cssi/SciSciGPT-SciSciNet huggingface dataset:
Alzheimer Disease Alters the Relationship of Cardiorespiratory Fitness With Brain Activity During the Stroop Task

Background Despite mounting evidence that physical activity has positive benefits for brain and cognitive health, there has been little characterization of the relationship between cardiorespiratory (CR) fitness and cognition-associated brain activity as measured by functional magnetic resonance imaging (fMRI). The lack of evidence is particularly glaring for diseases such as Alzheimer disease (AD) that degrade cognitive and functional performance. Objective The aim of this study was to describe the relationship between regional brain activity during cognitive tasks and CR fitness level in people with and without AD. Design A case-control, single-observation study design was used. Methods Thirty-four individuals (18 without dementia and 16 in the earliest stages of AD) completed maximal exercise testing and performed a Stroop task during fMRI. Results Cardiorespiratory fitness was inversely associated with anterior cingulate activity in the participants without dementia ( r =−.48, P =.05) and unassociated with activation in those with AD ( P >.7). Weak associations of CR fitness and middle frontal cortex were noted. Limitations The wide age range and the use of a single task in fMRI rather than multiple tasks challenging different cognitive capacities were limitations of the study. Conclusions The results offer further support of the relationship between CR fitness and regional brain activity. However, this relationship may be attenuated by disease. Future work in this area may provide clinicians and researchers with interpretable and dependable regional fMRI biomarker signatures responsive to exercise intervention. It also may shed light on mechanisms by which exercise can support cognitive function.
Post-Release Host-Specificity Testing of Pseudacteon tricuspis, a Phorid Parasitoid of Solenopsis Invicta Fire Ants

Inherent in any biological control program is the risk of nontarget effects. Pseudacteon tricuspis Borgmeier, a parasitoid phorid fly, has been introduced to the United States from South America as a potential biocontrol agent of the red imported fire ant, Solenopsis invicta Buren. We conducted tests of host specificity on introduced populations of P. tricuspis, which are attracted to alarm pheromones released by their hosts during events such as mound disturbances and interspecific interactions. We monitored disturbed mounds of S. invicta and its close congener, S. geminata (F.), during the expansion of P. tricuspis across north Florida and after populations had been established for � 3 years. We also tested host acceptance in established populations of P. tricuspis by offering trays containing S. invicta, S. geminata, and 14 additional ant species representing 12 different non-Solenopsis genera. Although P. tricuspis was commonly observed to hover over and attempt to oviposit on S. invicta, we never observed any parasitization attempts on any other ant species. As predicted by labo- ratory tests, released populations of P. tricuspis appear to be highly host specific and pose no obvious threat to nontarget species.
Hydrocephalus in Uganda: the predominance of infectious origin and primary management with endoscopic third ventriculostomy

Object. The aim of this prospective study was to investigate the causes of hydrocephalus in Uganda, the efficacy of endoscopic third ventriculostomy (ETV) in this environment, and whether existing parameters could be used to guide patient selection. Methods. Three hundred consecutive children, 81.3% of whom were younger than 1 year of age, underwent ventriculoscopy preceding ETV as an initial treatment for hydrocephalus. In 179 patients (60%) the hydrocephalus was caused by a cerebrospinal fluid infection; in 76% of patients the infection had occurred in the 1st month of life. In 229 patients (76.3%) ETV was performed; 2% of patients were lost to follow up after less than 1 month and the surgical mortality rate was 1.8%. The first ETV was successful in 115 patients (52%); the mean follow-up period was 15.2 months. The mean time to repeated operation following a failed ETV was 1.5 months. Sixty-five patients underwent a second endoscopy; 37 underwent a second ETV, of which 14 procedures (38%) were successful (mean follow-up period 12.25 months). The overall success rate for ETV was 59%. Among patients older than 1 year of age, the procedure was successful in 22 (81%) of 27 with postinfectious hydrocephalus (PIHC) and 18 (90%) of 20 with nonpostinfectious hydrocephalus (NPIHC). The success rate of ETV among those patients younger than 1 year of age was 59% (60 of 101) for patients suffering from PIHC and 40% (21 of 52) for those suffering from NPIHC. Age correlated with success for NPIHC (p = 0.0002) and PIHC (p = 0.0421). The success rate of the surgery for pa tients with myelomeningocele and hydrocephalus who were younger than 1 year of age was 40% (eight of 20). The success rate of the surgery for PIHC in infants younger than 1 year of age was 70% (44 of 63) among patients with aqueductal obstruction but 45% (14 of 31) among patients with aqueductal patency (p = 0.0254). Fourth ventricular size as demonstrated on cranial ultrasonography or computerized tomography scanning predicted whether the aqueduct was patent (p = 0.0001). Conclusions. Infection is the most common cause of hydrocephalus in Uganda. In all children older than 1 year of age and in those younger than 1 year of age with PICH and aqueductal obstruction, which was reliably predicted by cranial ultrasonography, ETV was effective.
Fine root dynamics along an elevational gradient in the southern Appalachian Mountains, USA

