cssi/SciSciGPT-SciSciNet huggingface dataset:
Variability in the Perception of Informed Consent for IV-tPA during Telestroke Consultation

Objective:To study the perception of informed consent among various raters for thrombolysis in acute ischemic stroke patients receiving intravenous tissue plasminogen activator (IV-tPA). Methods:Twenty randomly selected videotaped telestroke consultations of acute stroke patients administered IV-tPA were retrospectively reviewed. Adequacy of informed consent was reviewed by five raters: a neurologist and emergency physician who routinely treat stroke, a medical risk management paralegal, a bioethicist, and a lay person. Raters assessed the quality of the informed consent presentation by the treating physician and the degree of understanding demonstrated by the patient/family authorizing consent. Factors associated with adequacy of consent were analyzed. Results: Consent was rated as adequately understood by the patient-family in 78.6% cases. Agreement between all five raters with regard to the patient-family understanding of consent was poor and also between the subgroups of non-physician and physician (all k < 0.20). Similarly, the quality of the physician consent process was poor for agreement between all five raters (kD 0.07) or between the subgroup of the three non-physician raters (kD 0.06) and fair between the two physician raters (kD 0.24). The legal reviewer and the bioethicist rated the physician consent process as being of lower quality than did the two physicians and the layperson. Conclusion: Despite high variability in the perception of informed consent among raters in this time-sensitive clinical situation, almost 80% of patients were rated by all reviewers as having adequate understanding of risks and benefits of tPA. This suggests the need for a standardized but brief tPA consent process that includes patient/family demonstration of understanding.
Properties of DU-10wt%Mo Alloys Subjected to Various Post-Rolling Heat Treatments

Abstract Studies were completed to obtain mechanical properties of depleted uranium–molybdenum (U–Mo) alloys subjected to different post-processing treatments using microhardness, quasi-static tensile tests, and scanning electron microscopy failure analysis. U–Mo alloy foils are currently under investigation for potential fuel conversion of high power research reactors to low enriched uranium fuel. Although mechanical properties take on a secondary effect during irradiation, an understanding of the alloy behavior during fabrication and the effects of irradiation on the integrity of the fuel are essential. In general, the microhardness was insensitive to annealing temperature but decreased with annealing duration. Yield strength, Young's modulus, and ultimate tensile strength were affected in varying manners with both increasing annealing temperature and duration, and subjecting the alloy to rolling. The failure mode was insensitive to annealing conditions, but was significantly controlled by the impurity concentration of the alloy, especially carbon. Values obtained from literature are also provided with reasonable agreement based on extrapolation of annealing duration, even though processing conditions and applications were quite different in some instances.
The Salesperson as Outside Agent or Employee: A Transaction Cost Analysis

This descriptive study explores the reasons for integration of the personal selling function, i.e., the use of employee (“direct”) salespeople rather than manufacturers' representatives (“reps”). A hypothesized model is developed based on both transaction cost analysis and the sales force management literature. Data from 13 electronic component manufacturers covering 159 U.S. sales districts are used to estimate a logistic model of the probability of “going direct” in a given district. Results are shown to be stable across specification and estimation methods and to fit the data well. The transaction cost model is generally supported. The principal finding is that the greater the difficulty of evaluating a salesperson's performance, the more likely the firm to substitute surveillance for commission as a control mechanism, i.e., to use a direct sales force. Among other findings, direct sales forces are also associated with complex, hard-to-learn product lines and with districts that demand considerable nonselling activities. Several factors prove unrelated, including company size, the amount of travel a district requires, and the importance of key accounts. This article was originally published in Marketing Science, Volume 4, Issue 3, Pages 234--254, in 1985.
Vibrational mode and collision energy effects on reaction of H2CO+ with CO2

The effects of collision energy (Ecol) and five different modes of H2CO+ vibration on the title reaction have been studied over the center-of-mass Ecol range from 0.1 to 3.2 eV, including measurements of product ion recoil velocity distributions. Electronic structure and Rice–Ramsperger–Kassel–Marcus calculations were used to examine properties of various complexes and transition states that might be important along the reaction coordinate. Two product channels are observed, corresponding to Hydrogen Transfer (HT) and Proton Transfer (PT). Both channels are endothermic with similar onset energies of ∼0.9 eV; however, HT dominates over the entire Ecol range and accounts for 70–85% of the total reaction cross section. Both HT and PT occur by direct mechanisms over the entire Ecol range, and have similar dependence on reactant vibrational and collision energy. Despite these similarities, and the fact that the two channels are nearly isoenergetic and differ only in which product moiety carries the charge, their dynamics appear quite different. PT occurs primarily in large impact parameter stripping collisions, where most of the available energy is partitioned to product recoil. HT, in contrast, results in internally hot products with little recoil energy and a more forward–backward symmetric product velocity distribution. Vibration is found to affect the reaction differently in different collision energy regimes. The appearance thresholds are found to depend only on total energy, i.e., all modes of vibration are equivalent to Ecol. With increasing Ecol, vibrational energy becomes increasingly effective, relative to Ecol, at driving reaction. For HT, this transition occurs just above threshold, while for PT it begins at roughly twice the threshold energy.
Census of Genes Expressed in Porcine Embryos and Reproductive Tissues by Mining an Expressed Sequence Tag Database Based on Human Genes

