cssi/SciSciGPT-SciSciNet huggingface dataset:
501 NEPHRON-SPARING SURGERY AS THE NEW GOLD STANDARD FOR T1 (< 7 CM) RENAL CELL CARCINOMA: RESULTS OF A CONTEMPORARY UCLA SERIES.

Introduction and Objective Nephron-sparing surgery (NSS) is currently bring used for patients with small, localized renal cell carcinoma (RCC) tumors. We reviewed our experience with NSS as a treatment modality of choice for RCC in a contemporaneous cohort (2000-2005) (group 1) ( n = 60) and compared surgical outcomes, risk factors for recurrence, and complications to two older UCLA cohorts (1995-1999) (group 2) ( n = 211) and (1980-1994) (group 3) ( n = 90). The goal was to determine whether increasing the indications for NSS would increase morbidity or compromise surgical outcomes. In addition, each group was compared with a time-matched cohort of radical nephrectomy patients with similar tumor characteristics to compare oncological efficacy and rate of surgical complications. Results In group 1, 76%, 6.6%, and 17.4% of patients presented with T1, T2, and T3 disease respectively. This was not significantly different from the T stage distribution in the other time cohorts. In addition, no significant difference was found in mean tumor size (group 1 = 4.09 cm), the presence of positive nodes (group 1 = 4.3%) or metastatic disease (18.9%). In addition, no difference was found in tumor multifocality, tumor grade, complication rate, or the use of a drain. Mean length of stay significantly decreased from (group 3 = 7.69 days) to (group 1 = 4.09). Mean blood loss also significantly decreased over time from group 3 = 604.3 mL to group 1 = 425.0. Both of these decreased imply improved surgical technique as NSS became more routine at UCLA. Tumor recurrence and cancer-specific survival were not significantly difference across the time groups for patients that underwent NSS. In comparing the NSS patients with the radical nephrectomy cohort, NSS patients had both significantly less recurrences of RCC (5.8% vs 11.4%; p = .006) and increased mean time until recurrence (143 vs 137 months). In addition the NSS patients had a greater cancer survival rate (98% vs 79%; p Conclusions Improved surgical techniques with better hemostasis and optimized visualization have allowed NSS for larger and more complicated tumors to be performed without increasing morbidity or compromising oncologic efficacy. With longer survival of patients now expected, NSS should be based on this and other series and be considered the gold standard for T1 (≤ 7 cm) tumors rather than radical nephrectomy, which would place patients at future risk for renal insufficiency or hemodialysis.
Unified spin model for magnetic excitations in iron chalcogenides

Recent inelastic neutron scattering (INS) measurements on FeSe and $\mathrm{Fe}({\mathrm{Te}}_{1\ensuremath{-}x}{\mathrm{Se}}_{x}$) have sparked intense debate over the nature of the ground state in these materials. Here we propose an effective bilinear-biquadratic spin model, which is shown to consistently describe the evolution of low-energy spin excitations in FeSe, both under applied pressure and upon Se/Te substitution. The phase diagram, studied using a combination of variational mean-field, flavor-wave calculations and density-matrix renormalization group (DMRG), exhibits a sequence of transitions between the columnar antiferromagnet common to the iron pnictides, the nonmagnetic ferroquadrupolar phase attributed to FeSe, and the double-stripe antiferromagnetic order known to exist in ${\mathrm{Fe}}_{1+y}\mathrm{Te}$. The calculated spin structure factor in these phases mimics closely that observed with INS in the $\mathrm{Fe}({\mathrm{Te}}_{1\ensuremath{-}x}{\mathrm{Se}}_{x}$) series. In addition to the experimentally established phases, the possibility of incommensurate magnetic order is also predicted.
Binding of the cytoplasmic domain of CD28 to the plasma membrane inhibits Lck recruitment and signaling

The T cell costimulatory receptor CD28 is required for the full activation of naive T cells and for the development and maintenance of Foxp3(+) regulatory T (Treg) cells. We showed that the cytoplasmic domain of CD28 was bound to the plasma membrane in resting cells and that ligand binding to CD28 resulted in its release. Membrane binding by the CD28 cytoplasmic domain required two clusters of basic amino acid residues, which interacted with the negatively charged inner leaflet of the plasma membrane. These same clusters of basic residues also served as interaction sites for Lck, a Src family kinase critical for CD28 function. This signaling complex was further stabilized by the Lck-mediated phosphorylation of CD28 Tyr(207) and the subsequent binding of the Src homology 2 (SH2) domain of Lck to this phosphorylated tyrosine. Mutation of the basic clusters in the CD28 cytoplasmic domain reduced the recruitment to the CD28-Lck complex of protein kinase Cθ (PKCθ), which serves as a key effector kinase in the CD28 signaling pathway. Consequently, mutation of either a basic cluster or Tyr(207) impaired CD28 function in mice as shown by the reduced thymic differentiation of FoxP3(+) Treg cells. On the basis of these results, we propose a previously undescribed model for the initiation of CD28 signaling.
Confinement Tuning of a 0-D Plasma Dynamics Model

Investigations of tokamak dynamics, especially as they relate to the challenge of burn control, require an accurate representation of energy and particle confinement times. While the ITER-98 scalin...
Reflections on HLA Epitope-Based Matching for Transplantation.

