cssi/SciSciGPT-SciSciNet huggingface dataset:
Preconditioning of Antarctic maximum sea-ice extent by upper-ocean stratification on a seasonal timescale

This study uses an observationally constrained and dynamically consistent ocean and sea ice state estimate. The author presents a remarkable agreement between the location of the edge of Antarctic maximum sea ice extent, reached in September, and the narrow transition band for the upper ocean (0–100 m depths) stratification, as early as April to June. To the south of this edge, the upper ocean has high stratification, which forbids convective fluxes to cross through; consequently, the ocean heat loss to the atmosphere is an efficient way to cool the surface ocean to the freezing point during April to September. To the north, the upper ocean has low stratification such that the ocean heat loss to the atmosphere is not efficient to cool the upper ocean. The upper ocean is instead cooled mainly through mixing with the colder inflow carried by northward Ekman transport but cannot reach the freezing point due to the nature of mixing. Therefore, upper ocean stratification, dominated by salinity here, provides an important constraint on the northward expansion of Antarctic sea ice to its maximum.
Palliative Care for Geriatric Psychiatric Patients with Life-Limiting Illness

Many geriatric psychiatric patients face life-limiting illness. Optimal palliative care which focuses on aggressive symptom management while exploring advance care planning to help anticipate goals of care begins at the time of diagnosis of disease and continues until the end of life. Major neurocognitive disorder is discussed as a terminal illness that merits early palliative care involvement as physical complications are anticipated as part of the natural progression of disease. As life-limiting illness progresses, psychiatrists are often asked to weigh in the management of delirium, depressive, anxiety, and substance abuse disorders in the palliative care setting. Diagnostic and treatment challenges arise in managing these disorders because of medical frailty and the overlap of symptoms related to disease progression. Psychiatrists may also be asked to participate in evaluating patients who request physician aid in dying.
Intracavitary therapies for upper tract urothelial carcinoma.

ABSTRACTIntroduction: While radical nephroureterectomy remains the gold-standard for upper tract urothelial carcinoma (UTUC), there is a growing push for organ-sparing therapy in low-risk disease. Herein we review the use of intracavitary topical therapy for treatment of UTUC.Areas covered: A PubMed search was performed for studies pertaining to upper tract urothelial carcinoma, with 236 articles reviewed, and distilled for content pertinent to intracavitary therapy for UTUC. Topics discussed include agents used for management of UTUC, most commonly BCG, as well as techniques for administration. Additionally, we review the evidence for curative treatment for Cis versus adjuvant therapy for Ta/T1 disease. Finally, we discuss emerging technologies to improve agent delivery and efficacy in the upper tract.Expert commentary: No significant advances have occurred in topical management of UTUC in the past 2 decades. However, advances in diagnostic techniques such as modern ureteroscopes, and improved diagnostic...
The role of PANSS symptoms and adverse events in explaining the effects of paliperidone on social functioning: a causal mediation analysis approach.

To date, no study has evaluated the joint role of symptoms and adverse events as mediators of the effect of second-generation antipsychotics on patients’ social functioning. We used recently developed methods for mediation analysis with multiple mediators to clarify the interplay of adverse events and symptoms in explaining the effects of paliperidone (R code for implementing the mediation analysis for multiple mediators is provided). We used data from 490 participants in a 6-week randomized dose–response trial that assigned three fixed dosages of ER OROS paliperidone (3, 9, and 15 mg/day). The primary outcome was an individual’s score on the social performance scale assessed after 6 weeks. The sum of Positive and Negative Syndrome Scale (PANSS), weight gain, and extrapyramidal symptoms measured via the Simpson–Angus Scale after 5 weeks were investigated as potential mediators and effect modifiers of treatment effects. Results from mediation analyses showed that the improvements in social functioning are partly explained by reduction in PANSS symptoms. Suggestive evidence that adverse events could play a role as mediators was found. In particular, weight gain displayed a non-linear relationship with social functioning, whereby beneficial effects observed at small levels of weight gain were reduced in the presence of excessive weight gain. In conclusion, we found that the short-term effects of paliperidone on social functioning were dependent on the successful reduction in PANSS symptoms and possibly the occurrence of excessive weight gain, thus suggesting future directions for treatment and interventions. People with schizophrenia who take the antipsychotic drug paliperidone show the greatest improvements in social functioning if their disease symptoms decrease and they experience small levels of weight gain. Linda Valeri from McLean Hospital in Belmont, Massachusetts, USA, and colleagues applied a statistical method called mediation analysis to study clinical data from a 490-person, 6-week trial involving an extended-release formulation of paliperidone. As expected, the researchers showed that an individual’s score on a social performance scale—the primary outcome in the trial—could be explained in part by reductions in both positive symptoms, such as hallucinations, and negative symptoms, such as apathy. But in addition, a “side effect” impacted social functioning in an inverted-U shaped manner, with modest increases in body weight proving beneficial but too many extra pounds having a detrimental effect.
Critical perspectives of animal agriculture: introduction.

