cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract 169: Elucidating the role of GRK5 in Physiological Hypertrophy

Cardiac function is dynamically regulated by various G protein-coupled receptors (GPCRs). GPCR kinases (GRKs) are important in cardiac GPCR regulation through phosphorylation and desensitization of these receptors. GRK2 and GRK5 are the predominant GRKs in the heart, and the most widely characterized as they are both up-regulated in the failing heart. Prior studies from our Lab have determined that GRK5 plays a crucial role in pathological cardiac hypertrophy. Another type of hypertrophy termed, “physiological hypertrophy” occurs with exercise training and is defined as an enlargement in cardiac myocyte size leading to favorable cardiac adaptations. At present, it is unclear if GRK5 is a regulator of physiological hypertrophy in addition to its role in maladaptive hypertrophy. We hypothesize that GRK5 will not regulate physiological hypertrophy such that mice with cardiac-specific overexpression of GRK5 (TgGRK5) will yield a similar post-exercise cardiac physiological hypertrophic response as that of control wild-type (WT) mice. To test this hypothesis, TgGRK5 and WT mice were exposed to a 21 day high-intensity swimming exercise protocol. For each line, sham mice, which did not swim served as appropriate controls. At the conclusion of this protocol, mice were sacrificed and heart weight (HW), body weight (BW), and tibia length (TL) measured. TgGRK5 and WT mice both exhibited a characteristic 10-15% increase in HW/BW and HW/TL ratios, which are standard measures of cardiac hypertrophy. In addition, hearts were sectioned and H&E stained to evaluate myocyte size. Both TgGRK5 and WT mice exhibited a significant increase in myocyte size. Cardiac function was evaluated via echocardiography both prior to and after exercise training, and no changes were observed between TgGRK5 and WT mice after training. These data were re-affirmed in H9C2 cells and neonatal rat ventricular myocytes overexpressing either GFP or GRK5, which exhibited similar increases in cell size and AKT phosphorylation after IGF-1 treatment, a physiological hypertrophy stimulus. Taken together, these data suggest that physiological hypertrophy is similar in both control and TgGRK5 mice, confirming that GRK5 is solely a regulator of pathological cardiac hypertrophy.
Determination of Policosanol in Blood by Gas Chromatography-Mass Spectrometry

Octacosanol in blood was extracted with dichloricmethane.It was derivatized to trimethylsilyl ethers by N,O-Bis(trimethylsilyl) trifluoroacetamide.The compound was determined by gas chromatography-mass spectrometry and selected ion monitoring(SIM).Quantitative analysis was performed by measuring the area and comparing it to a calibration curve.
Urethral Stricture Disease in Children

AbstractWe review our experience with urethral stricture disease in 25 children who were seen between 1970 and 1979. Trauma was the most common etiology (48 per cent). Excellent results were obtained by 1-stage repair and multistage skin inlay urethroplasty. An average of 3.8 procedures per patient was required for multistage repairs versus 1.1 procedures per patient for 1-stage repair. Dilation alone averaged 1.7 procedures per patient and was successful in only 20 per cent. Dilation is unacceptable for management of most strictures in children and urethroplasty should be considered early in the treatment plan. One-stage urethroplasty, when applicable, is preferable to multistage repair. Seven children had a fractured pelvis with prostatomembranous urethral disruption, which was complete in 6 cases and partial in 1. Successful anatomical results were achieved ultimately in all of these cases. No patient who had erections preoperatively was impotent afterward. One child has been totally incontinent since ...
Therapeutic Jurisprudence and End-Of-Life Medical Care: Physician Perceptions of a Statute's Impact

Objective Assess the perceptions of Ohio physicians regarding the impact of their state's 1990 advance directive legislation on their medical practices when decisions need to be made and implemented concerning use of life-prolonging medical interventions, and to draw public policy. Design A mailed survey to physicians, to be completed and returned anonymously. The form contained ten questions to be answered according to a five-point Likert scale, a request for demographic information, and an opportunity to write additional comments on the form. Setting Surveys mailed to every physician on the Wright State University continuing medical education mailing list who had designated a specialty in internal medicine, family practice, or surgery. Main outcome measures Physicians' perceptions of the impact of Ohio's advance directive legislation on their communication with patients and families, anxieties about legal liability associated with end-of-life care, and willingness to limit life-prolonging medical interventions in specific situations. Results Mixed. While many physicians reported enhancements in relationships, communication, and willingness to respect patient and family wishes due to the statute, others reported an opposite effect. For many physicians, the statute made little impact on their practices. Conclusions The Ohio statute could benefit from rewriting, but there are inherent problems with advance directive laws. Professional education about death and dying issues and the chance for physicians to practice end-of-life treatment techniques are essential.
A phantom study to evaluate the effect of patient weight on SPECT-CT alignment in brain imaging.

