cssi/SciSciGPT-SciSciNet huggingface dataset:
Rapid wax plate modeling.

An accelerated method for the production of wax plate models from serial sections is described. Serial sections are projected on the back of 1 mm wax plates and the sharp image produced on the front of the plate is cut out directly with a knife. The construction of a simple projection apparatus which permits back-lighted projection is described and illustrated. The apparatus is built of common-size lumber and a small sheet of Plexiglas. It consists of a screen for the image and a wooden track on which a light source and microscope can be moved back and forth for different magnifications. Commercially available wax plates can be used. A method and the equipment needed to produce larger plates are described. The cut-out images when piled up to form the model are welded together and strengthened by inserting heated straight pins. The exterior of the model is smoothed with an electrically heated glass instrument which provides constant heat of desired temperatures. The construction of the glass instrument is illustrated.
Interstitial lung disease and gastroesophageal reflux disease: key role of esophageal function tests in the diagnosis and treatment

CONTEXT: Gastroesophageal reflux disease (GERD) is common in patients with respiratory disorders and interstitial lung fibrosis from diverse disease processes. However, a cause-effect relationship has not been well demonstrated. It is hypothesized that there might be more than a coincidental association between GERD and interstitial lung damage. There is still confusion about the diagnostic steps necessary to confirm the presence of GERD, and about the role of effective control of GERD in the natural history of these respiratory disorders. OBJECTIVES: To determine the prevalence of GERD in patients with respiratory disorders and lung involvement; the sensitivity of symptoms in the diagnosis of GERD; and the role of esophageal function tests (manometry and 24- hour pH monitoring) in the diagnosis and treatment of these patients. METHODS: Prospective study based on a database of 44 patients (29 females) with respiratory disorders: 16 patients had idiopathic pulmonary fibrosis, 11 patients had systemic sclerosis associated interstitial lung disease, 2 patients had polymyositis associated interstitial lung disease, 2 patients had Sjogren associated interstitial lung disease, 2 patients had rheumatoid artrithis associated interstitial lung disease, 1 patient had undifferentiated connective tissue diseases associated interstitial lung disease and 10 patients had sarcoidosis. The average forced vital capacity (% predicted) was 64.3%. All patients had esophageal function tests. RESULTS: Thirty patients (68%) had pathologic reflux (average DeMeester score: 45, normal <14.7). The average number of reflux episodes recorded 20 cm above the lower esophageal sphincter was 24. Sensitivity and specificity of heartburn were 70% and 57%, of regurgitation 43% and 57%, and of dysphagia 33% and 64%. Twelve patients with GERD underwent a laparoscopic fundoplication which was tailored to the manometric profile: three patients in which peristalsis was normal had a total fundoplication (360°) and nine patients in which the peristalsis was absent had a partial anterior fundoplication (180°). CONCLUSIONS: The results of our study show that: (a) abnormal reflux was present in about 2/3 of patients with respiratory disorders (idiophatic pulmonary fibrosis, connective tissue disorders and sarcoidosis), and it extended to the upper esophagus in most patients; (b) the sensitivity and specificity of reflux symptoms was very low; and (c) esophageal function tests were essential to establish the diagnosis of abnormal reflux, to characterize the esophageal function and guide therapy. Long term follow-up will be necessary to determine if control of reflux alters the natural history of these respiratory disorders.
Remembering the "pan" in "pandemic": considering the impact of global resource disparity on a duty to treat.

While Malm and colleagues (2008) do a fine job of considering the limits and merits of a duty to treat in the face of pandemic disease, they do so in the developed-world context. Developing world h...
A novel approach to integrating design into manufacturing and materials education through the fabrication of a scale model cannon

Prior to 2001 the materials and manufacturing laboratories in mechanical engineering at Texas A&M University were independent initiatives. Recently, these courses have been combined into one entity. It was proposed that if these two courses integrated fully under one project, that the students would better understand the place of materials and manufacturing in design. The proposed project was a 1/8th scale replica of a 12 Ib. Civil war Napoleon in a field mount. Existing labs were modified so that each topic contributed to the production of the cannon. Assessment of the lab was performed using three student surveys and two open ended qualitative essays graded using analytic rubrics. Survey results indicate that the students are highly enthused by the new class and feel they have improved in the required subjects. Analysis of the essays shows that the students in cannon class have a better understanding of the role and application of materials selection and manufacturing in design.
Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care

Background Computerized provider order entry (CPOE) is the process of entering physician orders directly into an electronic health record. Although CPOE has been shown to improve medication safety and reduce health care costs, these improvements have been demonstrated largely in the inpatient setting; the cost-effectiveness in the ambulatory setting remains uncertain.
A Viability Study of a Lithium Battery Powered Golf Cart

