cssi/SciSciGPT-SciSciNet huggingface dataset:
Safety of intravenous alteplase within 4.5 hours for patients awakening with stroke symptoms.

Background Up to 25% of acute stroke patients first note symptoms upon awakening. We hypothesized that patients awaking with stroke symptoms may be safely treated with intravenous alteplase (IV tPA) using non-contrast head CT (NCHCT), if they meet all other standard criteria. Methods The SAfety of Intravenous thromboLytics in stroke ON awakening (SAIL ON) was a prospective, open-label, single treatment arm, pilot safety trial of standard dose IV tPA in patients who presented with stroke symptoms within 0–4.5 hours of awakening. From January 30, 2013, to September 1, 2015, twenty consecutive wakeup stroke patients selected by NCHCT were enrolled. The primary outcome was symptomatic intracerebral hemorrhage (sICH) in the first 36 hours. Secondary outcomes included NIH stroke scale (NIHSS) at 24 hours; and modified Rankin Score (mRS), NIHSS, and Barthel index at 90 days. Results The average age was 65 years (range 47–83); 40% were women; 50% were African American. The average NIHSS was 6 (range 4–11). The average time from wake-up to IV tPA was 205 minutes (range 114–270). The average time from last known well to IV tPA was 580 minutes (range 353–876). The median mRS at 90 days was 1 (range 0–5). No patients had sICH; two of 20 (10%) had asymptomatic ICH on routine post IV tPA brain imaging. Conclusions Administration of IV tPA was feasible and may be safe in wakeup stroke patients presenting within 4.5 hours from awakening, screened with NCHCT. An adequately powered randomized clinical trial is needed. Clinical trial registration ClinicalTrials.gov NCT01643902.
Procainamide-induced lupus erythematosus. Clinical and laboratory observations

Abstract Procainamide hydrochloride in conventional doses can elicit a syndrome closely resembling systemic lupus erythematosus (SLE). The most frequent symptoms are polyarthralgia, myalgia, fever and pleurisy. Renal disease is notably absent. Conventional serologic tests give results similar to those in SLE except that serum complement is not decreased. A photodynamically induced complex between deoxyribonucleic acid (DNA) and procainamide is described which may be useful as a pathogenetic model. By a globulin precipitation method, patients with procainamide-induced lupus appear to have anti-body to denatured DNA and nucleohistone, but in contrast to idiopathic SLE, have little or no antibody to native DNA.
Local Automorphism Invariance: a Generalization of General Relativity

I propose a generalization of the Principle of Equivalence, upon which General Relativity is founded. General Relativity may be viewed as a gauge theory of local Lorentz invariance in the tangent space. The condition that the covariant derivatives of the Clifford algebra generators vanish, ∇ϕγν=0, then insures that the Riemann condition is satisfied, ∇ϕgρσ=0, and that the Riemann curvature tensor is identical to the field strength tensor for the gauge fields. I propose to extend local Lorentz invariance to the further demand of local automorphism invariance of the Clifford algebra. Local automorphism invariance is equivalent to allowing the basis spinors of the spinor space to be chosen locally, just as local Lorentz invariance is equivalent to allowing the basis vectors of the tangent space to be chosen locally. Consequently, the Clifford algebra generators are found not to have vanishing total covariant derivative, that is ∇ϕγν≠0, in contrast to the case of General Relativity. The additional dynamical degrees of freedom of the Clifford algebra generators may be conveniently prescribed to reside in drehbeins ("spin-legs"), these constituting the trans formation matrix between the local spinor basis and an arbitrarily assigned but constant spinorbasis. For the case of four-dimensional spacetime considered herein, the automorphism group is the conformal group, and therefore this theory may be viewed as a spinor inspired conformal extensionof General Relativity. However, if we treat this theory as an ordinary gauge theory, then the actiondoes not contain the Einstein-Hilbert term (that is, a term linear in the Ricci scalar). Nevertheless, I argue that the Einstein-Hilbert action, along with the mass of the spinor field and masses for some of the gauge fields, may all arise together as a symmetry breaking phenomenon in which the ground state is only invariant under Lorentz transformations
ANGULAR CHARACTERISTICS OF REFLECTIVITY FOR LAYERED STRUCTURES WITH IMPERFECTIONS

Techniques utilizing oblique incidence ultrasonic beams are proposed to obtain more information about material characterization and defect analysis in such layered structures as composite materials. To choose the appropriate testing parameters, calculations based on a multi-layered physical model were performed. This model was based on an assumption of a hexagonal class of symmetry for strongly anisotropic media with voids in an isotropic matrix and with transversely isotropic fibers with different volume fractions. The angular characteristics of reflectivity for such an immersed layered system have shown sufficient sensitivity of the critical angles to changes in effective material properties due to different values of volume fractions of the voids and fibers.
Trade study of advanced ballast control systems for an extraterrestrial submarine

Abstract Saturn's largest moon, Titan, has seas of cryogenic liquid methane and ethane as well as dynamic geology and a cycle of methane evaporation and rain. NASA is evaluating concepts for an extraterrestrial submarine to explore these seas from surface to bottom to shoreline, representing an unprecedented design challenge. The Titan submarine ballast system that controls the vertical ascent and descent must operate autonomously for a minimum of 365 dives in cryogenic seas below 95 K and handle liquid density variations up to 30%. Further complicating the concept is the high solubility of nitrogen gas in the seas, which leads to potential phase change and boiling issues during ballast pressure control. This paper presents a trade study of 7 advanced concepts for an autonomous submarine ballast system for Titan; 4 were down-selected as viable concepts. For each concept, analytical system description and sizing, autonomous concept of operation, parts list, and pros and cons are given. Systems are traded using mass, power, and complexity in control as metrics.
Assessment of literacy and numeracy skills related to non-steroidal anti-inflammatory drug labels.