2734 Objectives Multi-modality SPECT-CT allows for the localization of the physiologic uptake of administered radiopharmaceuticals relative to the anatomical structures as visualized by CT (fusion). Furthermore, the CT may be utilized for attenuation correction techniques. Both fusion and properly applied attenuation correction require that the SPECT and CT volumes be accurately aligned in 3D space. Alignment errors between the mechanically joined SPECT and CT scans are corrected by calibrating the combined system. In contrast to whole body imaging, when imaging the brain, the patient table is cantilevered into the gantry. This may result in a vertical shift (Y) between the acquired SPECT and CT volumes. This project evaluates the degree of SPECT to CT misalignment as patient weight increases. Methods An 8 ml hollow sphere containing 16 uCi of Tc-99m and a Hoffman brain phantom containing 2.4 mCi of Tc-99m were prepared. Both phantoms were included in the field of view and imaged with a Siemens Symbia T16 SPECT-CT system. Placed in the patient brain extension, the phantoms were imaged alone and with table weights to simulate a 94.1 kg, 80.0 kg, 70.0 kg, and 59.5 kg patient. Brain SPECT-CT images were reconstructed, fused and the extent of misalignment evaluated using a Siemens MI Applications system. Results Re-alignment of the CT to SPECT volumes resulted in vertical (Y) shifts of approximately 9 mm for the phantom only, and 11 mm, 12 mm, 10 mm and 10 mm for a 94.1 kg, 80.0 kg, 70.0 kg and 59.5 kg patient, respectively. Conclusions The findings indicate that increased patient weight has a negligible effect on SPECT to CT volume alignment in brain imaging, but the misalignment itself is significant and must be taken into account.
Should the Followup of Patients with Bladder Cancer Include Routine Excretory Urography

Abstract: This retrospective study was done to determine if patients who present with bladder tumors should be followed with routine excretory urograms to detect subsequent upper tract tumors at an early stage. The charts of 337 patients who have been followed for up to 9 years were reviewed. Excluding 1 patient with invasive transitional cell carcinoma of the distal ureter, no documented renal pelvic or ureteral tumor was discovered in any of the followup data. This finding is in contradistinction to patients who present with upper tract tumors and who are known to have a 44 to 54 per cent incidence of bladder tumor either pre-dating or post-dating the upper tract tumor. We conclude that routine excretory urography is neither cost-effective nor necessary for the followup of patients who present with bladder tumors.
Arachidonic Acid Release and Permeability Changes Induced by Endothelins in Human Cerebromicrovascular Endothelium

The vasoactive peptide endothelin-1 (ET-1) dose-dependently increased release of 51Cr from human cerebromicrovascular endothelial cells (HBEC), without affecting cell viability as assessed by lactate dehydrogenase release. ET-1 also induced transient accumulation of inositol triphosphate (IP3) and release of [3H] arachidonic acid (AA) from HBEC. The ET-1-induced 51Cr release, formation of IP3, and AA release from HBEC were competitively inhibited by selective ETA subtype receptor antagonist BQ-123. ET-1-stimulated 51Cr- and AA release from HBEC were potentiated by proteinkinase C (PKC) activator phorbol-myristate ester, and abolished by H7, an inhibitor of PKC. Dexamethasone, indomethacin, acetylsalicylic acid, imidazole, as well as the inhibitor of protein kinase A, H8, had no effect on 51Cr release. The results suggest that ETA-receptor mediated activation of PKC and increase in the HBEC‘permeability’for low molecular weight molecules in response to excessive release of endothelins from either HBEC or surrounding tissues during pathologic conditions may contribute to the formation of cerebral edema.
THALLIUM NMR AS A PROBE OF ALKALI ION INTERACTIONS AND OF COVALENCY IN ORGANOTHALLIUM COMPOUNDS

The thallium(205) chemical shift is greater than 4800 ppm and is very sensitive to the environment of the nucleus. For thallous ions, the change of the chemical shift with solvent is used to measure the preferential solvation of the ion. In addition, it is used to measure the stability constants of the cations Li + , Na + , K + , Rb + , Cs + , NE 4 + , Ag + with macrocyclic polyethers relative to that of the thallous ion. In organothallium compounds, the shift is a sensitive probe of covalency. Substituents on the phenyl ring in arylthallium compounds change the thallium chemical shift by over 55 ppm. The plot of the chemical shift vs. the substituent constant is roughly linear, but the shielding decreases with increasing electron donation in contrast to all other nuclei except 31p and 199 Hg.
Issues in measuring success in community-based Indigenous tourism: elites, kin groups, social capital, gender dynamics and income flows

AbstractTourism development is a key feature of the neoliberal economic development model. Through a mix of state and private investment, Indigenous communities in Mexico are encouraged to transform local cultural and environmental resources into tourist consumption sites. The process results in a shift toward reliance on tourism, in place of farming, leaving households with few alternative earning strategies amidst fluctuating tourist arrivals and income, confounding the relationship between tourism and sustainability and questioning the utility of tourism as a sustainable tool for development. This article analyses a community-based Indigenous tourism project in a rural Maya village in Mexico's Yucatan, and discusses strategies employed at household level to navigate the arrival of tourism. Funding agencies assessed this project based on a triple bottom line metric that accounts for ecological health, financial sustainability, and its relationship to local social capital; however, these fail to account ...
HSP27 Expression Associated with Luminal Subtypes of Breast Ductal Carcinomas in African American Women

Objectives: Heat shock protein 27 (HSP27) is a chaperone that is induced during cellular stress conditions and plays its role by inhibiting apoptosis. It is overexpressed in many cancers. Our objective was to evaluate HSP27 expression by immunohistochemistry in the four major subtypes of breast carcinoma (Luminal A, Luminal B, HER2, and triple negative) in a population …
Signaling perversion: Senator David Walsh and the politics of euphemism and dysphemism:

