cssi/SciSciGPT-SciSciNet huggingface dataset:
Development and validation of a clinical prediction rule for candidemia in hospitalized patients with severe sepsis and septic shock

Abstract Objective To develop and internally validate a prediction rule for the presence of candidemia in patients with severe sepsis and septic shock (candidemia rule) that will fill the gap left by previous rules. To compare the accuracy of the available Candida prediction models. Design Retrospective cohort study. Setting Barnes-Jewish Hospital, St. Louis, Missouri. Patients/Subjects Two thousand five hundred ninety-seven consecutive patients with a positive blood culture and severe sepsis or septic shock. Interventions Logistic regression and a bootstrap resampling procedure were employed for model development and internal validation. Measurements and Main Results Two hundred sixty-six (10.2%) had blood cultures positive for Candida spp. Mortality was significantly higher in patients with candidemia than in patients with bacteremia (47.0% versus 28.4%; P Conclusions We developed and internally validated a prediction rule for candidemia in hospitalized patients with severe sepsis and septic shock that outperformed previous prediction rules. Our study suggests that locally derived prediction models may be superior by accounting for local case mix and risk factor distribution.
Dynamics of Growth and Investment in the Kenyan Electric Power Sector

In many African countries there is a tension between grid and off-grid electric service provision and it is unclear whether a centralized or decentralized power system architecture will emerge. This paper explores some of the dynamics of system development in Kenya, where poor grid infrastructure has resulted in a thriving private market for photovoltaic panels and a growing number of industries are investigating shifting to on-site generation. The research is based on ethnographic interviews and observations in Kenya and uses system dynamics modeling tools to analyze qualitative and quantitative feedback in the system.
The Brief Self-Control Scale Predicts Jail Inmates’ Recidivism, Substance Dependence, and Post-Release Adjustment

Previous research finds that self-control is positively associated with adaptive and negatively associated with maladaptive behavior. However, most previous studies use cross-sectional designs, low-risk samples, and limited assessments of self-control. This study of 553 jail inmates examined the relationship of a valid measure of self-control (Brief Self-Control Scale) completed on incarceration with behavior before, during, and 1 year after incarceration. After controlling for positive impression management (PIM), self-control was negatively related to substance misuse, suicidality, risky sex, and criminal history prior to incarceration and post-release illegal substance misuse, recidivism, and positive adjustment. Lower self-control predicted increases in substance dependence at post-release compared with pre-incarceration. Self-control was not related to misbehavior during incarceration, nor alcohol use or HIV-risk behavior 1 year post-release. Results were consistent as a function of age, race, and gender. This study supports self-control as an important risk and protective factor in a sample of criminal offenders.
Deoxyuridine suppression studies in bone marrow in primary refractory sideroblastic anemia.

Because unexplained megaloblastic erythroid maturation occurs in patients with primary refractory sideroblastic anemia (PRSA), deoxyuridine (dU) suppression tests using125 I-UdR were performed on bone marrow from five patients with PRSA. All patients had megaloblastic alterations in the marrow erythroid precursors (with normal serum folate and B12 levels) and numerous ringed sideroblasts, and most had marrow iron overload. Results of the dU suppression tests were normal in all five, both with and without incubation with pharmacologic amounts of folate, B12, and pyridoxal phosphate with or without 1-serine. Despite occasional hematologic improvement subsequent to folate, pyridoxine, or pyridoxal phosphate (PLP) administration in some patients with PRSA, normal dU suppression implies that in our group the availability of B12 and folate (and possibly PLP) was not limiting in the utilization of folate for DNA-thymine synthesis. The marrow erythroid maturation defect remains unexplained.
SOA Simulation and Verification by Event-Driven Policy Enforcement

The verification of SOA (Service-Oriented Architecture) applications is important, and, simulation is a promising method because it provides runtime behavior and performance analysis. This paper uses a BPEL engine as a simulation engine to simulate SOA applications, and proposes an event- driven policy enforcement framework to verify the SOA applications during simulation.
Agar ultrasound phantoms for low-cost training without refrigeration.

