cssi/SciSciGPT-SciSciNet huggingface dataset:
The fate of internal mammary arterial implants and bypass conduits for myocardial revascularization: Experimental angiographic, histologic, and ultrastructural observations

Experimental angiographic, histologic, and ultrastructural observations were obtained from dogs to determine the fate of internal mammary artery (IMA) implants and aorta-coronary bypass (ACB) conduits in the 3 month postoperative period. Angiographic implant patency and evidence of implants forming collaterals with the coronary circulation did not accurately reflect anatomic luminal narrowing. Subendothelial fibrocellular proliferation similar to that described in saphenous vein grafts occurred with regularity in all IMA implants and ACB conduits. The intimal changes were much more severe in the IMA implants as compared to the ACB conduits: There was 25 to 95 per cent luminal narrowing in the IMA implants, whereas the ACB conduits rarely showed greater than 25 per cent luminal narrowing. Both reduced flow and surgical trauma appeared to be influential determining factors of the intimal proliferative process, whereas devascularization alone seemed less important.
Thomas Gordon’s Republicanism

The republican revival in England after the Glorious Revolution of 1688 led to a renewed interest in Roman authors and new translations and commentaries on Tacitus, Sallust, and passages from Cicero by the Whig propagandist Thomas Gordon.4 Gordon also collaborated with John Trenchard on a series of ‘Essays on Liberty’ entitled ‘Cato’s Letters’, which became immensely popular among American revolutionaries.5 Josiah Quincy’s will, written in 1774, left to his son ‘when he shall arrive at the age of fifteen years’ Algernon Sidney’s works, John Locke’s works, Lord Bacon’s works, Gordon’s Tacitus, and Cato’s Letters. ‘May the spirit of liberty rest upon him!’6 Gordon’s translations were available in nearly every library on the American continent, and widely read.7
Clairvoyant fusion: a new methodology for designing robust detection algorithms

Many realistic detection problems cannot be solved with simple statistical tests for known alternative probability models. Uncontrollable environmental conditions, imperfect sensors, and other uncertainties transform simple detection problems with likelihood ratio solutions into composite hypothesis (CH) testing problems. Recently many multi- and hyperspectral sensing CH problems have been addressed with a new approach. Clairvoyant fusion (CF) integrates the optimal detectors (“clairvoyants”) associated with every unspecified value of the parameters appearing in a detection model. For problems with discrete parameter values, logical rules emerge for combining the decisions of the associated clairvoyants. For many problems with continuous parameters, analytic methods of CF have been found that produce closed-form solutions–or approximations for intractable problems. Here the principals of CF are reviewed and mathematical insights are described that have proven useful in the derivation of solutions. It is also shown how a second-stage fusion procedure can be used to create theoretically superior detection algorithms for ALL discrete parameter problems.
A New Look into Childhood Acute ITP: The Relationship Between Thrombin Generation and Thrombocytopenia

Introduction: Immune thrombocytopenic purpura (ITP) is the most common cause of primary isolated thrombocytopenia of childhood. Although ITP results in profound thrombocytopenia, the severity of bleeding in this disease does not correlate well with the platelet count suggesting a compensatory procoagulant state. The primary aim of this study is to evaluate thrombin generation in childhood acute ITP patients compared to age-matched controls and examine procoagulant activity in relation to bleeding severity in childhood acute ITP. Methods: After IRB consent was approved, platelet poor plasma was isolated from acute ITP patients at the time of initial diagnosis and serially for up to 6 months post-diagnosis. A single sample was obtained from age-matched controls. Thrombin generation assays were run via the Calibrated Automated Thrombogram (CAT) using reagent containing 1pM tissue factor and 4uM phospholipid. Peak thrombin levels were measured and compared to control samples using paired t-test analysis. Clinical bleeding severity was assessed using a modified overall Buchanan bleeding score at each time point (0=no bleeding, 1=minor, 2=mild, 3=moderate, 4=severe, 5=life threatening bleeding). Results: Samples from 19 childhood acute ITP patients, mean age 7 years, and 8 controls, mean age 5 years, were assessed. The figure below demonstrates that despite profound thrombocytopenia, the peak thrombin values of acute ITP patients were higher than controls throughout the first 3-4 months following diagnosis. ITP assays were significantly different from controls at the following time-points: 1-2 weeks (p =0.001), 3-4 weeks (p =0.022), 5-8 weeks (p =0.0009), 9-12 weeks (p =0.004), and 13-16 weeks (p =0.006) post-diagnosis. Peak thrombin values returned to values similar to controls 17 weeks from diagnosis. With the onset of acute ITP, higher bleeding scores were related to more severe thrombocytopenia. In ITP patients, thrombin peak values remained elevated regardless of resolving thrombocytopenia and improved bleeding scores (see figure). Conclusion: To our knowledge, this is the first study to assess longitudinal thrombin generation using the CAT in childhood ITP patients. In a highly significant pattern, acute ITP patients demonstrated sustained elevated peak thrombin levels compared to controls, even at acute onset of disease. Certainly, thrombin release, and subsequent thrombin generation play a compensatory role to decrease bleeding among childhood ITP patients when the platelet count remains in the 10-50,000 range. But, based on bleeding scores, this elevated thrombin may not be able to overcome the bleeding phenotype at presentation when platelets are most profoundly decreased or absent. Greater understanding of the etiology of this thrombin potential in childhood acute ITP is critical, as the thrombocytopenia in this disorder may be triggered or linked to a larger post infectious or inflammatory coagulopathy. Disclosures No relevant conflicts of interest to declare.
Perceptions and practices regarding women’s vaginal health following radiation therapy: A survey of radiation oncologists practicing in the United States