Discussions of sexual reputation typically involve hints and innuendos, as sexual behavior often cannot be explicitly addressed in public domains. In this article we explore the role of signaling i...
Comparing planning problem compilation approaches for quantum annealing

One approach to solving planning problems is to compile them to other problems for which powerful off-the-shelf solvers are available; common targets include SAT, CSP, and MILP. Recently, a novel optimization technique has become available: quantum annealing (QA). QA takes as input problem instances of quadratic unconstrained binary optimization (QUBO) problem. Early quantum annealers are now available, though their constraints restrict the types of QUBOs they can take as input. Here, we introduce the planning community to the key steps in compiling planning problems to QA hardware: a hardware-independent step, mapping, and a hardware-dependent step, embedding. After describing two approaches to mapping general planning problems to QUBO, we describe preliminary results from running an early quantum annealer on a parametrized family of hard planning problems. The results show that different mappings can substantially affect performance, even when many features of the resulting instances are similar. We conclude with insights gained from this early study that suggest directions for future work.
Saccharedens versatilis gen. nov., sp. nov., a sugar-degrading member of the Burkholderiales isolated from Cephalotes rohweri ant guts.

Cephalotes ‘turtle’ ants host a core group of gut–associated symbionts, but their potential contributions to ant nutrition and disease resistance remain uncharacterized in vitro. To gain a better understanding of the metabolic capability of core symbionts belonging to the Burkholderiales , we cultivated and characterized strain CAG32T from the guts of Cephalotes rohweri ants. Strain CAG32T was rod-shaped, Gram-stain-negative, motile and formed pale-white colonies on trypticase soy agar. Optimum growth occurred under an atmosphere of 20 % O2 supplemented with 1 % CO2. Strain CAG32T grew under NaCl concentrations of 0–2.0 %, temperatures of 23–47 °C and pH values of 4.0–8.0, and was capable of producing n-butyric acid and degrading carbohydrates for growth. The G+C content of the genomic DNA was 59.2±0.6 mol% and the major fatty acids were C16 : 0, C16 : 1 ω7c/C16 : 1 ω6c, C17 : 0 cylcopropane, C12 : 0 and C14 : 0 3-OH/C16 : 1 iso I. The only respiratory quinone detected was ubiquinone-8 (Q-8) and the major polar lipids were phosphatidylethanolamine, phosphatidylglycerol and diphosphatidylglycerol. Based on phylogenetic analysis of the 16S rRNA gene sequence, strain CAG32T shared 96.9 % nucleotide similarity with its closest cultivated neighbours Bordetella petrii Se-1111RT and Bordetella bronchiseptica ATCC 19395T. This, combined with differences in the phenotypic and biochemical profile from neighbouring strains, warrants the classification of strain CAG32T as representing a novel species of a new genus within the Burkholderiales family Alcaligenaceae . The name Saccharedens versatilis gen. nov., sp. nov. is proposed. The type strain of Saccharedens versatilis is CAG32T (=NCIMB 15010T=DSM 100909T).
Enough or Too Much in EMR Training and Education

The healthcare industry is constantly growing and changing to keep up with the rising demand for treatment and technological improvements to treatment. With this growth and new technology comes a similar rise in costs. In order for healthcare systems to stay in the green they must constantly seek new ways to save money and better treat patients in an efficient manner. One of the tools the healthcare industry has chosen to lean on in order to facilitate this need is healthcare ERPs. The challenge of implementing ERP is tremendous. Many critical factors contribute to the success or demise of as a successful implementation. In order for these ERP systems to be effective however, end users must be willing and able to utilize the system as designed in an efficient manner. As such user acceptance is a key component in implementation success and healthcare IT needs to keep this at the forefront of their thoughts throughout the implementation process. User acceptance will increase through adequate training. Through research we have developed the Training Intensiveness Model. We propose this model will benefit other researchers and practitioners alike through its simplicity and ease of use.
Progressive band processing of automatic target generation process

Automatic target generation process (ATGP) has been widely used for unsupervised target detection. However, ATGP does not provide band information in target detection. This paper develops a progressive band process of ATGP (PBP-ATGP) so that ATGP can be carried out band by band progressively. Several advantages can be benefited resulting from PBP-ATGP. Such band by band progression capability makes PBP-ATGP able to identify significant bands for finding targets. This provides an effective means of selecting bands without performing band selection. Finally and most importantly, PBP-ATGP offers a progressive profile in target detection from band to band, a task for which no target detection techniques using full band information can provide.
The postoperative period

Emergence from anesthesia is a transition from a controlled to an uncontrolled state and is rife with possibilities of complications. The patient may be distressed by inadequate pain control, nausea, or shivering. However, complications involving the respiratory, the cardiovascular, the renal, or the neurological systems can be associated with significant morbidity and even mortality. A brief summary of the potential complications to be anticipated in the post-anesthesia care unit is described here.
Long-Acting Profile of 4 Drugs in 1 Anti-HIV Nanosuspension in Nonhuman Primates for 5 Weeks After a Single Subcutaneous Injection