Introduction Ultrasound is a technique that can be utilised to augment procedures to increase their safety and efficacy, but requires that health professionals be trained to use this imaging modality before it can be implemented. With the extremely high cost of manufactured phantoms, homemade alternatives are popular substitutes. Gelatine is commonly used as a matrix to suspend analogues and mimic tissue, but other substrates like ground meat can also be used. Both of these substrates require refrigeration and are subject to spoiling. Our research was designed to evaluate whether agar models would be superior to traditional Gelatine models in their sustainability and whether they would produce ultrasound images adequate for training. Methods Agar models of varying formulas (percent agar by weight with certain additives varied) were tested for acceptable fidelity to real tissue, ultrasound image quality, and durability compared to gelatine models and human tissue. Results A five percent by-mass agar model augmented with small amounts of suspended wheat flour presented as a model that could generate an ultrasound image that remarkably resembled that of real tissue. This agar model does not require refrigeration, is resistant to spoiling and desiccation, mimics tissue texture well, is durable enough to withstand high-volume training, and can be recycled to make new models. Conclusion Agar phantoms are easy to make, do not require refrigeration, and have multiple distinct advantages over gelatine models for ultrasound training in austere conditions.
New S-dualities in N = 2 supersymmetric SU(2) × SU(2) gauge theory

New S-dualities in a scale invariant N = 2 gauge theory with SU(2) × SU(2) gauge group are derived from embeddings of the theory in two different larger asymptotically free theories. The true coupling space of the scale invariant theory is a 20-fold identification of the coupling space found in the M- and string-theory derivations of the low energy effective action, implying a larger S-duality group. Also, this coupling space is different from the naively expected direct product of two SL(2,) fundamental domains, as it contains a different topology of fixed points.
Phase I study of amifostine as a cytoprotector of the gemcitabine/cisplatin combination in patients with advanced solid malignancies.

Our objective was to evaluate the role of amifostine as a cytoprotector in patients with solid tumors receiving the myelosuppressive regimen of gemcitabine/cisplatin combination. Patients with advanced solid tumors were randomized to gemcitabine-amifostine-cisplatin (GAP) or gemcitabine-cisplatin (GP) in Cycle 1 (C1) and then were crossed over to the other treatment in Cycle 2 (C2). Amifostine at 740 mg/m 2 , followed by gemcitabine and cisplatin, were given for 2 consecutive weeks, every 4 weeks. Two GP combinations were studied: G 1000 mg/m 2 and P 40 mg/m 2 days 1, 8 (high dose), and G 800 mg/m 2 and P 30 mg/m 2 days 1, 8 (low dose). Forty patients were enrolled. Of the 19 patients treated with high-dose GP, 11 (nine patients GP in C1 and GAP in C2, two patients GAP in C1 and GP in C2) completed 2 cycles of therapy. Of the eight non-evaluable patients, five patients dropped out due to toxicity or refusal after treatment with amifostine in C1. Of the 21 patients treated with low-dose GP, 15 (eight patients GP in C1 and GAP in C2, seven patients GAP in C1 and GP in C2) were likewise evaluable. The incidence of grade 3 or 4 hematologic toxicities was similar for GP and GAP during the first 2 cycles of treatment, and there were no statistically significant differences in mean absolute neutrophil count, hemoglobin level and platelet levels between the cycles in each arm. We conclude that amifostine, at 740 mg/m 2 , does not lead to less myelosuppression when combined with gemcitabine/cisplatin chemotherapy regimens and may possibly contribute to subjective intolerance.
Full Estimation Capacity Hierarchical Fractional Factorial Designs for a Class of Models

This article presents the characterizations of full estimation capacity (FEC) of the general hierarchical fractional factorial designs under a class of possible models for describing the data to be collected from planned experiments. The experimenter may not be sure what model will describe the data to be collected a priori but will suggest a class of possible models so that one model provides a better description than the others. The hierarchical designs (HDs) permit the estimation of different model parameters using its component designs. A general HD is presented for a 2m factorial experiment. The FEC properties are demonstrated under a variety of situations in terms of the number of runs.
Non-canonical distribution and non-equilibrium transport beyond weak system-bath coupling regime: A polaron transformation approach