Attributes of fine roots (<2.0 mm diameter) were quantified in five southern Appalachian plant communities along an elevational gradient. These attributes include the seasonal dynamics of fine root mass and length, the depth distribution of fine roots, fine root width and, most importantly, the annual appearance and disappearance of fine roots. The principal objectives of this study were two-fold: (1) to compare these attributes of fine roots between plant communities and (2) to compare the results of the two methods used to quantify the attributes: (1) harvesting roots from forest soil with soil cores and (2) photographing roots growing against the windows of minirhizotron boxes. The plant communities that were sampled are characteristic of the region and are designated as follows from lowest elevation (782 m) to highest elevation (1347 m): (1) xeric ridge, (2) cove hardwoods, (3) low elevation mixed oak, (4) high elevation mixed oak, and (5) northern hardwoods. Fine root mass varies seasonally in this temperate region with lowest and highest mass in the spring and autumn, respectively. Fine root mass and fine root mass appearance were lowest in the cove hardwood community and highest in the low elevation mixed oak community. The total length of fine roots was highest in the xeric ridge community and lowest in the low elevation mixed oak community. The high total root length in the xeric ridge community was due to the presence of an exceptionally dense mat of very fine roots found there. The width of these roots was significantly less than that of roots on all other plots. Subsequent regression illustrates two strong patterns in the data. First, fine root mass, fine root mass appearance and leaf production were positively correlated. Second, fine root length and soil moisture were negatively correlated. The accumulation of root mass in these communities was linked to overall site productivity and the development of root length in response to moisture stress. Only the timing of root growth initiation was related to elevation and the associated parameter of soil temperature. The best estimates of fine root appearance and disappearance were generated by harvesting roots rather than photographing them. Some methodological problems with root photography implemented in this study are addressed. # 2003 Elsevier B.V. All rights reserved.
Joints at high angles to normal fault strike: an explanation using 3-D numerical models of fault-perturbed stress fields

Structural methods based on homogeneous stress states predict that joints growing in an extending crust form with strike orientations identical to normal faults. However, we document a field example where the strikes of genetically related normal faults and joints are almost mutually perpendicular. Field relationships allowed us to constrain the fracture sequence and tectonic environment for fault and joint growth. We hypothesize that fault slip can perturb the surrounding stress field in a manner that controls the orientations of induced secondary structures. Numerical models were used to examine the stress field around normal faults, taking into consideration the eAects of 3-D fault shape, geometrical arrangement of overlapping faults, and a range of stress states. The calculated perturbed stress fields around model normal faults indicate that it is possible for joints to form at high angles to fault strike. Such joint growth may occur at the lateral tips of an isolated fault, but is most likely in a relay zone between overlapping faults. However, the angle between joints and faults is also influenced by the remote stress state, and is particularly sensitive to the ratio of fault-parallel to fault-perpendicular stress. As this ratio increases, joints can propagate away from faults at increasingly higher angles to fault strike. We conclude that the combined remote stress state and perturbed local stress field associated with overlapping fault geometries resulted in joint growth at high angles to normal fault strike at a field location in Arches National Park, Utah. # 1999 Elsevier Science Ltd. All rights reserved.
Photocatalysts with internal electric fields

The photocatalytic activity of materials for water splitting is limited by the recombination of photogenerated electron–hole pairs as well as the back-reaction of intermediate species. This review concentrates on the use of electric fields within catalyst particles to mitigate the effects of recombination and back-reaction and to increase photochemical reactivity. Internal electric fields in photocatalysts can arise from ferroelectric phenomena, p–n junctions, polar surface terminations, and polymorph junctions. The manipulation of internal fields through the creation of charged interfaces in hierarchically structured materials is a promising strategy for the design of improved photocatalysts.
Effect of probe frequency and gender on click-evoked ipsilateral acoustic reflex thresholds.

This study was designed to evaluate the effects of gender and probe frequency on the ipsilateral click-evoked acoustic reflex thresholds. Ipsilateral acoustic reflex thresholds were obtained from the left ear of each subject (12 male and 12 female normal young adults) by presenting clicks at the rate of 180/sec. The probe tone frequencies were 226, 678 and 1,000 Hz. The results revealed that acoustic reflex thresholds for the 678 Hz probe were significantly higher than those obtained with the 226 and 1,000 Hz probes. No gender differences were apparent. However, the static admittance was significantly correlated with the acoustic reflex thresholds for the 678 Hz probe in only the female subjects. For the 226 Hz probe, the elicitation of the reflex resulted in a decrease in static admittance in all the subjects. For the 678 Hz probe, the admittance decreased in 58% of the subjects and it increased in 42% of the subjects. For the 1,000 Hz probe, an increase in admittance was apparent in all of the subjects....
Allegiance to theory changes with the wind