Abstract Purpose Vaginal stenosis (VS) is a recognized complication of pelvic and vaginal radiation therapy (RT). Methods and materials A 26-item survey assessing the signs/symptoms, risk factors, diagnosis, prevention, treatment, and impact of VS on women's sexual health was distributed to radiation oncologists. Descriptive statistics were calculated. Chi-square tests examined differences in categorical responses. Results A total of 233 (10.5%) participants completed the entire survey. Twelve percent, 21%, and 68% report treating gynecologic (GYN) tumors only, non-GYN pelvic tumors only, or both, respectively. Regarding risk factors, 78% believed that VS can be caused by pelvic RT alone, 91% by vaginal brachytherapy alone, and 98% by combined pelvic RT and vaginal brachytherapy. Approximately one-half of respondents felt that being postmenopausal and having a hysterectomy before radiation therapy were risk factors for VS, whereas the other half felt that these were not risk factors. All respondents agreed that VS is a clinical diagnosis. Respondents indicated that VS symptoms include dyspareunia, vaginal pain, dryness, and/or bleeding (100%, 90%, 85%, and 72%, respectively); 65% indicated all 4. The most commonly recommended treatment for VS is vaginal dilator use. Radiation oncologists who treat GYN-only versus non-GYN cancers were more likely to perform a vaginal examination, to distribute written instructions regarding vaginal dilator use ( P = .002), to have vaginal bleeding reported after RT ( P = .001), and to refer patients to a sexual counselor ( P = .007). Most providers (73%) expressed willingness to participate in prospective research on the diagnosis and treatment of VS. Conclusions This is the first large-scale survey of radiation oncologists' perceptions and practices regarding VS. There is agreement among providers regarding the signs/symptoms of VS and strategies for its prevention/treatment using vaginal dilators. Further prospective and observational research is needed. This survey shows a willingness on the part of providers to take part in prospective research regarding the diagnosis, impact, and treatment of VS on women's sexual health.
Zeroth laws– hiding in plain sight [Basicmetrology]

The most famous and widely accepted "zeroth law" is the zeroth law of thermodynamics. The first and second laws were already in place, but a preliminary law was seen to be missing, perhaps because it was too "obvious." The missing piece postulates the existence of temperature and provides the rationale behind instruments (thermometers) that can measure temperature. It is this metrological oversight that makes this zeroth law and others like it a fit subject for a column on basic metrology.
Saints and Holy Beasts: Pious Animals in Early-Medieval Insular Saints’ Vitae

Shockro argues that animals occupy a unique position in early-medieval Insular saints’ vitae as the verifiers of the divine source of saints’ power and as the companions of saints. In these texts in which animals are the peers of saints, they are capable of the full spectrum of spiritual states traditionally associated with human spiritual growth, allowing them to become active participants in the Christian cycle of sin and redemption. Within individual vitae the progression of the animal and saint’s relationship from basic interaction to complex communication mirrors the spiritual development of the saint. These interactions speak to a vision of the Christian world in which animals are the collaborators with and companions of saints as they assist each other toward spiritual growth.
Evaluating the Effect of Display Realism on Natural Resource Decision Making

Abstract. Geographic information systems (GIS) facilitate location-based decision making. Despite the improved availability of GIS software to non-professionals, training in cartographic design has not followed suit. Prior research indicates that when presented with map choices, users are influenced by naive realism, a preference for realistic displays cotaining irrelevant, extraneous details, leading to decreased task efficiency. This study investigated the role of naive realism in decision making for natural resource management, a field that often employs geospatial tools. Data was collected through a GIS user ability test, a questionnaire and direct observation. Forty volunteer expert and non-expert resource managers evaluated the suitability of different sites for a land management scenario. Each participant was tested on two map display treatments containing different levels of realism – a simpler 2D display and a more complex 3D display – to compare task performance. Performance was measured by task accuracy and task completion time. User perceptions and preferences about the displays were also recorded. Display realism had an impact on performance and there were indications naive realism was present. Users completed tasks significantly faster on the 2D display and many individuals misjudged which display they were most accurate or fastest with. The results are informative for designing information systems containing interactive maps, particularly for resource management applications. The results also suggest that the order displays were presented had a significant effect and may have implications for teaching users map-based tasks.
Applications: Enrichment as Treatment

The knowledge that manipulation of the external stimulus world can have a measurable impact on the structure and neurochemistry of the brain and upon functionally important aspects of the behavior of mammals has opened the door to a broad variety of therapeutic and preventive applications. Examples of some of the possible applications that have been attempted are reviewed in this chapter.
Using peer review for self-audits of medical record documentation.

