cssi/SciSciGPT-SciSciNet huggingface dataset:
Characterizing sleep disorders in chronic hemodialysis patients

Forty-eight chronic hemodialysis (HD) patients (pts) completed questionnaires that used linear analogue scales (LAS), yes/no responses, and demographic data collection to characterize sleep disorders. Twenty-five pts (52%) reported problems sleeping. These pts graded sleep problems significantly higher than those without sleep problems (6.5 +/- 3 vs. 1.8 +/- 2, p less than 0.001 by LAS). Those with sleep disorders were more likely to smoke cigarettes (13/25 vs. 6/23, p less than 0.05) and have bone pain (14/25 vs. 6/23, p less than 0.05). No differences among pts with and without sleep problems were seen in age, gender, time on dialysis, caffeine intake, pruritus, feelings of sadness, worry, or anxiety, or Kt/V values (1.5 +/- 0.2 vs. 1.4 +/- 0.2, p less than 0.13). Restless legs (84%), onset insomnia (76%), and nighttime (76%) and early A.M. waking (72%) characterized the sleep disorders; symptoms suggesting nocturnal myoclonus were less common (20%). We conclude that sleep disorders are common in HD pts and may be exacerbated by tobacco use, bone pain, and restless legs. Kt/V does not correlate with sleep disorders. Further examination of this problem, including formal sleep studies, is needed.
Factors Influencing Diaphragmatic Compound Motor Action Potentials During Cryoballoon Ablation for Atrial Fibrillation.

Introduction The diaphragmatic compound motor action potentials (CMAPs) have been used to predict and prevent phrenic nerve injury (PNI) during cryoballoon ablation of right pulmonary veins. We sought to assess factors that influence the amplitude of the surface CMAP recordings. Methods and Results We analyzed CMAPs from consecutive patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation. CMAP recordings were obtained using ECG electrodes positioned in the “modified lead I” method while stimulating the right PN, until loss of capture (ascertained by palpation and fluoroscopy of the right hemi-diaphragm). A total of 55 patients (age 63±11 yrs; 60% men; BMI 31±6) had adequate CMAP recordings and were included for evaluation of CMAP signals. CMAPs demonstrated two distinct components, an early higher amplitude signal (pacing artifact) and a later lower amplitude signal (true diaphragmatic CMAP). There was no significant change in the true CMAP recording amplitude with decrease in stimulus strength (p = 0.1). There was no impact of BMI on CMAP amplitude (p = 0.93). There was a significant phasic respiratory variation in CMAP amplitude with a mean decrease in CMAP amplitude of 10.8% (range: 8–12%) with inspiration lasting an average of 2 beats (p 30% was noted in 6 cases (11%) and termination of cryoablation prevented PNI. Conclusion Diaphragmatic CMAP amplitude is not affected by stimulus strength or BMI. There is a significant respirophasic decrease in CMAP signal amplitude with inspiration. It is important to be aware of this variation to avoid premature termination of cryoablation. This article is protected by copyright. All rights reserved
A high speed superscalar PA-RISC processor

A novel processor implementing Hewlett-Packard's PA-RISC 1.1 (precision architecture-reduced instruction set computer) has been designed. A single chip implemented in a 0.8- mu m three-level metal CMOS technology includes the integer processor and a floating point coprocessor. The design operates at 100 MHz and is the first superscalar PA-RISC design. The processor cache is a large configurable memory implemented with industry standard SRAMs (static RAMs). High performance is achieved by high-frequency operation and a variety of techniques used to reduce the average number of cycles per instruction. >
Dynamic Phosphorylation of Apoptosis Signal Regulating Kinase 1 (ASK1) in Response to Oxidative and Electrophilic Stress

Apoptosis signal-regulating kinase 1 (ASK1) is a critical cellular stress sensor that senses diverse reactive chemotypes and integrates these chemical signals into a single biological pathway response. It is unknown whether ASK1 senses all stressors in the same way or if unique stress-specific mechanisms detect distinct chemotypes. In order to answer this question, we treated ASK1-expressing cells with two distinct stress activators, H2O2 and 4-hydroxy-2-nonenal (HNE), and monitored the phosphorylation state of ASK1. Phosphorylation is an important regulator for the activity of ASK1, and we hypothesized that these two chemically distinct molecules may produce differences in the phosphorylation state of ASK1. Shotgun mass spectrometry and manual validation identified 12 distinct ASK1 phosphosites. Targeted parallel reaction monitoring assays were used to track the phosphorylation dynamics of each confirmed site in response to treatment. Eleven phosphosites exhibited dynamic response to one or both treatments. Six of these sites were identified in both H2O2- and HNE-treated cells, and four of these exhibited a consistent response between the two molecules. The results confirm that different chemotypes produce distinct phosphorylation patterns in concert with activation of a common MAPK pathway.
Dynamical Behavior of Dislocations