There is a recent trend among low speed electric vehicle manufacturers to update traction batteries from older, heavy chemistries to new, lighter battery chemistries. In this viability study, a Club Car Villager LSV electric golf cart was converted from the original flooded lead acid batteries to hard carbon/mixed oxide lithium batteries. The range and speed of both chemistries are compared. This paper demonstrates a potential operational savings for ight electric vehicle users. Despite a reduction in volume, the lithium batteries outperformed the lead acid in both range (46.7% increase) and charging time (95% reduction). The range increase was due, in part, to a reduction in battery weight of 62.5%. In addition to range test results, implementation of the lithium battery management system and J1772 charger system used to support this conversion are discussed.
Nurturing the microbiome field

The Unified Microbiome Initiative Consortium's desire to organize research efforts across disciplinary and geopolitical boundaries is much needed (“A unified initiative to harness Earth's microbiomes,” A. P. Alivisatos et al. , Policy Forum, 30 October, p. [507][1]; published online 28 October 2015). Previous “Big Science” efforts have had a top-down focus: Large amounts of money are invested in the ideas of a small number of individuals. For the microbiome project, I would propose a bottom-up approach, in which a broad vision is outlined and then as many researchers as possible address those concepts in their biological systems with their own talents and research networks. Regardless of the structure of the initiative, this field belongs to its researchers, and we must nurture it to ensure continued funding and public interest. We must communicate our efforts to do robust hypothesis-driven research as well as the importance of descriptive studies that contribute to our still-incomplete census. The Consortium and the rest of us must lead by example in terms of transparency, robust methods, pre- and post-publication peer review, and acknowledgment of negative results. As much as we are enthusiastic about the role of the microbiome, we must also realize that it is not responsible for everything. It is exciting to see the nucleus of a grand vision for the field, but we must make the fundamentals of the scientific method central to our mission. [1]: /lookup/doi/10.1126/science.aac8480
Your Viral Past: A Comprehensive Method for Serological Profiling to Explore the Human Virome

This is an exciting time of rapid advancement in the field of infectious diseases diagnostics. Traditional methods to diagnose infections have typically been slow and relied on culture for detection of infectious agents. In recent years, however, there has been an explosion in new methodologies and instrumentation to diagnose infections, with a focus on optimization of therapy and antimicrobial stewardship. Newer assays have improved diagnostic testing in several ways, including reductions in turnaround time and improvements in analytical sensitivity and specificity. A major theme in testing for infectious diseases has been multiplexing of diagnostic tests, to allow simultaneous testing for several different pathogens within a single assay. The use of multiplex molecular assays, such as multiplex PCR, is now well established, and tests have been approved by the US Food and Drug Administration for 20 or more pathogens and genetic markers of antibiotic resistance from a single specimen. Although multiplex tests are increasingly common for detecting pathogens, they are much less common for detecting antibodies specific for pathogens. Although antibody responses against pathogens take a week or more to develop after initial infection, they are often long lived, so detecting these responses has the potential to indicate present, recent, or long-past infections. Most immunoassays detect antibodies against a single pathogen. These may be clinically useful, but clinical judgment must be used in the selection of assays, and the cause of an infection may not be detected if the appropriate antibody is not sought. Moreover, it would be cumbersome to use conventional immunoassays to try to determine the cumulative viral infections that a person has encountered over a lifetime. Our improved understanding of the many microorganisms that infect and colonize our bodies has led to a specific interest in the cumulative history of viral infections in humans. This has grown out …
Catalytic Activity in Lithium-Treated Core–Shell MoOx/MoS2 Nanowires

Significant interest has grown in the development of earth-abundant and efficient catalytic materials for hydrogen generation. Layered transition metal dichalcogenides present opportunities for efficient electrocatalytic systems. Here, we report the modification of 1D MoOx/MoS2 core–shell nanostructures by lithium intercalation and the corresponding changes in morphology, structure, and mechanism of H2 evolution. The 1D nanowires exhibit significant improvement in H2 evolution properties after lithiation, reducing the hydrogen evolution reaction (HER) onset potential by ∼50 mV and increasing the generated current density by ∼600%. The high electrochemical activity in the nanowires results from disruption of MoS2 layers in the outer shell, leading to increased activity and concentration of defect sites. This is in contrast to the typical mechanism of improved catalysis following lithium exfoliation, i.e., crystal phase transformation. These structural changes are verified by a combination of Raman and X-ra...
Introduction to Cognitive Literary Studies