You might be surprised at how much doctors can help one another improve in coding and documentation.
Abstract 2668: Regio- and stereospecific synthesis of oridonin D-ring aziridinated analogues for the treatment of triple-negative breast cancer via mediated irreversible covalent warheads

The covalent drugs dramatically resurge in recent years due to the comprehensive optimization of the structure-activity relationship (SAR) and structure-reactivity relationship (SRR). Natural product oridonin with an impressive pharmacological profile through its covalent enone warhead on the D-ring has attracted substantial SAR studies to appreciate its potential in the development of new molecular entities for the treatment of various human cancers and inflammation. Herein, for the first time we report the excessive reactivity of this covalent warhead and mediation of the covalent binding capability through a Rh2(esp)2-catalyzed mild and concise regio- and stereospecific aziridination approach. Intriguingly, new analogue YD0514 with a more drug-like irreversible covalent warhead has been identified to significantly induce apoptosis and inhibit colony formation against triple-negative breast cancer with comparable to enhanced antitumor effects in vitro and in vivo, while displaying lower toxicity to normal human mammary epithelial cells in comparison with oridonin. Citation Format: Ye Ding, Dengfeng Li, Chunyong Ding, Zhiqing Liu, Eric A. Wold, Na Ye, Haiying Chen, Mark A. White, Qiang Shen, Jia Zhou. Regio- and stereospecific synthesis of oridonin D-ring aziridinated analogues for the treatment of triple-negative breast cancer via mediated irreversible covalent warheads [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2668.
Effects of prostate cancer and exercise training on left ventricular function and cardiac and skeletal muscle mass

This study demonstrates the atrophic effects of prostate cancer on cardiac and skeletal muscle mass independent of anticancer treatment(s) that can be mitigated with moderate-intensity exercise. Th...
Linking immunity and sickness-induced sleep

We are all familiar with the sleepiness experienced during sickness. What is less often appreciated is that this increased need for sleep is caused by the release of signaling molecules by our own immune and nervous systems, and not by the infectious agents themselves (1). Indeed, for the spread of a virus or a bacterium, it would be much better if we were out and about when sick, instead of sleeping. On page 509 of this issue, Toda et al. (2) reveal another facet of the interplay between sleep and immunity by identifying NEMURI (NUR), an antimicrobial peptide (AMP) produced by the fruit fly Drosophila melanogaster that also has sleep-promoting properties. Because humans synthesize more than 100 different AMPs (3), this work could have implications for interactions between sleep and immunity during human disease.
BRADYCARDIA INDUCED PVCS VERSUS EXERCISE INDUCED PVCS: A DIAGNOSTIC DILEMMA

Sick sinus syndrome represents dysfunction of the sinoatrial node typically manifesting as severe sinus bradycardia, sinus pauses or sinus arrest on ECG or telemetry. A 67 year old athletic male presented with exertional dyspnea and lightheadedness. ECG and inpatient telemetry showed sinus
Expression of PD-1 and PD-Ls in Kaposi's sarcoma and regulation by oncogenic herpesvirus lytic reactivation

Abstract Kaposi's sarcoma-associated herpesvirus (KSHV) causes several cancers such as Kaposi's sarcoma (KS) and primary effusion lymphoma (PEL). PD-1/PD-Ls immune checkpoint molecules play important roles in cancer cell immune escape. The expression of PD-1/PD-Ls and their regulation by oncogenic viruses, in particular KSHV, remain largely undefined. Here we demonstrate strong PD-1/PD-L1/PD-L2 expression in KS tissues from a cohort of HIV + patients. We found that induction of KSHV lytic reactivation significantly upregulates PD-L1 expression on infected tumor cells, potentially through several major cellular signaling pathways and IL-1β, which may represent a novel mechanism for virus-associated tumor cell immune escape.
Preference and restorative potential for landscape models that depict diverse arrangements of defoliated, foliated, and evergreen plants

Abstract Increasing temperatures and exposure to sunlight in spring causes many deciduous, broadleaf plant species in temperate climates to foliate; decreasing temperatures and exposure to sunlight in fall prompts complete defoliation. Evergreen plants defoliate seasonally, yet retain green foliage throughout the year. One’s mood may also be affected by seasonal changes, though few studies have investigated whether seasonally induced visual changes to plants affect landscape preference and measures related to attention restoration. To address this need, we manipulated three variables in a Latin square to model nine color digital landscape views. Stimuli depicted scattershot, clustered, or formal compositions of defoliated, foliated, or evergreen plant species quantities that equaled zero, two, or four bits of Shannon’s Information Entropy, a mathematical measure of complexity. The dataset contained 59 respondents’ ratings of preference and restorative potential from September, and 47 respondents’ ratings of preference and restorative potential from January. Mann-Whitney test results indicate that September respondents rated evergreen scenes significantly lower in restorative potential than January respondents. Wilcoxon test results indicated that the foliage type and plant entropy values significantly affected preference and restorative potential ratings in September and January; results varied between the evaluation date, and preference and restorative potential ratings. The results of simple mediation analyses indicated that only the depiction of defoliation indirectly affected September and January restorative potential ratings through preference.
Urban Renewal through the Lens of Unsuccessful Projects: The Pralltown Neighborhood of Lexington, Kentucky:

This article examines the Pralltown neighborhood of Lexington, Kentucky, and the concept of the “unsuccessful” urban renewal project. Pralltown was created for and by freed slaves following the Civ...
Deswelling studies of pH and temperature-sensitive ultra-low cross-linked microgels with cross-linked cores

Microgels prepared without exogenous crosslinker have recently been explored for diverse applications in biotechnology. However, our fundamental understanding of structure-property relationships for this class of materials is still lacking, especially in the context of more complex structures such as core-shell particles. In this article, core-shell microgels were prepared by seed-mediated, surfactant-free emulsion polymerization using a N,N′-methylenebis (acrylamide) (BIS) cross-linked poly(N-isopropylacrylamide) (pNIPAm) microgel core upon which a crosslinker-free poly(N-isopropylacrylamide)-co-acrylic acid (ULC10AAc) shell was synthesized. Dynamic light scattering (DLS) and phase analysis light scattering (PALS) measurements show that the hydrodynamic radius and electrophoretic mobility of the core-shell microgels increase significantly with increasing pH due to the pH responsive ULC10AAc shell, while the temperature sensitivity of the microgels is also strongly pH dependent. The turbidity and the temperature-dependent scattering intensity plots of microgels at different pH also provide insight into the charged state of the microgels under the studied conditions. For example, we observe multiple temperature-induced transitions when the pH is either 4.5 or 6.5, illustrating that the core and shell domains, while remaining mechanically connected, are only partially coupled thermodynamically. These studies provide insight into the perturbation of ULC microgel behavior that might be brought about due to the presence of a higher density core region. Complex architectures such as these are relevant in biotechnology applications where the soft, deformable ULC shell is advantageous to control the polymer-biology interface, but a denser core region might be required to obtain a higher loading of encapsulated therapeutics, tracking dyes, or oligonucleotides. Thus, it is important to understand the synthetic conditions that allow a ULC shell to remain “ULC-like” despite the presence of a denser core.
Emerging Food Allergy Therapies

Many exciting food allergy therapies, including allergen-specific and non-specific treatment techniques, are currently under clinical investigation. The most well-studied treatment modality is food immunotherapy, which comes in several types including oral (OIT), epicutaneous (EPIT), and sublingual (SLIT). As a follow-up to the prior discussions on OIT and EPIT, this chapter focuses on emerging therapies that are earlier in development. With its growing body of evidence, this chapter begins with a general overview of SLIT, including its proposed mechanism of action, efficacy, and side effects. Advantages and disadvantages of SLIT when compared to OIT and EPIT are also highlighted. Other food-specific therapies reviewed in this chapter include peptide-based vaccines, recombinant allergen vaccines, allergen DNA vaccinations, and transgenic plants, which have less supportive clinical study data available but which present exciting possible treatment modalities. Studies evaluating the use of non-allergen-specific therapies in the treatment of food allergy, including anti-IgE treatment (used as monotherapy or as an adjunct to food-specific therapies), traditional Chinese medicine, and probiotics are also reviewed. Finally, understanding that food immunotherapy may become a standard part of clinical practice in the very near future, this chapter concludes with a discussion about patient-specific factors and preferences for the clinician to consider when deciding on the optimal treatment modality for an individual patient.
Synthesis, Crystal Structure, and Cooperative 3d-5d Magnetism in Rock Salt Type Li4NiOsO6 and Li3Ni2OsO6.

Two new transition metal oxides with the nominal chemical compositions of Li4NiOsO6 and Li3Ni2OsO6 were successfully synthesized. Both compounds crystallize in an ordered rock salt structure type i...
Evaluating spatial and temporal effects of planned special events on travel time performance measures

Abstract The effect of a planned special event on travel time performance measures varies spatially and temporally based on the type of the planned special event. Evaluating and assessing the effect helps practitioners proactively plan and improve traffic operations within its vicinity during the future planned special event. The objective of this paper, therefore, is to adopt a systemic evaluation method and examine the effect of a planned special event on travel time performance measures, over time and space, from the location of the planned special event. Raw travel time data obtained from a private data source was used to assess the spatial and temporal effects of two planned special events on travel time performance measures. Data were captured for each major road link within 3-miles of each planned special event location. Statistical analyses such as the t-test and Cohen's D were conducted to assess the difference in travel time performance measures during the day of the planned special event compared to the normal day. A statistically significant increase in travel times and travel time variations was observed on the day of the planned special event when compared to the normal day. However, the effect of the increase in travel times was observed to be small, whereas, the effect of the increase in the travel time variation was observed to be higher. Buffer time index (BTI) and planning time index (PTI) were observed to be significantly higher during the NASCAR race and for longer periods compared to the NFL game.
Deep Variational Network for High Quality 3D Ultrasound Imaging using Sparse Array