Background:Non-steroidal anti-inflammatory drugs are widely used and have a potential for over-the-counter misuse. Limited health literacy is associated with poor health outcomes. Identification of...
A Study on the Influence of Confining Pressure on the Behavior of Fiber-Reinforced Soil

The use of randomly distributed fiber as soil reinforcement is nowadays a popular ground improvement technique. The absence of weak plane is a major advantage of the fiber reinforcement over the other soil reinforcement techniques, where weak plane exit parallel to the reinforcement. Similar to the roots of plant, fiber binds soil particles through surface interaction between soil and fiber, which results in the improvement of the load carrying capacity of soil. In this study, a series of triaxial test were carried out to understand the effect of confining pressure on the strength and stiffness characteristics of the fiber-reinforced soil. The test results have shown that with increase in the confining pressure, peak stress and stiffness increases. But the performance of fiber reinforcement in strength improvement is more significant in case of lower confining pressure, because the reinforcing action of the fibers was suppressed by the increased confining pressure.
Close to the Bedside: A Systematic Review of Endogenous Retroviruses and Their Impact in Oncology.

Abstract Background Human endogenous retroviruses (HERVs) are genetic elements in the human genome, which resulted from ancient retroviral germline infections. HERVs have strong transcriptional promoters and enhancers that affect a cell's transcriptome. They also encode proteins that can exert effects in human cells. This review examines how our increased understanding of HERVs have led to their potential use as biomarkers and immunologic targets. Material and methods PubMed/Medline, Embase, Web of Science, and Cochrane databases were used in a systematic search to identify all articles studying the potential impact of HERVs on surgical diseases. The search included studies that involved clinical patient samples in diseases including cancer, inflammatory conditions, and autoimmune disease. Articles focused on conditions not routinely managed by surgeons were excluded. Results Eighty six articles met inclusion and quality criteria for this review and were included. Breast cancer and melanoma have robust evidence regarding the use of HERVs as potential tumor markers and immunologic targets. Reported evidence of the activity of HERVs in colorectal cancer, pancreatic cancer, hepatocellular cancer, prostate and ovarian cancer, germ cell tumors as well as idiopathic pulmonary hypertension, and the inflammatory response in burns was also reviewed. Conclusions Increasingly convincing evidence indicates that HERVs may play a role in solid organ malignancy and present important biomarkers or immunologic targets in multiple cancers. Innovative investigation of HERVs is a valuable focus of translational research and can deepen our understanding of cellular physiology and the effects of endogenous retroviruses on human biology. As strategies for treatment continue to focus on genome-based interventions, understanding the impact of endogenous retroviruses on human disease will be critical.
Rapid effects of testosterone on social decision-making in a monogamous California mice (Peromyscus californicus)

Social animals must cope with challenges and opportunities by adjusting how they react to a salient stimulus. Here we use California mice (Peromyscus californicus) and investigate the mechanisms underlying social decision-making by studying (i) rapid effects of testosterone (T) pulses on a male's decisions to approach a novel male (challenge) versus a receptive female (opportunity), and (ii) whether social experience shapes how such effects are manifested. In Experiment 1, we found that sexually naive males administered saline injections preferentially approached unfamiliar females over unfamiliar males, in contrast, 10 min after receiving a single T-injection, males expressed a preference for approaching unfamiliar males. Such an effect of T only occurred in sexually naive males, but not pair-bonded males, suggesting that the rapid effects of T on approach behavior may rely on the pair-bonding experiences. Experiment 2 investigated social decision-making across three repeated exposures to the challenge/opportunity situations. Only the initial decision, approach to the challenge, predicted future aggressive behaviors, and such an effect relied on the rapid actions of T. We also found that experience with the controlled challenge situation (the male intruder was restrained behind a wire mesh) dampened the approach to the male side (potential threat) when later exposed to the same conditions. This suggests that a resident's motivation to defend against a threatening individual may decrease as the threat posed by the "neighbors" is reduced. Overall rapid effects of post-encounter T pulses may play important roles in influencing behavioral decisions during social interactions.
Psychobiology and Psychoanalytic Methodology

As stated in the introduction, the major theoretical thrust of this book has been to structure present psychobiological thinking into a well-ordered system that would explain in physiological terms much of normal and neurotic human behavior. In the course of this effort, it became evident that by far the greatest proportion of mental activity takes place at an unconscious level. This conclusion led to a consideration of the various types of unconscious activity—the episodic, the procedural, and the visceral—and of the interactions between them and consciousness. Inevitably it became necessary to compare this psychobiological model with the Freudian model of the dynamic unconscious in terms of structure, function, and significance.
Characterization of urethral fibrosis in a rabbit model: Potential roles of Wnt-β catenin pathway and epithelial to mesenchymal transition.