Abstract Daily oral antiretroviral therapy regimens produce limited drug exposure in tissues where residual HIV persists and suffer from poor patient adherence and disparate drug kinetics, which all negatively impact outcomes. To address this, we developed a tissue- and cell-targeted long-acting 4-in-1 nanosuspension composed of lopinavir (LPV), ritonavir, tenofovir (TFV), and lamivudine (3TC). In 4 macaques dosed subcutaneously, drug levels over 5 weeks in plasma, lymph node mononuclear cells (LNMCs), and peripheral blood mononuclear cells (PBMCs) were analyzed by liquid chromatography–tandem mass spectrometry. Plasma and PBMC levels of the active drugs (LPV, TFV, and 3TC) were sustained for 5 weeks; PBMC exposures to LPV, ritonavir, and 3TC were 12-, 16-, 42-fold higher than those in plasma. Apparent T 1/2z of LPV, TFV, and 3TC were 219.1, 63.1, and 136.3 h in plasma; 1045.7, 105.9, and 127.7 h in PBMCs. At day 8, LPV, TFV, and 3TC levels in LNMCs were 4.1-, 5.0-, and 1.9-fold higher than in those in PBMCs and much higher than in plasma. Therefore, 1 dose of a 4-drug nanosuspension exhibited persistent drug levels in LNMCs, PBMCs, and plasma for 5 weeks. With interspecies scaling and dose adjustment, this 4-in-1 HIV drug-combination could be a long-acting treatment with the potential to target residual virus in tissues and improve patient adherence.
Contract Disclaimers in ERISA Summary Plan Documents: A Deceptive Practice

The Employment Retirement Income Security Act requires employers to provide employees covered by a retirement insurance plan with a sum mary of that plan, known as a "summary plan document" ("SPD"). The author argues that although the legislative intent behind SPDs is to pro mote simple and accurate communication of the provisions of the compre hensive plan, many employers circumvent this purpose by using contract disclaimers in their SPDs. When a company fails to state explicitly that an SPD is not a contract in its disclaimers, that company may lure some em ployees into thinking that they have benefits they do not have, or that they have met eligibility obligations which they have not met. The Article as serts that research concerning how readers interpret disclaimers has consid erable legal relevance. Next, the Article presents the results of a study which focused on readers' perception and understanding of a contract dis claimer used near the end of an SPD. The author concludes, supported by the results of the study, that the use of contract disclaimers works directly against accurate disclosure of comprehensive plans since contract disclaim ers almost invariably function to screen details from the reader.
Object-Category Processing, Perceptual Awareness, and the Role of Attention during Motion-Induced Blindness

Perceptual information represented in the brain, whether a viewer is aware of it or not, holds the potential to influence subsequent behavior. Here we tracked a well-established event-related-potential (ERP) measure of visual-object-category processing, the face-specific ventrolateral-occipital N170 response, across conditions of perceptual awareness. To manipulate perceptual awareness, we employed the motion-induced-blindness (MIB) paradigm, in which covertly attended, static, visual-target stimuli that are superimposed on a globally moving array of distractors perceptually disappear and reappear. Subjects responded with a button press when the target images (faces and houses) actually physically occurred (and thus perceptually appeared) and when they perceptually reappeared after an MIB episode. A comparison of the face-specific N170 ERP activity (face-vs-house responses) revealed robust face-selective ERP activity for physically appearing images and no such activity for perceptual reappearances following MIB episodes, suggesting that face-specific processing had continued uninterrupted during MIB. In addition, electrophysiological activity preceding an actual appearance of a target image, collapsed across face and house image types, was compared to that preceding the perceptual reappearance of a continuously present image (following MIB). This comparison revealed a parietally distributed positive-polarity response that preceded only reappearances following MIB. Such a result suggests a possible role of parietally mediated attentional capture by the present-but-suppressed target in the reestablishment of perceptual awareness at the end of an MIB episode. The present results provide insight into the level of visual processing that can occur in the absence of awareness, as well as into the mechanisms underlying MIB and its influence on perceptual awareness.
Vom Sprint zum Marathon

Was muss geschehen, damit mehr Frauen in Fuhrungspositionen gelangen? Wie sieht erfolgreiche Forderung von Frauenkarrieren in Unternehmen aus? Eva Faenger, Diversity Manager bei Hewlett Packard Enterprise Deutschland, erklart die Strategien und Masnahmen des Unternehmens und berichtet uber Erfahrungen und Erfolge.
Stress reappraisal during a mathematics competition: testing effects on cardiovascular approach-oriented states and exploring the moderating role of gender.

Background and objectives: Effects of reappraising stress arousal during an interpersonal competition were tested on physiological functioning and performance. Additionally, the moderating role of ...
Antiplatelet Effect of Ketorolac in Children After Congenital Cardiac Surgery.