The concept of polaron, emerged from condense matter physics, describes the dynamical interaction of moving particle with its surrounding bosonic modes. This concept has been developed into a useful method to treat open quantum systems with a complete range of system-bath coupling strength. Especially, the polaron transformation approach shows its validity in the intermediate coupling regime, in which the Redfield equation or Fermi’s golden rule will fail. In the polaron frame, the equilibrium distribution carried out by perturbative expansion presents a deviation from the canonical distribution, which is beyond the usual weak coupling assumption in thermodynamics. A polaron transformed Redfield equation (PTRE) not only reproduces the dissipative quantum dynamics but also provides an accurate and efficient way to calculate the non-equilibrium steady states. Applications of the PTRE approach to problems such as exciton diffusion, heat transport and light-harvesting energy transfer are presented.
Entanglement entropy of composite Fermi liquid states on the lattice: In support of the Widom formula

Quantum phases characterized by surfaces of gapless excitations are known to violate the otherwise ubiquitous boundary law of entanglement entropy in the form of a multiplicative log correction: S∼L^(d−1) log L . Using variational Monte Carlo, we calculate the second Renyi entropy for a model wave function of the ν=1/2 composite Fermi liquid (CFL) state defined on the two-dimensional triangular lattice. By carefully studying the scaling of the total Renyi entropy and, crucially, its contributions from the modulus and sign of the wave function on various finite-size geometries, we argue that the prefactor of the leading L log L term is equivalent to that in the analogous free fermion wave function. In contrast to the recent results of Shao et al. [Phys. Rev. Lett. 114, 206402 (2015)], we thus conclude that the “Widom formula” holds even in this non-Fermi liquid CFL state. More generally, our results further elucidate—and place on a more quantitative footing—the relationship between nontrivial wave function sign structure and S∼L log L entanglement scaling in such highly entangled gapless phases.
On Optimizing Reservation-Based Intersection Controls

Tile-based reservation intersection control for autonomous vehicles has the potential to reduce intersection delays beyond optimized traffic signals. A major question in implementing reservations is the underdetermined problem of resolving conflicting reservation requests. Previous work studied prioritizing requests by first come first served or holding auctions at intersections, but the possibilities are infinite. Furthermore, although selfish routing behavior could affect the benefits of the reservation prioritization, reservation control has not been studied with user equilibrium routing due to its microsimulation definition. This paper addresses these issues by presenting an integer program formulation of the conflict point simplification of reservations. The feasible region is transformed, resulting in a more tractable integer program on conflict regions for dynamic traffic assignment. Because the integer program is NP-hard we present a polynomial-time heuristic. Finally, we demonstrate the potential utility of this heuristic by demonstrating objective functions that reduce travel time and energy consumption on a city network.
Nasal/Oral Feeding Tube Insertion

This section provides a comprehensive procedural report nasal/oral feeding tube insertion procedure with up-to-date explanatory notes, synopsis of the indications and contraindications, and potential complications in an organized and practical format.
Microstructural evolution in a nanocrystalline Cu-Ta alloy: A combined in-situ TEM and atomistic study

Abstract Under intense heating and/or deformation, pure nanocrystalline (NC) metals exhibit significant grain coarsening, thus preventing the study of length scale effects on their physical response under such conditions. Hence, in this study, we use in-situ TEM heating experiments, atomistic modeling along with elevated temperature compression tests on a thermally stabilized nanostructured Cu–10 at.% Ta alloy to assess the microstructural manifestations caused by changes in temperature. Results reveal the thermal stability attained in NC Cu-10 at.% Ta diverges from those observed for conventional coarse-grained metals and other NC metals. Macroscopically, the microstructure, such as Cu grain and Ta based cluster size resists evolving with temperature. However, local structural changes at the interface between the Ta based clusters and the Cu matrix have a profound effect on thermo-mechanical properties. The lattice misfit between the Ta clusters and the matrix tends to decrease at high temperatures, promoting better coherency. In other words, the misfit strain was found to decrease monotonically from 12.9% to 4.0% with increase in temperature, leading to a significant change in flow stress, despite which (strength) remains greater than all known NC metals. Overall, the evolution of such fine structures is critical for developing NC alloys with exceptional thermo-mechanical properties.
The social class worldviews of first-generation college students