In Peter Hobbs' “Clouds: Their Beauty and Challenge,” (Eos, March 29, 1994) a few points are deserving of comment. He is indeed correct that “The cloud seeding hypothesis was based on a very simple, naive picture of the factors that control precipitation in real clouds.” It is worth noting that at the time almost the entire meteorological community shared the naive view that all precipitation particles begin as ice crystals according to the theory of Tor Bergeron. There can be little doubt that 4 decades hence some of the most cherished ideas of today will also appear to be naive. Hobbs' urging that we constantly question our own conclusions is good advice.
Normal Bandits of Unknown Means and Variances: Asymptotic Optimality, Finite Horizon Regret Bounds, and a Solution to an Open Problem

Consider the problem of sampling sequentially from a finite number of N > 2 populations, specified by random variables X i k , i = 1;:::; N; and k = 1; 2;:::; where X i k denotes the outcome from population i the k th time it is sampled. It is assumed that for each fixed i,fX i k gk>1 is a sequence of i.i.d. normal random variables, with unknown mean mi and unknown variance s 2 i . The objective is to have a policy p for deciding from which of the N populations to sample form at any time n = 1; 2;::: so as to maximize the expected sum of outcomes of n samples or equivalently to minimize the regret due to lack on information of the parameters mi and s 2 i . In this paper, we present a simple inflated sample mean (ISM) index policy that is asymptotically optimal in the sense of Theorem 4 below. This resolves a standing open problem from Burnetas and Katehakis (1996b). Additionally, finite horizon regret bounds are given.
Contrasting dynamics of a mutator allele in asexual populations of differing size.

Mutators have been shown to hitchhike in asexual populations when the anticipated beneficial mutation supply rate of the mutator subpopulation, NUb (for subpopulation of size N and beneficial mutation rate Ub) exceeds that of the wild-type subpopulation. Here, we examine the effect of total population size on mutator dynamics in asexual experimental populations of Saccharomyces cerevisiae. Although mutators quickly hitchhike to fixation in smaller populations, mutator fixation requires more and more time as population size increases; this observed delay in mutator hitchhiking is consistent with the expected effect of clonal interference. Interestingly, despite their higher beneficial mutation supply rate, mutators are supplanted by the wild type in very large populations. We postulate that this striking reversal in mutator dynamics is caused by an interaction between clonal interference, the fitness cost of the mutator allele, and infrequent large-effect beneficial mutations in our experimental populations. Our work thus identifies a potential set of circumstances under which mutator hitchhiking can be inhibited in natural asexual populations, despite recent theoretical predictions that such populations should have a net tendency to evolve ever-higher genomic mutation rates.
Striving for optimal care: Updates in quality, value, and patient experience

BACKGROUND Hospitalists are playing a growing role in quality improvement efforts, and they are increasingly spearheading programs to improve patient experience and healthcare value. We aimed to summarize and critique recent research related to quality, value, and patient experience in the clinical practice of hospital medicine. METHODS We reviewed articles published between January 2014 and February 2015, identified through a hand search of leading journals, continuing medical education collaborative journal reviews, Agency for Healthcare Research and Quality's Patient Safety network, and PubMed. The authors collectively selected 9 articles based on their relevance to hospital practice. We review their findings, strengths, and limitations and make recommendations for practice. This is a summary of an update we presented at the 2015 Hospital Medicine national meeting. RESULTS Key findings include: a comprehensive hand-off program was associated with improved patient safety; successful readmissions interventions were resource-intensive, multifaceted and increased patient capacity to handle illness; patient activation was correlated with lower resource use post-hospitalization; positive associations exist between patient experience and understanding of their hospitalization; hospitals and practitioners can adopt simple low-cost strategies to reduce the trauma of hospitalization; hospitalists frequently order low-value tests, most often to reassure themselves or their patients; broad-spectrum antibiotics are grossly overused in hospitalized patients leading to preventable harms including clostridium difficile colitis, and programs that support “self-stewardship” may help moderate this risk. CONCLUSIONS Recent research provides important insights into readmissions prevention, patient experience and low-value test ordering, as well as introduces interventions that may mitigate the risks of handoffs and the overuse of broad-spectrum antibiotics. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine
POWDERED MAGNESIUM - CARBON DIOXIDE COMBUSTION FOR MARS PROPULSION

Powdered magnesium - carbon dioxide combustion is examined as a potential in-situ propellant combination for Mars propulsion. Although this particular combination has relatively low performance in comparison to traditional bi-propellants, it remains attractive as a potential basis for future Martian mobility systems since it could be partially or wholly manufactured from indigenous planetary resources. As a means of achieving high mobility during long-duration Mars exploration missions, the poorer performing in-situ combination can, in fact, become a superior alternative to conventional storable propellants, which would need to be entirely transported from earth. Thus, the engineering aspects of powdered metal combustion devices are discussed including transport/injection of compacted powder, ignition, combustion efficiency, combustion stability, dilution effects, lean burn limits, and slag formation issues. It is suggested that these technological issues could be effectively addressed through a multi-phase research and development effort beginning with basic feasibility tests using an existing dump configured atmospheric pressure burner. Follow-on phases would involve the development and testing of a pressurized research combustor and technology demonstration tests of a prototypical rocket configuration.
Violent crimes and their relationship to personality disorders