HLA antibodies are primary causes of transplant rejection; they recognize epitopes which can be structurally defined by eplets. There are many reviews about HLA epitope-based matching in transplantation. This article describes some personal reflections about epitopes including a historical perspective of HLA typing at the antigen and allele levels, the repertoires of antibody-verified HLA epitopes, the use of HLAMatchmaker in determining the specificities of antibodies tested in different assays and finally, possible strategies to control HLA antibody responses.
Quantifying As-Cast and Homogenized AA7050 Mechanical Properties Through Compression Testing

Prior studies of cast AA7050 mechanical property are sparse, and only include the as-cast condition. In order to generate data for simulation of stress development in direct chill (DC) casting, compression tests were performed on AA7050 specimens in both as-cast and homogenized conditions in the temperature range of 20–500 °C at strain rates from 10−4 to 10−2 s−1 to a strain of 0.5. Results from test specimens having round and square cross-sections were compared to each other and to published tensile data. The round specimens are preferred due to less cornering effect. The flow stress-strain data is fit to the Ludwik equation to generate constitutive relations for the flow stress as a function of strain, strain rate and temperature. The microstructural changes from as-cast to homogenized structures lowers the flow stress of AA7050 with the removal of harder eutectic microconstituent. This effect is most significant at an intermediate temperature (200 °C) and decreases with increasing temperature.
Exploratory analysis of fines for water pollution in Bangladesh

As a consequence of rapid industrialization, the waterbodies of Bangladesh have transformed into seasonal dead zones from the ensuing pollution. Despite having environmental regulations to control industrial pollution, lack of effective enforcement has jeopardized environmental quality. Evaluation of enforcement mechanisms have not gained attention from researchers until recently. This qualitative and descriptive analysis illustrates the current enforcement regime for environmental compliance in Bangladesh focusing on fines levied on polluters. Although there are no official guidelines for fines based on type of violation, this paper identified that there are differences of fines among violation based on historical data. It was also found that textile factories are not penalized heavily compared to non-textile factories. Repeat offenders were found to be penalized at the same rate. This study can be used to design appropriate penalty structure based on violation types, and reform the enforcement system so that polluters pay principle is actually implemented.
Microdissection Testicular Sperm Extraction

Microdissection testicular sperm extraction (microTESE) is considered the gold standard method for surgical sperm retrieval among patients with non-obstructive azoospermia (NOA). In this review, we will discuss the optimal evaluation of NOA patients and strategies to medically optimize NOA patients prior to microTESE. In addition, we will also discuss technical principles and pearls to maximize the chances of successful sperm retrieval, sperm retrieval rates (SRR) based upon testicular histology, predictors of successful sperm retrieval, gonadal recovery following microTESE, and potential complications.
Impacts of the Mississippi River spillway opening on faecal coliform concentration in Lake Pontchartrain

This study focuses on explaining the role of the periodic opening of the Bonnet Carre Spillway on the faecal coliform levels in Lake Pontchartrain. Water quality data were collected by the Lake Pontchartrain Basin Foundation to analyse the faecal coliform bacteria levels, turbidity, salinity, temperature, and dissolved oxygen in the lake water. The results show that the faecal coliform concentrations were lower during the spillway opening than the preceding and subsequent months. Statistical analysis shows the dilution effect, characterized by an effective reduction in faecal coliform concentrations due to increase in water turbidity, coupled with decrease in water salinity and dissolved oxygen because of spillway opening. It is also indicated that the combine effect of more than one factor produces a significantly greater reduction in the faecal coliform than each factor acting independently. Periodic spikes in faecal coliform concentrations were observed at sampling points located near the outlets of streams and drainage canals with high settlement densities. A positive correlation (r = 0.78467) was found between the average faecal coliform counts and average monthly precipitations, highlighting the role of precipitation run-offs. The results of this study indicate that the spillway opening contributed to a reduction in the faecal coliform concentration in the lake's surface water during the studied periods.
Proxy-Reported Quality of Life and Family Impact for Children Followed Longitudinally by a Pediatric Palliative Care Team

Abstract Background: One goal of pediatric palliative care is to maintain quality of life for children and their families. Quality-of-life investigations may be enhanced by considering clinically important metrics in addition to statistical significance. Objective: The purpose of this study was to longitudinally evaluate the effect of time on quality of life and family impact for pediatric palliative care patients across all diagnoses and ages. Design: This prospective quality-of-life study included administration of a 23-item PedsQL™ Measurement Model to evaluate for physical, emotional, social, and cognitive dimensions of the child's quality of life and a 36-item PedsQL Family Impact Module to assess for the familial impact at time of initial palliative care consultation, Month 6, and Month 12. Setting/Subjects: All pediatric patients who received a palliative care consultation in our Midwestern free-standing children's hospital over a five-year period were included in the longitudinal study (n = 87). M...
Abstract A15: Downregulation of c-myc is synthetic lethal with PARP inhibitors in high MYC cancers independent of BRCA status