The most important single property of a dislocation is its mobility. For a given applied stress, this can be very high as in a weakly bonded crystal like talc, or very low as in tightly bonded diamond. The large ratio (of order 108), as well as the sensitivity of dislocation mobility to impurities, temperature, other dislocations, etc., makes a simple universal description of it unlikely. However, certain limiting cases can be described in a simple way and intermediate cases can be interpolated. This will be attempted here.
Disaster preparedness among opioid treatment programs: Policy recommendations from state opioid treatment authorities

Abstract Recent natural disasters in the US have demonstrated the enormous potential for opioid treatment programs (OTP) to be rendered inoperable, disrupting methadone dispensing for their patients. Discontinuation of dispensing has severe consequences for OTP patients, ranging from withdrawal, resumption of injection behaviors bearing risk of blood-borne disease transmission, and overdose risk. Interviews with OTP directors, staff, and patients generated a set of recommendations for strengthening OTP disaster preparedness which were then presented to 15 state opioid treatment authorities (SOTAs) from disaster-prone US states. SOTAs’ responses to recommendations were analyzed and then discussed with representatives of the Drug Enforcement Agency (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA). Findings include an enumeration of concrete improvements to disaster preparedness and point to the need for greater clarity within states about the SOTA's role and regulatory authority and greater interagency cooperation to overcome misconceptions and obstacles to implementation.
Distributed Parameter Control Design for Vibrating Beams Using Generalized Functions

Abstract The application of polyvinylidene fluoride (PVF 2 ) film to beams for the purpose of active vibration control is investigated for general boundary conditions and non-uniform spatial distributions. The film offers the possibility of formulating control laws without the necessity of modelling the beam in terms of its component vibrational modes. Lyapunov's direct method is used to derive the control laws. The analysis demonstrates that, while for most boundary configurations a spatially uniform control is appropriate, pinned-pinned. clamped-sliding, and clamped-clamped beams require non-uniform spatial distributions to be controllable. Candidate distributions are presented for these configurations. As a result of the investigation a set of guidelines is deduced for the design of non-uniform spatial film distributions.
Exchange of Gramicidin between Lipid Bilayers: Implications for the Mechanism of Channel Formation

The canonical mechanism of gramicidin (gA) channel formation is transmembrane dimerization of nonconducting subunits that reside in opposite bilayer leaflets. The channels do not open and close; they appear and disappear due to subunit association and dissociation. Many different types of experiments support this monomer ↔ dimer mechanism. Recently, however, this mechanism was challenged, based on experiments with lipid vesicle-incorporated gA under conditions where vesicle fusion could be controlled. In these experiments, sustained channel activity was observed long after fusion had been terminated, which led to the proposal that gA single-channel current transitions result from closed-open transitions in long-lived bilayer-spanning dimers. This proposal is at odds with 40 years of experiments, but involves the key assumption that gA monomers do not exchange between bilayers. We tested the possibility of peptide exchange between bilayers using three different types of experiments. First, we demonstrated the exchange of gA between 1,2-dierucoyl-sn-glycero-3-phosphocholine (DC22:1PC) or 1,2-dioleoyl-sn-glycero-3-phosphocholine (DC18:1PC) lipid vesicles using a fluorescence assay for gA channel activity. Second, we added gA-free DC22:1PC vesicles to both sides of planar DC18:1PC bilayers preincubated with gA, which reduced channel activity up to 10-fold. Third, we added gA-containing DC22:1PC vesicles to one or both sides of DC18:1PC planar bilayers, which produced much higher channel activity when the gA-containing vesicles were added to both sides of the bilayer, as compared to one side only. All three types of experiments show that gA subunits can exchange between lipid bilayers. The exchange of subunits between bilayers thus is firmly established, which becomes a crucial consideration with respect to the mechanism of channel formation.
Negative-Pressure Wound Therapy: Principles and Usage in Orthopedic Surgery

Negative-pressure wound therapy (NPWT) is being increasingly used in the management of different types of wounds over the last few decades. It relies on generating a negative pressure on the surface of the wound, which is believed to promote wound healing. Although NPWT is used for various types of chronic wounds, acute wounds, and surgical incisions, not all types of wounds may benefit from NPWT. A thorough understanding of the principles of NPWT is crucial for its appropriate use. This chapter reviews the basic concepts of NPWT and the current evidence in support of its use in various surgical fields, especially orthopedic trauma, total joint arthroplasty (TJA), and orthopedic oncology. NPWT is widely used in trauma patients especially when there are large soft-tissue defects precluding primary closure. The NPWT is also used as prophylactic dressing after hip and knee arthroplasty in high-risk patients. However, well-conducted trials are needed in the future to give definitive answers regarding the clinical superiority of NPWT over the conventional less expensive dressings.
The Role of Postoperative Imaging after Orbital Floor Fracture Repair