The American Society of Animal Science has recently focused its attention on a variety of contentious issues in animal agriculture. This paper deals with critique, a philosophical approach to analyzing and understanding issues. This method has been employed by various contemporary philosophers. For example, feminist theorists have used this approach to critically analyze sexual harassment. Critique involves a critical analysis of the discourse (ideas or language) and practices that define the social reality in which we live. How we think about the world and how we behave in it determines how we humans interact with each other as well as with the rest of nature. This social structure is associated with power structures that benefit some individuals and harm others. In this paper, I demonstrate how critique can be used to better understand the social reality of animal agriculture. By analyzing certain popular texts in this field, I show that a mechanical view of nature is dominant in animal agriculture and argue that such a view contributes to a social reality that can be harmful to some humans and other animals. I conclude that various contentious issues can be better addressed when we engage in a critical analysis of this conceptual framework and base our analysis on the experiences of many different people, including those who have been harmed by our current system of animal agriculture.
Chemistry and Structure of Silver Molecular Nanoparticles.

ConspectusSilver and gold molecular nanoparticles (mNPs) are a relatively new class of molecular materials of fundamental interest. They are high-nuclearity metal–organic compounds, with ligated metal cores, where the different character of bonding in the ligand shell and metal core gives rise to many of the unique properties of these materials. Research has primarily focused on gold mNPs, due to their good stability and the ease with which they may be synthesized and processed. To understand these materials as a general class, however, it will be necessary to broaden research efforts to other metals. Gold and silver are isoelectronic and have the same atomic radius, making the comparison of gold and silver mNPs attractive. The optical and chemical differences of the two metals provide useful contrasts, however, as well as a means to access a wider range of properties.In this Account, we focus on the synthesis, structure, and reactivity of silver mNPs. First, we review the origins and history of the field...
Older Donors Portend Worse Survival in Older and Younger Recipients after Heart Transplant: A UNOS Database Analysis

Purpose Older donors are increasingly used in an effort to expand the donor pool in heart transplantation. We used the UNOS registry to examine the impact of older donors on the survival of recipients of different ages. Methods The UNOS/OPTN registry (2005-2017) was interrogated for adult patients who successfully underwent an initial heart transplant without other simultaneous transplants. Donors and recipients in the highest quartile of age were labeled as older, and those below this threshold were labeled younger. Four groups of donor-recipient pairs were created: (1) younger donor and younger recipient, (2) younger donor and older recipient, (3) older donor and younger recipient, and (4) older donor and older recipient. Overall survival was analyzed using Kaplan Meier and Cox proportional hazards models. Results A total of 23,750 patients met inclusion criteria. Donors and recipients over the age of 42 and 61 were defined as older, respectively. Older recipients were more likely to be Caucasian, have diabetes, and have malignancy. Older donors were more likely to be female, Caucasian, have a history of smoking, hypertension, and cancer, and have died from a stroke. Median survival in groups 1, 2, 3, and 4 was 13, 11, 12, and 10 years, respectively. In unadjusted and multivariable analyses, old donors were associated with worse survival compared to younger donors in both older and younger recipients (Fig. 1). Compared to group 1, group 3 (hazard ratio [HR] 1.31; 95% confidence interval [CI] 1.22, 1.40) had worse survival. Compared to group 2, group 4 (HR 1.31; 95%CI 1.24, 1.39) had worse survival. Compared to group 1, groups 3 (HR 1.35; 95%CI 1.26, 1.46), and 4 (HR 1.70; 95%CI 1.55, 1.86) had worse survival. Causes of death were similar across groups. Conclusion Donors over the age of 42 are associated with worse survival compared to younger donors in both younger and older recipients after heart transplant. Further research is needed to optimize allocation and use of older donor organs.
Arthroscopic Primary Repair in the Multiple-Ligament Injured Knee

The multiple-ligament injured knee (MLIK) includes a variety of severe injuries, in which at least two major knee ligaments are disrupted. Recommended treatment of each type of MLIK generally consists of reconstruction of all injured ligaments, which can successfully restore knee stability and function. Recently, arthroscopic primary repair has been increasingly performed in patients with either proximally or distally avulsed cruciate ligaments. In this selected group, the ligaments are arthroscopically reattached to their anatomical footprint. By using primary repair, native tissues are preserved, which maintains proprioceptive function and avoids graft harvesting with subsequent tunnel drilling, which ultimately could hasten recovery, reduce postoperative arthrofibrosis, and minimize the long-term risk of osteoarthritis. In this chapter, we discuss the (I) indications for primary repair in the MLIK, (II) surgical technique of primary repair of major knee ligaments, (III) postoperative management, (IV) historical and recent results of primary repair in the MLIK, and (V) two case examples.
Uniaxial tensile testing standardization for the qualification of fiber reinforced plastics for fused filament fabrication

AbstractFused filament fabrication (FFF) is a material deposition technique enabling the rapid production of on-demand, customized parts. To support the widespread implementation of FFF into manufa...
Bone Marrow Small Molecule Radioprotectors.