PARP inhibitors represent a novel class of cancer therapeutics that exploit a synthetic lethal mechanism specific to cancer cells with a defect within the Homologous Recombination (HR) DNA repair pathway. Patients with a BRCA1/2 germ-line mutation have the highest response rate to PARP inhibitors. However, early clinical trial data has indicated that only ~30-40% BRCA mutant patients respond to PARP inhibitors. Coincidentally, the oncogene c-myc is the most frequently amplified gene in BRCA mutant tumors (~40-60%) which typically present as Triple Negative Breast Cancer (TNBC). The oncogene c-myc transcriptionally regulates several DNA repair genes, and correlates with poor survival among breast cancer patients. Therefore we hypothesized that dual combination therapy targeting c-myc and PARP is an effective therapeutic strategy in BRCA mutant tumors. C-myc siRNA induced increased sensitivity to PARP inhibitors in BRCA wild-type (MB231) & BRCA mutant (SUM149) TNBC cell lines and down regulated HR repair. Pan CDK inhibitor Dinaciclib demonstrated significant MYC inhibition across several TNBC cell lines. Additionally, Dinaciclib demonstrated synergistic growth inhibition in combination with PARP inhibitor Niraparib in both BRCA wild-type and mutant c-myc expressing TNBC cell lines. Combination therapy also leads to an increase in DNA damage (via γH2AX) with a decrease in HR repair (BRCA1/RAD51). TNBC cell line mouse xenografts demonstrated down regulation of c-myc and RAD51 in Dinaciclib + Niraparib treated tumors. Dual Dinaciclib + Niraparib therapy also induced synergistic growth inhibition in PARP inhibitor acquired resistant cell lines while demonstrating significant growth inhibition across a panel of c-myc overexpressing cancer cell lines (Ovarian, Prostate, Pancreatic, Colon & Lung). In conclusion, we demonstrated that dual CDK + PARP inhibition is synthetic lethal in both BRCA wild-type and mutant TNBC cell lines and is dependent upon down regulation of c-myc. This study supports c-myc as predictor of response to PARP inhibitor therapy and may also serve as a biomarker of response to Dinaciclib + PARPi therapy in high MYC expressing tumors. Citation Format: Jason PW Carey, Smruthi Vjayaraghavan, Kelly Hunt, Khandan Keyomarsi. Downregulation of c-myc is synthetic lethal with PARP inhibitors in high MYC cancers independent of BRCA status [abstract]. In: Proceedings of the AACR Precision Medicine Series: Opportunities and Challenges of Exploiting Synthetic Lethality in Cancer; Jan 4-7, 2017; San Diego, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2017;16(10 Suppl):Abstract nr A15.
Variability of ethanol concentration in rainwater driven by origin versus season in coastal and inland North Carolina, USA.

Rainwater ethanol concentrations were measured for one year (June 2013-May 2014) in central (Elon, NC) and coastal (Wilmington, NC) North Carolina, allowing for a comparison of the effects of coastal and marine rain on ethanol concentration and deposition both at the coast and 250 km inland. Rain samples were collected on an event basis and analyzed using enzyme oxidation and headspace solid-phase microextraction (HS-SPME). The volume-weighted average ethanol concentration at Elon (609 ± 116 nM) was higher than at Wilmington (208 ± 21 nM). Rainfall influenced by air masses originating over the Atlantic Ocean has previously been observed to be lower in ethanol concentration than terrestrial rain at the Wilmington location, and this was true during this study as well. Lower-ethanol marine and coastal air masses did not affect the concentration of ethanol in Elon rain, 250 km from the coast. This is likely due to the rapid supply of locally emitted ethanol to air masses moving over the land. No difference in rainwater ethanol concentrations was observed for Elon rain based on air mass back trajectories, most likely because all the rain was impacted by both anthropogenic and biogenic terrestrial sources typical of most inland areas. Seasonal variation in ethanol concentrations was significant in the inland location with elevated ethanol concentrations observed in fall; no seasonal variation was observed in coastal location rain. This study presents for the first time the different drivers for ethanol concentrations in rainwater from a coastal and a proximal inland location.
Student Learning Benefits of a Mixed-Reality Teacher Awareness Tool in AI-Enhanced Classrooms

When used in K-12 classrooms, intelligent tutoring systems (ITSs) can be highly effective in helping students learn. However, they might be even more effective if designed to work together with human teachers, to amplify their abilities and leverage their complementary strengths. In the present work, we designed a wearable, real-time teacher awareness tool: mixed-reality smart glasses that tune teachers in to the rich analytics generated by ITSs, alerting them to situations the ITS may be ill-suited to handle. A 3-condition experiment with 286 middle school students, across 18 classrooms and 8 teachers, found that presenting teachers with real-time analytics about student learning, metacognition, and behavior had a positive impact on student learning, compared with both business-as-usual and classroom monitoring support without advanced analytics. Our findings suggest that real-time teacher analytics can help to narrow the gap in learning outcomes across students of varying prior ability. This is the first experimental study showing that real-time teacher analytics can enhance student learning. This research illustrates the promise of AIED systems that integrate human and machine intelligence to support student learning.
Sensation Seeking and Risk Taking

Zuckerman has pursued the conceptualization and measurement of sensation seeking with such success that it is beginning to take its place alongside such long-established concepts as introversion and extraversion. Zuckerman conceives sensation seeking as a motive that can be measured as both trait and state.
Maternal Directive Behavior Revisited.