Persons committing murder and other forms of violent crime are likely to exhibit a personality disorder (PD) of one type or another. Essentially any personality disorder can be associated with violent crime, with the possible exception of avoidant PD. This includes those described in DSM as well as other disorders such as sadistic PD and psychopathy. The latter two, along with antisocial and paranoid PDs, are the most common personality accompaniments of violent crime. Narcissistic traits (if not narcissistic PD (NPD) itself) are almost universal in this domain, since violent offenders usually place their own desires and urges far above those of other persons. While admixtures of traits from several disorders are common among violent offenders, certain ones are likely to be the main disorder: antisocial PD, Psychopathy, Sadistic PD, Paranoid PD and NPD. Instrumental (as opposed to impulsive) spousal murders are strongly associated with NPD. Men committing serial sexual homicide usually show psychopathy and sadistic PD; half these men also show schizoid PD. Mass murderers usually show strong paranoid traits. With a focus on murder, clinical examples drawn from the crime literature and from the author's personal interviews reflect 14 varieties of personality disorder. Animal torture before adulthood is an important predictor of future violent (including sadistic) crime. Whereas many antisocial persons are eventually capable of rehabilitation, this is rarely the case with psychopathic or sadistic persons. Suggestions for future research are offered. Copyright © 2007 John Wiley & Sons, Ltd.
Back to the Music Class: Stories and Themes 30 Years Later

After nearly 30 years in higher education, a music education professor returned as a full-time general music teacher in an urban elementary school as a sabbatical project. This article chronicles the experience of getting hired, preparation, orientation, the first months of teaching, and, ultimately, a layoff. Throughout the narrative, the perspective of an older professional is contrasted with the memory of entry-level teaching some 30 years earlier. Points of discussion include social and educational climate of the times, student behavior, curriculum, undergraduate methods classes, and preservice music teacher preparation.
Medical Treatment of Chronic Daily Headaches: Chronic Migraine, Chronic Tension-Type Headaches, New Daily Persistent Headaches, Hemicrania Continua, and Medication Overuse Headache

The resistant medication overuse headache, chronic migraine, new daily persistent headache, and chronic tension-type headache patients often need a more intensive program that is interdisciplinary in nature. Physical therapy, medical, and focused psychological therapy are combined to create a treatment plan for each patient over a period of several weeks. Utilizing the same abortive and preventive principles found to be successful for less resistant cases, add paced physical rehabilitation and individually tailored stress reduction, psychotherapy, and biofeedback. Include behavioral evaluation and treatment, because ignoring psychological ramifications of chronic pain states, including headaches, as well as the psychological comorbidity commonly seen in the patient population, is tantamount to ignoring intra-abdominal trauma as the cause of shock in the severe accident-related head trauma case!
Compensation of self-heating-induced timing errors in bipolar comparators

Self-heating effects in bipolar comparators manifest themselves as signal-dependent output signal timing variation. In applications where comparator circuits are used for precise timing measurement of input signal threshold crossings, such as test and measurement instruments, self-heating presents a design challenge that must be addressed. A comparator circuit, utilizing a novel circuit-based self-heating compensation method, has been designed and fabricated in a BiCMOS HBT process. This self-heating compensation scheme differs from previously reported compensation circuitry in that it is designed for the compensation of asynchronous comparators. Measurements presented here demonstrate the effectiveness of the compensation circuitry at reducing self-heating-induced timing errors over a wide range of input signal amplitude and common-mode voltage.
Ethical Standards and Practices in Human Services and Health Care for LGBT Elders

Understanding and working with a population as diverse as LGBT elders is not possible without a grounding in ethics and its application to real-world problems faced by the older adults and their families. Principles of autonomy, beneficence, nonmaleficence, justice, fidelity, and veracity are critical for professionals to understand when confronting dilemmas that LGBT elders face. In this chapter, the authors use a case study to illustrate a real-world example of ethical and moral action. The purpose of this chapter is to provide a grounding in ethical principles and frameworks, as well as discuss pertinent codes of ethics, in order to make the case that an understanding of ethics is essential when dealing with the complex dilemmas that LGBT elders face.
Quality in hospitals: methodology for self-appraisal and change.

