to superior outcomes. However, this mantra has been recently usurped by the catchphrase "Stay at Home" during the coronavirus disease 2019 (COVID-19) pandemic. Fewer patients are presenting to hospitals with acute stroke; our census is down. Presumably the etiology of this phenomenon is either strict "social distancing" that some people may misperceive to exclude even emergent situations, or fears of contracting the virus while hospitalized. In this Short Report, we describe the year-over-year drop in stroke volume (ischemic and hemorrhagic both) coinciding with a paradoxical rise in acute reperfusion therapies at our university hospital. These data imply that stroke patients with mild/moderate symptoms are most likely staying home, and not receiving urgent therapies, and correspondingly, only the most severely disabled stroke patients are ultimately seeking and receiving help. We must remind our patients and the general public that our services are essential and available, as stroke still remains a medical emergency, and carries a likely higher overall mortality risk than COVID-19. As neurologists, we also must be vigilant for the atypical presentations and varied etiologies of stroke associated with COVID-19 as well.
NeoWarm: Kangaroo Mother Care with Continuous Temperature Tracking and Heating

Premature births are highly prevalent; world-wide, one in every ten births is premature. A common complication of premature birth is the inability of the newborns to regulate their own body temperature (hypothermia). Kangaroo Mother Care (KMC) is an effective strategy to mitigate this problem but has challenges. Namely, KMC requires constant engagement from the caregiver in order to keep the baby warm and to monitor the baby’s temperature every 4 hours. In this report we describe NeoWarm, a device designed to address these challenges via continuous integrated warming and automated temperature monitoring of the infant, both during KMC and when the caregiver takes a break. Pilot studies demonstrate the ability of the device to warm a simulated newborn from moderate hypothermia to ideal core temperatures within two hours.
Coronavirus Paid Leave: The Intersection of New State and Federal Laws

At the same time the federal government passed the Families First Coronavirus Response Act (FFCRA), which includes the Emergency Paid Sick Leave Act (EPSLA) and the Emergency Family and Medical Leave Expansion Act (EFMLEA), states passed their own paid leave laws, often with wider applicability than the federal law.
Optimizing Capital Investments in Construction

Originally published in Journal of the Construction Division , Vol. 102, No. 4, December 1976, pp. 629-636
Anesthesia for Proton Beam Therapy

Proton beam radiation is being used more frequently to treat malignancies, especially in the central nervous system. Protons have a larger mass than the photons used for standard radiation therapy and therefore can be directed more accurately to the lesion and minimize damage to the surrounding tissue. Although the therapy is not painful, anesthesia is often required so that the patient lies still and the beam can be directed accurately. A variety of techniques have been successfully used to anesthetize patients undergoing proton beam therapy. Currently intravenous propofol by infusion with spontaneous ventilation without airway instrumentation is the most popular method because it allows rapid recovery, helps prevent nausea and avoids the trauma of instrumenting the airway.
New Rules for Patient Data Sharing Risk Harm to our Most Vulnerable

Giving patients ownership of their data is a noble goal - studies show that patients who are more engaged with their care have improved adherence to medications and better patient-provider communication 1 Facilitating more patient-provider interactions through online portals has been shown to help address health disparities, especially in patients of color, and to improve patient satisfaction COMMENTARY 10 11 EN New Rules for Patient Data Sharing Risk Harm to our Most Vulnerable JESSICA J POURIAN, MD;DANIEL COGHLIN, MD KEYWORDS: 21st Century Cures Act, data sharing, adolescent health, confidentiality, health data Starting this April, patients will be able to access their electronic medical records (EMR) through online patient portals soon after their providers finish their notes [Extracted from the article] Copyright of Rhode Island Medical Journal is the property of Rhode Island Medical Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )
Chapter 4 – Advanced Members of the Ailuridae (Lesser or Red Pandas – Subfamily Ailurinae)