For three-dimensional (3D) ultrasound imaging, to obtain a 3D image with sufficient resolution, the inter-channel spacing (i.e., pitch) should be sufficiently small to avoid grating lobes and the aperture size needs to be large enough to ensure that the beam width is sufficiently small. Therefore, a matrix probe often consists of several thousands of channels resulting in requiring high system complexity. The sparse array (SA) method has been proposed to reduce the system complexity by selecting a set of active channels instead of fully-sampled channels; however, SA approach encounters focusing errors during beamforming which results in broadening the main lobe, as well as increasing the side-lobe and grating-lobe levels, which together degrade the image quality. In this study, a deep variational network has been presented to reconstruct the inactive channels for the sparse array system. The main advantage of the deep variational network is that this method can be trained with a comparably low number of training cases. This can be beneficial for medical 3-D/4-D ultrasound imaging reconstruction because large amount of raw 3D ultrasound RF channel data are not easy to acquire. In this study, 512 under-sampled channels were set as active by sampling 1024 channels uniformly. The fully sampled channel data (output) were captured as the ground truth using a 2-D matrix array. With the proposed method, the output image can improve the grating-lobe levels by 12.27 dB and 4.76 dB, respectively, for both the elevation and lateral projections.
Pathology and Pathophysiology of NTOS

Neurogenic TOS is usually due to a combination of predisposing factors and a hyperextension neck injury. Predisposing factors include cervical ribs, anomalous first ribs, an elongated transverse process of C7, a narrow scalene triangle, and various congenital bands and ligaments. The most common trauma is a whiplash injury, usually from a motor vehicle accident. The pathophysiology begins with trauma to the scalene muscles, causing tearing of muscle fibers and hemorrhage with subsequent replacement of the blood with microscopic scar tissue throughout the scalene muscles. The now tight muscles compress the nerve roots and trunks of the brachial plexus, subsequently causing the classic symptoms of extremity pain, paresthesia, and weakness. Further, the injured scalene muscles lead to neck pain and occipital headaches which are referred from the transverse process muscle origin.
Update on Perioperative Pediatric Pulmonary Hypertension Management

Pediatric pulmonary hypertension is a disease that has many etiologies and can present anytime during childhood. Its newly revised hemodynamic definition follows that of adult pulmonary hypertension: a mean pulmonary artery pressure >20 mmHg. However, the pediatric definition stipulates that the elevated pressure must be present after the age of three months. The definition encompasses many different etiologies, and diagnosis often involves a combination of noninvasive and invasive testing. Treatment often is extrapolated from adult studies or based on expert opinion. Moreover, although general anesthesia may be required for pediatric patients with pulmonary hypertension, it poses certain risks. A thoughtful, multidisciplinary approach is needed to deliver excellent perioperative care.
Of marsh and mangrove: coupled biophysical and anthropogenic drivers of 20th century wetland conversion in Tampa Bay Estuary, Florida (USA)

Abstract Dense mangrove swamps currently dominate tidal wetlands of the Tampa Bay Estuary System on the central peninsular Gulf Coast of Florida (USA). Late-19th century Coast and Geodetic Survey topographical charts and Government Land Office surveys, however, depict wetland systems dominated by salt marsh—therefore suggesting mangrove dominance as a product of 20th century encroachment. To clarify the primary drivers of ecosystem change, this study integrates sedimentological, paleobotanical, and radiometric analyses of sediment cores collected in 2018 with analyses of aerial photography taken between 1940 and 1997. Results empirically ground truth the wetland conversions inferred through analytical comparisons of historical and modern mapping and establish a high-resolution chronology for coastal environmental change. These results showed that salt marsh and salt prairie habitats persisted within Tampa Bay study areas until the mid-20th century. Mangrove forest rapidly encroached the study areas over a 20 year interval, between 1960 and 1980, immediately following intensive ditching for mosquito control. The findings demonstrate how coastal geoengineering, mangrove autoecology, and sea-level rise interacted across the late-20th century to accelerate the creation of novel seascapes.
Case Report: Clonorchis sinensis Infection Associated with Eosinophilic Pneumonia: A Case Report and Review of the Literature.

Clonorchis sinensis, a trematode prevalent in East Asia, causes hepatobiliary infection. Exposure typically occurs through ingestion of raw or undercooked fish containing the encysted larval form of the parasite. Extrahepatobiliary disease has not commonly been described. In this case report, we describe an unusual case of C. sinensis infection associated with eosinophilic pneumonia. A middle-aged man from China presented with subacute cough and was found to have a bilateral diffuse eosinophilic pneumonia with associated peripheral eosinophilia. Stool microscopy revealed C. sinensis eggs, and the patient improved after treatment with prednisone and praziquantel. Pulmonary clonorchiasis should be considered in patients with eosinophilic pneumonia from areas highly endemic for this pathogen.
Frequent but fragmented: use of note templates to document outpatient visits at an academic health center.