Aim To elucidate the precise cellular and molecular mechanisms that underlie urethral fibrogenesis. Methods Endoluminal electrocautery injury (using Karl Storz 10 Fr. Pediatric urethroscope) was employed in male rabbits (n = 6) to create mucosal injury. Retrograde urethrogram (RUG) and endoluminal ultrasound techniques were used to assess severity and changes in luminal cross-sectional area. Six control rabbits were subjected to sham injury, in which the electrocautery was inserted but not powered. Urethral tissues were harvested 30 days postinjury and subjected to RNA sequencing and quantitative polymerase chain reaction (qPCR) to determine changes in gene expression. Histological, immunostaining, and Western blot studies were used to determine changes in protein expression of known markers of fibrosis (eg, collagen, Integrinαv, GIV/Girdin, transforming growth factor-β (TGF-β), and pSMAD1,2,3). Results Trichrome staining confirmed increased connective tissue in urethral scar tissues. Immunostaining revealed a potential role for epithelial to mesenchymal cell transition (EMT) and positive labeling for all fibrotic markers (eg, collagen-1, Integrin αv, GIV/Girdin, transforming growth factor-β (TGF-β), and SMAD1,2,3). Western blot analysis confirmed increased protein levels of these fibrotic markers. Conclusion Our RNA sequencing and qPCR studies, in conjunction with our protein data, suggest that urethral mucosal fibrogenesis may be mediated by novel fibrogenic signaling pathways involving Wnt-β catenin, TGF-β, GIV/Girdin, and EMT which lead to increased collagen deposition. Therapeutic strategies targeting these pathways may be beneficial in attenuating fibrogenesis and stricture progression.
Analysis of Zero Waste Patternmaking Approaches for Application to Apparel

The apparel industry is a major contributor to environmental problems from textile manufacturing through garment production and distribution to consumer discard—donation, landfill, reuse, or otherwise (Gam et al., Int J Clothing Sci Technol 21(4):166–179, 2009). In 2015, there were estimated 400 billion square meters of fabrics produced worldwide and 60 billion square meters wasted during apparel production. Vennstrom (2012) stated that in the United Kingdom, around 2.35 million tons of waste comes from the clothing and textile industry per year, which estimates about 40 kilograms (kg) per person each year. Of the 40 kg (88 lbs) of apparel waste each year, 74% ends up in landfills (Vennstrom, 2012). Even though the fashion industry applies a variety of technologies to minimize the fabric waste in pursuit of cost reductions, it is still far from eliminating the waste of fabric during the cutting process. On average, 15% of fabric is wasted during the cut-and-sew garment production process (Rissanen & McQuillan, 2016). Professionals and researchers in apparel design and product development discipline are facing a tremendous challenge of combining the innovative patternmaking methods, aesthetics of apparel design, and fabric waste reduction.
Radiation and Chemotherapy for Brainstem Tumors

Gliomas originating in the brainstem are a heterogeneous group of tumors that can differ significantly in biology and prognosis. Despite recent insights into the biology of the most common brainstem glioma, diffuse intrinsic pontine glioma (DIPG), the standard treatment for brainstem gliomas has not changed significantly in nearly five decades. Radiation therapy is the mainstay of treatment for DIPG and other malignant brainstem gliomas, and is the only modality that improves outcomes for these tumors. While chemotherapy may have some utility for non-DIPG brainstem tumors, no chemotherapeutic agent has demonstrated significant efficacy within a clinical trial for children with DIPG. Diffuse brainstem gliomas in adults appears to have different biology, and adjuvant chemotherapy may have modest efficacy against adult malignant brainstem glioma. However, the prognosis for all patients with diffuse malignant brainstem gliomas remains dismal. Nevertheless, the recent distinction of DIPG as a unique clinical entity, development of tools such as cell lines and animal models to perform disease-specific pre-clinical studies, insight into its biologic underpinnings such as epigenetic dysregulation, and research to overcome defined obstacles to drug delivery have laid the groundwork for the development of novel, directed, disease-specific approaches that hold promise.
Early Fluid Accumulation and Intensive Care Unit Mortality in Children Receiving Extracorporeal Membrane Oxygenation