Obtaining postoperative images of maxillofacial fractures does not affect the clinical management of asymptomatic patients; however, few studies have evaluated the role of postoperative imaging in the context of orbital floor fractures. In this study, we evaluate current practice techniques and the role of postoperative imaging in the management of orbital floor fractures in isolation and with concomitant facial fractures. Retrospective review of patients who underwent open reduction and internal fixation of orbital floor fractures between 2005 and 2015 at a single medical institution. Operative and perioperative records were reviewed to characterize postoperative imaging as routine or as indicated by concerning clinical symptoms, and to correlate clinical outcomes to postoperative imaging patterns across all identified orbital floor fractures. A total of 139 patients underwent open reduction and internal fixation of orbital floor fractures. Of these, 75 (54%) had zygomaticomaxillary (ZMC) involvement. The remaining 64 (46%) were isolated orbital floor fractures. Overall, 54 (39%) patients underwent postoperative imaging. Of these, 38 (70%) had postoperative imaging in the absence of concerning clinical symptoms. There was no observed difference in complication rates in those who underwent postoperative imaging, and those who did not. Patients with orbital + ZMC fractures underwent a significantly higher number of postoperative imaging studies (p
Aging, Inheritance, and Gift-Giving

Publisher Summary The topic of inheritance has taken on new meaning in social discourses on aging within numerous disciplines in the social and behavioral sciences. Understanding the social dimensions of giving across generations is key to understanding how changes in traditional expectations and practices will affect family life in general, and how adult children and their elderly parents will receive support, as they grow older. Inheritance and bequests can have a significant impact on retirement security and quality of life as people grow older. The two dominant explanations of motivations for intergenerational transfers (altruism and exchange) have interesting implications for the expected relationship between public and private transfers before and after death. This chapter provides a basic understanding of what is known about the concept of inheritance and gift-giving in terms of how older people balance the competing claims of helping family members during their lifetimes, saving for old age, and leaving a meaningful inheritance. One study of family inheritance practices based on in-depth interviews of late-life families examines differences based on social characteristics in exchange patterns, the feelings of commitment toward performing roles and to meeting filial obligations, and the extent to which economic factors constrain the decision to give gifts in later life. Further study of the social implications of inheritance for baby boomers and generations to come is also needed, including analyses of the impact of wealth transfers among family members during their lifetimes as well as at death.
Hormonal Physiology of the Ovary and Adrenal Cortex

The central mission of the ovary is to provide fertilizable ova, but it also has a complicated secondary agenda, made possible by the fact that it secretes steroidal and possibly nonsteroidal hormones: (1) the long-term project, beginning in intrauterine life and extending through puberty, of developing the genital organs and the secondary sex characteristics; (2) the preparation, during each cycle, of the genital tract for reception of sperm and the transport and implantation of the fertilized ovum; (3) the nurture of the oocyte and the provision of factors necessary for controlling meiotic division; and (4) participation in the refined dialogue with pituitary and hypothalamus that makes possible the specifically human phenomenon of single ovulation.
Characterizing porosity in bone-like porous media from frequency dependent attenuation

Osteoporosis affects both pore size and density in cortical bone. Quantifying levels of osteoporosis by inferring these micro-architectural properties from ultrasonic wave attenuation in cortical bone has yet to be done. Here, we propose a phenomenological power law model that captures the dynamics of frequency dependent attenuation in non-absorbing porous media mimicking a simplified cortical bone structure. We first demonstrate that, although it is frequency dependent, apparent absorption does not depend upon pore density and pore concentration, justifying the use of non-absorbing media for the simulations. We generate scattering attenuation data for various combinations of pore diameters (ranging from 20 to 100 μm) and pore densities (ranging from 3 to 10 pore/[mm]2) using a 2D FDTD package (Simsonic), which simulates the propagation of elastic waves at frequencies of 1–8 MHz. The model is then optimized to fit these datasets by solving an inverse problem under an ordinary least squares (OLS) framework. With this we establish linear, functional relationships between the optimized power law model parameters and the micro-architectural parameters. These relationships showed that ranges of porosity could be inferred from attenuation data. Applying these techniques to attenuation data from cortical bone samples could allow one to characterize the micro-architectural properties of bone porosity.
Total synthesis of micrococcin P1 and thiocillin I enabled by Mo(VI) catalyst

Thiopeptides are a class of potent antibiotics with promising therapeutic potential. We developed a novel Mo(vi)-oxide/picolinic acid catalyst for the cyclodehydration of cysteine peptides to form thiazoline heterocycles. With this powerful tool in hand, we completed the total syntheses of two representative thiopeptide antibiotics: micrococcin P1 and thiocillin I. These two concise syntheses (15 steps, longest linear sequence) feature a C-H activation strategy to install the trisubstituted pyridine core and thiazole groups. The synthetic material displays promising antimicrobial properties measured against a series of Gram-positive bacteria.
Normal Speech and Hearing by Age 5 as a Goal for Children With Cleft Palate