Abstract A total of 98 898 expressed sequence tags (ESTs) derived from embryos and reproductive tissues in pigs were identified in the GenBank “est_others” database. Pig embryos were collected at 11, 12, 13, 14, 15, 20, 30, and 45 days after gestation. The reproductive tissues were sampled from testis, ovary, endometrium, hypothalamus, anterior pituitary, uterus, and placenta. A gene-oriented approach was developed to annotate these porcine EST sequences to census the genes expressed from these sources. Of the 33 308 mRNA sequences from the human genes used as references (data accessed on 1 November 2002), 9410 had the porcine EST homologs expressed in embryos and 11 795 had the EST homologs expressed in reproductive tissues. The entire genome contributes at least 28.3% of its genes to embryo development and 35.4% of its genes to reproduction. Using the EST entry numbers as indicators of gene expression, we determined that the gene expression patterns differ significantly between embryos and reproductive ...
Knowledge discovery in large image databases: dealing with uncertainties in ground truth

This paper discusses the problem of knowledge discovery in image databases with particular focus on the issues which arise when absolute ground truth is not available. The problem of searching the Magellan image data set in order to automatically locate and catalog small volcanoes on the planet Venus is used as a case study. In the absence of calibrated ground truth, planetary scientists provide subjective estimates of ground truth based on visual inspection of Magellan images. The paper discusses issues which arise in terms of elicitation of subjective probabilistic opinion, learning from probabilistic labels, and effective evaluation of both scientist and algorithm performance in the absence of ground truth. Data from the Magellan volcano detection project is used to illustrate the various techniques which we have developed to handle these issues. The primary conclusion of the paper is that knowledge discovery methodologies can be modified to handle lack of absolute ground truth provided the sources of uncertainty in the data are carefully handled.
Joint phy-mac design for opporunistic spectrum access with multi-channel sensing

This paper addresses the design of opportunistic spectrum access (OSA) where secondary users are allowed to sense and access multiple channels in the spectrum without causing unacceptable interference to primary users. Integrated in OSA design are a spectrum sensor at the physical (PHY) layer and a sensing and an access strategy at the MAC layer. Within the framework of partially observable Markov decision process, we develop a separation principle for the joint OSA design, leading to an explicit optimal design of the spectrum sensor and a closed-form optimal access strategy when spectrum sensor and access strategy are designed independently across channels. We also propose two heuristic approaches that exploit the correlation among channel occupancies, one at the PHY layer and the other at the MAC layer. Simulation results indicate that the exploitation of channel correlation at the PHY layer is more effective than that at the MAC layer, and that the detection capability of the spectrum sensor can be improved by exploiting MAC layer information.
Nest structure and colony cycle of the Allegheny mound ant, Formica exsectoides Forel (Hymenoptera: Formicidae)

Summary The nest structure and colony cycle of a population of Allegheny mound ants, Formica exsectoides, were examined in central Michigan. The dispersion pattern of mounds was random. Nest structure and presence of brood were primarily determined by excavation of twenty-three nests over three intervals from June through September. Additional excavations of five nests in 1990 and ten nests in 1991 provided further details on nest structure and colony cycle. Most galleries occurred within the mound and upper 30 cm of soil, but some activity reached depths of 100 to 270 cm. Depth of nests showed little correlation with external measurements of height and diameter. Immature stages were recovered from two strata: the upper 20 cm of nest and mound and the lowest nest depths. Alate sexual forms were found in or near the mound in July, and numerous dealate queens were collected in September from peripheral galleries near the soil surface.
Digital Suppression of Spurious PLL Tones in A/D Converters

In a nonideal PLL circuit, leakage of the reference signal into the control line produces spurious tones. When the distorted PLL signal is used in an analog-to-digital converter (ADC), it injects the spurious tones into the sampled data. These distortions are particularly harmful for wideband applications, such as spectrum sensing, since they affect the detection of vacant frequency bands. This paper analyzes this distortion effect in some detail and proposes estimation and filtering techniques in the digital domain to clean the data and remove the PLL leakage effects. Rather than remove the PLL sidebands by perfecting the circuitry, the proposed approach focuses on compensating their effect on the sampled data by using signal processing compensation algorithms. We study the performance of the proposed estimation algorithms and compare it with the corresponding Cramer-Rao bound (CRB). Such digitally based approaches are cost effective since the cost of perfecting the analog circuits can be prohibitive due to regular variations and imperfections in circuit fabrication processes.
A Novel gene detection method based on period-3 property

Processing of biomolecular sequences using communication theory techniques provides powerful approaches for solving highly relevant problems in bioinformatics by properly mapping character strings into numerical sequences. We provide an optimized procedure for predicting protein-coding regions in DNA sequences based on the period-3 property of coding region. We present a digital correlating and filtering approach in the process of predicting these regions, and find out their locations by using the magnitude of the output sequence. These approaches result in improved computational techniques for the solution of useful problems in genomic information science and technology.
Statistical analysis of students' performance in new engineering science core courses with economic and design concepts