A comparative analysis of the directives produced by mothers while interacting with young children with Down syndrome and normally developing children was conducted. The results not only replicated previous findings of increased rates of directives by mothers of children with down syndrome but also identified several qualitative differences in the types of directives produced. Mothers of mentally retarded children produced a high number of requests for their children to perform actions, requested actions that were relatively difficult, and asked their children to attend to information that was not directly related to children's current focus of attention. Results suggest that group differences in maternal directive behavior cannot be explained on the basis of children's behavior but appear to reflect differences in maternal interactive intentions.
Some psycholinguistic aspects of metaphor

In view of the variety of implicit and explicit definitions of metaphor in the philosophical, psychological, and linguistic literature, this chapter reviews the “standard” definition of metaphor. It attempts to furnish an alternative definition of metaphor that seems to accord better with the facts. The chapter discusses various issues related to the processes involved in the comprehension of metaphors. All metaphors give rise to what is usually called metaphorical tension, which is a result of the conceptual incompatibility inherent in a metaphor taken in its context. The comprehension of the metaphor requires the elimination of the tension, that is, the elimination of aspects of the meaning of words, phrases or sentences that when interpreted literally give rise to tension. The general point that needs to be emphasized is that if something is a metaphor then it will be contextually anomalous if interpreted literally. The psychological implications of a Gricean approach to metaphor seem clear enough.
The Trials and Tribulations of Modeling and Measuring in Surface Water Hydrology

Historically speaking, modeling of the precipitation runoff process got its start in the engineering side of hydrology. The development of these models was primarily driven by societal needs for water resources structural design purposes (i. e., dams and reservoirs, aqueducts, etc.), and operational requirements, such as flood forecasting. Most such models are “lumped”, rather than “distributed”, and their structures (i. e., process equations) are influenced by availability of observations and data constraints. Precipitation runoff models vary in their levels of complexity, ranging from the rational formula, the Soil Conservation Service (SCS) curve number model (SCS, 1964), the antecedent precipitation index (API) method in the “simple” category to the more complex Stanford-type conceptual rainfall-runoff (CRR) models and, finally to the physically based distributed models such as HEC-1 (Feldman, 1995) and KINEROS (Woolhiser et al., 1990; Smith et al., 1995). The spatial and temporal scale of their application varies from model to model, but ranges from tens to thousands of square miles and from minutes and hours to a few days, respectively.
Attempts to Mimic Enzymes — Report from the Battle Front

Combining catalytic and binding groups can lead to multifunctional catalysts that imitate enzymes. Good progress has been made toward bona fide enzyme mimics, but many problems remain. A frank recognition of these problems points the way to improved artificial enzymes.
Quasi-Patents and Semi-Patents in Biobanking

Until recently, genetic researchers were like early mapmakers charting the world’s coastlines with only compasses and notepads. The map of the human genome, like an ancient map of the world, was sketched in crooked and uncertain strokes. In the year 2000, things changed. The completion of the Human Genome Project yielded the first-ever molecular blueprint of the human body. In time, this blueprint may develop into a detailed atlas of preventions, diagnoses, and cures for deadly diseases. The research necessary to reach this goal will rely on biobanks—repositories of biological materials and associated data. Today, wide varieties of such facilities are in operation at universities, hospitals, corporations, and non-profit entities worldwide. Some examples include the United Kingdom Biobank, the Duke Biobank, the University of Pennsylvania Tumor Tissue Bank, the National Gene Vector Biorepository at the Indiana University School of Medicine, the Mayo Clinic Biobank, the da Vinci European Biobank, and Genetic Alliance Biobank. Often suspended in paraffin wax or liquid nitrogen, the tissue samples in biobanks come from a variety of sources: participants in clinical trials, patients who undergo surgery or routine medical tests, recruited donors, and contributions from patients’ families. These samples are usually accompanied by useful information, such as a tissue donor’s age, sex, race, cancer history, family medical history, allergies, and medications [Heaney C et al. (2009) The perils of taking property too far. http://www.stanford.edu/group/sjlsp/cgi-bin/orange_web/articles/index.php?CatID=1009. Accessed 7 May 2010]. Today, the storage of human tissues and associated data is a sophisticated practice. Even as biobanks grow in size and sophistication, their future is uncertain. At most biobanks, critical questions regarding the allocation of property, both real and intangible, remain unanswered. Who should own physical samples and data? Who should have access to samples, data, and research findings, and on what terms? Patents present further quandaries: who should have access to patented inventions stemming from research? Should exceptions be made for the non-commercial use of patented ideas? Should the fruits of biobank research be shared with donors in order to encourage future donations? In this article, we formulate possible answers to these questions.
Matrix-Free Method for Transient Maxwell-Thermal Cosimulation in Arbitrary Unstructured Meshes