The best definition of cognitive literary studies was offered by Alan Richardson in 2004. Richardson starts by pointing out that “cognitive” is a broad term, referring to “an overriding interest in the active (and largely unconscious) mental processing that makes behavior understandable.” Given the tremendous variety of research programs that investigate mental processing, “cognitive science,” too, is a broad umbrella term. It signifies an interdisciplinary venture, “rather like ‘feminist studies’ or ‘cultural studies,’ ” that is “loosely held together by a set of common interests, allegiances, and reference points rather than a coherent discipline unified by shared paradigms and methodologies.” It is fitting then that the definition of cognitive literary studies should focus not on the boundaries, goals, or methods of the field but on its dynamic, relational nature. Richardson sees it as “the work of literary critics and theorists vitally interested in cognitive science. . ., and therefore with a good deal to say to one another, whatever their differences.”1 This dialogic, decentralized view has shaped the trajectory of cognitive approaches to literature over the last decade. On the one hand, cognitive literary scholars actively seek professional venues for talking to one another (for instance, the membership in the Modern Language Association official discussion group on cognitive approaches to literature has grown from 250 in 1999, the year it was organized, to 700 in 2009, and to 2,000 in 2013).2 On the other hand, because they don’t see themselves as working on a puzzle whose pieces must fit neatly together, they feel no need to iron out differences3 among their “potentially conflicting aims and methodologies.”4 Indeed, given what a messy proposition the human mind/brain is and how little we still know about it, striving toward a grand unified theory of cognition and literature is to engage in mythmaking.5 OUP UNCORRECTED PROOF – FIRSTPROOFS, Thu Aug 28 2014, NEWGEN
Serum Levels After Single Oral Doses of 6-(α-Phenoxypropionamido) Penicillanate and Penicillin V.

ConclusionsPotassium 6-(α-phenoxypropionamido) penicillinate and potassium phenoxymethyl penicillin are absorbed in essentially the same manner in normal men and produce comparable levels of antibacterial activity in the serum. Both of these penicillins are qualitatively similar to penicillin G in their susceptibility to penicillinase produced by Staphylococcus aureus.
Xenoestrogens and breast cancer.

Chemophobia, the unreasonable fear of chemicals, is a common public reaction to scientific or media reports suggesting that exposure to various environmental contaminants may pose a threat to health. The specter of cancer, birth defects, and irreversible effects on infants and children invariably scares people and leads to demands for action. During the past five to six years, there has been widespread scientific debate and media coverage concerning a new potential threat to human health — environmental exposure to chemicals with endocrinologic activity. Attention has focused primarily on the weakly estrogenic organochlorine pollutants, including commercially produced chemicals such as polychlorinated . . .
Time-Series Analysis on Association between Air Pollution and Outpatient Visits for Respiratory Diseases in a Hospital in Shanghai

[Objective] To evaluate the short-term health effects of air pollutants on outpatient visits for respiratory diseases in Shanghai.[Methods] Daily data on outpatient visits to a Grade III Class A hospital for respiratory diseases, meteorological data, and air pollution data from January 1, 2010 to October 31, 2012 were collected.A time-series analysis by generalized additive model was conducted to examine the relationship between air pollutants and daily outpatient visits, controlling for time trends, day-of-week effect, holiday effect, and weather conditions.[Results] The daily outpatient visits for respiratory diseases ranged from 76 to 382 over the study period.In the single-pollutant model, SO2 concentration with lagged 4 days and NO2 and PM10 concentrations with lagged 6 days showed the most significant influence on outpatient visits.The excess relative risks of daily outpatient visits for a 10- μg/m3 increment in SO2, NO2, and PM10 were 0.69%(RR=1.006 9, 95%CI: 1.003 5-1.010 3), 0.54%(RR=1.005 4, 95%CI: 1.002 8-1.007 9), and 0.20%(RR=1.002 0, 95%CI: 1.001 1-1.002 8), respectively.In the multiple-pollutant models, all pollutants effect estimates were lower compared with the results of the single-pollutant model when other pollutants were adjusted, but the positive correlations still existed between the pollutants and the daily outpatient visits for respiratory diseases.[Conclusion] The ambient air pollutant concentrations of SO2, NO2, and PM10 are positively associated with daily outpatient visits for respiratory diseases.
Comprehensive Internationalization: Examining The What, Why, And How At Community Colleges

Community colleges enroll nearly half of the total U.S. undergraduates, have the most diverse student population, and serve as the only contact with postsecondary education for many students. Community colleges have engaged in internationalization efforts for decades. Most rely on study abroad and international students as the only methods to internationalize their campuses. A focus on study abroad is not an effective method to internationalize the campus and provide all students with the global awareness and skills necessary to be successful in today’s society. The American Council on Education Model for Comprehensive Internationalization (2012a), Knight’s (1997) rationales framework, and Knight’s (2004) approaches framework to form the conceptual model to analyze the what (meanings), why (rationales/motivations), and how (strategies and models) of community colleges’ internationalization efforts. College sites for the study included Montgomery College, Tidewater Community College, and Orange Coast College. All site colleges participated in one of the American Council on Education’s (ACE) comprehensive internationalization projects. This qualitative collective case study sought to describe the experience and process of comprehensive internationalization in the community college sector, to identify the perceived rationales and motivations to internationalize, to determine the successes and challenges of the comprehensive internationalization
Intake and digestibility of low-quality meadow hay by cattle receiving various levels of whole shelled corn.