Recent changes to billing policy have reduced documentation requirements for outpatient notes, providing an opportunity to rethink documentation workflows. While many providers use templates to write notes-whether to insert short phrases or draft entire notes-we know surprisingly little about how these templates are used in practice. In this retrospective cross-sectional study, we observed the templates that primary providers and other members of the care team used to write the provider progress note for 2.5 million outpatient visits across 52 specialties at an academic health center between 2018 and 2020. Templates were used to document 89% of visits, with a median of 2 used per visit. Only 17% of the 100 230 unique templates were ever used by more than one person and most providers had their own full-note templates. These findings suggest template use is frequent but fragmented, complicating template revision and maintenance. Reframing template use as a form of computer programming suggests ways to maintain the benefits of personalization while leveraging standardization to reduce documentation burden.
Pathology of intestinal ischemia

Intestinal ischemia produces a spectrum of gross and microscopic pathologic changes that range from transmural necrosis to reversible mucosal injury. Depending on the stage at which tissue is examined, findings may reflect the acute injury or reparative changes. This article reviews the diagnosis of the pathologic findings in differential intestinal ischemia.
Longitudinal changes of manganese-dependent superoxide dismutase and other indexes of manganese and iron status in women

The effect of dietary factors on manganese-dependent superoxide dismutase (MnSOD) activity in humans has not been studied. We longitudinally evaluated changes in MnSOD activity and other indices of manganese and iron status in 47 women during a 124-d supplementation study. Subjects received one of four treatments: placebo, 60 mg iron, 15 mg manganese, or both mineral supplements daily. Manganese supplementation resulted in significant increases in lymphocyte MnSOD activity and serum manganese concentrations from baseline values but no changes in urinary manganese excretion or in any indices of iron status. Oral contraceptive use and the stage of the menstrual cycle did not confound the use of lymphocyte MnSOD activity or serum manganese to monitor manganese status, but fat intake affected both indices. This work demonstrated that lymphocyte MnSOD activity can be used with serum manganese concentrations to monitor manganese exposure in humans.
Survival analysis of complete veneer crowns vs. multisurface restorations: a dental school patient population

The purpose of this study was to compare the longevity of crowns versus large multisurface restorations in posterior teeth. The investigation used the treatment database at Virginia Commonwealth University School of Dentistry. The inclusion criteria for the final data set used for analysis were: only one restored tooth per patient, premolars with three or more restored surfaces, molars with four or more restored surfaces, molars and premolars restored with complete veneer metal crowns, or crowns veneered with metal and porcelain. The Kaplan-Meier approach was used to visualize the survival curves, and the Cox proportional hazards model was used for analysis of predictor variables. The investigation indicates crowns survive longer than large restorations and premolar restorations survive longer than molar restorations. The median survival for crowns exceeded 16.6 years, with the median survival of premolar restorations being 4.4 years and molar restorations 1.3 years. An interaction between age and treatment was discovered, with overall survival decreasing as patient age increases. The doctor supervising the treatment also affected survival with treatment supervised by specialists lasting longer than treatment supervised by nonspecialists.
Relationship Between Anxiety and Standardized Patient Test Performance in the Medicine Clerkship

PURPOSE: Anxiety is thought to affect test performance. Studies have shown that students with low levels of test anxiety achieve higher scores on multiple choice question (MCQ) examinations than those with high anxiety levels. Female students have been shown to have higher test anxiety levels than male students. Standardized patient (SP) examinations are being used in medical schools and for licensing purposes. As SP exams are relatively new, there are few studies measuring anxiety levels for the SP test. The purpose of this study was to measure and compare medicine clerkship student SP versus MCQ examination anxiety levels and to determine if level affected test performance. METHODS: The Spielberger test attitude inventory was used to measure anxiety in 150 students rotating through the clerkship. Students completed questionnaires after the MCQ and SP examinations. Mean examination scores and anxiety levels were compared. Based on questionnaire scores, students were divided into 3 groups: low, moderate, and high anxiety. The MCQ and SP examination scores were analyzed to determine if male/female anxiety-level affected test performance. RESULTS: There were no meaningful anxiety-level differences between the SP and MCQ examinations. An inverse relationship between anxiety level and test scores was not identified. Female students had higher anxiety levels but sex differences did not influence examination performance. DISCUSSION: Medicine clerkship student test performance is not affected by anxiety level. Implications of the findings for incorporating stress management training in medical school curricula and suggestions for future research are discussed.
Adamantinoma of the Tibia. An ultrastructural and immunohistochemical study