Purpose of this study was to evaluate the impact of early fluid accumulation and renal dysfunction on mortality in children receiving extracorporeal membrane oxygenation (ECMO). Retrospective cohort study of neonatal and pediatric patients who received ECMO between January 2010 and December 2012 in a tertiary level multidisciplinary pediatric intensive care unit (ICU). Ninety-six patients were included, and forty-six (48%) of them received continuous renal replacement therapy (CRRT) during ECMO. Overall mortality was 38.5%. Proportion of patients with acute kidney injury (AKI) at ICU admission was 33% and increased to 47% at ECMO initiation. High-risk diagnoses, extracorporeal cardiopulmonary resuscitation (ECPR), and venoarterial (VA)-ECMO were more common among nonsurvivors. Nonsurvivors had significantly higher proportion of AKI at ICU admission (OR: 2.59, p = 0.04) and fluid accumulation on ECMO day 1 (9% vs. 1%, p = 0.05) compared with survivors. Multivariable logistic regression analysis (adjusted for a propensity score based on nonrenal factors associated with increased mortality) demonstrated that fluid accumulation on ECMO day 1 is significantly associated with increased ICU mortality (OR: 1.07, p = 0.04). Fluid accumulation within the first 24 hours after ECMO cannulation is significantly associated with increased ICU mortality in neonatal and pediatric patients. Prospective studies evaluating the impact of conservative fluid management and CRRT during the initial phase of ECMO may help further define this relationship.
Fibula Fracture: Plate versus Nail Fixation.

Backgroud Intramedullary fixation has only uncommonly been used in the fibula although it may confer some advantages. Our goal was to investigate a single surgeon's learning curve with initial usage of an intramedullary device for fibular fixation based on surgical time and quality of reduction. Methods Prior to initiation of this study, an experienced ankle fracture surgeon performed fibular nail fixation in a sawbones and a cadaver setting. Between February and August 2018, all patients who suffered from a distal fibula fracture underwent fibula fixation (n = 20) using the Fibulock (Arthrex). Patients were retrospectively investigated and compared with a control of fibular plate fixation. The tourniquet time, time of anesthesia, and surgery time were recorded as well as the quality of reduction. Results In the 20 cases, the mean tourniquet time was 68.9 ± 23.2 minutes for nail fixation, while in the fibular plate fixation group, the mean time was 75.8 ± 23.9 minutes (p = 0.37). Two patients had slight malreductions (first and third cases): one was corrected with a lag screw outside the nail, the other was an elderly patient with significant blistering in whom an entirely percutaneous reduction was performed. Conclusions Intramedullary fixation for fibular fractures does not appear to have a significant learning curve for an experienced ankle fracture surgeon.
Analysis of the "centrosome-ome" identifies MCPH1 deletion as a cause of centrosome amplification in human cancer

The centrosome is the microtubule organizing center of human cells and facilitates a myriad of cellular functions including organization of the mitotic spindle to ensure faithful chromosome segregation during mitosis, cell polarization and migration, and primary cilia formation. A numerical increase in centrosomes, or centrosome amplification (CA), is common in cancer and correlates with more aggressive clinical features and worse patient outcomes. However, the causes of CA in human cancer are unclear. Many previous studies have identified mechanisms of CA in cellulo, such as overexpression of PLK4, but it is unclear how often these are the primary mechanism in human disease. To identify a primary cause of CA, we analyzed The Cancer Genome Atlas (TCGA) genomic and transcriptomic data for genes encoding the 367 proteins that localize to the centrosome (the “centrosome-ome”). We identified the following candidates for primary causes of CA: gain-of-function alterations of CEP19, CEP72, CTNNB1, PTK2, NDRG1, SPATC1, TBCCD1; and loss-of-function alterations of CEP76, MCPH1, NEURL4, and NPM1. In cellulo analysis of these candidates revealed that loss of MCPH1/microcephalin caused the most robust increase in centriole number. MCPH1 deep gene deletions are seen in 5–15% of human cancers, depending on the anatomic site of the tumor. Mechanistic experiments demonstrated that loss of MCPH1 caused a CDK2-dependent increase in STIL levels at the centrosome to drive CA. We conclude that loss of MCPH1 is common in human cancer and is likely to be a cause of CA.
Systematic optimization of ultrasound grayscale imaging presets and its application in abdominal scanning.

Purpose Ultrasound grayscale imaging preset optimization has often been qualitative and dependent upon vendor application specialists. This study aimed to propose a systematic approach for grayscale imaging preset optimization and apply the approach in a clinical abdominal scan setting. Methods A six-step approach was detailed including identification of clinical task, adjustment of basic parameters, fine-tuning of advanced parameters, image performance metrics confirmation, clinical evaluation and data analysis, and implementation of new presets and monitoring of clinical usage. Its application in an abdominal scanning task was described for each step with phantoms, volunteers, and software tools. Results Clinical image data analytics facilitated the understanding of the imaging task, relevant transducers, and target characteristics, in addition to specific requests from radiologists. Quantitative measurements were made on global image contrast and gray map function. In addition, clinically relevant phantoms and volunteer scans without and with acoustic distortion layers were involved to determine the new presets. Furthermore, phantom signal to noise ratio study and clinical evaluation using volunteers with different body habitus were utilized to confirm the superiority of the new presets. Quantitative clinical usage monitoring demonstrated successful implementation of the new presets. Conclusions A systematic approach for grayscale imaging preset optimization has been proposed and successfully applied for a specific clinical task. This approach was designed to be generalizable and relatively flexible, which would facilitate movement away from previous qualitative and subjective approaches.
Sugar feeding patterns of New York Aedes albopictus mosquitoes are affected by saturation deficit, flowers, and host seeking.