Existing electrical–thermal cosimulation methods require solving a system matrix when handling inhomogeneous materials and irregular geometries discretized into unstructured meshes. In this paper, a matrix-free method is developed for cosimulating full-wave Maxwell’s equations and the thermal diffusion equation in the time domain. The method is free of matrix solutions regardless of the shape of the element used for space discretization. A theoretical stability analysis is also developed for the coupled electrical and thermal analysis, which is nonlinear in nature. Numerical experiments on both unstructured tetrahedral and triangular prism element meshes have validated the accuracy and efficiency of the proposed method.
Optimizing the Electrical Conductivity of Screen Printed Silver Conductive Tracks by Post Treatment

Screen printed silver conductive tracks have been used or are being explored for applications in membrane switches, solar cells, radio frequency identification (RFID) antennas, diabetic testing strips, sensors etc. For many of these applications, optimizing the electric conductivity of the printed tracks is crucial. It has been noticed that the electric conductivity of the printed conductive tracks are highly dependent on the post-processing conditions. However, the understanding of the effect is limited. In this paper, preliminary study results show that ambient temperature drying followed by heat treatment offers the lowest resistance (highest conductance) for printed conductive tracks.
Dosimetry for Iodine-131 Therapy for Metastatic Differentiated Thyroid Cancer

Dosimetry is one of the two methods of selecting prescribed activity of I-131 for the treatment of metastatic differentiated thyroid cancer. The objective of this chapter is to present an overview of dosimetrically determined prescribed activity of I-131 for the treatment of metastatic differentiated thyroid cancer (DTC) with a discussion of (1) definitions, (2) the fundamentals of radiation therapy, (3) empiric vs. dosimetrically determined prescribed activity of I-131, (4) the fundamentals of I-131 dosimetry, (5) overview of whole body and lesional dosimetry, (6) simplified dosimetry, (7) review of the literature, and (8) recommendations for determination of prescribed activity of I-131 for differentiated thyroid cancer. This chapter will not discuss dosimetry for selection of prescribed activity of I-131 for Graves’ disease, autonomous nodule, or nontoxic multinodular goiter.
Anterior Cervical Discectomy and Fusion Outcomes over 10 Years: A Prospective Study.

Study Design.Prospective cohort study with >10-year follow-up.Objective.To assess the long-term, >10-year clinical outcomes of anterior cervical discectomy and fusion (ACDF) and to compare outcomes based on primary diagnosis of disc herniation, stenosis or advanced degenerative disc disease (DDD), n
Abstract 3752: Fabrication and validation of anin vitrobone marrow microenvironment for the study of prostate cancer progression

Metastasis is responsible for the vast majority of cancer deaths, motivating the investigation of how the disease progresses in the face of each obstacle put forth by the body. While disseminated tumor cells (DTCs) are detected in the bone marrow of many prostate cancer patients, only 1% of DTCs yield macrometastases. There is pressing need for an in vitro system to study the characteristics of the interactions with the microenvironment that influence prostate cancer progression. High-throughput DNA-directed single-cell patterning was used to create an in vitro bone-marrow microenvironment that provides replicates of these miniature systems within an easy-to-images conventional chamber slide. This system enables the study of the contributions of several cell types present in the bone marrow microenvironment. Cell types in the in vitro system to be represented by cell lines include bone cells (osteoblasts and osteoclasts), cells of hematopoietic lineage (macrophages, osteoclasts), and endothelial cells. Optimization strategies for cell culture conditions, pattern design, and fabrication parameters will be described as well the incorporation of prostate cancer cells to study cell-cell interactions. Applying high-throughput DNA-directed cell-patterning system yielded a highly complex cellular system that can be used to answer open questions about prostate cancer metastasis. Citation Format: Molly Kozminsky, Lydia Sohn. Fabrication and validation of an in vitro bone marrow microenvironment for the study of prostate cancer progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3752.
Leveraging the outpatient pharmacy to reduce medication waste in pediatric asthma hospitalizations

Background and objective Previous local quality improvement focused on discharging patients with inhaled corticosteroids (ICS) "in-hand" decreased healthcare reutilization after hospitalization for an asthma exacerbation. However, as a result of these new processes, some patients admitted for an asthma exacerbation received more than one ICS inhaler during their admission, contributing to medication waste and potential patient confusion regarding their discharge medication regimen. We sought to decrease this waste. Methods We conducted a quality improvement project to reduce the prescribing of multiple ICS inhalers to patients at a large academic children's hospital. Our primary outcome measure was the monthly percentage of patients admitted with an asthma exacerbation who were administered more than one ICS inhaler. A secondary outcome measure evaluated the reliability of the new process of using the hospital-based outpatient pharmacy to supply ICS "in-hand" and verify insurance coverage. After the process map review, we hypothesized a delay in the initial ICS treatment decision would allow for both a finalized discharge medication plan and a standardized process to verify outpatient insurance coverage. Results The mean percentage of patients receiving more than one ICS inhaler decreased from our baseline of 7.4% to 0.7%. Verification of outpatient prescription insurance coverage via the outpatient pharmacy increased from 0.7% to 50%. The average inpatient cost (average wholesale price) for ICS decreased by 62% to $90.25. Conclusions Our process change to use the outpatient pharmacy to dispense and verify insurance coverage for ICS medication was associated with a reduction in medication waste during admission for an asthma exacerbation.
What happens when formal and informal norms conflict for it usage