The light microscopic, ultrastructural, and immunohistochemical characteristics of two tibial adamantinomas are presented. The immunohistochemical studies utilized specific antibodies against Factor VIII-related antigen and keratin protein, considered as markers for endothelial and epithelial cells, respectively. These revealed positive staining for keratin in the tumor cells of both cases, whereas Factor VIII was not found in either. Ultrastructurally, both tumors had tonofilaments, desmosomes, gap junctions, microvillous-like projections, and basement membranes. Patient 1 had disease that was histologically of the classic spindle cell type; the disease of Patient 2 was atypical and closely resembled an epithelioid angiosarcoma. Immunohistochemical and ultrastructural findings in each case indicate an epithelial component in tibial adamantinoma.
Superfluid He 4 interferometer operating near 2 K

We report the observation of quantum interference in superfluid $^{4}\mathrm{He}$. The interferometer, an analog of a dc-superconducting quantum interference device (SQUID), employs a recently reported phenomenon wherein superfluid $^{4}\mathrm{He}$ exhibits Josephson frequency oscillations in an array of submicron apertures. An interference pattern is generated by reorienting the loop of the superfluid ``SQUID'' with respect to the Earth's rotation vector, thereby varying the rotation flux in the loop. The experiment is performed at $2\phantom{\rule{0.2em}{0ex}}\mathrm{K}$, a temperature 2000 times higher than previously achieved with superfluid $^{3}\mathrm{He}$. We find that the interference exists not only when the aperture array current-phase relation is a sinusoidal function characteristic of the Josephson effect, but also at lower temperatures where it is linear and oscillations occur by phase slips. The modest requirements for the interferometer ($2\phantom{\rule{0.2em}{0ex}}\mathrm{K}$ cryogenics and fabrication of apertures at the level of $100\phantom{\rule{0.3em}{0ex}}\mathrm{nm}$) and its potential resolution suggest that, when engineering challenges such as vibration isolation are met, superfluid $^{4}\mathrm{He}$ interferometers could become important scientific probes.
Regulation of bovine adipose tissue metabolism during lactation. 1. Lipid synthesis in response to increased milk production and decreased energy intake.

Abstract Effects of genetic selection for milk secretion and dietary energy restriction on adipose tissue lipid synthesis were tested in first lactation Holsteins. Daughters of bulls of 795 kg or 167 kg of Predicted Difference, base 1974, for milk had a 305 d first lactation of 8626 and 7038 kg of milk at 3.02 and 2.71% milk fat, respectively. Animals of each genetic group were allotted to treatments of a diet of 40% hay and 60% concentrate or of 60% hay, 40% concentrate ad libitum from 0 to 140 d of lactation. First lactation heifers fed the low energy diet ate 19% less net energy and produced 7% less milk of 28% more milk fat percent compared with heifers fed the high energy diet. Lipogenesis rates at 15, 30, 60, and 180 d postpartum in heifers fed low energy diets were 107, 66, 21, and 166% of those in heifers fed high energy diets. Rates of lipogenesis in adipose tissue of heifers of high genetic merit were 40, 10, 45, and 66% of those in low genetic merit heifers at 15, 30, 60, and 180 d postpartum. Lipogenesis in bovine adipose tissue homeostatically adapts to decreased energy intake and home orhetically adapts to genetically selected increase in milk fat secretion.
Distribution, transformation and bioavailability of trivalent and hexavalent chromium in contaminated soil

The purpose of this study was to investigate solid-phase distribution, transformation, and bioavailability of Cr in Cr(III) and Cr(VI) contaminated soils. The effects of EDTA treatment on solid-phase distribution of Cr in soils were also examined. The results show that Cr in both initially Cr(III)- and Cr(VI)-contaminated soils was mainly present in the organic matter bound fraction. Chromium had similar solid-phase distribution and similar overall binding intensity in both Cr(III)- and Cr(VI)-contaminated soils after a growing season. Transformation between Cr(III) and Cr(VI) took place in both Cr(III)- and Cr(VI)-treated soils. Chromium in the Cr(III)-contaminated soils was mostly present as Cr(III), while Cr in Cr(VI)-treated soils was mainly transformed into Cr(III). About 2% of Cr in native non-treated soils was found as Cr(VI). EDTA treatment increased Cr in soluble and exchangeable fraction in Cr(III)-treated soils. In both Cr(III)- and Cr(VI)-contaminated soils, Cr in oxide bound and organic matter bound fractions was bioavailable to Indian mustard.
SU‐GG‐T‐375: A Custom‐Developed Method for Accurate Dose Recalculation of Patient Plans Entered into Clinical Trials