Background Sugar feeding is an important behavior which may determine vector potential of female mosquitoes. Sugar meals can reduce blood feeding frequency, enhance survival, and decrease fecundity, as well as provide energetic reserves to fuel energy intensive behaviors such as mating and host seeking. Sugar feeding behavior can be harnessed for vector control (e.g. attractive toxic sugar baits). Few studies have addressed sugar feeding of Aedes albopictus, a vector of arboviruses of public health importance, including dengue and Zika viruses. To address this knowledge gap, we assessed sugar feeding patterns of Ae. albopictus for the first time in its invasive northeastern USA range. Methodology/principal findings Using the cold anthrone fructose assay with robust sample sizes, we demonstrated that a large percentage of both male (49.6%) and female (41.8%) Ae. albopictus fed on plant or homopteran derived sugar sources within 24 hrs prior to capture. Our results suggest that sugar feeding behavior increases when environmental conditions are dry (high saturation deficit) and may vary by behavioral status (host seeking vs. resting). Furthermore, mosquitoes collected on properties with flowers (>3 blooms) had higher fructose concentrations compared to those collected from properties with few to no flowers (0-3). Conclusions/significance Our results provide the first evidence of Ae. albopictus sugar feeding behavior in the Northeastern US and reveal relatively high rates of sugar feeding. These results suggest the potential success for regional deployment of toxic sugar baits. In addition, we demonstrate the impact of several environmental and mosquito parameters (saturation deficit, presence of flowers, host seeking status, and sex) on sugar feeding. Placing sugar feeding behavior in the context of these environmental and mosquito parameters provides further insight into spatiotemporal dynamics of feeding behavior for Ae. albopictus, and in turn, provides information for evidence-based control decisions.
Rural Smart Shrinkage and Perceptions of Quality of Life in the American Midwest

Rural communities in the American Midwest have experienced upheaval since the 1980s with shrinking populations, an exodus of younger people, job losses, and aging infrastructure. Evidence shows that these trends are unlikely to be reversed in most places. Despite this, high-cost and unproven economic growth strategies are still promoted as the most appropriate responses. This chapter presents findings from an interdisciplinary research project about quality of life (QoL) in rural Iowa that proposes changing the analytical paradigm in this context from growth to one that sees adaptation to population loss as a form of resiliency. Using qualitative and quantitative data, the research considers how some shrinking rural communities in Iowa have been better able to adapt than others. The research shows that negative trends in QoL perceptions in these towns were best mitigated by investing in community services and social capital, rather than in economic development. This process is described as rural smart shrinkage, a term borrowed from research on shrinking cities and applied here to rural communities for the first time. The framework shifts away from associating population loss with community decline and instead emphasizes intentional and low-cost strategies that may sustain shrinking rural communities into the future.
Higher Fatigue Prospectively Increases the Risk of Falls in Older Men.

Author(s): Renner, Sharon W; Cauley, Jane A; Brown, Patrick J; Boudreau, Robert M; Bear, Todd M; Blackwell, Terri; Lane, Nancy E; Glynn, Nancy W | Abstract: Background and objectivesFatigue is a common complaint and shares many risk factors with falls, yet the independent contribution of fatigue on fall risk is unclear. This study's primary aim was to assess the association between fatigue and prospective fall risk in 5642 men aged 64-100 enrolled in the Osteoporotic Fractures in Men Study (MrOS). The secondary aim was to examine the association between fatigue and recurrent fall risk.Research design and methodsFatigue was measured at baseline using the Medical Outcomes Study (short form) single-item question "During the past four weeks, how much of the time did you feel energetic?" Responses were then classified: higher fatigue = "none," "a little," or "some" of the time and lower fatigue = "a good bit," "most," or "all" of the time. We assessed falls using triannual questionnaires. Fall risk was examined prospectively over 3 years; recurrent falling was defined as at least 2 falls within the first year. Generalized estimating equations and multinomial logistic regression modeled prospective and recurrent fall risk as a function of baseline fatigue status, adjusted for demographics, medications, physical activity, and gait speed.ResultsMen with higher (26%) versus lower baseline fatigue were older (75.1 ± 6.2 vs 73.2 ± 5.7 years), 24% less active, and had worse physical function (gait speed = 1.09 ± 0.24 vs 1.24 ± 0.21 m/s), all p l .0001. Within 1 year, 25.4% (n = 1409) had fallen at least once, of which 47.4% (n = 668) were recurrent fallers. Men with higher versus lower fatigue had 25% increased fall risk (relative risk = 1.25, 95% CI: 1.14-1.36) over 3 years follow-up, but had 50% increased odds of recurrent falling (odds ratio = 1.50, 95% CI: 1.22-1.85) within the first year.Discussion and implicationsFatigue is an important risk factor of falling independent of established risk factors. Reductions in fatigue (ie, increased energy) may lessen the burden of falls in older men and provide a novel avenue for fall risk intervention.
Leadership Views on the Barriers and Incentives to Clinical Preceptorship.