Two trials were conducted to evaluate the effects of whole shelled corn supplementation on intake and digestibility of low-quality meadow hay by cattle. In Trial 1, four ruminally cannulated steers (avg BW 418 kg) were used in a latin square design with four treatments (no corn or corn fed at .25%, .50% or .75% of BW). Hay DMI decreased (P = .002) linearly .43 g for each gram of increase in corn intake. In contrast, total diet DMI increased (P = .001) linearly as level of corn supplementation increased. Apparent DM digestibility of the diet increased (P = .026) linearly, whereas hay DM digestibility was not affected (P greater than .05) by supplemental corn, although the DM digestion coefficient for hay alone was 24% higher than for hay fed with corn at .75% of BW. Ruminal ammonia concentration and pH were not affected (P greater than .05) by treatments; however, ratio of acetate:propionate and acetate:butyrate responded (P less than or equal to .097) quadratically to increased corn supplementation. Corn supplementation resulted in a cubic (P less than or equal to .081) decrease in meadow hay NDF disappearance from nylon bags suspended in the rumen at all incubation intervals after 4 h. In Trial 2, 45 crossbred, nonlactating, pregnant cows (avg BW 474 kg) were used in a completely randomized design with three treatments (no corn, .91 and 1.81 kg corn.hd-1.d-1). Cow performance was not altered (P greater than .05) by treatments.(ABSTRACT TRUNCATED AT 250 WORDS)
External Factors in Debt Sustainability Analysis: An Application to Latin America?

This paper develops a framework for debt sustainability analysis that integrates econometric estimates of the effect of global factors on a set of key domestic variables that determines public and external debt dynamics. The methodology is applied to assess debt sustainability in Latin America—a region highly sensitive to external conditions. Results suggest that, while some countries in the region are well placed to withstand moderate or even large foreign shocks, many would benefit from strengthening their fiscal positions to be able to deploy countercyclical policies under adverse scenarios, especially tail events. External sustainability, on the other hand, does not appear to be a source of concern for most countries.
Impact of alternative footwear on human balance

Alternative footwear are those that are most commonly used for casual or recreational purposes, over the course of the day. The purpose of this study was to examine the effects of three forms of alternative footwear (thong style flip-flops, clog style Crocs®, and Vibram Five-Fingers®) on balance with a low-intensity workload. Eighteen healthy male adults (age: 22.9 ± 2.88 years; height: 179 ± 6.0 cm; mass: 81.3 ± 8.8 kg) participated in this study. Balance performance along with electromyographic (EMG) measures was assessed with sensory organization test (SOT) and motor control test on the Neurocom Equitest, while donning alternative footwear, prior to and after a one-mile walk at a self-selected pace. Sway velocities and root-mean-square sway, SOT equilibrium scores, postural response latencies, and EMG measures from lower leg muscles were analysed using a 3 × 2 (footwear × time) repeated-measures ANOVA. Results from balance variables revealed a significant main effect difference for footwear in the eyes...
Using Movements and Habitat Utilization as a Functional Metric of Restoration for Estuarine Juvenile Fish Habitat

AbstractResource managers use habitat restoration to offset estuarine habitat loss; however, there is limited information about how functionally successful restorations have been, particularly with respect to their use by mobile marine predators. Restoration monitoring efforts typically use point-of-capture metrics to assess fish community recovery and habitat use, but this provides little insight into how fish habitat use changes through time. Using translocation experiments, we integrated the movements of California Halibut Paralichthys californicus, a conservation target species, into a point-of-capture monitoring program in a restored tidal creek estuary. Large halibut (>25 cm) were captured more frequently in the main stream channel, while small ones (<25 cm) were typically caught in the innermost marsh creeks. We actively tracked these fish (n = 20; size range = 26.6–60.5 cm TL) acoustically to identify their preferred habitats and challenged these habitat associations by means of translocations to ...
Labyrinths of the Mind and the City: Both Real and Virtual

Publisher Summary Virtual worlds represent new labyrinths confronting the human bodies and experiences of space with paradoxes of a new order. The labyrinths of the past were always spatial in conception, being metaphors of disorientation, while labyrinths of “the virtual” are meta-labyrinths, becoming places of strange knots and irrational dizziness. In fact, these meta-labyrinths are abstract and formal, not material; they are constantly moving and changing into structures that cannot be imagined. It is not so much a matter of disorientation and losing one's way, but actually developing entirely new languages with which to move between the formal models and synthetic images of the virtual and the sensual experiences they provide as one walks, touches, sees, and feels synthetic aspects of these virtual worlds. Once immersed within computer-generated cyberspace, it is obliged to pay close attention to the links and nodes that interlace reality and appearances, illusions and symptoms, images and models in these new virtual worlds―because full immersion in the virtual means that everything inside relates to the synthetic reality of cyberspace and not to exterior physical space.
Patterns, extensions, and conclusions

In this short chapter we will go over the results of Chapters 7 and 8, trying to look for common arguments and patterns in the final estimates. It will be clear that problems are paired and that by looking at the type of transmission condition we can predict what kind of regularity the data needs to have. We will next give two simple extensions of this theory, to problems defined on screens and to problems on linear elasticity. The chapter will finish with an overview of part of the literature and mentioning some work in progress.
Chemical Activation Study of the Unimolecular Reactions of CD3CD2CHCl2 and CHCl2CHCl2 with Analysis of the 1,1-HCl Elimination Pathway.