The authors report the results of a 4-year project to influence speech and hearing outcomes, employing direct program-management strategies with both multidiscipline professionals and family member...
Accuracy of Pressure Manometers on Resuscitation Devices From Various Manufacturers

Background: Monitoring pressure while ventilating patients using manual resuscitation devices is important to prevent lung injury and gastric inflation. Our goal for this study is to determine whether each device9s pressure manometer reading is accurate when compared to what is being measured inside the lung. Our hypothesis is that there will be no difference between the pressures on the manometers and the four targeted pressures, also there will be no difference between each device. Methods: A model composed of a single adult Michigan Instruments Test lung with a compliance of 0.015 (L/cm H2O), a 22-mm adapter in line, and a Michigan Instruments Pneuflo Resistor of 5 (cm H2O/L/s) was used to test each device. A software program called Pneuview3 was used to graph delivered pressures over time inside the test lung. A single investigator static held each device until the graph on the Pneuview3 software remained constant for two seconds, while targeting pressures of 10, 20, 30, and 40 cm H2O with 0 PEEP. Three trials were conducted for each device at the four targeted pressures. The devices that were used include the Air Flow Manual Resuscitator/Ventilator (Vent Lab, Grand Rapids, MI), the Adult BVM, the Neo-Tee, and Reusa-Tee T-Piece Resuscitators (Mercury Medical, Clearwater, FL) and the Neo-Puff T-Piece Resuscitator (Fisher & Paykel, Tamaki, New Zealand). Results: All resuscitation device pressure manometers were significantly different from one another (P=.001), except the Neo-Tee and NeoPuff (P=. 137). The pressure manometer on the Reusa-Tee by Mercury Medical tested to be the most accurate of all devices tested with an average of 1.01 cm H2O difference than the targeted pressures. The Vent Lab BVM tested to be the least accurate of all devices tested with an average of 8.65 cm H2O difference than the target pressures. In general, accuracy decreased as ventilating pressure increased. Conclusions: All devices tested had a less than 5 cm H2O difference than the targeted pressure except the Vent Lab BVM. The majority of the devices manometers proved to be accurate when targeting the four specific pressures. Having an accurate pressure manometer helps clinicians insure that proper ventilation of the lungs is occurring while minimizing hazards and complications.
The effects of ligand deprotonation on the binding selectivity of the phenylalanine hydroxylase active site

Abstract There are many targets for dopaminergic molecules in the body; these molecules can activate or inhibit these targets with beneficial or detrimental effects. Phenylalanine hydroxylase (PheOH) is a tetradydrobiopterin-dependent monooxygenase that converts phenylalanine into tyrosine. Both phenylalanine and tyrosine are important components in the anabolism of dopamine. A deficiency of PheOH or inhibition of the enzyme can cause hyperphenylalaninemia, which gives rise to phenylketonuria (PKU), a disease that can cause severe cognitive side effects. A suite of dopaminergic derivatives has been developed to be tested in the PheOH active site. The inhibitory effectiveness of these dopaminergic derivatives on PheOH has been measured via in silico models, in which the interaction energies between each substrate and the enzymatic active site were calculated. A crystal-structure of the PheOH active site, with bound thienylalanine—a known inhibitor—was isolated from the Protein Data Bank (PDB ID: 1KW0). The positions of novel dopaminergic derivatives were optimized in the active site using M062X/6-31G with implicit solvation and with flexible amino acid side-chains. Interaction energies between the ligands and the protein were calculated using M062X with the 6–311+G* basis set. We report promising novel catechols that do not inhibit this enzyme. Results show deprotonation of the ligands by the active site can strongly affecting their binding strength, thus the pKas for all novel ligands were calculated and are reported.
Impacts of Distributed Energy Resources and Load Models on Conservation Voltage Reduction

Several studies and field tests have shown the potential of conservation voltage reduction (CVR) to decrease peak demand, energy consumption, and system losses. Nonetheless, the energy savings achievable by CVR is dependent on the load model, which could be constant power, current, impedance, or any combination of these models. Also, the use of distributed energy resources (DERs) at the distribution level presents a challenge to successful CVR implementation as these resources could cause voltage fluctuations in the system. This paper studies the impact of load models on CVR implementation in a distribution system feeder interfaced with renewable DERs. Load flow analyses are carried out using constant power (PQ) and constant impedance (Z) load models, respectively, and the resulting effects on feeder losses and energy consumption are observed as CVR is implemented. In addition, the impacts of DERs and voltage regulation devices on the feeder voltage profile are analyzed. The feeder losses showed opposite trends with constant PQ and Z loads as CVR is implemented. Overall, the results showed varied impacts of load models and DER output on feeder losses, energy consumption, and bus voltages in the distribution network.
Placement disruption in foster care: Children’s behavior, foster parent support, and parenting experiences