Abstract Development of small molecule radioprotectors is a major national priority. Two groups of compounds have particular promise. The first group targets the mitochondria based upon previous data with transgene MnSOD which when expressed in the mitochondria prevents apoptosis and increases radioprotection. These agents contain the antioxidant tempol or nitric oxide synthetase inhibitor 2-amino-5,6-dihydro-6-methyl-4H-1,3-thiazine (AMT) attached to a hemi-gramicidin linker which targets the mitochondria. The second group consists of the dietary agent resveratrol and acetylated variants. Mouse hematopoietic progenitor 32Dcl3 cells were incubated for 1 hr in 10 μM tempol, AMT, or gramicidin linked tempol XJB-5-125 (tempol), XJB-7-75 (tempol) or JP4-039 (AMT). In separate experiments, 32Dcl3 cells were incubated for 1 hr in resveratrol or acetylated resveratrol. The cells were then irradiated to doses ranging from 0 to 8 Gy, plated in 0.8% methylcellulose, and incubated in a 5% CO2 incubator for 7 days. Colonies of greater than 50 cells were counted with the data analyzed using linear quadratic or single-hit, multi-target models. 32Dcl3 cells incubated in 10 μm tempol before irradiation resulted in no change in radiation sensitivity while incubation in XJB-5-125 or XJB-7-75 had decreased radiosensitivity. XJB-5-125 had an increased Do of 1.91 ± 0.67 Gy compared to 1.32 ± 0.09 Gy for 32Dcl3 cells incubated in tempol and 1.35 ± 0.27 Gy for control 32Dcl3 cells (p = 0.045 or 0.040, respectively). Incubation in XJB-5-75 resulted in an increased shoulder on the survival curve with an n of 19.4 ± 2.6 compared to 8.7 + 1.6 for cells incubated in tempol or 6.9 +1.8 for control 32Dcl3 cells (p = 0.025 or 0.022). Incubation in JP4-039 resulted in an increased Do of 2.2 ± 0.1 Gy compared to 1.24 ± 0.15 or 1.13 ± 0.06 for cells incubated in AMT or control 32Dcl3 cells only, respectively (p = 0.0115 or 0.0098, respectively). Incubation of 32Dcl3 cells in resveratrol or acetylated resveratrol before irradiation resulted in an increased shoulder on the survival curve of 33.2 ± 5.7 or 57.5 ± 9.9, respectively, compared to 6.9 ± 1.8 for 32Dcl3 cells (p = 0.0122 or 0.0072, respectively). These compounds were tested in mice receiving an LD50/30 irradiation dose. C57BL/6NHsd mice were injected intraperitoneally with 10 mg/kg of XJB-5-125, XJB-7-75or JP4-039 or 25 mg/kg of resveratrol or acetylated resveratrol and irradiated 10 mins later along with control mice to 9.5 Gy whole body irradiation. The mice injected with XJB-5-125, XJB-7-75, JP4-039 or acetylated-resveratrol had increased survival compared to control irradiated mice (p ≤ 0.0004). Therefore, four new small molecules have been identified which demonstrate significant radioprotective properties both in vitro and in vivo.
Husserlian “Reduction” Seen from the Perspective of Phenomenological “Life” in the Ortegan School

In keeping with one of the announced purposes of this Congress (and most likely the main one) of assessing the scope of Husserlian intuitions in present-day phenomenological philosophies, disciplines, and arts, I propose to examine briefly in the following study some points of contact between Husserl and Ortega so as to be able to indicate in general way how the phenomenology of the great German thinker affected the Spanish philosopher.
Effect of minimum quantity lubrication and vortex tube cooling on laser-assisted micromilling of a difficult-to-cut steel:

Laser-assisted micromilling is a promising micromachining process for difficult-to-cut materials. Laser-assisted micromilling uses a laser to thermally soften the workpiece in front of the cutting ...
Energy-saving algorithm for data centre network based on genetic algorithm

This thesis focuses on network equipments in the data centre which has caused rapidly growth of energy consumption recent years. The switches account for the largest proportion of energy consumption of network equipments, so turning off unneeded switches can reduce energy consumption effectively. Based on this point, we develop a high-efficient routing algorithm based on genetic algorithm (GA) in order to improve energy consumption of network equipments. Genetic algorithm is a kind of a heuristic algorithm which solves the optimisation problem rapidly by imitating the way of the natural selection, but to a certain degree, it reduces accuracy. It is a complicated problem to decide routing path in a short period, so we choose genetic algorithm to achieve our goals. In our simulation, we make some improvements of GA in order to fit our problem and raise the accuracy of its solution.
Outcomes of reoperative surgery in severely obese patients after sleeve gastrectomy: a single-institution experience.