Purpose: To compare a custom‐developed method for accurate dose recalculation of patient plans entered into clinical trials with results from a common treatment planning system. Method and Materials: A measurement‐driven multiple‐source model with the Dose Planning Method (DPM) Monte Carlo(MC)dose calculation algorithm was previously developed, validated, and benchmarked for the Varian 6 MV and 10 MV photon beams. Several patient cases have been recalculated and compared to the calculations from a Pinnacle planning system. Intensity modulated radiation therapy(IMRT) prostate, IMRT abdomen, stereotactic body radiotherapylung, and IMRTlung patient cases were selected. Results:Field sizes from 4 cm × 4 cm to 40 cm × 40 cm were validated to within 2% of the maximum dose and 2 mm distance to agreement. At least 95% of the data tested met the validation criteria. Benchmark treatments planned using anthropomorphic phantoms were tested to within 3% of the target dose and 2 mm distance to agreement. At least 85% of the data tested met the benchmark criteria. Disagreement in the patient plan evaluation tended to occur at heterogeneity interfaces where electronic disequilibrium occurred, and in the beam penumbra, where scattered radiation was more prominent. The ratios of planning system calculation to MC calculation for the mean dose of the gross and planning target volumes for the patient plans ranged from 0.984 to 1.016. Conclusion: These results show that this MCsoftware code generates answers similar to the Pinnacle system for IMRT and SBRT treatment plans. Differences are consistent with the superior physics modeling inherent in the Monte Carlo code. We believe the method will be useful for recalculating dose distributions for patients entered into clinical trials. Work supported by PHS CA010953, CA081647, and R01 CA85181 awarded by NCI, DHHS
The AsemiP anomaly detector: comparative performance in hyperspectral imagery

Remote collections of hyperspectral sensor imagery (HSI) often produce extremely large data sets that make storage and transmission difficult. Smart reduction of such a large data set has been a challenge. Automatic anomaly detection has been cited as a suitable method for remote processing of HSI, although automatic anomaly detection using HSI is itself a challenging problem owing to the impact of the atmosphere on spectral content and the variability of spectral signatures. In this paper, we present the performance of an anomaly detection algorithm known as an approximation to semiparametric (AsemiP) anomaly detector. This detector was conceptualized and developed in the Army Research Laboratory (ARL), where it became a favorite technique for the intended purpose using HSI. This detector uses fundamental theorems of large sample theory to implement a notion of indirect comparison, and it supersedes an earlier ARL technique that uses a semiparametric (SemiP) model, as a basis for statistical inference. The strength of both algorithms is that no prior knowledge is assumed about the target and/or the clutter statistics, albeit AsemiP has an advantage over SemiP of not using an iterative algorithm which is sensitive to arbitrary initial conditions. The AsemiP anomaly detector was tested using real hyperspectral data and compared to alternative techniques, including a benchmark approach, yielding some good results.
Performance evaluation of optical CDMA networks with random media access schemes

This paper presents a performance analysis approach for OCDMA networks, which takes into account both the physical layer characteristics and random media access schemes. Analysis results demonstrate its effectiveness in characterizing the OCDMA network dynamics.
Probabilistic Flutter Analysis of a Mistuned Bladed Disks

This paper presents the results of a probabilistic flutter study of a mistuned bladed disk using a high fidelity model including both structural and aerodynamic coupling. The approach used in this paper is relatively fast because it does not require any additional information than that required of a tuned flutter analysis, with the exception of the mistuned blade frequencies. The case study shows that the stability of the fleet can be significantly affected by the standard deviation of blade frequencies and the pattern in which they are arranged in the wheel. A method for understanding and identifying the beneficial patterns is presented.Copyright © 2006 by ASME
Measures of nematode community structure and sources of variability among and within agricultural fields

Whole nematode communities, extracted from soil samples taken from agricultural fields, were enumerated by taxonomic family and trophic group (i.e., bacterivores, fungivores, omnivores, plant-parasites, and predators) to evaluate nematode community structure as an indicator for monitoring ecological condition of soil. No differences were found in mixing treatments or methods of packing or shipping samples. However, extraction using Cobb's sifting and gravity method, followed by sucrose centrifugation, gave greater recovery of free-living nematodes than elutriation followed by sucrose centrifugation. Population means and variance of the sampled area were similar when sampled using different strategies for collecting soil samples within fieds, including several patterns, directions and repetitions of transects. Components of variation associated with ratios among the five trophic groups of nematodes and selected indices of community structure were quantified as variation among regions, among counties, among agricultural fields (2-ha area), among transects within agricultural fields, and within composite soil samples. The variance component for'within composite soil samples' was relatively large compared to the other components of variance. Variation within composite soil samples was less for maturity indices (based on life-history strategy characteristics), ratio of bacterivores to plant-parasites, sum of bacterivores and fungivores, populations of plant-parasites, and populations of bacterivores than for trophic diversity indices, populations of fungivores, populations of omnivores, populations of predators, or the ratio of fungivores to bacterivores. With a single composite sample per field, the ability to differentiate ecological condition of soils among fields within a region improved if the variance among and within fields exceeded the variance within composite samples. Given the variance components, power curves indicated that detection of a 10% change (with 0.8 power) in the ecological condition of soils within a region between two time periods would require sampling a minimum of 25 and 50 fields with one composite soil sample analyzed per field for the maturity and trophic diversity index, respectively. More than 100 fieldsper region would be required to detect temporal change in populations of individual trophic groups. Biplots of maturity indices, but not of trophic diversity or populations of individual trophic groups, identified clear differences among fields. Thus, maturity indices, which differentiated among sampling sites better and more efficiently than trophic diversity indices or measures based on populations of individual trophic groups, may be appropriate for use in a regional and/or national monitoring program.