Abstract Background The majority of children in foster care 24 months or longer experience three or more placements. Children’s behavior problems are a primary contributor to multiple moves, but little is known about how behavior problems and other stressors lead to disruptions. This study focused on foster parents’ experiences of parenting a child at risk for moves using the determinants of parenting model (Belsky, 1984) to identify potential correlates of difficult parenting experiences and placement disruption. Objective To identify factors associated with difficult parenting experiences and placement disruption. Participants Foster parents (N = 139) caring for children age 8–14 in long term foster care with a history of two or more moves were randomly selected in a large Midwestern state in the U.S. Methods Participants completed a 90-minute telephone interview (86% response rate). Placement moves were tracked prospectively for two years. Parenting experiences and disruption were analyzed using multiple and logistic regression. Results Results support aspects of the determinants of parenting model. Behavior problems, children’s risk to others, low support, and stress were significantly associated with more difficult parenting experiences (βs = .28, .22, .18, .19, respectively, ps Conclusions These findings support attending to foster parents’ parenting experiences, children’s risk to others, social support and stress to better support placements of children at risk for disruption.
SoK: Security Evaluation of Home-Based IoT Deployments

Home-based IoT devices have a bleak reputation regarding their security practices. On the surface, the insecurities of IoT devices seem to be caused by integration problems that may be addressed by simple measures, but this work finds that to be a naive assumption. The truth is, IoT deployments, at their core, utilize traditional compute systems, such as embedded, mobile, and network. These components have many unexplored challenges such as the effect of over-privileged mobile applications on embedded devices. Our work proposes a methodology that researchers and practitioners could employ to analyze security properties for home-based IoT devices. We systematize the literature for home-based IoT using this methodology in order to understand attack techniques, mitigations, and stakeholders. Further, we evaluate \numDevices devices to augment the systematized literature in order to identify neglected research areas. To make this analysis transparent and easier to adapt by the community, we provide a public portal to share our evaluation data and invite the community to contribute their independent findings.
Localized corrosion of low-carbon steel at the nanoscale

Mitigating corrosion remains a daunting challenge due to localized, nanoscale corrosion events that are poorly understood but are known to cause unpredictable variations in material longevity. Here, the most recent advances in liquid-cell transmission electron microscopy were employed to capture the advent of localized aqueous corrosion in carbon steel at the nanoscale and in real time. Localized corrosion initiated at a triple junction formed by a solitary cementite grain and two ferrite grains and then continued at the electrochemically-active boundary between these two phases. With this analysis, we identified facetted pitting at the phase boundary, uniform corrosion rates from the steel surface, and data that suggest that a re-initiating galvanic corrosion mechanism is possible in this environment. These observations represent an important step toward atomically defining nanoscale corrosion mechanisms, enabling the informed development of next-generation inhibition technologies and the improvement of corrosion predictive models.
Whole building life cycle environmental impacts and costs: A sensitivity study of design and service decisions

Abstract Improvements in building performance have focused on improving the energy efficiency of buildings, while, more recently, impacts associated with material production have also gained interest across the industry. However, emerging issues surrounding sustainability and resilience of buildings warrant a more holistic understanding of building design. This study presents a framework for the quantitative assessment of a range of sustainability and resilience performance aspects during early building design. The framework brings together a multitude of developed methods such as environmental life cycle assessment, life cycle costing, energy modeling, and seismic loss assessment to estimate the energy, water, and material-related environmental and economic costs. The framework is then used to conduct a sensitivity study investigating the potential shifts in the importance of various design and service aspects related to buildings. The main novelty is the broader consideration of building-scale and regional-scale energy and water services along with other typically considered building design features, and the consideration of regional seismic hazards for lifetime repairs. The results reinforce the long-known significance of use phase energy consumption for environmental impacts but show how the energy source type overshadows typical energy-efficiency design aspects, which are also less cost-effective considering the current state of the electricity market. The results also show the potentially significant contribution of different wastewater treatment scenarios on the environmental impacts of buildings and the changes in the share of embodied material impacts across locations. The presented framework could be used more broadly for a holistic building assessment useful for early design decision making.
Simulation and Analysis of Quality of Service (QoS) of Voice over IP (VoIP) through Local Area Networks

A Local Area Network is designed and simulated to investigate the effect of Quality of Service (QoS) on the performance of the network. The experiment examines the performance of non-QoS scenario and QoS scenario. Voice Jitter, Voice Mean Opinion Score value, Voice Packet End-to-End Delay, Voice Packet Delay Variation, Voice traffic received, and Voice traffic sent are used as performance parameters. The result demonstrates that QoS scenario outperformed non-QoS scenario. Therefore, the Quality of Service (QoS) has improved the overall performance of the network.
System Level Synthesis via Dynamic Programming

System Level Synthesis (SLS) parametrization facilitates controller synthesis for large, complex, and distributed systems by incorporating system level constraints (SLCs) into a convex SLS problem and mapping its solution to stable controller design. Solving the SLS problem at scale efficiently is challenging, and current attempts take advantage of special system or controller structures to speed up the computation in parallel. However, those methods do not generalize as they rely on the specific system/controller properties.We argue that it is possible to solve general SLS problems more efficiently by exploiting the structure of SLS constraints. In particular, we derive dynamic programming (DP) algorithms to solve SLS problems. In addition to the plain SLS without any SLCs, we extend DP to tackle infinite horizon SLS approximation and entrywise linear constraints, which form a superclass of the locality constraints. Comparing to convex program solver and naive analytical derivation, DP solves SLS 4 to 12× faster and scales with little computation overhead. We also quantize the cost of synthesizing a controller that stabilizes the system in a finite horizon through simulations.
A Florida public health-based endocrine clinic for low-income pregnant women with diabetes.