Background:Ketorolac is used for pediatric analgesia after surgery despite its known platelet inhibition via the arachidonic acid (AA) pathway. The degree of platelet inhibitory effect after cardia...
Active Fault Management in Autonomous Systems Using Sensitivity Analysis

Abstract The absence of human senses and experience in autonomous systems pose a variety of unforeseen challenges. One of these challenges is the effective health monitoring of autonomous systems. This paper proposes a comprehensive active fault management framework. The proposed framework works on the measured signal and control inputs of the system. The set of residuals and isolation tests, which is part of the passive fault diagnosis system, have the capability of adapting to new and unforeseen scenarios. If the fault is not isolable or detectable in magnitude, it will be excited by manipulating the inputs of the system in a controlled fashion. Once the fault is confirmed, it will be mitigated to minimize the performance degradation and damage to the system. The later part of the framework on active fault diagnosis (sensitivity analysis based fault excitation and mitigation) has been demonstrated for a powertrain of an autonomous electric vehicle. The simulation results confirm the effectiveness of the proposed active fault management framework.
The synthesis of thrombin inhibitor L-370,518 via an α-hydroxy-β-lactam

Abstract We describe an efficient synthesis of thrombin inhibitor L-370,518 ( 1 ) via β-lactam 2 . The synthesis of 2 is carried out in six steps from 4-aminocyclohexane carboxylic acid, with a yield of 27%.
Abstract 4003: Colon sessile serrated polyps associate with endometrial polyps

Background: Colon and endometrial polyps are current health issues and their incidences are on the rise. Due to conflicting reports of higher colon polyps in patients with endometrial polyps, we aimed to evaluate if there is such an association in African Americans, a population at high risk for colorectal cancer. Method: We retrospectively reviewed all female patients who had endometrial (EN) presentations (n=3,600) and colonoscopy (n=14,888) at Howard University Hospital from January 2004 to December 2015. We selected cases with endometrial poly and control without this diagnosis who underwent colonoscopy. Clinical [Body Mass Index (BMI), diabetes (DM), hypertension (HTN), Tamoxifen intake, age] and pathological (histology, location, type of lesions) features of Cases and Controls were collected. Association between EN and colon polyp was tested using multivariable logistic regression analysis. We excluded the patients with endometrial cancer. Results: We recruited 664 cases and 118 controls. Cases were statistically significant older (median age of 60 vs. 57 in controls) and had higher rates of smoking and DM than controls. However, the overall colon polyp prevalence in the two groups was not statistically different (54% vs 52% in controls and cases, respectively). In subgroups of subject with colon polyp, sigmoid and rectal polyps were more prevalent in controls than cases. Sessile serrated polyps/adenomas (SSPs) were more frequent in cases (8% vs. 2%, p=0.03) while benign mucosa was more so in controls. Whether considering the overall study population or just those with colon polyps, SSPs lesions associated with an Odds Ratio of 4.6 (p=0.02) for EN polyp occurrence, after adjusting for confounder. Conclusion: Our study shows that the overall colon polyp’s prevalence was similar in endometrial polyp patients compared to endometrial-polyp free controls. However, a significant association between SSP with endometrial polyps was noted. Females with colon lesions of the SSP type might benefit from a screening for endometrial polyp in an age-independent manner. Note: This abstract was not presented at the meeting. Citation Format: Hassan Brim, Taraneh Tarjoman, Shirin Ganjali, Saman Azam, Negin Farsi, Edward Lee, Babak Shokrani, Farshad Aduli, Carla Williams, Adeyinka Laiyemo, Akbar Soleimani, Zaki Sherif, Mehdi syed Nouraie, Hassan Ashktorab. Colon sessile serrated polyps associate with endometrial polyps [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4003.
When Exception to Policy Is Exceptional Policy: How Booking Physical Therapy Appointments Too Far in the Future May Adversely Impact Access to Care, Business Optimization, and Readiness.

Introduction Physical therapy (PT) is a high-volume service that treats musculoskeletal injury and improves return-to-duty rates. Our experience suggests that no-show (NS) and patient cancellation (PC) rates increase the further appointment that is booked in the future, impede access to care, and increase the healthcare delivery costs. The article's purpose is to examine PT National Capitol Region (NCR) appointment data to inform appointment policies. Methods We utilized one year of retrospective Military Health System Management and Reporting Tool and Composite Health Care System Ad Hoc Data Pulls to review NCR PT appointment data to evaluate the effect of timing on NS and PC rates. Results We analyzed 797 new appointments at Walter Reed National Military Medical Center. Data revealed that 16% of patients seen within 10 days NS or PC; 22% of patients seen between 11 and 20 days NS or PC; 28% of patients seen 21 to 30 days NS or PC; and 25% of patients seen over 30 days after consultation NS or PC. We analyzed 182,134 PT appointments (all types) in the NCR. The NS rate was 11.1% (range 8.4-14.9%). Conclusions At Walter Reed National Military Medical Center, 17% of new appointments were lost when they were booked over 20 days in advance; additionally, NS and PC rates were greatest after 20 days from consultation.
Derivation of Classical Mechanics in an Energetic Framework via Conservation and Relativity