The social class worldviews (social class beliefs, attitudes, and values) of 14 first-generation college students were investigated with qualitative interviews. Consensual qualitative research analysis revealed first-generation students’ perspectives on the development of their social class worldviews, the effect of these worldviews on their transitions to college, and vice versa. The students’ pre-college beliefs and values promoted hard work and college attendance as a means of financial success. The transition to college created disequilibrium in the social class worldviews of the students interviewed, who in turn responded by attempting to adapt to the new culture, emphasizing their social class background, or downplaying the role of social class in their lives altogether. College professionals working with first-generation students are encouraged to facilitate dialogues with first-generation students about their social class worldview and its impact on students’ engagement with the college community.
Using Dominance Analysis to Decompose Narcissism and Its Relation to Aggression and Externalizing Outcomes

Research on narcissism has shown it to be multidimensional construct. As such, the relations the larger construct bear with certain outcomes may mask heterogeneity apparent at the more basic trait level. This article used the Five Factor Narcissism Inventory, a Five-Factor Model-based measure of narcissism that allows for multiple levels of analysis, to examine the relative importance of narcissistic traits in relation to aggression, externalizing behavior, and self-esteem outcomes in two independent samples. The relative importance of the narcissism factors was determined through the use of dominance analysis-a relatively underused method for determining relative importance among a set of related predictors. The results showed that antagonism, compared with agentic extraversion and neuroticism, was the dominant predictor across all forms of aggressive behavior. Additional analyses showed that subscales within the broader factor of antagonism also showed differential importance relative to one another for certain aggression outcomes. The results are discussed in the context of the relation between narcissism and aggression and highlight the utility of using extensions of regression-based analyses to explore the heterogeneity within personality constructs.
Through the Grapevine: A Comparison of News in Microblogs and Traditional Media

In recent years the greater part of news dissemination has shifted from traditional news media to individual users on microblogs such as Twitter and Reddit. Therefore, there has been increasing research effort on how to automatically detect newsworthy and otherwise useful information on these platforms.
Organizational Structures and Retrieval Algorithms

This chapter describes organizational structures and retrieval algorithms. Each algorithm for searching a database corresponds to an organizational structure, a way of organizing the items in the database. In general, each search algorithm knows how to search one type of organizational structure. One set of algorithms can search B-trees; another set is designed to search heaps. Algorithms for searching a case library, too, are each associated with a different organizational structure. The qualities of the search algorithms associated with each organizational structure parallel the qualities of the structures. Some organizational structures are bushy and meant to be searched in parallel; they are searched using breadth-first algorithms. Other organizational structures are deep; they are searched by depth-first algorithms. Some are meant for serial machines, and others are meant for parallel machines. Algorithms reflect that distinction. Some organizational structures discriminate items from each other coarsely; others discriminate more finely. Algorithms for searching these types of structures differ in the way they interact with matching functions.
Feedback induced chaotic transitions in crossed-field devices

The recirculating hub charge causes nonlinear feedback between the input and the output in Crossed-Field Amplifiers. By varying some control parameters, such as the secondary emission coefficient or the recirculating charge fraction, the operation exhibits transitions from steady state, to limit cycles and finally to unpredictable (chaotic) behavior. The amplifier dynamics is described by a truncated system of fluid equations following guiding center trajectories1. Numerical integration of these equations yields very good agreement with experimental results, while reducing the computation time by three orders of magnitude compared to particle simulations. A pass-to-pass map is employed to investigate whether the chaotic transitions in CFAs follow the 'universal' rout to chaos for nonlinear-dissipative systems.
Medication class enrichment analysis: a novel algorithm to analyze multiple pharmacologic exposures simultaneously using electronic health record data

Objective Observational studies analyzing multiple exposures simultaneously have been limited by difficulty distinguishing relevant results from chance associations due to poor specificity. Set-based methods have been successfully used in genomics to improve signal-to-noise ratio. We present and demonstrate medication class enrichment analysis (MCEA), a signal-to-noise enhancement algorithm for observational data inspired by set-based methods. Materials and methods We used The Health Improvement Network database to study medications associated with Clostridium difficile infection (CDI). We performed case-control studies for each medication in The Health Improvement Network to obtain odds ratios (ORs) for association with CDI. We then calculated the association of each pharmacologic class with CDI using logistic regression and MCEA. We also performed simulation studies in which we assessed the sensitivity and specificity of logistic regression compared to MCEA for ORs 0.1-2.0. Results When analyzing pharmacologic classes using logistic regression, 47 of 110 pharmacologic classes were identified as associated with CDI. When analyzing pharmacologic classes using MCEA, only fluoroquinolones, a class of antibiotics with biologically confirmed causation, and heparin products were associated with CDI. In simulation, MCEA had superior specificity compared to logistic regression across all tested effect sizes and equal or better sensitivity for all effect sizes besides those close to null. Discussion Although these results demonstrate the promise of MCEA, additional studies that include inpatient administered medications are necessary for validation of the algorithm. Conclusions In clinical and simulation studies, MCEA demonstrated superior sensitivity and specificity for identifying pharmacologic classes associated with CDI compared to logistic regression.
Addressing extensibility and fault tolerance in can-based automotive systems: Special session paper