Chemically activated C2D5CHCl2 molecules were generated with 88 kcal mol–1 of vibrational energy by the recombination of C2D5 and CHCl2 radicals in a room temperature bath gas. The competing 2,1-DCl and 1,1-HCl unimolecular reactions were identified by the observation of the CD3CD═CHCl and CD3CD═CDCl products. The initial CD3CD2C—Cl carbene product from 1,1-HCl elimination rearranges to CD3CD═CDCl under the conditions of the experiments. The experimental rate constants were 2.7 × 107 and 0.47 × 107 s–1 for 2,1-DCl and 1,1-HCl elimination reactions, respectively, which corresponds to branching fractions of 0.84 and 0.16. The experimental rate constants were compared to calculated statistical rate constants to assign threshold energies of 54 and ≈66 kcal mol–1 for the 1,2-DCl and 1,1-HCl reactions, respectively. The statistical rate constants were obtained from models developed from electronic-structure calculations for the molecule and its transition states. The rate constant (5.3 × 107 s–1) for the unimol...
Management of Gastroesophageal Reflux Disease

Management of gastroesophageal reflux disease (GERD) commonly starts with an empiric trial of proton pump inhibitor (PPI) therapy and complementary lifestyle measures, for patients without alarm symptoms. Optimization of therapy (improving compliance and timing of PPI doses), or increasing PPI dosage to twice daily in select circumstances, can reduce persistent symptoms. Patients with continued symptoms can be evaluated with endoscopy and tests of esophageal physiology, to better determine their disease phenotype and optimize treatment. Laparoscopic fundoplication, magnetic sphincter augmentation, and endoscopic therapies can benefit patients with well-characterized GERD. Patients with functional diseases that overlap with or mimic GERD can also be treated with neuromodulators (primarily antidepressants), or psychological interventions (psychotherapy, hypnotherapy, cognitive and behavioral therapy). Future approaches to treatment of GERD include potassium-competitive acid blockers, reflux-reducing agents, bile acid binders, injection of inert substances into the esophagogastric junction, and electrical stimulation of the lower esophageal sphincter.
Right Ventricular Dyssynchrony Before and After Pulmonary Thromboendarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension

ABSTRACTBackground: Left ventricular dyssynchrony has been studied extensively, but this is not the case with right ventricular (RV) dyssynchrony. Our aim was to investigate RV dyssynchrony through 2D speckle strain imaging in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after pulmonary thromboendarterectomy (PTE).Methods: We measured 2D peak RV strain (%) of the RV free-wall and time to peak strain (ms) of its three freewall segments (base, mid, and apex) in 127 consecutive CTEPH patients (51 ± 14 years, 59% female) with adequate images pre- and post-PTE. RV strain was calculated using Epsilon Imaging EchoInsight® software. RV dyssynchrony was measured using two methods: the standard deviation of peak systolic strain and the standard deviation of time (ms) to peak strain (RVDT) between the three RV free-wall segments.Results: Mean RV free wall strain did not change significantly after PTE (−11.4 ± 5.7 to −11.2 ± 5.6%, p = 0.67). However, RV dyssynchrony improved dramatic...
The Effect of Alcohol on Fluid and Electrolyte Metabolism

Since the time that the technique of fermentation was learned by prehistoric man, alcohol has been used primarily for its cerebral manifestations, often with unfortunate physiologic consequences. Undoubtedly, a common clinical observation on which Shakespeare commented in Act II, Scene iii of Macbeth was that the drinking of alcoholic beverages promotes an increased flow of urine. Despite this observation, it is of interest how clinical impressions of heavy drinkers changed drastically throughout the history of medicine. During the eighteenth and nineteenth centuries and until 1938, most persons who ingested large quantities of alcohol were described as being “dropsical” (Coffey, 1966). Indeed, between 1718 and 1751 in London, deaths from “dropsical conditions” reached an unprecedented level. It should be noted that this was a general term used for any abnormal amount of fluid in cellular tissue or body cavity, and most forms were associated with excessive drinking. When the mortality rate fell rapidly, physicians at this time attributed the decline to a marked attenuation of public drunkenness. In addition to general edematous states as a result of alcohol ingestion, cerebral edema has been frequently described (Sutton, 1813; Snowden, 1820; Hayward, 1822). Postmortem investigations of patients who died from delirium tremens revealed markedcongestion and turgidity of cerebral blood vessels, turgidity of dural sinuses, together with an increase in subarachnoid and ventricular quantities of cerebrospinal fluid. When the dura was opened, marked quantities of serous fluid were discharged (Sutton, 1813; Snowden, 1820; Hayward, 1822). Treatment was directed at dehydrating the patient because of the “dropsical conditions,” and such techniques as conservative blood letting, purgation (Sutton, 1813; Hayward, 1822), emetics (Klapp, 1817; Snowden, 1820), and hot tub baths (Hayward, 1822; Wright, 1830) were used. Spinal drainage was often used in an attempt to relieve the cerebral edema (Steinbach, 1915).
Melatonin, Light & Noise Reduction To Improve Sleep in the Neurological Intensive Care Unit (P01.025)