Abstract Background Despite its popularity, sleeve gastrectomy (SG) is not devoid of postoperative complications and weight regain. Some of these cases warrant conversion to Roux-en-Y gastric bypass or proximal gastrectomy with Roux-en-Y esophagojejunostomy. Complications after conversion are scarcely reported in the literature. Objectives Report and review the outcomes of reoperation on severely obese patients with weight regain or complications after SG. Setting Bariatric Surgery Center of Excellence; Community Hospital, United States. Methods We retrospectively reviewed the medical records of patients converted from SG to Roux-en-Y gastric bypass/proximal gastrectomy with Roux-en-Y esophagojejunostomy at our center, from 2004 to 2018. Patients were stratified by reason for conversion. Group A included those converted for complications (leaks, strictures, or gastroesophageal reflux disease) and group B for reported weight regain. Demographic characteristics, postoperative outcomes, and complications were described. Results From 77 conversions identified, 63.6% (n = 49) underwent primary SG at an outside hospital. We observed predominant female (68.8%; n = 53) and Caucasian (76.6%; n = 59) populations. Conversions for complications were performed in 67.5% (n = 52) and for weight regain in 32.4% (n = 25). The most common conversion indication in group A was chronic leak (29.9%; n = 23), followed by gastroesophageal reflux disease (20.8%; n = 16), and stricture (16.9%; n = 13). Overall, major complications occurred in 16.9% (n = 13) and minor complications in 19.4% (n = 15). In group A, most common major complications were anastomotic leak and organ space surgical site infection (3.9%; n = 2 each); the most common minor complication was nonperforated marginal ulcer (7.7%; n = 4). In group B, the most common major complication was perforated marginal ulcer (8%; n = 2); the most common minor complication was stricture (16%; n = 4). Group B mean preconversion body mass index was 38.4 ± 4.3 and percentage excess body mass index loss was 48 ± 33, 63 ± 45, 59 ± 63, and 73 ± 25 (12, 24, 36, ≥48 mo). Conclusions Our experience shows that major complications can occur in up to 17% of patients after conversion. Conversion to Roux-en-Y gastric bypass in nonresponders appears to be a safe and effective option for body mass index reduction.
Developing equations to predict waist circumference measurements based on the National Heart, Lung, and Blood Institute method from the World Health Organization method

Abstract Purpose The purpose of the study was to convert waist circumference (WC) measurements obtained by the World Health Organization (WHO-WC) method to the National Heart, Lung, and Blood Institute (NHLBI-WC) method. Methods During 2016, the National Health and Nutrition Examination Survey participants aged 20 years and older had two different WC measurements taken (n = 2405). The mean differences in the WC between the NHLBI-WC and WHO-WC measurements were calculated. Multivariable prediction models were developed to predict the NHLBI-WC from the measured WHO-WC. Sensitivity and specificity of the abdominal obesity classification (AOC) were calculated for the measured WHO-WC and the predicted NHLBI-WC. Kappa coefficients were calculated to evaluate the agreements between the AOC derived from the NHLBI-WC and from the WHO-WC and the predicted NHLBI-WC. Results The mean differences between the NHLBI-WC and WHO-WC were 0.8 cm for males and 3.2 cm for females (P ≤ .05). Sensitivity of the AOC for the measured WHO-WC was 93% for males and 87% for females, and the specificity of the AOC was 97% or greater for both genders. Sensitivity and specificity of the AOC for the predicted NHLBI-WC were 95% or greater for both genders. The AOC derived from the predicted NHLBI-WC had higher agreements for both genders. Conclusions The prediction equations provided may be used to predict the NHLBI-WC from the WHO-WC for comparability in WC estimates across studies.
Beyond clinical food prescriptions and mobile markets: parent views on the role of a healthcare institution in increasing healthy eating in food insecure families

Children in food-insecure families face increased barriers to meeting recommendations for fruit and vegetable consumption. Hospitals and pediatric healthcare institutions have attempted to alleviate food-insecurity through various internal programs like food prescriptions, yet little evidence for these programs exist. Consistent with a patient-centered perspective, we sought to develop a comprehensive understanding of barriers to fruit and vegetable consumption and a parent-driven agenda for healthcare system action. We conducted six qualitative focus group discussions (four in English, two in Spanish) with 29 parents and caregivers of patients who had screened positive for food-insecurity during visits to a large pediatric healthcare system in a midwestern U.S. city. Our iterative analysis process consisted of audio-recording, transcribing and coding discussions, aiming to produce a) a conceptual framework of barriers to fruit and vegetable consumption and b) a synthesis of participant programmatic suggestions for their healthcare system. Participants were 90% female, 38% Black/African American and 41% Hispanic/Latino. Barriers to fruit and vegetable consumption in their families fell into three intersecting themes: affordability, accessibility and desirability. Participant-generated intervention recommendations were multilevel, suggesting healthcare systems focus not only on clinic and community-based action, but also advocacy for broader policies that alleviate barriers to acquiring healthy foods. Parents envision an expanded role for healthcare systems in ensuring their children benefit from a healthy diet. Findings offer critical insight on why clinic-driven programs aimed to address healthy eating may have failed and healthcare organizations may more effectively intervene by adopting a multilevel strategy.
Emergence of wasp dope in rural Appalachian Kentucky.