The notions of conservation and relativity lie at the heart of classical mechanics, and were critical to its early development. However, in Newton’s theory of mechanics, these symmetry principles were eclipsed by domain-specific laws. In view of the importance of symmetry principles in elucidating the structure of physical theories, it is natural to ask to what extent conservation and relativity determine the structure of mechanics. In this paper, we address this question by deriving classical mechanics—both nonrelativistic and relativistic—using relativity and conservation as the primary guiding principles. The derivation proceeds in three distinct steps. First, conservation and relativity are used to derive the asymptotically conserved quantities of motion. Second, in order that energy and momentum be continuously conserved, the mechanical system is embedded in a larger energetic framework containing a massless component that is capable of bearing energy (as well as momentum in the relativistic case). Imposition of conservation and relativity then results, in the nonrelativistic case, in the conservation of mass and in the frame-invariance of massless energy; and, in the relativistic case, in the rules for transforming massless energy and momentum between frames. Third, a force framework for handling continuously interacting particles is established, wherein Newton’s second law is derived on the basis of relativity and a staccato model of motion-change. Finally, in light of the derivation, we elucidate the structure of mechanics by classifying the principles and assumptions that have been employed according to their explanatory role, distinguishing between symmetry principles and other types of principles (such as compositional principles) that are needed to build up the theoretical edifice.
Experiences of Breastfeeding among Disabled Women

Abstract Background Although breastfeeding has been extensively studied, there remains a paucity of data about the breastfeeding experiences of disabled women. Despite indications of similar pregnancy rates, disabled women seem to breastfeed at lower rates. Emerging research on the intersection of breastfeeding and disability has begun to shed light on how aspects of disability may impact breastfeeding. Methods This digital and participatory action research study used semistructured video or telephone interviews to evaluate the experiences of breastfeeding among 24 disabled women through descriptive content analysis. The cross-disability sample was composed of women with self-identified intellectual, developmental, physical, sensory, and psychiatric disabilities. Some women had multiple disabilities. Results Qualitative analysis revealed four themes relating to breastfeeding among disabled women: 1) communication difficulties with lactation consultants, 2) milk supply and latch problems, 3) intense pressure to breastfeed, and 4) positive interactions with health care providers. Conclusions This study provides new information about the breastfeeding experiences of women with disabilities. Our findings suggest that disabled women should be better supported in their breastfeeding decisions and require greater access to disability-affirmative and informative clinical resources and accessible communication.
Poesía fuera del cancionero: la inscripción de lo cotidiano y lo sublime

RESUMEN El articulo destaca la importancia de la poesia del siglo XV como vehiculo comunicativo que se vale de diferentes soportes textuales para inscribir el mundo material, al que dota de significado y con el que forma un macro-signo. La conexion entre el libro y la cultura material puede verse en particular en la inscripcion de edificios publicos y privados, objetos de uso cotidiano como copas y platos, asi como de la indumentaria, entre la que se incluyen las joyas.
Allopatric Plant Pathogen Population Divergence following Disease Emergence.

ABSTRACT Within the landscape of globally distributed pathogens, populations differentiate via both adaptive and nonadaptive forces. Individual populations are likely to show unique trends of genetic diversity, host-pathogen interaction, and ecological adaptation. In plant pathogens, allopatric divergence may occur particularly rapidly within simplified agricultural monoculture landscapes. As such, the study of plant pathogen populations in monocultures can highlight the distinct evolutionary mechanisms that lead to local genetic differentiation. Xylella fastidiosa is a plant pathogen known to infect and damage multiple monocultures worldwide. One subspecies, Xylella fastidiosa subsp. fastidiosa, was first introduced to the United States ∼150 years ago, where it was found to infect and cause disease in grapevines (Pierce’s disease of grapevines, or PD). Here, we studied PD-causing subsp. fastidiosa populations, with an emphasis on those found in the United States. Our study shows that following their establishment in the United States, PD-causing strains likely split into populations on the East and West Coasts. This diversification has occurred via both changes in gene content (gene gain/loss events) and variations in nucleotide sequence (mutation and recombination). In addition, we reinforce the notion that PD-causing populations within the United States acted as the source for subsequent subsp. fastidiosa outbreaks in Europe and Asia. IMPORTANCE Compared to natural environments, the reduced diversity of monoculture agricultural landscapes can lead bacterial plant pathogens to quickly adapt to local biological and ecological conditions. Because of this, accidental introductions of microbial pathogens into naive regions represents a significant economic and environmental threat. Xylella fastidiosa is a plant pathogen with an expanding host and geographic range due to multiple intra- and intercontinental introductions. X. fastidiosa subsp. fastidiosa infects and causes disease in grapevines (Pierce’s disease of grapevines [PD]). This study focused on PD-causing X. fastidiosa populations, particularly those found in the United States but also invasions into Taiwan and Spain. The analysis shows that PD-causing X. fastidiosa has diversified via multiple cooccurring evolutionary forces acting at an intra- and interpopulation level. This analysis enables a better understanding of the mechanisms leading to the local adaptation of X. fastidiosa and how a plant pathogen diverges allopatrically after multiple and sequential introduction events.
Esophageal Obstruction and Death in a Nonverbal Patient