OBJECTIVE: To increase total sleep time by using melatonin and mitigating environmental disruptions in brain injured patients. BACKGROUND: Sleep in the ICU is often abnormal. Patients in medical ICUs have deficient melatonin production, which may lead to decreased sleep; light and sound levels have been implicated in fragmented sleep in medical/surgical ICUs. Given the cognitive, autonomic, and metabolic impact of sleep deprivation, both supplemental melatonin and mitigating environmental disruption in the ICU have been tried, but with variable results. Sleep has not been well studied in neurological ICU patients. DESIGN/METHODS: Adult neurological ICU patients undergoing continuous electroencephalography were randomized to receive oral melatonin, sound-reducing headphones, and eye covers vs standard care. A sleep montage including electromyography and flow was used to score sleep on 24-hr periods 1 & 3 as per American Academy of Sleep Medicine criteria. Primary endpoint was total sleep time. Secondary endpoints included the ability to measure sleep and outcome at discharge. RESULTS: 12 patients were enrolled, 6 in each arm. The mean age was 57.9; there were no significant differences between those who received intervention and those who did not regarding illness severity, intubation, or neurological exam. There were no differences between total sleep time on days 1 or 3. There were no significant differences in functional outcome upon discharge. Up to 78% of patients could not be scored using standard criteria; those who could had disorganized sleep, decreased slow-wave sleep and a mean of 85 awakenings over an average of 7 hours of sleep during 19 hours of recording. CONCLUSIONS: Sleep in many neurological ICU patients cannot be scored using standard methods. Those who could be scored had fragmented sleep with loss of restorative sleep stages. Larger patient sample size or alternative methods of scoring sleep are needed to better evaluate the use of sleep interventions in brain injured patients. Supported by: A 2011-2012 Pfizer Fellowships in Epilepsy from Pfizer9s Medical and Academic Partnerships program. Disclosure: Dr. Foreman has received research support from Pfizer9s Medical and Academic Partnerships program. Dr. Claassen has nothing to disclose. Dr. Bazil has received personal compensation for activities with Pfizer, Inc., Lundbeck Research USA, Inc., and Eisai Inc. Dr. Bazil has received personal compensation in an editorial capacity for Current Neurology and Neuroscience Reports, and The Medical Letter.
Sampling Methods and the Accredited Population in Athletic Training Education Research

Context: We describe methods of sampling the widely-studied, yet poorly defined, population of accredited athletic training education programs (ATEPs). Objective: There are two purposes to this stu...
Abstract WP151: Targeted Engagement of the Premotor Component of the Motor Network After Stroke

Introduction: Dorsal premotor cortex (PMd) is an important neural correlate of motor recovery after stroke. A protocol that targets engagement of this component of the motor network through changes in task demands may be a useful rehabilitation tool. Therefore, the purpose of this study was to determine the response to a period of practice targeted at PMd using a well-defined behavioral condition (action selection). Methods: Twelve individuals post-stroke (age: 56.9±7.7 years; months post-stroke: 46.5±46.7; UE FM motor score: 41.8±14.9) completed a task that required right or left movement of a joystick with the weaker hand under two conditions. In the Select Condition, the individual moved right or left based on an abstract, visual rule; this condition has been shown to activate PMd. In the Execute Condition, the individual moved the same direction on every trial. The task was practiced for four consecutive days and completed during functional MRI on Days 1 and 4. Results: Accuracy improved and reaction ...
Predictive projections

This paper addresses the problem of learning control policies in very high dimensional state spaces. We propose a linear dimensionality reduction algorithm that discovers predictive projections: projections in which accurate predictions of future states can be made using simple nearest neighbor style learning. The goal of this work is to extend the reach of existing reinforcement learning algorithms to domains where they would otherwise be inapplicable without extensive engineering of features. The approach is demonstrated on a synthetic pendulum balancing domain, as well as on a robot domain requiring visually guided control.
Conditioning: Modification by Peripheral Mechanisms

This paper examines the idea that peripheral hormones, particularly those of the sympatho-adrenal system, are part of the normal machinery of learning and memory. Blood-borne hormones, although widely distributed in the body have very specific actions because of the nature and location of their receptive sites.
Modal reduction of a parametrically forced confined viscous flow

A model for estimating the onset of parametric instability in a stably stratified two-dimensional confined viscous flow is presented. The model uses a superposition of modal responses to independent Mathieu equations and is calibrated using a small number of numerical Floquet results.
Serological Testing of the HLA Antigens

In recent years, the demand for HLA testing has increased greatly, to the extent that it has outpaced the capacity of HLA-typing laboratories to adequately fulfill this need. This is due, in part, to an increasing application of HLA typing not only to organ and tissue transplantation, but also to granulocyte and platelet transfusion (Mittal et al., 1976). To provide optimally HLA-matched platelets to various thrombocytopenic patients, it is necessary that large numbers of potential donors be HLA-phenotyped prospectively.
An unusual case of sustained ventricular tachycardia from acute pulmonary embolism

Pulmonary embolism (PE) is a known cause of cardiac arrest, typically through pulseless electrical arrest or asystole. Very rarely, PE is linked to ventricular tachycardia (VT). A 64 year old male presented with left lower extremity DVT and acute bilateral PE confirmed on CT scan (1A).
Embedding the Problems Doesn't Make Them Go Away.