Background and aims Recent reports have highlighted the emergence of 'wasp dope' as an issue of concern, but epidemiological evidence is lacking. Wasp dope is a crystalline substance created by electrifying pyrethroid-containing insecticides (e.g. wasp sprays) that may give users a methamphetamine-like 'rush'. This paper describes wasp dope use and correlates of use in a sample of people who use drugs (PWUD) in Appalachian Kentucky, a region that has been an epicenter of opioid use and related harms in the United States. Methods Respondent-driven sampling and targeted street outreach were used to recruit PWUD. Eligibility criteria included being aged at least 18 years, residing in one of five Appalachian Kentucky counties, and having either used opioids or injected any drug to get high in the prior 30 days. Interviewer-administered surveys queried participants' (n = 278) recent (past 6 months) wasp dope use, other substance use and demographic characteristics. Prevalence ratios (PR) were estimated using generalized estimating equations assuming a Poisson outcome distribution in a cross-sectional analysis. Results Recent wasp dope use was reported by 16.1% of participants. Men and people who recently experienced homelessness and transportation difficulties were twice or more as likely to have used wasp dope compared with their counterparts [PR = 2.08, 95% confidence interval (CI) = 1.11, 3.87, PR = 2.78, 95% CI = 1.64, 4.72 and PR = 2.01, 95% CI = 1.06-3.81, respectively]. While wasp dope use was associated with injection drug use and using opioids and other substances to get high in unadjusted analyses, the factor most strongly associated with wasp dope use was methamphetamine use (PR = 17.23, 95% CI = 2.57, 115.61), specifically methamphetamine injection (PR = 4.47, 95% CI = 1.56, 12.78). Conclusions Among people who use drugs in rural Kentucky, USA, more than one in six people surveyed reported using wasp dope in the past 6 months, nearing the percentage using cocaine/crack (20%) and fentanyl/carfentanil (25%). Wasp dope use was higher among men and strongly associated with homelessness, transportation access, methamphetamine use and injection drug use.
Donors, Buyers, and Information Disclosure in Crowdfunding Markets: A Case of Platform Split-up

Crowdfunding platforms, a fast-growing method for entrepreneurs to finance their ventures, are struggling in improving crowdfunding campaigns’ market performance as platforms expand to include more diverse participants. In this paper, the authors study how a platform policy that changes the platform size and backer composition (donors vs. buyers) influences the platform participant behaviors and the platform market outcomes, using an event study of Indiegogo’s launch of Generosity.com for charity campaigns. Their results show a higher probability of reaching funding goals and more funds collected for the Indiegogo platform's business campaigns after the platform split-up. Such changes are driven by fewer campaigns being launched on Indiegogo after the platform change, and more importantly, more costly campaign information (such as images and videos) provided by the campaign creators. Buyers are more sensitive to such campaign information and, therefore, contribute more to campaigns after the platform change. These results are consistent with the notion that the entrepreneurs’ information disclosure strategy is driven by potential backers’ motivations to support the campaign. The study provides rich and important managerial implications for platforms and their participants.
Electrodeposited metallic glasses with superlative wear resistance

Abstract The electrodeposition route to obtain amorphous alloys offers a facile, low-cost, and versatile alternative to conventional melt quenching. However, there are significant knowledge gaps in tribological properties and wear mechanisms for electrodeposited metallic glasses (EMGs). Here, the wear behavior and the scratch response of a model binary amorphous alloy system were investigated. Electrodeposited Ni–P metallic glasses were systematically studied as a function of composition, with amorphous alloy formation over the narrow range of 10 at% to 20 at% phosphorus. The electrodeposited metallic glasses showed hardness values in the range of 6.6–7.4 GPa, modulus in the range of 155–163 GPa, and friction coefficient around 0.50. Among the studied alloys, electrodeposited Ni80P20 showed the lowest wear rate, which was two orders of magnitude lower than electrodeposited pure Ni. The wear mechanism was determined to be extensive plastic deformation along with mild ploughing, micro tears, and formation of discontinuous lubricious oxide patches. Scratch tests showed an increase in critical load for damage initiation with the increase in phosphorus content among the amorphous alloys following the trend: Ni80P20 > Ni85P15 > Ni90P10. The overall wear rate for the electrodeposited metallic glasses was found to be lower than most reported bulk metallic glasses (BMGs). This represents a fundamental study on structure-property correlations in electrodeposited metallic glasses and demonstrates the versatility of electrodeposition in tuning the surface properties of amorphous alloys.
Long-term exposure to aircraft noise and risk of incident cardiovascular disease in the Women’s Health Initiative

Background: Aircraft noise is a persistent concern for communities surrounding airports. Studies have reported associations with cardiovascular disease (CVD), but few studies have been longitudinal...
Efficient randomized tensor-based algorithms for function approximation and low-rank kernel interactions.

In this paper, we introduce a method for multivariate function approximation using function evaluations, Chebyshev polynomials, and tensor-based compression techniques via the Tucker format. We develop novel randomized techniques to accomplish the tensor compression, provide a detailed analysis of the computational costs, provide insight into the error of the resulting approximations, and discuss the benefits of the proposed approaches. We also apply the tensor-based function approximation to develop low-rank matrix approximations to kernel matrices that describe pairwise interactions between two sets of points; the resulting low-rank approximations are efficient to compute and store (the complexity is linear in the number of points). We have detailed numerical experiments on example problems involving multivariate function approximation, low-rank matrix approximations of kernel matrices involving well-separated clusters of sources and target points, and a global low-rank approximation of kernel matrices with an application to Gaussian processes.
Thyroid Lobectomy for T1 Papillary Thyroid Carcinoma in Pediatric Patients.