Objectives To evaluate pregnancy outcomes of low-income women with diabetes-complicated pregnancies who received care from an embedded, public health-based endocrine specialty clinic (ESC) in Florida. Design This program evaluation used retrospective chart data to analyze client characteristics, pre-program and during-program glycemic control, and pregnancy outcomes of women enrolled in a prenatal ESC. Sample Ninety-two low-income, pregnant women with type 1/type 2 diabetes or gestational diabetes (GDM) comprised this racially/ethnically diverse sample. Variables/analysis Neonatal outcomes included frequencies of prematurity, hypoglycemia, hyperbilirubinemia, and birth weight-for-gestational-age categories. Differences in maternal HbA1C at program entry and mean HbA1C during ESC care were determined by a Wilcoxon and paired sample t test. Results HbA1C levels during ESC care (6.9 ± 1.4) were less than program entry HbA1C levels (7.9 ± 1.8) for women with pregestational diabetes (Z = -3.364, p = .001). Among women with GDM, mean HbA1C values during ESC care (5.5 ± 0.4) did not significantly differ (t(51) = -0.532, p > .05) from program entry HbA1C levels (5.5 ± 0.5), suggestive of glycemic goal achievement. No neonatal hypoglycemia or hyperbilirubinemia cases were observed in both groups. Approximately 11% of births were preterm, and 16% of neonates were large-for-gestational-age. Conclusions A public health-based ESC for low-income pregnant women with diabetes may positively affect pregnancy outcomes.
Landscaping preferences influence neighborhood satisfaction and yard management decisions

Abstract Residential landscapes support human well-being and ecological functioning in urban ecosystems. Trees and native plants in yards and neighborhoods positively influence satisfaction, an important component of human well-being and quality of life. However, these patterns may not hold true in arid ecoregions, where the composition of desert vegetation contrasts the tall, broad-leafed trees of temperate regions. The effects of xeric, desert-like landscaping on satisfaction with the neighborhood environment are especially important to consider given the large amount of resources required to support people’s propensity for grassy yards. Although place satisfaction is related to pro-environmental behavior, the multi-scalar relationship between yard management decisions and satisfaction with the neighborhood environment has yet to be established. Here, we test the social-ecological dynamics of landscape preferences, satisfaction with trees and desert plants, and management intensity in residential yards and neighborhoods throughout the desert city of Phoenix, Arizona, USA. We found that wealthy neighborhoods close to desert open space were intensively managed and supported the highest levels of satisfaction. However, there was no direct relationship between satisfaction and management intensity for people who preferred xeric landscaping. Instead, management intensity for people with xeric preferences was related to demographics, such as income and home ownership. There was a relationship between satisfaction and management intensity for people with mesic preferences, suggesting a resource cost to maintain satisfaction for lush, green landscaping in a desert city. Overall, our study supports the assertion that changing yard landscaping may not result in desired changes for high-input management practices.
Combined Medicine-Pediatrics Fellowships: A Guide for Fellowship Directors and Residents.

Dual training in Internal Medicine-Pediatrics (MedPeds) was recognized by the American Board of Medical Specialties in 1967. Residents complete 24 months each in Internal Medicine and Pediatrics and are board-eligible for both at the conclusion of training. Graduates are eligible for fellowships in either or both fields. Many graduates pursue fellowship training. A small absolute number of graduates apply for dual training in adult and pediatric subspecialties, but those that do bring direct, in-depth clinical experience across the lifespan, and familiarity with care in both pediatric and adult settings. As such, they contribute unique perspectives and capabilities to their fellowship and future practice. This includes the ability to provide subspecialty care in settings with limited resources, where they are able to address needs without age restrictions, and in the transition of subspecialty care for emerging adults with childhood-onset conditions. Due to the small number of applicants pursuing joint adult and pediatric fellowships, many fellowship directors may have limited experience with dual fellowships but may want to create opportunities for these unique trainees. This summary was developed jointly by residents, fellows, MedPeds program directors, and fellowship directors in Pediatrics and Internal Medicine subspecialties, and approved by their respective leadership councils to offer some key points on common questions, suggest additional resources, and share best practices, with a goal of facilitating this process for fellowship programs and residents alike.
Home Health Nurses’ Journey Toward Culture-Sensitive/Patient-Centered Skills: A Grounded Theory Study:

Introduction. Home health patients, who are members of minority and vulnerable groups, suffer disparate outcomes. Patient-centered care (PCC) and culturally-competent care (CCC) aim to facilitate h...
The Denier in Chief: Faith in Trump and Techniques of Neutralization in a Pandemic

Based on a March 28–29, 2020 MTurk survey (N = 1,000), the current study examined how faith in President Donald Trump’s statements downplaying the risks and his responsibility for the COVID-19 pand...
Association Between Cumulative Low-Density Lipoprotein Cholesterol Exposure During Young Adulthood and Middle Age and Risk of Cardiovascular Events.