Publisher Summary This chapter deals with the advanced members of Ailuridae. A side from a few well-represented taxa such as Simocyon batalleri and Pristinailurus bristoli, the fossil record of the Ailuridae consists of mostly isolated teeth and fragmentary specimens. However, these two taxa are beginning to shed new light on this group of specialized carnivorans. The selection of the various dental characters appears to have been mosaic, with different teeth specializing at different rates (and with different focal zones). In addition, some forms specialized in hypercarnivory, while others were becoming adapted to hypocarnivory to varying degrees. It is quite likely that Simocyon's move to the trees may have directly led to the selection of features which allowed this group to exploit flowers and/or fruit (in addition to eating meat), and therefore hypocarnivory may have been a direct result of this change in lifestyle. Moreover, it appears that although both living “pandas” use their so-called “falsethumb” for feeding, each lineage acquired this unique trait via different pathways—one for feeding and one for climbing—making this one of the most fascinating examples of convergent evolution. Lastly, as demonstrated by Pristinailurus bristoli, not every member of this group remained arboreal, which may have reduced its ability to compete with other more generalized omnivores, and ultimately to the extinction of nearly every member of this group.
Be Nice to One Another

The moral ideal, or rather the moral idealism, in eighteenth century German idealistic literature is embattled; in fact, it is one of the most misunderstood and misrepresented issues in literary history. This is not, as everybody knows, because today we are not able to feel and act morally, i.e. idealistically. Rather it is because morality plays such a diminutive role in the public sphere and in our scholarly discussions. We simply are not accustomed nor trained to think that way any more. We connect “morality” with the imperatives of social convention or with sacrificing everything, including universal values, morality itself, to the demands of a religion or a nation state and its head. By “ideal” and “idealism” we seem to understand promise and hope: either with Holderlin for the return of the gods, of faith, or with Marx for the advent of Utopias of material wealth and total freedom.
Song learning, dialects, and dispersal in the bewick's wren.

Zusammenfassung Junge Thryomanes bewickii wurden im William L. Finley National Wildlife Refuge by Corvallis, Oregon, USA, untersucht. Sie werden nach etwa 35 Tagen von ihren Eltern unabhangig. Elf ♂♂ waren auf eine durchschnittliche Entfernung von 1,2 km verstreut (im Bereich von 0,1 bis 3,2 km). Vier ♂♂ (60, 80, 110 und 135 Tage alt) auserten Jugendgesang (subsong) in Revieren, die sie lebenslang besetzt hielten. 60 Tage ist hochstwahrscheinlich das durchschnittliche Alter fur Reviergrundung und Beginn des Jugendgesangs. Das durchschnittliche Lied-Repertoire von 31 ausgewachsenen ♂♂ bestand aus 16 Liedtypen. Jeder Liedtyp bestand aus einer stabilen und mehrmals wiederholten Sequenz, die 2—5 melodische Themen hat (Anhaufungen von Noten oder Trillern). Der Jugendgesang des 60 Tage alten ♂ enthielt etwa 95 % der Themen des Repertoires eines Erwachsenen; bei einem zweiten Vogel waren alle Typen von Themen und Sequenzen im Alter von 115 Tagen vollstandig ausgebildet. Ein Thema oder hochstens ein ganzer Liedtyp, der sich bei einem jungen ♂ entwickelt, mus — wie Ahnlichkeitsvergleiche zeigen — auf Erfahrungen beruhen, die das Tier vor Grundung seines Reviers gemacht hat. Die meisten Liedtypen im Repertoire sind jedoch vergleichbar mit den Liedern der ♂♂, die unmittelbare Nachbarn des neu gegrundeten Reviers sind. Folglich ist die Bereitschaft zum Lernen von Themen und Sequenzen am grosten, einige Zeit nachdem sie von ihren Eltern unabhangig werden (35 Tage), jedoch vor dem Beginn des Jugendgesangs (60 Tage). Wahrend der Gesangs-Entwicklung lernen junge ♂♂ die Lieder Erwachsener, mit denen sie haufigen und engen Kontakt haben. Da die Reviere, die wahrend der Entwicklung des Liedes gegrundet wurden, dauerhaft sind und wahrend des ubrigen Jahres verteidigt werden, sind die Repertoires der Nachbar-♂♂ beinahe identisch. Einige Junge uberqueren geringe Populations-Barrieren, die dann den akustischen Kontakt mit ♂♂ der anderen Seite verringern. Lernen neuer Lieder kommt deshalb beschrankt vor. Die Variationen kommen zustande durch mangelhaftes Nachahmen eines Liedes, vielleicht auch durch Improvisation oder “Drift”. Darum fehlen viele Lieder, die an einer Stelle haufig sind, anderswo, auch ganz in der Nahe, vollkommen.
Nutrition and foraging strategies of the black howler monkey (Alouatta pigra) in Palenque National Park, Mexico