Importance The current recommendation for pediatric patients with papillary thyroid cancer (PTC) is a total thyroidectomy. This recommendation applies to all stages of PTC, including papillary thyroid microcarcinoma (≤1 cm, T1a) tumors. Objective To evaluate the characteristics of American Joint Committee on Cancer T1 PTC tumors in a large pediatric population and to identify a subgroup of patients who may benefit from a thyroid lobectomy instead of a total thyroidectomy. Design, Setting, and Participants This retrospective cohort study was conducted from January 1, 2009, to May 31, 2020. The study took place at a tertiary care medical center and included 102 patients who were surgically treated for T1 PTC: 52 with stage T1a (≤1 cm) tumors and 50 with stage T1b (>1 cm but ≤2 cm) tumors. Main Outcomes and Measures Primary outcomes included the presence of bilateral disease and lymph node metastasis. Results A total of 102 patients (mean age, 15.3 years [range, 9.7-18.9 years]; 84 girls [82.4%]) were included in the analysis. Among 52 patients with T1a tumors, 10 (19.2%) had bilateral disease, and 15 (28.8%) had central neck lymph node (N1a) metastasis. Among 50 patients with T1b tumors, 10 (20%) had bilateral and 13 (26%) had N1a disease. Of those with T1a, unilateral multifocality was associated with bilateral disease (odds ratio [OR], 2.1; 95% CI, 1.3-3.4) and N1a disease (OR, 5.1; 95% CI, 1.5-17.6). Both N1a disease (OR, 20.0; 95% CI, 3.5-115.0) and ≥4 positive lymph nodes (OR, 8.6; 95% CI, 1.2-60.9) were associated with bilateral disease. In patients with no pathologic evidence of lymph node metastasis (N0), there was a 95% rate of unilateral PTC. In patients with T1b tumors, unilateral multifocality was also associated with bilateral disease (OR, 1.8; 95% CI, 1.3-2.7). Patients with T1b tumors had an increased risk of lateral (N1b) neck lymph node metastasis when compared with those with T1a tumors (OR, 3.7; 95% CI, 1.0-14.5). Conclusions and Relevance The findings of this cohort study suggest that, in patients with unifocal T1a PTC without clinically evident nodal disease on preoperative ultrasonography, a thyroid lobectomy and central neck dissection may be considered. If there is no evidence of unilateral multifocality or if there are fewer than 4 positive lymph nodes on postoperative pathology, then close observation may be considered. These findings have substantial clinical implications and may result in practice changes regarding the extent of thyroid surgery on low-stage pediatric PTC.
Deep Pelvic Side Wall Anatomy; A Case of Laparoscopic Management of Vaginal Vault Fistula to the Presacral Area

Study Objective Video presentation showing retroperitoneal dissection and deep pelvic side wall anatomy. Design Case presentation. Setting Tertiary medical center. Patients or Participants 74-year-old female with history of type 2 diabetes, hypertension, and a vaginal hysterectomy with left sacrospinous ligament suspension nine years ago, presented with fever and found to have bacteremia. Abdominal and pelvic MRI showed a presacral and precoccygeal loculated collections, sacral osteomyelitis, and fistula from the left superior vaginal vault to one of the presacral collections. Interventions Laparoscopic resection of sacrospinous fistula tract. Measurements and Main Results The patient showed significant improvement in her symptoms with resolution of low back pain, vaginal discharge and bleeding. Conclusion Gentle dissection with maintained hemostasis, creating windows, and starting from less distorted anatomy are key points in retroperitoneal dissection.
Public Health Data

Relying on coroners’ reports instead of police submissions, the Center for Disease Control and Prevention’s National Center for Health Statistics National Vital Statistics System presents another large system to report homicides. This chapter will describe the system, its benefits, and offers some comparisons to police data on murders.
Improving Browsing Performance: A study of four input devices for scrolling and pointing tasks

Navigating through online documents has become an increasingly common HCI task. This paper investigates alternative methods to improve user performance for browsing World Wide Web and other documents. In a task that involved both scrolling and pointing, we compared three input methods against the status-quo. The results showed that a mouse with a fmger wheel did not improve user’s performance; two other methods, namely a mouse with an isometric rate-control joystick operated by the same hand and a two handed system that put a mouse on the dominant hand and a joystick on the other, both significantly improved users’ performance. A human factors analysis on each of the three input methods is also presented.
The logic of well being. Therapeutic narratives in Cairo, Egypt.