Auriemma et al. (2020) provide a valuable service in identifying what is so troubling about categorical exclusion criteria in COVID-19 crisis standards of care. We are not convinced, however, that ...
The immune system in infants: Relevance to xenotransplantation

Despite the improvement in surgical interventions in the treatment of congenital heart disease, many life-threatening lesions (eg, hypoplastic left heart syndrome) ultimately require transplantation. However, there is a great limitation in the availability of deceased human cardiac donors of a suitable size. Hearts from genetically engineered pigs may provide an alternative source. The relatively immature immune system in infants (eg, absence of anti-carbohydrate antibodies, reduced complement activation, reduced innate immune cell activity) should minimize the risk of early antibody-mediated rejection of a pig graft. Additionally, recipient thymectomy, performed almost routinely as a preliminary to orthotopic heart transplantation in this age-group, impairs the T-cell response. Because of the increasing availability of genetically engineered pigs (eg, triple-knockout pigs that do not express any of the three known carbohydrate antigens against which humans have natural antibodies) and the ability to diagnose congenital heart disease during fetal life, cardiac xenotransplantation could be preplanned to be carried out soon after birth. Because of these several advantages, prolonged graft survival and even the induction of tolerance, for example, following donor-specific pig thymus transplantation, are more likely to be achieved in infants than in adults. In this review, we summarize the factors in the infant immune system that would be advantageous in the success of cardiac xenotransplantation in this age-group.
Minimax Prediction in Tree Ising Models

Graphical models are often used to facilitate efficient computation of posteriors in order to make predictions. With this objective in mind, we consider the problem of estimating the parameters of a graphical model with known structure from samples such that posteriors computed using the model are accurate. Focusing on tree-structured binary Markov random fields, our main result is a sharp characterization of the dependence on number of samples needed for all pairwise marginals (and hence posteriors of one variable given another) to be accurate: n = Θ(η−2 logp) samples are necessary and sufficient to estimate model parameters such t √ hat all marginals of arbitrary order k are accurate to within kη. The result implies that prediction error is bounded uniformly, with no dependence on the strength of interactions. We will also show that these guarantees are achievable using moment matching techniques.
Skeletal Muscle Mass Loss During Cancer Treatment: Differences by Race and Cancer Site.

OBJECTIVES To examine skeletal muscle mass change in a racially diverse sample of patients undergoing cancer treatment, determine significant predictors of muscle mass loss, and explore the interaction of race and cancer site. SAMPLE A SETTING A retrospective analysis was conducted for 212 patients seeking treatment at a university hospital clinic. METHODS A VARIABLES Skeletal muscle mass index (SMI) was determined by computed tomography at the time of cancer diagnosis and with cancer treatment. RESULTS One hundred thirty-four patients (63%) had SMI loss with cancer treatment. Race and cancer site were found to be significant predictors of SMI loss. Compared to other racial groups, non-Hispanic Black (NHB) patients had the greatest SMI loss (p < 0.001) with cancer treatment. NHB patients with rectal cancer experienced the greatest SMI loss compared to patients of other races and cancer types. IMPLICATIONS FOR NURSING To improve survivorship care for patients with cancer, it is essential to develop strategies for assessing and managing skeletal muscle mass loss throughout treatment, particularly for NHB patients with rectal cancer.
DAS28-CRP Cutoffs for High Disease Activity and Remission Are Lower Than DAS28-ESR in Rheumatoid Arthritis.

Objective Guidelines do not specify how cutoffs for high disease activity differ between the Disease Activity Score 28-joint count indices DAS28-erythrocyte sedimentation rate (ESR) and DAS28-C-reactive protein (CRP). Studies that compare DAS28-CRP and DAS28-ESR depend on data from clinical trials, registries, or practices with multiple providers. Existing studies use data from patients who received immunosuppressive therapy. This study compared the DAS28-ESR and DAS28-CRP values from immunosuppressive treatment-naive patients in a single physician practice. Methods A retrospective electronic medical chart review was conducted for new diagnoses of rheumatoid arthritis (RA; International Classification of Diseases [ICD]-9 714), based on the American College of Rheumatology/European League against Rheumatology 2010 RA classification criteria. The number of patients with high disease activity (>5.1) was compared using ESR and CRP data to calculate the proportion of discordance. A receiver operator curve and Youden index was used to calculate the DAS28-CRP high disease activity cutoff estimation that corresponds with DAS28-ESR of more than 5.1. Results There were 171 patients included in this study. The baseline mean DAS28-ESR was higher than the baseline mean DAS-28 CRP: 5.1 ± 1.2 versus 4.1 ± 1.0 (P 5.1) compared with only 14.6% when measured by DAS28-CRP. Discordance was 33.9%. κ coefficient was only .307. Receiver operator curve and Youden index analysis suggested that the cutoff point for high disease activity of DAS28-CRP greater than 4.1, which corresponds to DAS28-ESR greater than 5.1. Similarly, DAS28-ESR posttreatment scores were significantly higher than DAS28-CRP. When measured by DAS28-ESR, patients in remission had higher scores as measured by DAS28-ESR (1.81) than DAS28-CRP (1.45). Conclusion There is a difference between DAS28-ESR and DAS28-CRP, even when calculated for immunosuppressive treatment-naive patients. DAS28-CRP is significantly lower than DAS28-ESR.
Is the Balassa-Samuelson Hypothesis still relevant? Cross-country evidence from 1950 -2017