Importance Low-density lipoprotein cholesterol (LDL-C) is a major risk factor for cardiovascular disease (CVD). Most observational studies on the association between LDL-C and CVD have focused on LDL-C level at a single time point (usually in middle or older age), and few studies have characterized long-term exposures to LDL-C and their role in CVD risk. Objective To evaluate the associations of cumulative exposure to LDL-C, time-weighted average (TWA) LDL-C, and the LDL-C slope change during young adulthood and middle age with incident CVD later in life. Design, Setting, and Participants This cohort study analyzed pooled data from 4 prospective cohort studies in the US (Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Framingham Heart Study Offspring Cohort, and Multi-Ethnic Study of Atherosclerosis). Participants were included if they had 2 or more LDL-C measures that were at least 2 years apart between ages 18 and 60 years, with at least 1 of the LDL-C measures occurring during middle age at 40 to 60 years. Data from 1971 to 2017 were collected and analyzed from September 25, 2020, to January 10, 2021. Exposures Cumulative exposure to LDL-C, TWA LDL-C, and LDL-C slope from age 18 to 60 years. Main Outcomes and Measures Incident coronary heart disease (CHD), ischemic stroke, and heart failure (HF). Results A total of 18 288 participants were included in this study. These participants had a mean (SD) age of 56.4 (3.7) years and consisted of 10 309 women (56.4%). During a median follow-up of 16 years, 1165 CHD, 599 ischemic stroke, and 1145 HF events occurred. In multivariable Cox proportional hazards regression models that adjusted for the most recent LDL-C level measured during middle age and for other CVD risk factors, the hazard ratios for CHD were as follows: 1.57 (95% CI, 1.10-2.23;Pfor trend = .01) for cumulative LDL-C level, 1.69 (95% CI, 1.23-2.31;Pfor trend Conclusions and Relevance This cohort study showed that cumulative LDL-C and TWA LDL-C during young adulthood and middle age were associated with the risk of incident CHD, independent of midlife LDL-C level. These findings suggest that past levels of LDL-C may inform strategies for primary prevention of CHD and that maintaining optimal LDL-C levels at an earlier age may reduce the lifetime risk of developing atherosclerotic CVD.
Social Support for Nonconformity

Publisher Summary This chapter aims to improve the understanding of the underlying processes responsible for the effectiveness of social support as a means of producing nonconformity. The term “social support” refers to the presence of one person in a group who gives a response that agrees with the subject's private belief or perception—in a word, a partner. Although social support is a very effective technique for reducing conformity to the group, other approaches to conformity reduction are also possible. One could argue that simply reversing the direction of the variables that increase conformity would, in like manner, result in a decrease in conformity. The chapter discusses the generalization of nonconformity. Within-content generalization does appear to occur even when the subject is alone, provided the partner does not actually change his pattern of answering and begin to agree with the group. Under the broad classification of social and cognitive factors, several experiments have been reported that examined the psychological mechanisms hypothesized to account for the social support effect. Among the social factors that contribute to the effectiveness of social support are the expected reactions of the group and attribution of the causal locus of dissent to situational rather than to dispositional sources. Cognitive factors shown to contribute to the effectiveness of social support include a restructuring of the meaning of the stimulus and the response, and independent assessment of physical and social reality. Relationship with the social supporter has also been discussed in the chapter.
Relaxation of dilute polymer solutions following extensional flow

Abstract The relaxation of dilute polymer solutions following stretch in uniaxial extensional flow is investigated via Brownian dynamic simulations of a flexible freely-draining bead-rod chain. The bead-rod chain simulations are compared to Brownian dynamic simulations of a FENE dumbbell and numerical calculations of a FENE-PM chain. A universal relaxation curve for the stress decay from steady-state is found by shifting the results to lie on the curve described by the relaxation of an initially straight chain. For all the models investigated, the initial rapid decay of the polymer stress decreases at a rate which scales for large Weissenberg number, Wi as Wi 2 . Our universal curve is in good qualitative and in some cases quantitative agreement with the available experimental data: it is particularly good in predicting decay after stretch at the largest strains. We find hysteresis in comparing the stress versus birefringence during the startup of flow and subsequent relaxation for the bead-rod chain and FENE dumbbell, but not for the FENE-PM chain. The hysteresis in the latter model is lost in the preaveraging of the nonlinear terms. The bead-rod model also displays a configuration hysteresis. The hysteresis observed in these models is in qualitative agreement with recent experiments involving polystyrene-based Boger fluids.
Institute of Food Technologists (IFT) Education Division Competition 2013 Winner‐A Consumer's Guide to Probiotics: A Glimpse into the Big Picture of a Microscopic World