Quality assurance requires rigorous self-assessment and peer review, based on clearly defined standards for practice.
Modeling the Lamination of a Multilayered Tape Cast Ceramic Component With Fugitive Phases Before Sintering

A small finished ceramic component with micro-channels or other complex geometry requires a high degree of dimensional accuracy. The accuracy of the finished ceramic component depends upon the accuracy of the unfired ceramic body before sintering. One approach to creating micro-channels in ceramics is the fugitive phase approach. In this approach a sacrificial material is placed within the unfired ceramic to form channels or voids. The fugitive phase is removed or sacrificed during the subsequent sintering. For this paper, the authors examine the lamination step of the fugitive phase approach computationally. In the lamination step layers of unfired tape cast ceramic and layers of fugitive phase material are pressed together before sintering. The geometry examined in this paper is a quarter-symmetry model of a ten ceramic layer and nine fugitive phase layer structure. Three dimensional modeling is used to capture out of plane motion, displacement of the fugitive phase pieces, viscoelastic deformation, and rebounding when the layered structure is removed from the die press. The unfired ceramic is modeled as tape cast mullite and the fugitive phase is paper. The fugitive phase is modeled as linear elastic while the unfired ceramic is modeled as viscoelastic at a range of temperatures. The authors examine the filling of voids, pressure gradients, and conditions during unloading.
Distribution and Movement of the Oriental Cockroach (Orthoptera: Blattidae) Around Apartment Buildings

Distribution and movement of marked oriental cockroaches, Blatta orientalis L., were studied at four apartment buildings during the summers of 1984 and 1985. Porches were the primary cockroach harborage sites during the summer. In a mark/recapture study, 50% of marked, resighted cockroaches remained at one porch, 35% moved within an area on one side of a building, 13% moved between the front and back of a building, and 2% moved between buildings. Only 2% of these resighted cockroaches moved indoors.
Salt-Induced Self-Assembly of Bacteria on Nanowire Arrays

Studying bacteria-nanostructure interactions is crucial to gaining controllable interfacing of biotic and abiotic components in advanced biotechnologies. For bioelectrochemical systems, tunable cell-electrode architectures offer a path toward improving performance and discovering emergent properties. As such, Sporomusa ovata cells cultured on vertical silicon nanowire arrays formed filamentous cells and aligned parallel to the nanowires when grown in increasing ionic concentrations. Here, we propose a model describing the kinetic and the thermodynamic driving forces of bacteria-nanowire interactions.
Analog front-end and telemetry systems

This chapter describes general design methods and considerations for analog front-end and telemetry systems with a focus on biomedical implant applications. A number of analog front-end topologies are presented for biological signals recording and electrical stimulation. A telemetry system based on an inductively coupled power transfer configuration is illustrated with various built-in passive data telemetry schemes. An active data transmitter design based on an RF voltage-controlled oscillator is also described to achieve high data rate telemetry over an appreciable distance.
Tanzanian heroin users and the realities of addiction

Fear and loathing, and attempts to escape it, dominate the emotional life of young drug users in Dar es Salaam.1 Fear of alosto (withdrawal) drives their pursuit of heroin. Almost all young men and women dependent on heroin disdain the ways they live their lives and rue the day they first tried heroin. Over time drug users experience perceived and enacted stigma as they interact with their families, friends, neighbors, and others they encounter, for they are no longer able to hide their use. Their bodies and actions easily reveal the illegal drug practices they engage in. After providing the context in which heroin use emerged in Dar es Salaam, this chapter examines the ways heroin injectors negotiate their material, emotional, and physical worlds.
Gold icosahedral nanocages: Facile synthesis, optical properties, and fragmentation under ultrasonication

Abstract Because of their unique optical properties, gold nanocages are excellent candidates for biomedical applications. Traditionally, they are prepared using a method that involves the galvanic replacement reaction between Ag nanocubes and HAuCl4. Here we demonstrate a different approach for the facile synthesis of Au icosahedral nanocages containing twin boundaries, as well as a compact size below 15 nm and ultrathin walls of only a few atomic layers thick. Their optical properties could be tuned by simply controlling the etching time, a result that was also validated by computational modeling. We further evaluated the feasibility of fragmenting the nanocages using ultrasonication.
Bacteria on Urine Microscopy Is Not Associated with Systemic Infection in Patients with Obstructing Urolithiasis.

Abstract Introduction: Determining whether bacterial presence in urine microscopy represents infection is important as ureteral stent placement is indicated in patients with obstructing urolithiasi...
Languages without subjects

The Protestant interior linguistic subject expressed through language or speech is often predicated upon a contrast with languages or forms of speech that deny subjectivity. That is, linguistic subjectivity or interior depth is often produced through the contrast with linguistic surfaces, with languages that in one way or another are considered incapable of supporting subjectivity. In colonial Lutheran New Guinea early missionaries felt they had to cut through both a tropical rainforest and a linguistic forest. In the latter case they used church-promulgated lingua francas to do so, even though many speakers would not have the fluency that Protestant theories of spontaneous sincerity usually assume. The Lutherans hoped to establish the subject-making depth of their lingua francas through comparisons with and promulgation of a form of Pidgin English that they argued could never produce a (Christian) self. In this article I examine how Lutheran missionaries tried to construct Pidgin English as a despised se...
Impact of Team Collaboration on Cybersecurity Situational Awareness

Information complexity and expanse of cybersecurity space surpasses the cognitive ability of individual analysts to be truly situationally aware. Team level situation awareness in cyber security can be described as the coordinated perception and comprehension of significant events in the network by all team members that serve as the basis for effective response actions. Effective teamwork is imperative to transform individual analysts’ disparate cognition and situation awareness into team level, collective cognition and situation awareness. We employed a hybrid methodology that makes opportunistic use of a mix of field observations, simulation, modeling, and laboratory experimentation to study and improve team situation awareness in the cyber security domain. Findings from experiments summarized in this chapter demonstrate the important role of teamwork at every level of cyber security defense and the detrimental effect of team process loss on overall cyber defense performance.
History of medication-assisted treatment and its association with initiating others into injection drug use in San Diego, CA.