An increasingly common source of conflict arises from formal organizational norms regarding technology that may clash with an individual's personal norms. When formal norms are established to prote...
Psychosocial Bullying Among Nurse Educators: Exploring Coping Strategies and Intent to Leave

PURPOSE To examine the incidence of workplace bullying among nurse educators and explore potential relationships between workplace bullying, professional demographics, coping strategies, and intent to leave. DESIGN The investigator used a cross-sectional, descriptive, correlational design and Bronfenbrenner's Process-Person-Context-Time model to examine workplace bullying among nurse educators in the northeastern United States. METHODS A web-based survey was utilized to collect data from a final sample of 470 nurse educators from nine states in the northeastern United States. The instruments included a demographic section, followed by the Negative Acts Questionnaire-Revised (NAQ-R), the Coping Strategy Indicator (CSI), and a three-item job intent turnover questionnaire. Descriptive and parametric statistics were generated for data analysis. FINDINGS Forty-five percent (n = 212) of participants self-identified as targets of bullying in the workplace within the preceding 6 months. The most frequently reported negative acts encountered among the nurse educators surveyed were being excluded, having one's opinion ignored, and being exposed to an unmanageable workload. Furthermore, statistically significant relationships were identified between workplace bullying and coping strategies (r = .53: p < .01) and intent to leave (r = .58: p < .01) among nurse educators. CONCLUSIONS Workplace bullying among nurse educators is a serious problem impacting the profession. Heightened awareness and diverse initiatives targeting workplace bullying can positively impact retention of qualified nurse educators. CLINICAL RELEVANCE Findings from this study may contribute to the development of strategies to mitigate the effects of psychosocial bullying and enhance retention of nurse educators.
Inpatient Specialty-Level Palliative Care Is Delivered Late in the Course of Hepatocellular Carcinoma and Associated With Lower Hazard of Hospital Readmission.

Abstract Context Little is known about receipt of specialty-level palliative care by people with hepatocellular carcinoma (HCC) or its impact on health care utilization. Objectives Identify patient characteristics associated with receipt of specialty-level palliative care among hospitalized HCC patients and measure association with time to readmission. Methods We used logistic regression to examine relationships between receipt of inpatient palliative care consultation by HCC patients at an academic center (N = 811; 2012–2016) and clinical and demographic covariates at index hospitalization. We used a survival analysis model accounting for competing risk of mortality to compare time to readmission among individuals who did or did not receive palliative care during the admission and performed a sensitivity analysis using kernel weights to account for selection bias. Results Overall, 16% received inpatient palliative care consults. Those who received consults had worse laboratory values than those who did not. In a multivariable model, higher Model for End-Stage Liver Disease Sodium, receipt of sorafenib, and higher pain scores were significantly associated with increased odds of palliative care, whereas liver transplantation and admission to a surgical service were associated with lower odds. For time to readmission (2076 hospitalizations for 811 individuals with 175 palliative care visits), the subhazard ratio for readmission for patients who received consults was 0.26 (95% CI = 0.18–0.38) and 0.35 (95% CI = 0.24–0.52) with a kernel-weighted sample. Conclusion Inpatient palliative care consultation was received by individuals with more advanced disease and associated with lower readmission hazard. These findings support further research and the development of HCC-specific programs that increase access to specialty-level palliative care.
CRISPR-Cas9 multiplex genome editing of the hydroxyproline-O-galactosyltransferase gene family alters arabinogalactan-protein glycosylation and function in Arabidopsis

Arabinogalactan-proteins (AGPs) are a class of hydroxyproline-rich proteins (HRGPs) that are heavily glycosylated (> 90%) with type II arabinogalactans (AGs). AGPs are implicated in various plant growth and development processes including cell expansion, somatic embryogenesis, root and stem growth, salt tolerance, hormone signaling, male and female gametophyte development, and defense. To date, eight Hyp-O-galactosyltransferases (GALT2–6, HPGT1–3) have been identified; these enzymes are responsible for adding the first sugar, galactose, onto AGPs. Due to gene redundancy among the GALTs, single or double galt genetic knockout mutants are often not sufficient to fully reveal their biological functions. Here, we report the successful application of CRISPR-Cas9 gene editing/multiplexing technology to generate higher-order knockout mutants of five members of the GALT gene family (GALT2–6). AGPs analysis of higher-order galt mutants (galt2 galt5, galt3 galt4 galt6, and galt2 galt3 galt4 galt5 gal6) demonstrated significantly less glycosylated AGPs in rosette leaves, stems, and siliques compared to the corresponding wild-type organs. Monosaccharide composition analysis of AGPs isolated from rosette leaves revealed significant decreases in arabinose and galactose in all the higher-order galt mutants. Phenotypic analyses revealed that mutation of two or more GALT genes was able to overcome the growth inhibitory effect of β-D-Gal-Yariv reagent, which specifically binds to β-1,3-galactan backbones on AGPs. In addition, the galt2 galt3 galt4 galt5 gal6 mutant exhibited reduced overall growth, impaired root growth, abnormal pollen, shorter siliques, and reduced seed set. Reciprocal crossing experiments demonstrated that galt2 galt3 galt4 galt5 gal6 mutants had defects in the female gametophyte which were responsible for reduced seed set. Our CRISPR/Cas9 gene editing/multiplexing approach provides a simpler and faster way to generate higher-order mutants for functional characterization compared to conventional genetic crossing of T-DNA mutant lines. Higher-order galt mutants produced and characterized in this study provide insight into the relationship between sugar decorations and the various biological functions attributed to AGPs in plants.
Low Noise Amplifier With 7-K Noise at 1.4 GHz and 25 °C