This paper presents the results of statistical analysis conducted on the data collected from a four-year project funded by National Science Foundation. The primary objective of this multi-year, project involving five institutions was to determine the performance of the engineering students in a core of four integrated engineering science courses featuring advanced design and economic content.
Resurrecting american dominance in science and engineering: The demise and rebirth of the American doctoral student in science and technology

Throughout our history, the ability of the United States to produce new innovative technology has made this country a world power, economically, politically, and technologically. However, the country is losing its dominance as a technological superpower. One of the reasons for this “quiet crisis”, as identified by Thomas Friedman, is the fact that the United States is losing scientists and engineers faster than can be replaced. There is a troubling shortage of young scientists and engineers to replenish the technical workforce and an even more severe shortage of American students opting to continue graduate education. The shortage is so severe that some view it as a threat to national security. One reason suggested for the shortage of American students in master's and Ph.D. programs is the present structure and philosophy of graduate programs in our universities. The vast majority of Ph.D. granting universities is focused on the traditional model of Ph.D. education: to create graduates for placement in other universities. This paper discusses the genesis of the “quiet crisis” from economic, political, and technological points of view and suggests an alternative approach to graduate education that broadens the focus to include much close collaboration with the private sector and government.
StateSpace Feedback Control

This chapter describes several approaches to the design of feedback controllers for systems modeled in state space form, including multiple-input multiple-output (MIMO) systems. Static state feedback is a multidimensional extension of proportional control, and dynamic state feedback can be viewed as the state-space analog to PI (proportional integral) control. Pole placement design determines the poles needed to achieve the desired closed-loop properties and then computes the feedback gains required. Linear quadratic regulation (LQR) employs an optimization technique that parameterizes the trade-off between control error and control effort.
Sectionalism and American Foreign Policy: The Political Geography of Consensus and Conflict

For over two decades American foreign policy has been the subject of protracted conflict. Deep divisions exist over the uses of American power. This study argues that this conflict is regional in nature and is part of a larger struggle over national priorities between the nation's oldest and newest industrializing regions. Using Congress as a proxy for the national polity, I employ a spatial model to describe and analyze the regional bases of legislative voting over foreign policy. I show that since the late 1960s conflicts over foreign policy matters have pitted the “manufacturing belt” against the “sunbelt.” I argue that this regional conflict goes a long way in explaining the difficulty America's political leaders have experienced in articulating a vision of the national interest that inspires broad domestic support.
Resolving references and identifying existing knowledge in a memory based parser

Learning by reading systems, designed to acquire episodic (instance based) knowledge, ultimately have to integrate that knowledge into an underlying memory. In order to effectively integrate new knowledge with existing knowledge such a system needs to be able to resolve references to the instances (agents, locations, events, etc.) it is reading about with those already existing in memory. This is necessary to extend existing memory structures, and to avoid incorrectly producing duplicate memories. Direct Memory Access Parsing (DMAP) leverages existing knowledge and performs reference resolution and memory integration in the early stages of parsing natural language text. By performing incremental memory integration our system can reduce the number of ambiguous sentence interpretations and coreference mappings it will explore in-depth, however this savings is currently canceled out by the run-time cost of reference resolution algorithm. This paper supports the continued investigation of this line of research, which is to identify and evaluate the extent to which semantic and episodic memory can facilitate natural language understanding, especially when used early in the language understanding process.
Seeking the Balance between Fairness and Efficiency

Immediately after the Labour Party’s general election victory in 2001, the Guardian ran an article on what it called ‘a government drive to bring about a US-style productivity revolution during Labour’s second term’. Alongside the article, the paper ran a photograph of Gordon Brown launching that drive at a breakfast meeting in a London hotel. Alongside him at that photo shoot, looking suitably sleepy and not yet quite fully awake, sat Patricia Hewitt and Estelle Morris, then respectively the Secretaries of State for Industry and Education.1 The picture served to remind us that the implementation of the Brown strategy for economic modernization involved departments other than the Treasury, and that the target of the strategy was wider than those departments of state whose spending the Treasury so carefully controlled. Implementation of the Brown strategy required initiatives from other parts of the government machine: not least from the Department of Trade and Industry and from a department of education whose precise title and remit changed with the election. Prior to 2001 it was the Department for Education and Employment; then (when its employment functions had been repositioned in an independent Department for Work and Pensions) it became the Department for Education and Skills. Either way, the DfEE/DfES was, and remains, one of the Treasury’s key handmaidens in the delivery of the New Labour project, and the DTI was and remains the other.
Core-shell nanoscale coordination polymers combine chemotherapy and photodynamic therapy to potentiate checkpoint blockade cancer immunotherapy