Medication-assisted treatment (MAT) remains the gold standard for the treatment of opioid use disorder. MAT also reduces the frequency of injecting among people who inject drugs (PWID). Relatedly, data suggest that PWID play a key role in the initiation of others into drug injecting by exposing injecting practices to injection-naive drug users. Our primary objective was to test whether a history of MAT enrollment is associated with a reduced odds of PWID providing injection initiation assistance. Preventing Injecting by Modifying Existing Responses (PRIMER; NIDA DP2-DA040256–01), is a multi-site cohort study assessing the impact of socio-structural factors on the risk that PWID provide injection initiation assistance. Data were drawn from a participating cohort of PWID in San Diego, CA. The primary outcome was reporting ever providing injection initiation assistance; the primary predictor was reporting ever being enrolled in MAT. Logistic regression was used to model associations between MAT enrollment and ever initiating others into injecting while adjusting for potential confounders. Participants (n = 354) were predominantly male (n = 249, 70%). Thirty-eight percent (n = 135) of participants reported ever initiating others into injection drug use. In multivariate analysis, participants who reported a history of MAT enrollment had significantly decreased odds of ever providing injection initiation assistance (Adjusted Odds Ratio [AOR]: 0.62, 95% Confidence Interval [CI]: 0.39–0.99). These preliminary findings suggest an association between MAT enrollment and a lower odds that male PWID report providing injection initiation assistance to injection-naive drug users. Further research is needed to identify the pathways by which MAT enrollment may impact the risk that PWID initiate others into drug injecting.
Impact of Intended Mode of Delivery on Outcomes in Preterm Growth-Restricted Fetuses.

Background Scheduled cesarean is frequently performed for fetal growth restriction due to concerns for fetal intolerance of labor. Objective We compared neonatal outcomes in preterm growth-restricted fetuses by intended mode of delivery. Study Design We performed a retrospective cohort study of indicated preterm births with prenatally diagnosed growth restriction from 2011 to 2014 at a single institution. Patients were classified by intended mode of delivery. The primary outcome was a composite of adverse neonatal outcomes, including perinatal death, cord blood acidemia, chest compressions during neonatal resuscitation, seizures, culture-proven sepsis, necrotizing enterocolitis, and grade III–IV intraventricular hemorrhage. Secondary analysis was performed examining the impact of umbilical artery Dopplers. Results Of 101 fetuses with growth restriction, 75 underwent planned cesarean deliveries. Of those induced, 46.2% delivered vaginally. Delivery by scheduled cesarean was not associated with a decreased risk of the composite outcome (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 0.45–5.78), even when only those with abnormal umbilical artery Dopplers were considered (aOR, 2.8; 95% CI, 0.40–20.2). Conclusion In this cohort, planned cesarean was not associated with a reduction in neonatal morbidity, even when considering only those with abnormal umbilical artery Dopplers. In otherwise appropriate candidates for vaginal delivery, fetal growth restriction should not be considered a contraindication to trial of labor.
TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear

Purpose To perform a cost analysis comparison for managing common ocular disorders in an eye emergency department (ED) versus an urgent care setting using a time-driven activity-based cost model (TDABC) to assist physicians and staff in appropriate allocation of resources at their own institution. Design Retrospective analysis. Setting Massachusetts Eye and Ear (MEE) ED and Same-Day Services (SDS), which runs as an urgent care clinic. Population Patients diagnosed with corneal abrasions, dry eyes, conjunctivitis, and styes were identified between April 2014 and August 2015 (n = 2,408 [ED], 26 [SDS]). We determined resources used in delivery of care, which included personnel, consumables, space capacity, and equipment. Costs were identified based on time the patient spent with each resource. Main Outcome Average visit length and associated personal, space, equipment, and consumable costs. Results Average visit length was 196 and 53 minutes, respectively, primarily due to longer wait times in the ED. Personnel and space costs were higher in the ED compared with SDS ($68.92 vs. $51.37 and $24.44 vs. $12.86, respectively). This led to an overall higher total resource cost for patients seen in the ED compared with SDS ($108.41 vs. $81.53, respectively). Conclusion For common ocular disorders, total SDS costs were 25% less than ED costs at MEE primarily due to personnel and space utilization. Treating patients with nonemergent ocular problems outside the ED can lead to shorter visit times for patients as well as lower overall costs.
The Scientist in the Classroom Partnership program: an innovative teacher professional development model

ABSTRACTThis article presents an in-depth study supporting the Scientist in the Classroom Partnership (SCP) program as a model of effective professional development (PD) for K-12 teachers. The goal of this study was to determine the core and structural features of the SCP program necessary for effective teacher PD. The SCP partners a classroom teacher with an STEM graduate student or postdoctoral fellow to co-teach 1 day per week during the academic year. During the summer, the teacher and fellow work together in a 10-day workshop to build the partnership, learn inquiry-based pedagogical strategies, and develop curriculum. Teacher participants from 9 years of the program were surveyed to determine the impact on the participants. In addition, teachers attended a 1-day retreat that allowed for data collection during storytelling and focus-group sessions. Likert surveys were analyzed, and the storytelling and focus-group data were coded for analysis. Five core and three structural features emerged from this ...
An automatic method for renal cortex segmentation on CT images: evaluation on kidney donors.