This article describes a low noise amplifier which is believed will have a transformative impact because of the following characteristics: 1) the noise temperature at a physical temperature of 25 °C is a factor of 4 lower than typical commercial LNAs; 2) the noise decreases to 4.5 K at a temperature of −40 °C, a temperature realizable with solid-state coolers; 3) the LNA has an integrated, extremely stable noise source to facilitate measurement of system noise temperature; and 4) the amplifier is powered by a dc voltage and controlled by a tone signal on the RF output cable thus requiring no additional wiring. The amplifier benefits systems in the low microwave frequency range with low background temperature, such as those for space communications and radio astronomy, but without the capital and maintenance costs of cryogenic systems. This article describes the construction and test results with an emphasis on the manufacturability and accuracy of the noise measurements. Finally, the noise of a system deploying the LNA is described.
Procurement, Reduction, and Use of Lithic Technology from ca. 9500–11,800 Years Ago at Niidhaayh Na’, Central Alaska

The middle Tanana Valley near Fairbanks, Alaska has been the subject of nearly a century of archaeological research focused on the earliest inhabitants of the region. Recent research at Niidhaayh N...
Semantic Memory and Psychological Semantics

Publisher Summary This chapter presents a theoretical approach to semantic memory, which is applicable to a wide range of semantic phenomena. The chapter discusses the topic of semantic memory in psycholinguistic perspective and then demonstrates how semantic propositions are verified. A semantic feature representation is first assumed, which distinguishes between defining and characteristic features. This representation is then coupled with a two-stage processing model, and then the resulting Feature Comparison model is applied to the results of studies requiring the verification of simple subset statements. This model offers an explicit explanation of semantic relatedness and category size effects in this paradigm. The Feature Comparison model is then extended to accommodate findings from recent Same-Different experiments. The extended model proves capable of encompassing a range of semantic relatedness findings, including some newly reported effects which seem problematic for other models. The basic Feature Comparison model is applied for the verification of simple property statements. While the representation of property information necessitates several new structural and processing considerations, the basic model provides an explanation of various semantic effects on verification.
Snow as an accumulator of air pollutants

Using simple analytical techniques, the amounts of air pollutants accumulated in winter snow were determined and the results correlated with lichen survival on trees. Pollutants measured were particulate matter, sulfate, and chloride. An inverse relationship was found between amounts of each of these pollutants and the abundance of various lichens.
Experimental Methods: A Primer for Economists

List of figures and tables Preface Acknowledgments 1. Introduction 2. Principles of economics 3. Experimental design 4. Human subjects 5. Laboratory facilities 6. Conducting an experiment 7. Data analysis 8. Reporting your results 9. The emergence of experimental economics Appendices Glossary References Index.
The metabolic cost of mounting an immune response in male brown anoles (Anolis sagrei).

The tradeoff between reproduction and survival is central to life-history theory and is thought to reflect underlying energetic tradeoffs between reproduction and self-maintenance. Immune responses to parasites and pathogens are important components of self-maintenance in many species, but whether these defenses impose significant energetic costs has only been tested in a handful of organisms. We tested for a metabolic cost of mounting an immune response in the male brown anole (Anolis sagrei), a lizard in which we have previously shown that reproduction causes a marked reduction in immune response to the novel antigen phytohaemagglutinin (PHA). We treated captive male anoles with a subcutaneous injection of either PHA, which induces an immune response that manifests as localized swelling, or saline vehicle as a control. Prior to injection and at 24, 48, and 72 hr post-injection, we measured swelling at the site of injection and whole-animal resting metabolic rate (RMR) using stop-flow respirometry. Although we detected a robust swelling response to PHA at 24, 48, and 72 hr post-injection, mean RMR did not differ between treatments at any of these time points. However, within the PHA treatment group, RMR increased with the extent of swelling, suggesting a variable metabolic cost that scales with the magnitude of the induced immune response. Although individual anoles varied considerably in the extent to which they responded to PHA challenge, our results suggest that an immune response can impose a substantial metabolic cost (potentially as much as 63% above baseline RMR) for individuals that do respond maximally. J. Exp. Zool. 323A: 689-695, 2015. © 2015 Wiley Periodicals, Inc.
Usefulness of texture features for segmentation of lungs with severe diffuse interstitial lung disease