The design of automotive electronic systems needs to address a variety of important objectives, including safety, performance, fault tolerance, reliability, security, extensibility, etc. To obtain a feasible design, timing constraints must be satisfied and latencies of certain functional paths should not exceed their deadlines. From functionality perspective, soft errors caused by transient or intermittent faults need to be detected and recovered with fault tolerance techniques. Moreover, during the lifetime of a vehicle design or even the same car, updates are often needed to add new features or fix bugs in existing ones. It is therefore critical to improve the design extensibility for accommodating such updates without incurring major redesign and re-verification cost. In this work, we discuss the metrics for measuring latency, fault tolerance and extensibility, and present a simulated annealing based algorithm to search the design space with respect to them. Experimental results on industrial and synthetic examples demonstrate clear trade-offs among these objectives, and hence the importance of quantitatively analyzing such trade-offs and exploring the design space with automation tools.
Spirituality and Quality of Life in Black Patients With Cancer Pain.

Abstract Purpose The objective of this study was to examine the associations between spirituality and overall quality of life (QOL) and individual QOL domains in black patients with cancer pain. Methods A secondary data analysis of a parent study exploring pain medication adherence in black patients receiving around-the-clock opioids with cancer pain was performed. All the participating patients completed Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being Scale (spirituality), Brief Pain Inventory (pain severity and interference), Edmonton Symptom Assessment Scale (symptoms), and Functional Assessment of Cancer Therapy—General (QOL). Pearson correlation and multiple linear regression analyses were conducted to examine the associations between spirituality and overall QOL and QOL domains and to identify the predictors of overall QOL and QOL domains. Results Black patients treated for cancer pain (n = 102) completed the study. Pearson correlation showed significant positive associations between spirituality and overall QOL (P Conclusions Spirituality is associated with decreased pain and lower symptom burden and may serve as a protective factor against diminished overall QOL, specifically social, emotional, and functional domains in black patients with cancer pain. There is a need to develop spirituality-based interventions along with symptom management interventions to improve QOL for this population.
Learning Compressible 360° Video Isomers

Standard video encoders developed for conventional narrow field-of-view video are widely applied to 360° video as well, with reasonable results. However, while this approach commits arbitrarily to a projection of the spherical frames, we observe that some orientations of a 360° video, once projected, are more compressible than others. We introduce an approach to predict the sphere rotation that will yield the maximal compression rate. Given video clips in their original encoding, a convolutional neural network learns the association between a clip's visual content and its compressibility at different rotations of a cubemap projection. Given a novel video, our learning-based approach efficiently infers the most compressible direction in one shot, without repeated rendering and compression of the source video. We validate our idea on thousands of video clips and multiple popular video codecs. The results show that this untapped dimension of 360° compression has substantial potential-"good" rotations are typically 8-10% more compressible than bad ones, and our learning approach can predict them reliably 82% of the time.
Ponatinib-induced cardiotoxicity: delineating the signalling mechanisms and potential rescue strategies