Advanced colorectal cancer is one of the deadliest cancers, with a 5-year survival rate of only 12% for patients with the metastatic disease. Checkpoint inhibitors, such as the antibodies inhibiting the PD-1/PD-L1 axis, are among the most promising immunotherapies for patients with advanced colon cancer, but their durable response rate remains low. We herein report the use of immunogenic nanoparticles to augment the antitumour efficacy of PD-L1 antibody-mediated cancer immunotherapy. Nanoscale coordination polymer (NCP) core-shell nanoparticles carry oxaliplatin in the core and the photosensitizer pyropheophorbide-lipid conjugate (pyrolipid) in the shell (NCP@pyrolipid) for effective chemotherapy and photodynamic therapy (PDT). Synergy between oxaliplatin and pyrolipid-induced PDT kills tumour cells and provokes an immune response, resulting in calreticulin exposure on the cell surface, antitumour vaccination and an abscopal effect. When combined with anti-PD-L1 therapy, NCP@pyrolipid mediates regression of both light-irradiated primary tumours and non-irradiated distant tumours by inducing a strong tumour-specific immune response.
Reduction of Factor VIII Inhibitor Formation with F.VIII-Pulsed Tolerogenic Dendritic Cells in the Murine Hemophilia A Model.

Inhibitor formation is a severe complication of hemophilia, occurring in up to 25% and associated with poor response to factor replacement, uncontrolled bleeding, and high morbidity. Preventing inhibitor formation is, thus, a major goal of hemophilia management. The role of dendritic cells (DC) in regulating immune response has been increasingly recognized: immature DC (imDC) induce T regulatory cells in vitro and promote Ag-specific tolerance in vivo. We, therefore, studied the role of imDC propagated from bone marrow with GM-CSF + TGFβ to prevent inhibitor formation in the hemophilia A murine model. Following tail vein injection of recombinant F.VIII (Advate, Baxter) 2.5 U (0.2 μg) on days 0, 2, and 4 in hemophilia A exon 16 KO C57Bl/6 mice, anti-VIII antibodies were detected by semi-quantitative APTT (scored 1-4), peaking on day 6. On rechallenge with F.VIII 2.5 U on days 12, 14, and 16, anti-VIII was detected, peaking on day 17. Anti-VIII production was associated with high level splenic T cell proliferation in response to F.VIII stimulation in vitro, measured by 3 H-thymidine incorporation in mixed lymphocyte reaction (MLR). By contrast, there was no antibody formation in F.VIII-treated Wt C57Bl/6 mice: the latter was associated with low T cell response to F.VIII in vitro. Functionally immature DC (imDC) were propagated from the bone marrow of hemophilia A mice with GM-CSF (4ng/ml) and TGFβ (0.2ng/ml). For comparison, functionally mature dendritic cells (mDC) were propagated with GM-CSF (4ng/ml) and IL-4 (1000U/ml).The former (imDC) demonstrated deficient NF-kB binding activity in nuclear protein as detected by gel shifting assay and expressed low level of costimulatory molecules CD80, CD86; by contrast, the latter (mDC) demonstrated enhanced NF-kB binding activity and high levels of co-stimulatory molecules. Administration of 2x10 6 F.VIII-pulsed imDC (20U/ml x 24h) 7 days before F.VIII dosing on days 0, 2, and 4, led to reduction in inhibitor formation on day 6 (score 1.6 vs. 2.3 in control group) which was further reduced on day 8 (score 1.0 vs. 2.0 in control group). The inhibitor could not be detected on day 8 in 2 of 4 mice pretreated with F.VIII-pulsed imDC. By contrast, high levels of inhibitor were detected in mice pretreated with F.VIII-pulsed mDC (score 3.3). Rechallenge with F.VIII on day 10 in imDC-treated mice resulted in no increase in the reduced or absent anti-VIII effect on day 12. Splenic T cells (CD3+) from the imDC-pretreated mice showed lower proliferative capacity when restimulated in vitro with F.VIII, suggesting that imDC induced F.VIII unresponsiveness. These studies show that FVIII-pulsed imDC reduce the intensity of inhibitor formation, and suggest the potential role of modified DC in preventing or reducing F.VIII inhibitor formation.
The Software Company Machine

Software company employees live in silos. Software developers learn how to develop software but learn little or nothing about marketing, sales, or finance. Consequently, software development companies do not function as systems. Instead, they function as a set of totally asynchronous and rarely communicating divisions that succeed by accident, not by design. A software development company (in fact, any company) might achieve more success if it thinks of itself as a finely crafted and well-tuned machine. A software development company is a machine comprising three engines: the financial engine provides resources to power the other two engines. Each engine can thrive only when all three engines thrive. Properly maintaining the engines requires a plan that shows how resources move across the engine boundaries as a function of time. Software development companies will thrive more when managers of individual engines understand how the entire machine behaves.
Environmental cues used by Greater Sage-Grouse to initiate altitudinal migration

ABSTRACT Migration is a behavioral strategy to access resources that change across a landscape. Animals must ultimately interpret cues to properly time movements that match changing resource quality. Many animals do this by responding primarily to indirect indicators of resource quality such as an internal biological clock or photoperiod. Others are heavily dependent on more direct indicators such as weather or plant phenology. Timing of movement also can be modified by factors specific to individuals. We used time-to-event models for Greater Sage-Grouse (Centrocercus urophasianus) to investigate whether an altitudinal avian migrant was influenced by direct indicators of resource quality when timing migration, and whether timing was influenced by individual characteristics, during the spring (winter to breeding range), summer (breeding to summer range), and fall (summer to winter range) transitional seasons. Greater Sage-Grouse interpreted direct indicators of resource quality, especially temperature, whe...
Patulous Eustachian Tube Dysfunction: Patient Demographics and Comorbidities.