Rationale and Objectives The aims of this study were to develop and validate an automated method to segment the renal cortex on contrast-enhanced abdominal computed tomographic images from kidney donors and to track cortex volume change after donation. Materials and Methods A three-dimensional fully automated renal cortex segmentation method was developed and validated on 37 arterial phase computed tomographic data sets (27 patients, 10 of whom underwent two computed tomographic scans before and after nephrectomy) using leave-one-out strategy. Two expert interpreters manually segmented the cortex slice by slice, and linear regression analysis and Bland-Altman plots were used to compare automated and manual segmentation. The true-positive and false-positive volume fractions were also calculated to evaluate the accuracy of the proposed method. Cortex volume changes in 10 subjects were also calculated. Results The linear regression analysis results showed that the automated and manual segmentation methods had strong correlations, with Pearson's correlations of 0.9529, 0.9309, 0.9283, and 0.9124 between intraobserver variation, interobserver variation, automated and user 1, and automated and user 2, respectively ( P P t test). The overall true-positive and false-positive volume fractions for cortex segmentation were 90.15 ± 3.11% and 0.85 ± 0.05%. With the proposed automated method, the time for cortex segmentation was reduced from 20 minutes for manual segmentation to 2 minutes. Conclusions The proposed method was accurate and efficient and can replace the current subjective and time-consuming manual procedure. The computer measurement confirms the volume of renal cortex increases after kidney donation.
CARDIAC ALTERNATION: ALTERNATION OF HEART SOUNDS AND MURMURS.

Abstract Two patients are presented who exhibited unusual forms of cardiac alternation. One of these, a man with myocardial disease of unknown type, showed alternation of an atrial or summation gallop sound and an alternating second sound. The first sound did not vary. He also had sphygmic alternation, though this was not detected at the same time. The other patient, a man with aortic stenosis, had an obvious pulsus alternans and a grossly alternating systolic murmur. In addition, he showed alternation of the atrial sound and the first sound together with simultaneous electrical alternation. The mechanisms are discussed.
Investigating the effect of relevance and reachability constraints on SAT encodings of planning

Recently, satisfiability (SAT) techniques have been shown to be more efficient at extracting solutions from a planning graph in Graphplan (Blum & Furst 1995) than the standard backward search(Kautz & Selman 1998). Graphplan gains efficiency from forward propagation and backward use of mutual exclusion constraints. The utility of SAT techniques for solution extraction raises two important questions: (a) Are the mutual exclusion constraints equally useful for solution extraction with SAT encodings? (b) If so, are there additional types of propagated constraints that can benefit them even more? Our ongoing research investigates these two questions. The mutual exclusion relations (mutex) used in the standard Graphplan, that we shall refer to as fmutex constraints, are propagated by the following rules: Two facts and are fmutex if all actions supporting are pair-wise fmutex with all actions supporting . Two actions are fmutex if action deletes another action ’s preconditions or effects, or if preconditions of are pairwise fmutex with preconditions of . Fmutex relations propagate forward from the initial state to provide “reachability” information to the backward search. Though they increase the size of the SAT encoding with a quadratic number of additional clauses, the overall encoding is simplified through unit-propagation based methods. E.g., fmutexes helps an 11 step/73 action logistics problem that takes 6 min 30 sec on Blackbox to solve in 7sec (60x speedup). It is also possible to propagate “relevance” relations starting from the goals. Such constraints would not be useful for standard Graphplan, unless it conducts the search in the forward direction. In contrast, the search in SAT encodings is “directionless” in that it neither goes exclusively backward from goals nor exclusively forward from the initial state. Any variable that has the best heuristic properties (smallest live domain (Tsang 1993), maximum unit propagation (Li & Anbulagan 1997)) is selected, irrespective of its position in the corresponding planning graph. This means that the solver can potentially exploit mutex relations based on reachability as well as relevance. With this insight, we developed two types of constraints that can be propagated in backward direction, and carry relevance information: Backward mutex (bmutex): Bmutex constraints attempt to capture the idea that two actions (or propositions) are never relevant together. Facts in the goal level are not bmutex. If actions and give the same set of facts at the next level, then is bmutex with . Moreover, if all the
Rupture of Giant Anterior Sacral Meningocele in a Patient with Marfan Syndrome: Diagnosis and Management.