Abstract This paper examines understandings of curative action among women in a traditional ( baladi ) quarter of Cairo, Egypt. It is based on research in a mother-childhealth (MCH) clinic and the surrounding urban area. It probes healing strategies and understandings revealed in therapeutic narratives. These narratives are commentaries on disease progression, curative action and surrounding events—both relevant and irrelevant. Fragments of narratives embedded in conversation are framed by stylistic shifts; they are eventually codified into elaborated accounts which are referenced for years after the illness episode. Therapeutic narratives present a system of knowledge which mediates between the everyday experience of diagnosis and curative action and the cultural context (ethnoetiology, ethnophysiology, concepts of fate and envy). They provide a biographic and experimental context for perception and diagnosis of illness. They also facilitate transformation of diagnosis and prognosis. The article presents baladi therapeutic narratives as a specific instance of a culture-wide phenomenon of ‘tacking down’ illness episodes to make sense of them. Discussion also highlights the baladi -specific curative system with its principles of regularity and fluidity, and the baladi -specific logic of proximity, specificity, and multiplicity which organizes baladi therapeutic narratives. Cases presented demonstrate how baladi women evaluate the meaning of experience and action while recounting illness episodes and how they corroborate their curative action with past experience and community standards. Through continual re-evaluation a finely woven web of rationale evolves as a woman with a difficult problem such as delayed conception or a persistently weak child moves through curing strategies. Diagnosis is always subject to revision; explanations of what is happening are constantly generated—whether in respect of mundane activity or of the event's meaning. Narrative recounting is the locus par excellence for the aggregation of cognitions concerning a whimsical universe where baladi people's main power lies in their skill at verbal manipulation. However, it is not used in lieu of action. Narratives provide an arena for the negotiation of reality and of correct action; they do not discount reality, but make sense of it.
Effects of feeding 4 levels of soy protein for 3 and 6 wk on blood lipids and apolipoproteins in moderately hypercholesterolemic men

Background: Replacing animal protein with soy protein has been shown to reduce total and LDL-cholesterol concentrations in humans. However, the minimum amount of soy protein required for significant reduction of blood lipids is not known. Objective: We evaluated the amount of soy protein needed to reduce blood lipids in moderately hypercholesterolemic men. Design: Eighty-one men with moderate hypercholesterolemia (total cholesterol concentration between 5.70 and 7.70 mmol/L) were studied. After a 3-wk lead-in on a Step I diet, total cholesterol was measured and subjects were randomly divided into 5 groups. For 6 wk, each group received 50 g protein/d, which included isolated soy protein (ISP) and casein, respectively, in the following amounts: 50:0, 40:10, 30:20, 20:30, and 0:50 (control group) g. Blood was collected at baseline and weeks 3 and 6 of the intervention. Results: At week 6, significant reductions (P <0.05) from baseline compared with the control group were found for non-HDL and total cholesterol and apolipoprotein (apo) B for all ISP groups (except total cholesterol with 40 g ISP). At week 3, significant reductions (P < 0.05) were found in apo B for the groups that consumed ≥30 g ISP and in non-HDL cholesterol for the groups that consumed ≥40 g ISP. HDL-cholesterol, apo A-I, lipoprotein(a), and triacylglycerol concentrations were not significantly affected by dietary treatment. Conclusion: Our findings show that consuming as little as 20 g soy protein/d instead of animal protein for 6 wk reduces concentrations of non-HDL cholesterol and apo B by 2.6% and 2.2%, respectively.
Dental Hygienists’ Perceptions of Barriers to Graduate Education

To advance the profession of dental hygiene, graduate education is necessary to support growth in research, education, administration, and practice in the discipline and to sustain credibility in a climate in which other health professions require entry-level master’s and doctoral degrees. The purpose of this study was to explore what dental hygienists perceive as barriers to pursuing a graduate degree. A survey was developed based on the literature and other national surveys. Data were collected from 160 respondents to the survey: 50 percent held an entry-level baccalaureate degree in dental hygiene, while the rest held an entry-level associate degree (48 percent) or certificate (2 percent) in dental hygiene. All respondents had completed a bachelor’s degree. The top five barriers these respondents identified in pursuing graduate education were as follows: 1) cost of graduate education, 2) family responsibilities are too great, 3) concerns about personal funding to pay for graduate education, 4) finding time for graduate school while working, and 5) fear of thesis research. Dental hygiene is one of the few health professions that still have entry-level degrees at the associate and baccalaureate levels. The profession needs to reduce such barriers to enable dental hygienists to pursue graduate education and thus ensure an adequate supply of future leaders, educators, and researchers.
Hemolytic anemia due to warm autoantibodies

The diagnosis of autoimmune hemolytic anemia (AHA) requires evidence of shortened red blood cell (RBC) survival mediated by autoantibodies directed against autologous RBCs. About 80 percent of patients with AHA have warm-reactive antibodies of the IgG isotype; the remainder exhibit cold-reactive autoantibodies. Typical patients exhibit anemia, reticulocytosis, spherocytes and polychromasia on the blood film and a positive direct antiglobulin test (DAT). Increased indirect serum bilirubin, urinary urobilinogen and serum lactate dehydrogenase (LDH), and decreased serum haptoglobin are not required for the diagnosis, but are frequently present. Patients with AHA and no underlying associated disease are said to have primary or idiopathic AHA. AHA in patients with associated autoimmune disease and certain malignant or infectious diseases is classified as secondary. The etiology of AHA is unknown. Patients with symptomatic anemia require transfusion of RBCs. Prednisone and splenectomy may provide long term remission. Rituximab, intravenous immunoglobulin, immunosuppressive drugs and danazol have been effective in refractory cases and for patients who are poor candidates for surgery.
Desulfurization of Jet Fuel JP-5 Light Fraction by MCM-41 and SBA-15 Supported Cuprous Oxide for Fuel Cell Applications