Abstract Background There are more than 100,000 cases of esophageal foreign body in the United States each year. Most cases resolve spontaneously; however, complete esophageal obstruction is a medical emergency. Patients with developmental disabilities are at high risk, because a large percentage of this population is effected by dysphagia, pica, tooth loss, or impulsive swallowing. In some cases, the diagnosis of esophageal foreign body can be made clinically, with the typical presentation including coughing, inability to tolerate secretions, drooling, vomiting, and dysphagia. In other instances, imaging is needed to confirm the diagnosis. Case Report A nonverbal adult patient with history of mental retardation and dysphagia presented to the emergency department (ED) after a choking episode with persistent coughing. An x-ray study of the chest showed mild opacity at the left lung base and she was discharged with antibiotics. She returned to the ED that day with worsening symptoms suggestive of aspiration pneumonia. A computed tomography scan of the chest revealed numerous cylindrical objects in the esophagus, later identified as crayons. At least 28 crayons were removed via 3 endoscopies. During this time, the patient developed aspiration pneumonia, respiratory distress, and septic shock. Why Should an Emergency Physician Be Aware of This? Delayed recognition of foreign body puts patients at risk for esophageal perforation, aspiration, airway compromise, infection, sepsis, and death. In nonverbal patients presenting with upper respiratory symptoms, it is especially important to consider esophageal foreign body in the differential diagnosis, because this group is high risk for missed diagnosis and complications secondary to the foreign body.
Some results on $${\mathbb {F}}_4[v]$$-double cyclic codes

Let $$\mathrm {R}={\mathbb {F}}_4+v{\mathbb {F}}_4, v^2=v$$ . A linear code over $$\mathrm {R}$$ is a double cyclic code of length (r, s), if the set of its coordinates can be partitioned into two parts of sizes r and s, so that any cyclic shift of coordinates of both parts leave the code invariant. In polynomial representation, these codes can be viewed as $$\mathrm {R}[x]$$ -submodules of $$\frac{\mathrm {R}[x]}{\langle x^r-1\rangle }\times \frac{\mathrm {R}[x]}{\langle x^s-1\rangle }$$ . In this paper, we determine generator polynomials of $$\mathrm {R}$$ -double cyclic codes and their duals for arbitrary values of r and s. We enumerate $$\mathrm {R}$$ -double cyclic codes of length $$(2^{e_1},2^{e_2})$$ by giving a mass formula, where $$e_1$$ and $$e_2$$ are positive integers. Some structural properties of double constacyclic codes over $$\mathrm {R}$$ are also studied. These results are illustrated with some good examples.
The Long-Run Impact of the 1968 Washington, DC Civil Disturbance

This paper studies the urban development impacts of the civil disturbances that took place in Washington, DC following the assassination of Martin Luther King Jr. in 1968. We collect novel archival data that allow us to compare lots destroyed during the disturbances to neighboring properties on the same block. Though these lots exhibit no ex ante differences, destruction in 1968 led to large and persistent disinvestment. Destroyed properties were more likely to remain empty for 30 years and remain 20 percent less capital dense today. This finding, which contrasts with rapid rebuilding that has occurred after urban destruction in other historic episodes, highlights the stigmatization that resulted and the challenges that city leaders faced in taking on the redevelopment effort themselves.
Reusable Schedule Design and Execution Framework for Autonomous Mission Management in Space

Aerospace mission autonomy can improve mission capabilities, reduce the burden on ground operators, and prevent mission failure when encountering unexpected situations. However, autonomy comes at t...
Emergency Department Visits for Radiation Cystitis Among Patients with a Prostate Cancer History.

Objectives To elucidate the national burden of emergency department (ED) visits for radiation cystitis (RC), a known complication of radiation therapy to the pelvic area, among patients with a prostate cancer history, and identify those who are at increased risk of requiring invasive measures. Methods This study queried the Nationwide Emergency Department Sample for all ED visits from January 2006 to December 2015 with a primary diagnosis of radiation cystitis and secondary diagnosis of prostate cancer. ED visits were characterized by demographic factors, socioeconomic factors, and hospital characteristics. Weighted frequencies were used to create national estimates for all data analysis. Results A weighted total of 17,382 ED visits occurred for RC among patients with a prostate cancer history, of which 9,655 (55.5%) were treated with an invasive procedure. Notable factors associated with undergoing an invasive procedure included having a prior prostatectomy (odds ratio [OR], 5.48; 95% confidence interval [CI], 2.62-11.46), urinary retention (OR, 1.35; 95% CI, 1.12-1.64), hematuria (OR, 1.20; 95% CI, 1.01-1.42), and undergoing a blood transfusion (OR 2.12; 95% CI, 1.72-2.62). ED visits that were associated with invasive procedures had a higher median total charge ($34,707.53 vs $15,632.53) and an increased median length of stay (5 days vs 3 days) compared to visits without an invasive procedure. Conclusions Among ED visits for RC in prostate cancer, approximately one half required an invasive procedure for treatment. While radiation remains an effective modality for patients with prostate cancer, providers should be mindful of RC as a potential complication.
WE‐F‐304‐02: Recurrent HNC Treated with SBRT: TCP‐Based Outcome Estimates