We developed an automated method for the segmentation of lungs with severe diffuse interstitial lung disease (DILD) in multi-detector CT. In this study, we would like to compare the performance levels of this method and a thresholdingbased segmentation method for normal lungs, moderately abnormal lungs, severely abnormal lungs, and all lungs in our database. Our database includes 31 normal cases and 45 abnormal cases with severe DILD. The outlines of lungs were manually delineated by a medical physicist and confirmed by an experienced chest radiologist. These outlines were used as reference standards for the evaluation of the segmentation results. We first employed a thresholding technique for CT value to obtain initial lungs, which contain normal and mildly abnormal lung parenchyma. We then used texture-feature images derived from co-occurrence matrix to further segment lung regions with severe DILD. The segmented lung regions with severe DILD were combined with the initial lungs to generate the final segmentation results. We also identified and removed the airways to improve the accuracy of the segmentation results. We used three metrics, i.e., overlap, volume agreement, and mean absolute distance (MAD) between automatically segmented lung and reference lung to evaluate the performance of our segmentation method and the thresholding-based segmentation method. Our segmentation method achieved a mean overlap of 96.1%, a mean volume agreement of 98.1%, and a mean MAD of 0.96 mm for the 45 abnormal cases. On the other hand the thresholding-based segmentation method achieved a mean overlap of 94.2%, a mean volume agreement of 95.8%, and a mean MAD of 1.51 mm for the 45 abnormal cases. Our new method obtained higher performance level than the thresholding-based segmentation method.
Ayahuasca use in cross-cultural perspective.

(2005). Editors' Introduction: Ayahuasca Use in Cross-Cultural Perspective. Journal of Psychoactive Drugs: Vol. 37, Ayahuasca Use In Cross-Cultural Perspective, pp. 119-121.
Diagnosis, treatment, and analysis of long-term outcomes in idiopathic normal-pressure hydrocephalus.

Objective The response to shunt surgery for idiopathic normal-pressure hydrocephalus (INPH) is variable because INPH is difficult to distinguish from other conditions causing the same symptoms. To date, no clinical picture or diagnostic test can distinguish INPH or predict response to cerebrospinal fluid (CSF) shunt surgery. We reviewed our 10-year experience with INPH to characterize long-term outcome and to identify independent predictors of outcome after shunt surgery. Methods Patients were classified as having INPH only if they had: 1) ventriculomegaly, 2) two or more INPH clinical features, 3) no risk factor for secondary normal-pressure hydrocephalus, 4) A- or B-waves on CSF pressure monitoring, and 5) clinical improvement during a 3-day CSF drainage trial via a spinal catheter. Independent predictors of outcome were assessed via a multivariate proportional hazards regression analysis. Results One hundred thirty-two patients underwent 179 shunt surgeries. Forty-four (33%), 79 (60%), and 99 (75%) patients demonstrated objective improvement 3, 6, and 24 months after shunt surgery, respectively. Gait improved first in 88 (93%) patients. Dementia and urinary incontinence were twofold less likely to improve. Radiological evidence of corpus callosum distension, gait impairment as the primary symptom, and shorter duration of INPH symptoms predicted improvement. Duration of symptoms and gait as the primary symptom were independent predictors by multivariate analysis. Conclusion INPH can be diagnosed accurately with CSF pressure monitoring and CSF drainage via a spinal catheter. CSF shunting is safe and effective for INPH with a long-term shunt response rate of 75%. Independent predictors of improvement are the presence of gait impairment as the dominant symptom and shorter duration of symptoms.
Physiological basis of myocardial perfusion imaging with the technetium 99m agents

In recent years, several technetium 99m-labeled myocardial perfusion agents have been under investigation to determine their utility in assessing regional myocardial blood flow and cellular viability. 99m Tc sestamibi (2-methoxyisobutyl isonitrile), one of the most promising of these agents, is a lipophilic cation that is sequestered largely within mitochondria by the large negative transmembrane potential. Experimental studies have shown that this agent is taken up in the myocardium in proportion to blood flow, but like other diffusible radionuclides underestimates flow at high flow rates. Fractional extraction (E max ) for 99m Tc sestamibi is lower than that for thallium 201, but net myocardial uptake is comparable between the two radionuclides. Compared with 201 Tl, 99m Tc sestamibi does not significantly redistribute. Studies have shown that 99m Tc sestamibi uptake after reperfusion, preceded by varying periods of coronary occlusion, reflects the degree of myocardial salvage and viability. 99m Tc teboroxime, another promising new perfusion agents, is a boronic acid adduct of technetium dioxime complexes. E max of 99m Tc teboroxime is higher than E max for 201 Tl, but myocardial washout is very rapid (half-life=21 minutes). Myocardial uptake is proportional to regional flow as found with 99m Tc sestamibi and 201 Tl.