Background Clinical education often relies on a one-to-one student-preceptor model. Recruiting and retaining quality preceptors to sustain this model has become increasingly difficult at academic institutions across the nation. While ample literature describes preceptor barriers and incentives as viewed by physician educators, few studies explore the issue from institutional leadership perspectives. Objectives This study aimed to describe leadership perceptions across an academic institution to better understand knowledge gaps, system barriers, and proposed solutions to help institutions take action and address preceptor shortages. Methods Between February and July 2019, the researchers conducted one-on-one semi-structured interviews with sampled representation of Medical College of Wisconsin leadership. The researchers reviewed transcriptions of each interview verbatim and used a qualitative grounded theory approach to generate content codes and themes. Researchers iteratively refined codes using the constant comparison method until all interviews were analyzed and final themes and subthemes were defined. Results Twelve institutional leaders participated, of whom 5 were clinical executives, 1 was an academic executive, 4 were academic deans, and 2 were educational directors. Analysis yielded 4 major themes: student impact, recognition, physician well-being, and leadership. Conclusion Each content theme highlighted areas to consider when addressing preceptor issues within an institution: (1) leadership knowledge gaps regarding the scope of preceptor challenges, particularly time commitments and the number of preceptors required; (2) improving career advancement or promotion criteria to recognize teaching efforts; (3) enhanced physician well-being from teaching, while important, may no longer be sufficient for participation, especially without financial compensation; (4) distributed leadership may be needed to address issues at the course, clinic, and system levels.
Barotropic instability of a time-dependent parallel flow

This study examines the long-wavelength instabilities of an inviscid parallel time-dependent current on the beta-plane. The basic flow is represented by the Kolmogorov pattern, the amplitude of which is modulated in time. Particular attention is given to the regime in which the corresponding steady flows are stable according to the Rayleigh–Kuo criterion. It is shown that the presence of a fluctuating component, regardless of how weak it may be, always renders the basic current linearly unstable. The destabilization is attributed to the resonant forcing of large-scale Rossby waves. The analysis is based on the asymptotic multiscale model, which is validated by numerical simulations. Since most geophysical flows are inherently time-dependent, the associated shear instabilities could represent a significant and ubiquitous source of barotropic turbulence.
Subtle chirality effects of a D/l-Cysteine on the intrinsic acidity and conformation of isomeric tripeptides ACA and AdCA

Abstract Chirality effects on the intrinsic acidity of oligopeptides have been studied using a pair of stereoisomeric tripeptides containing two alanine (A) residues and either an L- or a d -cysteine, ACA and AdCA, where the C-terminus is amidated. The gas-phase acidities were determined by mass spectrometry measurements. The extended kinetic method yielded the deprotonation enthalpy (ΔacidH) and the gas-phase acidity (ΔacidG) of ACA to be 328.0 and 322.7 kcal/mol (1372.4 and 1350.2 kJ/mol), and of AdCA to be 327.8 and 322.4 kcal/mol (1371.5 and 1348.9 kJ/mol), respectively. Although the quantitative difference is small, the branching ratio bracketing experiments clearly indicate that AdCA is a stronger gas-phase acid than ACA. Conformations were obtained via a step-wise conformational search, followed by geometry and frequency calculations at the B3LYP/6-311 + G (d,p) level of theory. Theoretical gas-phase acidities are in good agreement with the experiments, which also suggests that AdCA is a stronger gas-phase acid. The enhanced acidity of the d -cysteine containing peptide is likely due to the adoption of a unique bent conformation upon deprotonation at the thiol group, which enables more favorable hydrogen bonding interactions within the peptide ion. The findings imply that chirality change on a single amino acid residue may have a notable effect on the biochemical properties of peptides.
A pilot spectroscopy study of adversity in adolescents

Abstract Background Childhood adversity is a global health problem affecting 25–50% of children worldwide. Few prior studies have examined the underlying neurochemistry of adversity in adolescents. This cross-sectional study examined spectroscopic markers of trauma in a cohort of adolescents with major depressive disorder (MDD) and healthy controls. We hypothesized that historical adversity would have a negative relationship with spectroscopic measures of glutamate metabolites in anterior cingulate cortex. Methods Adolescent participants (aged 13–21) underwent a semi-structured diagnostic interview and clinical assessment, which included the self-report Childhood Trauma Questionnaire (CTQ), a 28-item assessment of childhood adversity. Proton magnetic resonance spectroscopy (1H-MRS) scans at 3 Tesla of an anterior cingulate cortex (ACC) voxel (8 cm3) encompassing both hemispheres were collected using a 2-dimensional J-averaged sequence to assess N-acetylaspartate (NAA), Glx (glutamate+glutamine) and [NAA]/[Glx] concentrations. Generalized linear models assessed the relationships between CTQ scores and metabolite levels in ACC. Results Thirty-nine participants (17 healthy controls, 22 depressed participants) underwent 1H-MRS and completed the CTQ measures. There were decrements in [NAA]/[Glx] ratio in the ACC of participants with childhood adversity while no significant relationship between CTQ total score and any of the ACC metabolites was found in the combined sample. Exploratory results revealed a positive association between Glx levels and CTQ scores in depressed participants. Conversely the [NAA]/[Glx] ratio had a negative association with total CTQ scores in the depressed participants. Emotional Abuse Scale showed a significant negative relationship with [NAA]/[Glx] ratio in the combined sample when adjusted for depression severity. Conclusions Our findings suggest that childhood adversity may impact brain neurochemical profiles. Further longitudinal studies should examine neurochemical correlates of childhood adversity throughout development and in populations with other psychiatric disorders.
The Disability Movement's Critique of Rehabilitation's Medical Model: A Rebuttal.