Abstract. We revisit the Balassa and Samuelson hypothesis based on the relationship between real exchange rate and total factor productivity relative to the United States and investigate with panel data set of 182 countries from 1950 to 2017. Results, suggest that there is an inverse relationship between the two, an increase in productivity results in an increase in real exchange rate and the findings supports the hypothesis. We use a range of tests including Arellano-Bond Dynamic Panel Data (both fixed and random effect) estimator and findings validates the hypothesis. All these additional tests confirm that the relationship between real exchange rate and relative factor producity are related in the long-run also. Keywords. Balassa–Samuelson effect; Exchange rate, Fixed effect model, Random effect model, Trade and globalization. JEL. C15, E31, F31, F41.
Primary care quality and cost for privately insured patients in and out of US Health Systems: Evidence from four states.

OBJECTIVE To characterize physician health system membership in four states between 2012 and 2016 and to compare primary care quality and cost between in-system providers and non-system providers for the commercially insured population. DATA SOURCES Physician membership in health systems was obtained from a unique longitudinal database on health systems and matched at the provider level to 2014 all-payer claims data from Colorado, Massachusetts, Oregon, and Utah. STUDY DESIGN Using an observational study design, we compared physicians in health systems to non-system physicians located in the same state and geography on average cost of care (risk-adjusted using the Johns Hopkins' Adjusted Clinical Grouper), five HEDIS quality measures, one measure of developmental screening, and two Prevention Quality Indicator Measures. DATA COLLECTION/EXTRACTION METHODS Patients in commercial health plans were attributed to a primary care physician accounting for the plurality of office visits. A cohort for each quality measure was constructed based on appropriate measure specifications. PRINCIPAL FINDINGS The share of physicians in health systems increased steadily from 2012 to 2016 and ranged from 48% in Colorado to 63% in Utah in 2016. Compared to physicians not in a system, system physicians performed similarly on most HEDIS quality metrics compared to non-system physicians. Patients attributed to in-system physicians had about 40% higher rates (P < .05) of Ambulatory Care Sensitive Admissions (measured in admissions per 100 000:921.33 in-system vs 674.61 not-in-system for acute composite; 2540.91 in-system vs 1972.17 for chronic composite In-system providers were associated with $29 (P < .05) higher average per member per month costs (453.37 vs 432.93). Overall, differences in performance by system membership were relatively small compared to differences across states and geography. CONCLUSION A growing share of physicians is part of a health system from 2012 to 2016. Providers in health systems are not delivering primary care more efficiently than non-system providers for the commercially insured.
On the 10-micron silicate feature in Active Galactic Nuclei

The 10-micron silicate feature observed with Spitzer in active galactic nuclei (AGN) reveals some puzzling behavior. It (1) has been detected in emission in type 2 sources, (2) shows broad, flat-topped emission peaks shifted toward long wavelengths in several type 1 sources, and (3) is not seen in deep absorption in any source observed so far. We solve all three puzzles with our clumpy dust radiative transfer formalism. (1) We present the spectral energy distribution (SED) of SST1721+6012, the first type 2 quasar observed to show a clear 10-mic silicate feature in emission. We constructed a large database of clumpy torus models and performed extensive fitting of the observed SED, constraining several of the torus parameters. We find that the source bolometric luminosity is ~3*10^12 L_sun. Our modeling suggests that <35% of objects with tori sharing characteristics and geometry similar to the best fit would have their central engines obscured. This relatively low obscuration probability can explain the clear appearance of the 10-mic emission feature in SST1721+6012 together with its rarity among other QSO2. (2) We also fitted the SED of PG1211+143, one of the first type 1 QSOs with a 10-mic silicate feature in emission. Among similar sources, this QSO appears to display an unusually broadened feature whose peak is shifted toward longer wavelengths. Although this led to suggestions of non-standard dust chemistry in these sources, our analysis fits such SEDs with standard galactic dust; the apparent peak shifts arise from radiative transfer effects. (3) We find that the distribution of silicate feature strengths among clumpy torus models closely resembles the observed distribution, and the feature never occurs deeply absorbed. (abridged)