Desulfurization of a JP-5 light fraction (841 ppmw S) for on-board fuel cell applications was investigated by π-complexation adsorption with mesoporous SBA-15 and MCM-41 supported Cu2O. The effect of support and reduction temperature on the sulfur adsorption capacity was studied. The adsorbents were characterized with N2 physical adsorption and CO chemisorption. The results showed that the mesoporous structures of the support remained intact during adsorbent preparation. It was found that significant breakthrough occurred at 10.0 mL/g for desulfurization of the JP-5 light fraction by Cu2O/MCM-41 reduced at 700 °C. The MCM-41 was more effective than SBA-15 as the support for Cu2O adsorbents in desulfurizaiton of jet fuel. The sulfur adsorption capacity increased with the reduction temperature. The spent Cu2O/MCM-41 was regenerated by heating in air and the regenerated adsorbent was tested for reuse. The results showed that ∼100% of the sulfur capacity could be recovered.
Time-lapse Diffraction Tomography For Trigonal Meshes With Temporal Data Integration Applied to CO2 Sequestration Monitoring

Summary Time-lapse imaging has been successfully applied by oil industry for reservoir monitoring along the years. Another relevant application using similar theoretical background although with different purposes, is to monitor CO2 sequestration to detect possible leaks that may cause environmental impact. We propose to reduce the number of parameters and consequently to simplify the update surveys by two complementary key concepts: (1) keeping relevant information from previous surveys to be updated by a smaller new survey; (2) using adaptive trigonal mesh that is finer at predicted time-varying regions and coarser otherwise. To achieve our goals, we proposed an approach to integrate data from previous surveys joint with an adaptive trigonal mesh framework applied to diffraction tomography. We used these concepts to develop an inversion algorithm for CO2 sequestration monitoring, which successfully imaged a synthetic model using VSP geometry.
Osteochondroma (tracheobronchial choristoma) of the esophagus. Report of a case.

Osteochondroma (tracheobronchial choristoma) of the esophagus is a rare tumor. Survey of the literature revealed only one reported case in which an esophageal osteochondroma was known to have been removed during the patient's life. The case reported herein is another one of an esophageal osteochondroma that was successfully removed surgically. The possible explanations in pathogenesis of this unusual tumor are discussed and a brief review of the other benign esophageal tumors is given.
The importance of place: Unraveling the vulnerability of fisherman livelihoods to the impact of marine protected areas

Abstract Marine protected areas (MPAs) hold great promise as an effective conservation tool, but the potential negative socioeconomic impacts of MPAs remain poorly understood. Indeed, little work has been done to advance the frameworks and methods needed to assess, measure, and communicate the potential negative socioeconomic impact of MPAs and incorporate this information in MPA planning and management efforts. To address this gap, we test a vulnerability assessment termed the Livelihood Vulnerability Index (LVI) that is designed to measure the relative potential impact a proposed MPA network may have upon fisherman livelihoods. To test the LVI, specifically we ask, how does the vulnerability of fishermen to the impact of MPAs differ across place? We explore this question through two core areas of inquiry surrounding the study of vulnerability assessments: 1) Ranking and comparing vulnerability and 2) Explaining attributes of vulnerability. Through this study we demonstrate how the historical and current conditions fishermen experience in a given place shape vulnerability levels in various ways. Variability in the attributes of a particular place such as weather conditions, the size of fishing areas, availability of alternative fisheries, and changes in kelp cover contribute inherently as measures of vulnerability but they also shape fishermen perceptions of what are important measures of vulnerability. Secondly, counter to existing notions, the use of weights in vulnerability assessments may not significantly impact vulnerability scores and ranking. Together these findings emphasize the need to test vulnerability assessments against actual experienced impact or harm across geographies and groups of fishermen towards an informed refinement of vulnerability assessments. We emphasize that the particularities of place are critical to understand, to appropriately assess and thus to effectively mitigate vulnerability in order to promote the future well being of fisherman livelihoods.
Games and social network structure

We examine repeated games played among members of a society who are connected in a social network. Players can observe each others' play, but can only directly affect the payoffs of their social neighbors. We characterize the social network patterns that sustain repeated cooperative equilibrium behavior and are robust in various ways. High levels of cooperation can only be sustained as robust equilibria in specific sorts of social networks, and so analyzing repeated games can have strong implications for how social network structure affects its members' behaviors and welfare.
Quality in Inclusive and Noninclusive Infant and Toddler Classrooms

The quality of care in infant and toddler classrooms as compared across inclusive (n=64) and noninclusive classrooms (n=400). Quality was measured using the Infant/Toddler Environment Rating Scale-Revised (ITERS-R). An exploratory and confirmatory factor analysis revealed four distinct dimensions of quality within the ITERS-R. Inclusive classrooms were higher in quality on the overall scale as well as on three of the four factor-based scales. Teachers reported, on average, that children had mild to moderate disabilities. Correlational analyses indicated that neither having more children with disabilities nor having children with more severe disabilities was associated with higher or lower quality scores. Teacher education and teacher-child ratios were important predictors of quality. Information on low-scoring items on the Personal Care Routines subscale is also presented.