Objective:The objective is to describe a large cohort of patients presenting with patulous Eustachian tube (pET) dysfunction.Study Design:Retrospective patient series.Setting:Tertiary referral center.Patients:All outpatient visits (2004–2016) that were assigned ICD9 code (381.7-Patulous Eustachian t
Serum long noncoding RNA HOTAIR as a novel diagnostic and prognostic biomarker in glioblastoma multiforme.

Glioblastoma multiforme (GBM) is the most common and aggressive malignant adult primary brain tumor. Despite surgical resection followed by radiotherapy and chemotherapy, the median survival rate is approximately 14 months. Although experimental therapies are in clinical trials for GBM, there is an urgent need for a peripheral GBM biomarker for measuring treatment response. As we have previously demonstrated that the long noncoding RNA HOX Transcript Antisense Intergenic RNA, or HOTAIR, is dysregulated in GBM and required for GBM cell proliferation, we hypothesized that HOTAIR expression may be utilized as a peripheral biomarker for GBM. HOTAIR expression was measured in serum from 43 GBM and 40 controls using quantitative real-time PCR (qRT-PCR). The PCR products were subsequently subcloned into pCR™4-TOPO®TA vectors for DNA sequencing. A ROC curve was also generated to examine HOTAIR’s prognostic value. The amount of HOTAIR in serum exosomes and exosome-depleted supernatant was calculated by qRT-PCR. The relative HOTAIR expression was also investigated in 15 pairs of GBM serum and tumors. We detected HOTAIR in serum from GBM patients. HOTAIR levels in serum samples from GBM patients was significantly higher than in the corresponding controls (P < 0.0001). The area under the ROC curve distinguishing GBM patients from controls was 0.913 (95% CI: 0.845–0.982, P < 0.0001), with 86.1% sensitivity and 87.5% specificity at the cut-off value of 10.8. HOTAIR expression was significantly correlated with high grade brain tumors. In addition, Pearson correlation analysis indicated a medium correlation of serum HOTAIR levels and the corresponding tumor HOTAIR levels (r = 0.734, P < 0.01). We confirmed via sequencing that the amplified HOTAIR from serum contained the HOTAIR sequence and maps to the known HOTAIR locus at 12q13. The serum-derived exosomes contain HOTAIR and the purified exosomes were validated by western blot and nanoparticle tracking analysis. Importantly, our results demonstrate that serum HOTAIR can be used as a novel prognostic and diagnostic biomarker for GBM.
The Policy Context of the White Mountain Stewardship Contract

The White Mountains region of Arizona consists of the high-elevation, forested terrain roughly encompassed by the Apache-Sitgreaves National Forests (fig. 12.1) and White Mountain Apache tribal lands (the Ft. Apache Reservation). Conditions in the ponderosa pine (Pinus ponderosa) forest that predominates here reflect those throughout much of the western United States. These historically frequent-fire forests, once characterized by open stands, an abundance of larger trees, and a rich ground cover of grasses and forbs, are now more commonly overstocked with small-diameter pines and lack a productive grass layer; such conditions leave them susceptible to uncharacteristic, stand-replacing fires (Cooper 1960; Johnson 1994; Covington 2003). The White Mountains region also resembles much of the western United States in that it was recently the scene of divisive social and political conflict regarding public land management, endangered species, timber harvesting, and wildlife. Conflicts took the form of legal challenges to federal timber sales, the intervention of federal courts in management decisions, and accusations and finger-pointing as activity in the woods ground to a halt and local mills closed down (Nie 1998; Abrams and Burns 2007).
The Role of Tumor Necrosis Factor α in Modulating the Quantity of Peripheral Blood-Derived, Cytokine-Driven Human Dendritic Cells and Its Role in Enhancing the Quality of Dendritic Cell Function in Presenting Soluble Antigens to CD4+ T Cells In Vitro