Developing a dignifying disability policy requires coming to terms with both the disability rights advocates’ opposition to the medical model and the cultural denial of age-related disability.
Reactions of Small Reactive Species with DNA

Chronic inflammation caused by diverse chemical, physical, and infectious factors increases the risk of malignant cell transformations and the progression of human cancers. The enhanced production of reactive oxygen and nitrogen species (ROS and RNS, respectively) generated during the inflammatory response gives rise to the formation of genotoxic DNA lesions. The accumulation of oxidatively generated DNA lesions enhances the mutagenic burden of the cells, which can lead to cancer. A primary target of ROS and RNS is guanine, the most easily oxidizable natural nucleic acid base. The primary one-electron oxidation step or reaction with hydroxyl radicals generates guanine radicals that undergo a cascade of chemical reactions with diverse nucleophiles and free radicals to yield the final oxidation products. Keywords: DNA; oxidative stress; inflammation; electron transfer; oxidation; radical; carbonate radical anion; nitrogen dioxide; peroxynitrite; nitrosoperoxycarbonate
Turning Commons into Clubs: Harmonization Upwards Via Issue Structure

Issues of international cooperation are plagued by the possibility of free-riders; in the case of public goods, cooperative outcomes, although underprovided, may nevertheless be effected by a sufficiently motivated subset of relevant actors. Global common pool resources, on the other hand, are rival, and therefore lack of participation by all significant actors can undermine the ability of anyone to address the problem in question, as efforts to mitigate climate change suggest. Lessons from recent work on Flag-of-Convenience shipping suggest that changing the point of regulation to one involving a club good (like access to ports) rather than a common pool resource (such as protection of the ocean from pollution) can lead to more successful cooperation. This paper examines the conditions under which issues may be amenable to changing issue structure via point of regulation.
Trusted computing: strengths, weaknesses and further opportunities for enhancing privacy

This paper assesses how trusted computing technology can enhance privacy, both in the short and long term, and provides a variety of examples. In addition, potential negative privacy implications are assessed and outstanding issues are highlighted that need to be addressed before trusted computing could be provided in a privacy-friendly manner within the consumer space.
Studies of 5'-deiodinase activity in rats differing in hepatic lipogenic activity.

Studies of the relationship of hepatic 5'-deiodinase activity to hepatic lipogenic capacity were conducted. Rats of the Zucker, BHE, and Sprague-Dawley strains were used. BHE and Sprague-Dawley rats were starved and refed a 65% glucose diet, whereas lean and obese Zucker rats were fed a stock diet; the rats were thus different in hepatic lipogenic capacity. After hepatic 5'-deiodinase activity was determined, we found that rats genetically predisposed to increased hepatic lipogenesis had less deiodinase activity than rats without this genetic feature. The role of the interaction between the thyroid hormones and glucocorticoid in the activity of hepatic deiodinase was also studied. Adrenalectomized (ADX) or intact BHE and Sprague-Dawley rats were injected with saline, thyroxine, or triiodothyronine and either saline or glucocorticoid. The normal Sprague-Dawley rats made predictable adjustments to their deiodinase activity when their hormonal status was manipulated, whereas the BHE rats responded as though ...
Affine-Invariant Visual Features Contain Supplementary Information to Enhance Speech Recognition

The performance of audio-based speech recognition systems degrades severely when there is a mismatch between training and usage environments due to background noise. This degradation is due to a loss of ability to extract and distinguish important information from audio features. One of the emerging techniques for dealing with this problem is the addition of visual features in a multimodal recognition system. This paper presents an affine-invariant, multimodal speech recognition system and focuses on the supplementary information that is available from video features.
Response of the intact lamb fetus to acidosis

Abstract Metabolic acidosis was induced in 9 intact lamb fetal preparations utilizing hydrochloric acid solutions. During the study periods, all fetuses demonstrated metabolic acidosis (arterial pH, 6.94–7.11, base excess, −12.6 to −22). The cardiovascular effects on the fetus and ewe were negligible. In all fetal lambs there was a significant increase in the urinary excretion of titratable acid, ammonium, and phosphate, and a corresponding decrease in fetal urine pH. Although it is evident that renal compensation to metabolic acidosis in the fetus is limited when compared to that of the adult, it appears that the lamb fetus is able to significantly increase hydrogen ion excretion in response to prolonged metabolic acidosis.
Worlds in collision: Is a rational energy policy possible for Western Europe?

Abstract The image of worlds in collision is apt as the overlay to any discussion of energy policy in Western Europe. It is suggested here that there are several rationalities or managing strategies that people choose to use to deal effectively or cope with the world around them. Of the five basic paradigms, three play an active role in the social conflict over energy policy. Two of these are nearly diametrically opposed in that what one ‘sees’ as the problem, the other ‘sees’ as the solution. A bridging group provides an institutional framework so the opposing two can co-exist. From acceptance of these different realities as valid and necessary to near- as well as long-term human interests, a policy approach is suggested. It is addressed primarily to this bridging group, and is designed to limit or remove the blocking role played by one of the other active groups.
The effect of a client's age upon the employment preferences of therapeutic recreation majors.