Stereotactic Body Radiation Therapy (SBRT) was introduced clinically more than twenty years ago, and many subsequent publications have reported safety and efficacy data. The AAPM Working Group on Biological Effects of Hypofractionated Radiotherapy/SBRT (WGSBRT) extracted published treatment outcomes data from extensive literature searches to summarize and construct tumor control probability (TCP) and normal tissue complication probability (NTCP) models for six anatomical regions: Cranial, Head and Neck, Thoracic, Abdominal, Pelvic, and Spinal. In this session, we present the WGSBRT’s work for cranial sites, and recurrent head and neck cancer. From literature-based data and associated models, guidelines to aid with safe and effective hypofractionated radiotherapy treatment are being determined. Further, the ability of existing and proposed radiobiological models to fit these data is considered as to the ability to distinguish between the linear-quadratic and alternative radiobiological models such as secondary cell death from vascular damage, immunogenic, or bystander effects. Where appropriate, specific model parameters are estimated. As described in “The lessons of QUANTEC,” (1), lack of adequate reporting standards continues to limit the amount of useful quantitative information that can be extracted from peer-reviewed publications. Recommendations regarding reporting standards are considered, to enable such reviews to achieve more complete characterization of clinical outcomes. 1 Jackson A, Marks LB, Bentzen SM, Eisbruch A, Yorke ED, Ten Haken RK, Constine LS, Deasy JO. The lessons of QUANTEC: recommendations for reporting and gathering data on dose-volume dependencies of treatment outcome. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S155–60. Learning Objectives: 1. Describe the techniques, types of cancer and dose schedules used in treating recurrent H&N cancers with SBRT 2. List the radiobiological models that compete with the linear-quadratic model in explaining the results of hypofractionated RT 3. Describe the dose/volume metrics that are considered safe in SBRT treatment of tumors near the optic structures. 4. Discuss the efficacy of hypofractionation and dosing schedules used in treating vestibular schwannomas 5. Identify some difficulties in modeling TCP and NTCP for cranial tumors treated with hypofractionation. One moderator, Dr. Grimm, designed and holds intellectual property rights to the DVH Evaluator software tool which is an FDA-cleared product in commercial use, and can analyze some of this data. No others have relevant conflicts of interest.
Quantitative assay of low levels of benzo[a]pyrenediol epoxide bound to DNA by acid-induced liberation of tetraols followed by chromatography and fluorometric detection.

Publisher Summary Because of the intrinsic fluorescence associated with benzo[a]pyrene (BP) and its metabolites, this chapter explores the use of fluorescence detection for quantitating the amount of BP-diol epoxide (BPDE) bound to the DNA of exposed animals. Such techniques may have application to the detection of other fluorescent carcinogens as well. To quantitate the amount of BP bound to DNA treated with BPDE, extensive phenol extraction was first used to remove any noncovalently bound BP. The DNA was then subjected to mild acid hydrolysis, which removes 100% of the bound BP from the DNA in the form of tetraol. No concomitant destruction of the tetraol occurs under these conditions. If 100 μg of DNA is isolated from a single mouse treated with BP and then analyzed by fluorescence liquid chromatography, a binding frequency of 5 molecules of BP per l08 bases is detectable. This level of sensitivity is about a factor of 10 less than that calculated by Baird for 100 μg of DNA employing a specific activity of 20 Ci of tritiated BP per millimole. Additional improvements in the fluorescence assay are planned utilizing Cd-He laser excitation (A = 325 nm), which could increase the sensitivity by another order of magnitude.
A compact and low power microwave ECR broad ion beam source for low pressure materials processing

To meet industrial and research requirements for a physically compact, long-life, high-current-density, broad-beam ion source capable of operating with chemically active gases such as CF/sub 4/ and O/sub 2/, the multicusp ECR ion source concept has been redesigned to increase output beam current while reducing its physical size. The physical size of the cylindrical applicator has been reduced to an outside diameter of 3.75 in. and a cavity inside diameter of 3.5 in. while retaining a discharge diameter of 5 cm. The multicusp magnets have been removed from the microwave excitation region. Improved water and gas cooling allow for higher-power (>200 W) operation. The double extraction grids have been redesigned for greater transparency and, hence, greater beam current densities. The discharge is now self-starting at low pressures. When excited with the TE/sub 111/ mode at 2.45 GHz, the source operates efficiently and easily at low input gas flows (1-5 sccm) and pressures in Ar, O/sub 2/, and N/sub 2/ gases. Ion densities of 10/sup 11/-10/sup 12/ cm/sup -3/ have been achieved with input power levels of less than 200 W, and beam current densities in excess of 10 mA/cm/sup 2/ are produced with multigrid-extraction optics. >
Laws of Fear: Beyond the Precautionary Principle

Acknowledgements Introduction Part I. Problems: 1. Precautions and paralysis 2. Behind the precautionary principle 3. Worst case scenarios 4. Fear as wildfire Part II. Solutions: 5. Reconstructing the precautionary principle - and managing fear 6. Costs and benefits 7. Democracy, rights, and distribution 8. Libertarian paternalism with Richard Thaler 9. Fear and liberty A concluding note: fear and folly Index.
Does Industry-level Analysis Improve Profitability and Growth Forecasts?

A long history of economic theory suggests that industry membership plays an important role in explaining a firm's financial performance. In this paper we investigate the usefulness of industry benchmarks and industry level analysis for predicting a firm's future profitability and growth. Specifically we investigate whether incorporating the industry performance metric provides incremental information over the firm specific metric for explaining performance one-year-ahead. We also investigate the usefulness of performing industry level analysis relative to an analysis of all firms pooled across the economy. We find little or no incremental explanatory power from incorporating industry information for predicting future profitability, defined either as return on equity or return on net operating assets. Nor do we find industry information incrementally informative for predicting growth in net operating assets. We do, however, find significant improvement from incorporating industry information for predicting growth in sales. These general results hold for one-, three-, and five-year windows, and are robust to alternative industry classification schemes.