Because dendritic cells (DC) are critically involved in both initiating primary and boosting secondary host immune responses, attention has focused on the use of DC in vaccine strategies to enhance reactivity to tumor-associated antigens. We have reported previously the induction of major histocompatibility complex class II-specific T-cell responses after stimulation with tumor antigen-pulsed DC in vitro. The identification of in vitro conditions that would generate large numbers of DC with more potent antigen-presenting cell (APC) capacity would be an important step in the further development of clinical cancer vaccine approaches in humans. We have focused attention on identifying certain exogenous cytokines added to DC cultures that would lead to augmented human DC number and function. DC progenitors from peripheral blood mononuclear cells (PBMC) were enriched by adherence to plastic, and the adherent cells were then cultured in serum-free XVIVO-15 medium (SFM) for 7 days with added granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4). At day 7, cultures contained cells that displayed the typical phenotypic and morphologic characteristics of DC. Importantly, we have found that the further addition of tumor necrosis factor alpha (TNFalpha) at day 7 resulted in a twofold higher yield of DC compared with non-TNFalpha-containing DC cultures at day 14. Moreover, 14-day cultured DC generated in the presence of TNFalpha (when added at day 7) demonstrated marked enhancement in their capacity to stimulate a primary allogeneic mixed leukocyte reaction (8-fold increase in stimulation index [SI]) as well as to present soluble tetanus toxoid and candida albicans (10- to 100-fold increases in SI) to purified CD4+ T cells. These defined conditions allowed for significantly fewer DC and lower concentrations of soluble antigen to be used for the pulsing of DC to efficiently trigger specific T-cell proliferative responses in vitro. When compared with non-TNFalpha-supplemented cultures, these DC also displayed an increased surface expression of CD83 as well as the costimulatory molecules, CD80 and CD86. Removal of TNFalpha from the DC cultures after 2 or 4 days reduced its enhancing effect on DC yield, phenotype, and function. Thus, the continuous presence of TNFalpha over a 7-day period was necessary to achieve the maximum enhancing effect observed. Collectively, our findings point out the importance of exogenous TNFalpha added to cultures of cytokine-driven human DC under serum-free conditions, which resulted in an enhanced number and function of these APC. On the basis of these results, we plan to initiate clinical vaccine trials in patients that use tumor-pulsed DC generated under these defined conditions.
Ultrasound: a technique useful in determining the side of ovulation

It is often assumed that ovulation commonly occurs from alternating sides each month, but it is unknown whether it can occur repeatedly from the same side. In an effort to answer this question, we selected 39 women from our infertility clinic who had six consecutive courses of ultrasound (US) to monitor ovulation and in whom the side of ovulation was recorded. Nine patients (23.1%) ovulated from the same side for six consecutive cycles, whereas no patient alternated side of ovulation in the same period of time. Stimulation with clomiphene citrate and/or human menopausal gonadotropin that results in single ovulation did not affect this pattern. The data were analyzed statistically with the use of a Markov Chain Model and the chi-square goodness-of-fit; the occurrence of persistent same-side ovulation was significant to P ≤0.001.
Non-cognitive factors predicting success in orthopedic surgery residency

Admissions to orthopedic surgery is a highly competitive process. Traditionally measures such as United States Medical Licensing Examination (USMLE) Step 1, class rank, AOA status have been major determinants in the ranking process. However, these traditional objective measures show mixed correlation to clinical success in orthopedic surgery residency. There have been several studies on the cognitive factors and their correlation with success in residency. However, it is clear that residency requires more than objective cognition, emphasizing complex social interactions that are influenced by non-cognitive variables including personality, work ethic, etc. This review aims to summarize the current understanding of non-cognitive factors influencing performance in orthopaedic surgical residency.
The Old King and the Elder Brother: As You Like It, Scripture, and the Problem of Political Resistance

This article argues that Shakespeare's As You Like It stages Reformation-era concerns over political theology, specifically regarding the question of resistance to a superior. It contends that in t...
Removal of cyanotoxins by potassium permanganate: Incorporating competition from natural water constituents.

Abstract In recent years, harmful algal blooms capable of producing toxins including microcystins, cylindrospermopsin, and saxitoxin have increased in occurrence and severity. These toxins can enter drinking water treatment plants and, if not effectively removed, pose a serious threat to human health. The work here investigated the efficacy of permanganate oxidation as a treatment strategy, with a focus on incorporating competition by cyanobacterial cells and dissolved organic matter (DOM). We report rate constants of 272 ± 23 M−1 s-1 for the reaction between permanganate and microcystin-LR, 0.26 ± 0.05 M−1 s−1 for the reaction between permanganate and cylindrospermopsin, and, using chemical analogs, estimate a maximum rate constant of 2.7 ± 0.2 M−1 s−1 for the reaction between permanganate and saxitoxin. We conclude that permanganate only shows potential to remove microcystins. No pH (6−10) or alkalinity (0–50 mM) dependence was observed for the rate of reaction between microcystin-LR and permanganate; however, a temperature dependence was observed and can be characterized by an activation energy of 16 ± 5 kJ mol−1. The competition posed by cyanobacterial cells was quantified by an apparent second order rate constant of 2.5 ± 0.3 × 10-6 L μg chl-a−1 s−1. From this apparent second order rate constant, it was concluded that cyanobacterial cells are not efficient scavengers of permanganate within typical contact times but this second order rate constant can be used to accurately predict microcystin degradation in algal-impacted waters. The competition posed by DOM depended on both the amount of DOM present (as measured by TOC) and its electron donating capacity (as predicted by SUVA-254 or E2/E3 ratio). DOM was concluded to scavenge permanganate efficiently and we forward that this should be considered in permanganate dosing calculations.
A brewery in a foundry, a winery in a strip mall: adaptive reuse by food enterprises

As a result of deindustrialization, many urban neighborhoods in the US continue to face challenges posed by underutilized and abandoned properties. The adaptive reuse of these sites for food production is one way of addressing these challenges. This article presents six such cases, in the form of farming and artisanal food production, in post-industrial sites in New York City, Newark, New Jersey, and two cities in Ohio—Dayton and Springfield. We focus on three aspects of adaptive reuse for food production: the building used, the building’s location, and the enterprise’s development process. In closing, we consider the influence these enterprises may have on the surrounding neighborhood and the city at large.
Undersedation During Total Hip Arthroplasty Reduction Results in Worse Patient Outcomes.