One of the core competencies in the Institute of Food Technologists (IFT) education standards is for students to achieve competency in communication skills (that is, oral and written communication, listening, interviewing, and so on). According to the IFT guidelines, by the time students graduate, they should not only be able to search for and condense information, but also be able to “communicate technical information to a nontechnical audience.” The Education Division of IFT sponsors a writing competition for undergraduate students to bring attention to and promote the development of communication skills. It has been shown that employees/entry-level scientists who can communicate technical and nontechnical concepts succinctly will be in a better position to achieve management status after entering the work force. Monetary prizes are awarded to the authors of the top three papers. A revised version of the winning entry is published in the Journal of Food Science Education for dissemination to a world-wide audience.
Effects of Border Price Changes on Agricultural Wages and Employment in Mexico

This paper measures the impact of North American Free Trade Agreement–induced real border price changes of Mexican imports and exports on wages and employment of agricultural workers in Mexico. I find that changes in real border prices of crops did not affect agricultural wages. On the other hand, increases in the real price of vegetables (main agricultural export) were associated with an increase in employment in the cultivation of vegetables, whereas the drop in the real price of corn (main agricultural import) reduced the employment in the corn sector. This is in line with the predictions of neoclassical trade theory: in the absence of mobility costs or sector-specific skills, factors moved smoothly from import-competing sectors into export-competing sectors. Copyright © 2012 John Wiley & Sons, Ltd.
Cuts in Cartesian Products of Graphs

The k-fold Cartesian product of a graph G is defined as a graph on k-tuples of vertices, where two tuples are connected if they form an edge in one of the positions and are equal in the rest. Starting with G as a single edge gives G^k as a k-dimensional hypercube. We study the distributions of edges crossed by a cut in G^k across the copies of G in different positions. This is a generalization of the notion of influences for cuts on the hypercube. We show the analogues of results of Kahn, Kalai, and Linial (KKL Theorem [KahnKL88]) and that of Friedgut (Friedgut's Junta theorem [Friedgut98]), for the setting of Cartesian products of arbitrary graphs. Our proofs extend the arguments of Rossignol [Rossignol06] and of Falik and Samorodnitsky [FalikS07], to the case of arbitrary Cartesian products. We also extend the work on studying isoperimetric constants for these graphs [HoudreT96, ChungT98] to the value of semidefinite relaxations for edge-expansion. We connect the optimal values of the relaxations for computing expansion, given by various semidefinite hierarchies, for G and G^k.
Medicare at Forty

This year marks the 40th anniversary of the Medicare Program. Medicare has achieved its two basic goals of ensuring access to care for elderly and disabled beneficiaries and protecting them from severe financial hardship. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 represents an important improvement by adding prescription drug coverage. Medicare's major future challenge is responding to the retirement of the baby boom generation and rising health care costs. Promising policy options should aim to ensure health and financial security for beneficiaries and proactively use Medicare's purchasing power to achieve greater efficiency and quality in health care for Medicare beneficiaries and all Americans. More policy attention needs to be focused on debating Medicare's future, a more complex issue than even Social Security.
A layered tin(II) phosphonate, [Sn(C6H5O3P)]n

Poly­[tin(II)-μ-phenyl­phospho­nato], [Sn(C6H5O3P)]n, was synthesized solvothermally at 423 K and crystallized in the monoclinic system, space group Cc. The inorganic layers consist of alternating pyramidal Sn and tetrahedral P centers, joined by doubly bridging O atoms. The corner-sharing SnO3 and PO3C6H5 polyhedra define a corrugated layer of six-membered rings. The layers are connected along the unique b axis by interdigitated phenyl rings of the phenyl­phospho­nate groups.
Focused ultrasound and immunotherapy

Thermal therapy has tremendous potential to augment the benefits of immunotherapy. The ability of heat to stimulate both general and tumor specific responses, in part through heat shock protein mediated mechanisms has been known for over two decades. Significant challenges persist however in translating these effects into predictable and meaningful clinical responses. More recently the association of radiation with immune stimulation and in some cases specific anti-tumor immune response has been defined.
A unique multifocal osteoblastoma-like tumor of the bones of a single lower extremity. Report of a case.

Osteoblastoma is a relatively uncommon benign bone-forming tumor. It usually arises in a long tubular bone or in the spine and it is virtually always solitary. Several variants have been described according to their particular morphological and clinical features 3 . We report a unique multifocal osteoblastoma-like tumor involving the bones of one lower extremity