Research has shown that negative attitudes toward the old are often prevalent among health care personnel who either work closely with older patients or who are preparing for health careers. The primary intent of this investigation was to explore the attitudes of therapeutic recreation (TR) majors toward older adults in relation to expressed job preferences. Ninety-five TR majors completed the “Therapeutic Recreation Work Preference Survey.” This instrument is a 105 item forced-choice survey which cross-matches five different disability categories (i.e., sensory impairment, chemical dependency, psychiatric impairment, physical impairment, and chronic health condition) with three age categories (i.e., youth: birth to 20 years; adult: 21–54 years; and senior: 55 +). The Bradley-Terry-Luce model was employed to reduce the 105 preference probability parameters to 15 strength parameters. Statistical analysis indicated that for the sample population expressed work preference decreased as the hypothetical client...
Lipids in Aqueous Solution: The Formation of the Cell Membrane

So far, this textbook has dealt with the thermodynamics and properties of aqueous solutions. The properties of bulk water have also been considered. However, cells and biological systems are not comprised of simple homogeneous solutions or bulk aqueous phases. One of the most fundamental conceptual as well as structural components of biological organization is the presence of a delimiting membrane. In a very real sense, cells are defined physically and functionally as different from their environment by the cell membrane. The organization of most biological systems, and certainly eukaryotic cells, depends on compartmentalization of cellular functions. This compartmentalization, which allows varied microenvironments to exist in close proximity, is dependent on the membranes that constitute the boundaries of the compartmentalized organelles. Virtually all biological membranes are comprised of lipid molecules arranged in bilayers, with inserted or attached protein and carbohydrate molecules playing a variety of roles at or in the lipid phases. While, in general, the formation of a membrane can occur with a wide variety of polymeric substances including proteins and carbohydrates, biological membranes share the property of depending on lipid molecules to form the membrane structure itself. Although membranes in cells are comprised primarily of hydrophobic lipid elements, they almost always separate two phases whose predominant species is water. Generally, these aqueous-dominated phases are treated as aqueous solutions. Biological membranes are characterized as being permeable to some but not to all of the components of these solutions. The arrangement of these aqueous-lipid-aqueous “phases” leads to a generalized mechanism through which the cell can perform a wide variety of tasks that allow it to sense, judge, and respond to its environment. In other words, the membrane not only defines where the cell as “self” and the environment as “not self” begins and ends, but also it allows the cell to collect information and energy from the environment, process these inputs, and respond in a variety of output patterns. The membrane either is active in or is the site of action for physical separation and protection; mediation of the flow of chemical species into and out of the cell; accumulation and conversion of energy and electric charge for the cell; and information processing and exchange between cellular elements and the environment, both local and remote. Understanding biological systems in any modern sense demands a familiarity with the physics and chemistry that allows a membrane to form and to function in such diverse ways. This section will focus on certain biophysical and biochemical aspects of lipid membrane formation from which a more complete description of the cell can eventually emerge.
MHC-Mismatched Chimerism Is Required for Induction of Transplantation Tolerance in Autoimmune Nonobese Diabetic Recipients

In nonautoimmune recipients, induction of mixed and complete chimerism with hematopoietic progenitor cells from MHC (HLA)-matched or -mismatched donors are effective approaches for induction of organ transplantation immune tolerance in both animal models and patients. But it is still unclear whether this is the case in autoimmune recipients. With the autoimmune diabetic NOD mouse model, we report that, although mixed and complete MHC-mismatched chimerism provide immune tolerance to donor-type islet and skin transplants, neither mixed nor complete MHC-matched chimerism does. The MHC-mismatched chimerism not only tolerizes the de novo developed, but also the residual pre-existing host-type T cells in a mismatched MHC class II-dependent manner. In the MHC-mismatched chimeras, the residual host-type peripheral T cells appear to be anergic with upregulation of PD-1 and downregulation of IL-7Rα. Conversely, in the MHC-matched chimeras, the residual host-type peripheral T cells manifest both alloreactivity and autoreactivity; they not only mediate insulitis and sialitis in the recipient, but also reject allogeneic donor-type islet and skin grafts. Interestingly, transgenic autoreactive BDC2.5 T cells from Rag1(+/+), but not from Rag1(-/-), NOD mice show alloreactivity and mediate both insulitis and rejection of allografts. Taken together, MHC-mismatched, but not MHC-matched, chimerism can effectively provide transplantation immune tolerance in autoimmune recipients.
A multicast ATM switch with slotted ring fabric

This paper proposes a scalable, optical fiber, slotted ring ATM switch architecture. The internal switching fabric and transport mechanism is developed, a model formulated, and deterministic performance analysis equations derived. The delay and blocking performance metrics of a 16/spl times/16 switch with 150 Mbps links are given. It is shown that zero blocking performance can be achieved, as can delays as low as several bit times.