Abstract Background Total hip arthroplasty (THA) dislocation is a common reason for presentation to the emergency department (ED) postoperatively. Prior literature has shown that propofol conscious sedation provides the fewest complications and the shortest time to reduction. However, we are aware of no prior reports exploring sedative dosing regimens. We hypothesized that “undersedated” patients would have worse outcomes compared to appropriately sedated patients based on dose. Methods This is a retrospective review of isolated propofol conscious sedation performed in the ED for closed reduction of THA dislocations from 2013 to 2019. Prior authors have used at least 0.5 mg/kg/dose for sedation with propofol. Therefore, to allow a 10% rounding error, a dose of less than 0.45 mg/kg/dose was considered undersedated. Demographic information was collected and outcomes including sedation time, number of doses, complications, and successful reductions were analyzed in univariable and multivariable analyses. Results A total of 79 THAs were included for analysis with mean age 65.5 (16.2) years and weight 84.1 (21.3) kg. Thirty-seven (46.8%) patients had undergone revision surgery and 44 (55.7%) previously had a dislocation. A total of 39 patients were undersedated. There was no significant difference in demographics or arthroplasty-specific variables between undersedated and “protocol” sedation patients. In multivariable analysis, undersedated patients had significantly longer sedation time (P = .020), more re-doses (by mean 3 doses; P Conclusion Historically, conscious sedation for THA dislocations has been the responsibility of the emergency room clinician. In consideration of our outcomes, we advocate for a multidisciplinary team to create a sedation protocol, emphasizing the need to maintain a dosing regimen of 0.5 mg/kg/dose to improve the care of THA patients.
Effectiveness of Beauveria bassiana against Piezodorus guildinii (Hemiptera: Pentatomidae), a key pest of soybeans in the neotropics

Redbanded stink bug, Piezodorus guildinii (Westwood), is a neotropical pest of soybean in the southern United States and the Neotropical Americas. Two strains of Beauveria bassiana (Bals.-Criv) Vui...
A Scalable Controlled Set Invariance Framework with Practical Safety Guarantees

Most existing methods for guaranteeing safety within robotics require time-consuming set-based computations, which greatly limit their applicability to real-world systems. In recent work, the authors have proposed a novel controlled set invariance framework to tackle this limitation. The framework uses a classical barrier function formulation, but replaces the difficult task of computing large control invariant sets with the more tractable tasks of (i) finding a controller that stabilizes the system to a backup set, and (ii) verifying that this backup set is invariant under the stabilizing controller. In this paper, we build upon these results to show that the requirement of proving invariance of the backup set can be relaxed at the expense of providing weaker guarantees on the safety of the system. This trade-off is shown to be favorable in practice, as the theoretically weaker safety guarantees are sufficient in many practical applications. The end result is a framework with a computational complexity that scales quadratically. The effectiveness of the approach is demonstrated in simulation on a Segway.
Effect of beta blocker use in soft tissue sarcomas.

e23571Background: Soft tissue sarcomas (STS) are a rare, heterogenous group of cancers that tend to have a poor prognosis and few effective treatment strategies. Beta blockers (BB), in particular n...
A Look Under the Hood: Regulatory Policy Making and the Affordable Care Act

The Affordable Care Act (ACA) was signed into law a decade ago. Partisanship has limited the number of statutory changes, leaving the law mostly unchanged across the past 10 years. However, the ACA delegated vast powers to the executive branch, which opened the door for significant regulatory policy-making activities (also called "rulemaking"). We collected data on all regulatory actions related to the Affordable Care Act that have been taken since its passage to provide the first exploratory analyses of both the public law itself and the ensuing rulemaking activities. We also provide illustrative examples of two controversial issues: short-term limited-duration insurance plans and contraceptive coverage for women. Despite relative statutory stasis, regulatory actions have continued to shape the implementation of the Affordable Care Act. Both the Obama and Trump administrations have taken advantage of a vast delegation of policy-making power. Importantly, regulatory policy making holds the potential to yield significant changes depending on the policy goals of the presidential administration. Scholars, policy makers, and the public are well-advised to pay attention to ACA-related rulemaking activities. Moreover, "quasi-rulemaking" (i.e., the use of agency guidance as a policy tool) remains largely unexplored but could indicate an even greater regulatory enterprise than illustrated here.
Suppression of Beam Breakup in Linear Induction Accelerators by Stagger Tuning