Background Marfan syndrome is a genetic disorder that results in the weakening of connective tissues. Dural ectasia has been defined as a feature of Marfan syndrome and is present in up to 92% of patients. Rarely, dural ectasia can erode through the sacrum expanding into an anterior sacral meningocele. Case Description Information for this case report was gathered from patient notes and imaging from the patient chart. This is a case of a 46-year-old woman who presented with urinary incontinence, early satiety, and back pain in the setting of a known anterior sacral meningocele. Before operative management, the anterior sacral meningocele ruptured with the patient presenting signs and symptoms of intracranial hypotension. Conservative management did not alleviate the pain. She was ultimately managed with posterior sacroplasty followed by anterior sacral meningocele resection and placement of a lumboperitoneal shunt. The patient did not have reaccumulation of the meningocele or recurrent symptoms at the latest follow-up. Conclusions The progression of dural ectasia in Marfan syndrome to an anterior sacral meningocele is uncommon. It is important to identify the characteristics associated with an expanding dural ectasia as this patient's symptoms progressed over time and the meningocele grew large. Given its rarity, there are no guidelines in place regarding size at which repair of an anterior sacral meningocele should occur prophylactically. It is important to review these cases in order continue to learn about progression, management, and outcomes of patients with an anterior sacral meningocele.
Apnea Threshold in Pediatric Brain Death: A Case with Variable Results Across Serial Examinations.

Consensus guidelines currently exist for the evaluation of pediatric patients with suspected brain death. The guidelines include the requirement for two consistent examinations separated by an observation period and a threshold of 60 mm Hg for PaCO2 during apnea testing. We present a patient who met all prerequisites to perform brain death examination but had variability in examinations during apnea testing. We discuss our strategy in managing these unexpected findings, including the importance of open and ongoing communication with the family, and the implications for current guidelines for the determination of brain death in pediatric patients.
Abstract 021: Interleukin-21 Plays a Critical Role in Hypertension and Vascular Dysfunction

T cell derived cytokines, interleukin 17A (IL17A) and interferon gamma (IFNg), promote angiotensin II (Ang II)-induced hypertension and end-organ damage. Interleukin 21 (IL21), produced primarily b...
Thoracic spine manipulation for the management of mechanical neck pain: A systematic review and meta-analysis.

Objective To investigate the role of thoracic spine manipulation (TSM) on pain and disability in the management of mechanical neck pain (MNP). Data sources Electronic databases PubMed, CINAHL, Pedro, Embase, AMED, the Cochrane Library, and clinicaltrials.gov were searched in January 2018. Study selection Eligible studies were completed RCTs, written in English, had at least 2 groups with one group receiving TSM, had at least one measure of pain or disability, and included patients with MNP of any duration. The search identified 1717 potential articles, with 14 studies meeting inclusion criteria. Study appraisal and synthesis methods Methodological quality was evaluated independently by two authors using the guidelines published by the Cochrane Collaboration. Pooled analyses were analyzed using a random-effects model with inverse variance methods to calculate mean differences (MD) and 95% confidence intervals for pain (VAS 0-100mm, NPRS 0-10pts; 0 = no pain) and disability (NDI and NPQ 0–100%; 0 = no disability). Results Across the included studies, there was increased risk of bias for inadequate provider and participant blinding. The GRADE approach demonstrated an overall level of evidence ranging from very low to moderate. Meta-analysis that compared TSM to thoracic or cervical mobilization revealed a significant effect favoring the TSM group for pain (MD -13.63; 95% CI: -21.79, -5.46) and disability (MD -9.93; 95% CI: -14.38, -5.48). Meta-analysis that compared TSM to standard care revealed a significant effect favoring the TSM group for pain (MD -13.21; 95% CI: -21.87, -4.55) and disability (MD -11.36; 95% CI: -18.93, -3.78) at short-term follow-up, and a significant effect for disability (MD -4.75; 95% CI: -6.54, -2.95) at long-term follow-up. Meta-analysis that compared TSM to cervical spine manipulation revealed a non-significant effect (MD 3.43; 95% CI: -7.26, 14.11) for pain without a distinction between immediate and short-term follow-up. Limitations The greatest limitation in this systematic review was the heterogeneity among the studies making it difficult to assess the true clinical benefit, as well as the overall level of quality of evidence. Conclusions TSM has been shown to be more beneficial than thoracic mobilization, cervical mobilization, and standard care in the short-term, but no better than cervical manipulation or placebo thoracic spine manipulation to improve pain and disability. Trial registration PROSPERO CRD42017068287
Factor Structure and Psychometric Properties of the Child Oral and Motor Proficiency Scale

The purpose of this study was to identify the factor structure of the Child Oral and Motor Proficiency Scale (ChOMPS) and to evaluate the psychometric properties, including internal consistency rel...
Behavioral Engagement Shifts Among At-Risk High School Students Enrolled in Online Courses:

Academic behaviors such as attendance are highly associated with academic outcomes. High schools are also increasingly turning to online courses to educate their most marginalized students. In this...