Food resources consumed by primates vary markedly in nutritional content. As a result, foragers must develop a feeding strategy to select resources that balance energy and macronutrient intake and reduce the consumption of fiber and toxins. In this study, we collected data on dietary patterns, rates of food consumption, and weight of food items consumed and combined them with published values of the nutritional content of Neotropical foods to estimate energy and nutrient intake during a 10-month period in two groups (N = 16 individuals) of black howler monkeys (Alouatta pigra) inhabiting Palenque National Park, Mexico. Although howler monkeys are generally assumed to exploit a leaf-dominated diet and be energy-limited, our results indicated that black howlers met their estimated energy requirements, consuming an average of 0.58 MJ of overall energy per metabolic body mass per day. The howlers also surpassed protein requirements by consuming an average of 8.2 g of protein per metabolic body mass per day. The amount of time they spent resting was not correlated with the amount of leaves or fruit in the diet or with overall energy intake. Therefore, despite consuming a leaf-heavy diet during some months of the year, black howlers do not appear to be energy-limited. Additionally, the howlers maintained a relatively consistent level of average daily protein energy intake regardless of diet composition, while non-protein energy intake varied in response to the amount of ripe fruits consumed. Although our use of published nutritional data introduces error, these findings suggest that black howler feeding ecology is more similar to other fruit-eating atelines than previously suspected, and several common assumptions regarding howler behavior and feeding ecology need to be reexamined. Am. J. Primatol. 76:774–787, 2014. © 2014 Wiley Periodicals, Inc.
The Impact of Inpatient Palliative Care Consultations on 30-Day Hospital Readmissions

Abstract Background: Inpatient palliative care consultations have been shown to reduce acute care utilization by reducing length of stay, but less is known about their impact on subsequent costs including hospital readmissions. Objective: The study's objective was to examine the impact of inpatient palliative care consultations on 30-day hospital readmissions to a large urban academic medical center. Methods: The hospital's electronic medical record system was used to identify all live discharges between August 2013 and November 2014. After adjusting for a propensity score, readmission rates were compared between palliative care and usual care groups. Results: Of the 34,541 hospitalizations included in the study, 1430 (4.1%) involved a palliative care consult. After adjusting for the propensity score, patients seen by palliative care had a lower 30-day readmission rate—adjusted odds ratio (AOR) 0.66, 0.55–0.78; p<0.001. Adjusted rates were 10.3% (95% confidence interval [CI] 8.9%–12.0%) for palliative car...
The Relationship Between 25-Hydroxyvitamin D and Homocysteine in Asymptomatic Adults

Context: Hyperhomocysteinemia is an independent risk factor for premature atherosclerosis and thromboembolism. 25-Hydroxyvitamin D [25(OH)D] may modulate the expression of genes involved in homocysteine metabolism. Objective: Little is known about the relationship between homocysteine and 25(OH)D. We hypothesized an inverse and nonlinear association between 25(OH)D and homocysteine. Design: We analyzed data from the continuous National Health and Nutrition Examination Survey 2001–2006 for asymptomatic adults (≥18 y). Setting: Linear regression models with spline adjusted for cardiovascular disease risk factors were used to explore nonlinearity. Main Outcomes Measure: Mean change (β-coefficients with 95% confidence intervals) in homocysteine was reported per 10 ng/mL change in 25(OH)D. Results: Mean (SD) age and homocysteine levels of 14 630 participants were 47.2 (20) years and 8.8 (4.7) μmol/L, respectively, whereas the median (interquartile range) of 25(OH)D was 21 (15–27) ng/mL. Without using spline, w...