Beam breakup (BBU) in linear induction accelerators (LIA) is suppressed by the solenoidal magnetic-field focusing of the electron beam. Amplification of BBU instability can also be significantly reduced by using cells having different transverse impedances. This so-called “stagger tuning” occurs naturally on one of the LIAs used for flash radiography at the Los Alamos National Laboratory. In this article, we use computer simulations to demonstrate how the natural stagger tuning functions, and how it might be used on advanced LIAs under consideration. Other means for engineering stagger tuning into LIAs are also investigated. Results of these simulations show promise for mitigation of BBU by reduction of the effective impedance, thereby relieving the necessity for extraordinarily strong solenoidal fields for designs with a large number of cells.
Abstract 17264: Predictive Value of Plasma Ceramide C24:0/C16:0 Ratio in Patients With Heart Failure With Preserved Ejection Fraction in the TOPCAT Study

Introduction: Heart failure (HF) with preserved ejection fraction (HFpEF) is an “emerging epidemic” as nearly half of all patients with HF have HFpEF. However, most HF biomarkers, including plasma ...
Understanding the impact of nocturnal hypoxemia in pediatric sickle cell disease.

Citation:Ehsan Z. Understanding the impact of nocturnal hypoxemia in pediatric sickle cell disease. J Clin Sleep Med. 2021;17(2):119–120.
Mathematics and Methodology: Spinoza Contra Skepticism

This chapter argues that a due consideration of the nature of true mathematical ideas and the use to which Spinoza puts them against skeptical disputation suggest that his philosophical methodology is more Cartesian than has often been appreciated. The discussion of this chapter allows me to introduce a number of the major concepts and themes that scaffold the discussion of ensuing chapters, in particular, the distinction between intrinsic and extrinsic features of ideas, the key epistemic notions of adequacy and truth, the foundational role of God in Spinoza’s system, and the question of the reality of mathematical objects.
Zeolite Crystal Growth in Space

The extensive use of zeolites and their impact on the world’s economy has resulted in many efforts to characterize their structure and improve the knowledge base for nucleation and growth of these crystals. Zeolite crystal growth (ZCG) experiments have been conducted in space by many researchers. The results have been varied with little overall constancy with respect to the types of zeolites grown, the procedures used, and methodologies employed for comparison of terrestrial and microgravity processed crystals. Results from this laboratory have indicated that solutions must be mixed in space, and that the nucleation mechanism as well as the growth mechanism is affected by the “suppression” of fluid motion. Earlier flight experiments (STS-43, STS-50 and STS-57) indicated that by controlling the nucleation event, the size of the crystals could be increased with improved structural quality compared to the ground-based controls. This was hypothesized to be the result of hindrance of the solution/dissolution mechanism caused by reduced fluid motion. USML-2 (STS-73) zeolite experiments were designed to further enhance the understanding of nucleation and growth of zeolite crystals, while attempting to provide a means of controlling the defect concentration in microgravity. Zeolites A, X, and Silicalte were grown during the 16-day United States Microgravity Laboratory number 2 (USML-2) mission. All zeolites were successfully grown in the 16 day mission. The zeolite A and X crystals were in general larger in dimension (10–50%), but not substantially different in crystal perfection as measured by their lattice parameters. However, They were significantly smoother as indicated by AFM. Zeolite β as well as Silicalite were only slightly larger in size but, appear to have different distributions of Aluminum atoms as determined by selective catalytic reactions.
Middle Grades Teacher Practices during the COVID-19 Pandemic

As of March 31, 2020, the closure of schools in 192 countries due to the COVID-19 pandemic had resulted in over 1.6 billion learners being temporarily forced out of school buildings. New educational inequities arose, and existing ones were exacerbated. Acknowledging that disruption may also stimulate innovation, the purpose of this qualitative research was to identify possible improvements in middle grades teachers’ practices as they enacted emergency remote instruction. Through narrative responses provided to an online survey administered between May 27 and June 19, 2020, 332 middle grades educators self-identified aspects of their teaching practice that improved while teaching remotely. Findings included deepened knowledge of individual learners;increased individualized instruction;greater opportunities for student choice and self-pace;more timely assessment feedback;enhanced family engagement;and increased technology skills. Implications of this study for educational practice, and for school scheduling in particular, are examined.
Spirituality in Clinical Practice: Incorporating the Spiritual Dimension in Psychotherapy and Counseling

Foreword. Preface. Part I: Spirituality and the Therapeutic Process. The Spiritual Dimension and the Therapeutic Process. Spiritual Dynamics in the Therapeutic Process. Part II: Incorporating Spirituality in the Therapeutic Process. Therapeutic Alliance: Establishing an Effective Relationship. Therapeutic Alliance: Maintaining an Effective Relationship. Assessment: Initial and Ongoing Evaluation. Case Conceptualization. Treatment Planning and Selection. Psychotherapeutic Interventions. Psychospiritual Interventions. Spiritual Interventions. Interventions With Groups and Couples. Termination and Related Considerations. Ethical, Legal, and Professional Training Considerations. References. Author Index. Subject Index.