Aims Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myelogenous leukaemia (CML). However, cardiotoxicity of these agents remains a serious concern. The underlying mechanism of these adverse cardiac effects is largely unknown. Delineation of the underlying mechanisms of TKIs associated cardiac dysfunction could guide potential prevention strategies, rescue approaches, and future drug design. This study aimed to determine the cardiotoxic potential of approved CML TKIs, define the associated signalling mechanism and identify potential alternatives. Methods and results In this study, we employed a zebrafish transgenic BNP reporter line that expresses luciferase under control of the nppb promoter (nppb:F-Luciferase) to assess the cardiotoxicity of all approved CML TKIs. Our in vivo screen identified ponatinib as the most cardiotoxic agent among the approved CML TKIs. Then using a combination of zebrafish and isolated neonatal rat cardiomyocytes, we delineated the signalling mechanism of ponatinib-induced cardiotoxicity by demonstrating that ponatinib inhibits cardiac prosurvival signalling pathways AKT and extra-cellular-signal-regulated kinase (ERK), and induces cardiomyocyte apoptosis. As a proof of concept, we augmented AKT and ERK signalling by administration of Neuregulin-1β (NRG-1β), and this prevented ponatinib-induced cardiomyocyte apoptosis. We also demonstrate that ponatinib-induced cardiotoxicity is not mediated by inhibition of fibroblast growth factor signalling, a well-known target of ponatinib. Finally, our comparative profiling for the cardiotoxic potential of CML approved TKIs, identified asciminib (ABL001) as a potentially much less cardiotoxic treatment option for CML patients with the T315I mutation. Conclusion Herein, we used a combination of in vivo and in vitro methods to systematically screen CML TKIs for cardiotoxicity, identify novel molecular mechanisms for TKI cardiotoxicity, and identify less cardiotoxic alternatives.
Training community providers in evidence-based treatment for PTSD: Outcomes of a novel consultation program.

OBJECTIVE Extensive research supports the use of prolonged exposure (PE) and cognitive processing therapy (CPT), for posttraumatic stress disorder (PTSD) in veterans and service members. PE and CPT have been disseminated nationally across the Department of Veterans Affairs (VA) facilities. Many service members and veterans receive care outside the VA where access to these gold standard psychotherapies can be limited. This paper presents a novel program developed to train community providers in the use of PE and CPT and their application to veterans with PTSD through the use of a medium-touch approach to consultation. METHOD Four 2-day trainings (2 in PE, 2 in CPT) were delivered to a total of 170 participants over an 8-month period. A subset of approximately 10 providers per training (n = 42) received 6 months of weekly, group phone consultation following the 2-day training. All providers were assessed pre- and posttraining, as well as 3 and 6 months after their training. Outcomes for the training workshop alone and the training plus 6 months of consultation were compared. RESULTS While participant knowledge, t = -22.57, p < .001 and comfort (χ² = 74.00, p < .001) with PE and CPT significantly increased immediately following the 2-day training, those who received consultation were more likely to implement (χ² = 20.88, p < .001) and either complete or be close to completing PE or CPT with patients (χ² = 20.57, p < .001) 6 months following training. CONCLUSIONS Despite some limitations, these preliminary data support that consultation is an important component to include in PTSD therapy training and implementation in the community. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Self-Reported Reasons for Abstinence from Illicit Drugs

Objective: To provide a more balanced understanding of the initiation and restraint of substance use, educators, clinicians, and researchers would benefit from a review of research assessing the re...
Incidence of Pediatric Cervical Spine Injuries in Iraq and Afghanistan.

OBJECTIVE Military providers frequently treat civilians, including pediatric patients. Cervical spine injuries in pediatric trauma patients occur infrequently, with limited data on the incidence. The aim of this study was to describe the incidence of cervical spine injuries in pediatric patients in Iraq and Afghanistan. METHODS We queried the Department of Defense Trauma Registry for all pediatric encounters from January 2007 to January 2016. We searched within that dataset for all cervical spine fractures. RESULTS From January 2007 through January 2016 there were 3439 pediatric encounters. There were 36 subjects identified (1.0%) with a cervical spine fracture. Of those with a cervical spine fracture, 6 (17%) had a prehospital cervical collar placed, which did not improve survival to hospital discharge (collar, 66.7% vs no collar, 83.3%, P = 0.573). Of those with a cervical spine fracture, 6 (17%) had a documented spinal cord injury. The median age of subjects with a cervical spine fracture was 9.5 years and the majority (63.9%) were male. Most were injured by explosion (41.7%). The median composite injury score was higher in subjects with a cervical spine fracture compared with those without one (16.5 vs 10, P < 0.001). Subjects with a cervical spine fracture had longer lengths of stay in the intensive care unit (median 3 days vs 1, P = 0.012) and a trend toward worse survival to hospital discharge (80.6%, n = 29, vs 90.3%, n = 3074, P = 0.079). CONCLUSIONS Cervical spine injuries occurred infrequently in pediatric patients in Iraq and Afghanistan. When a fracture was present, almost one in five patients had spinal cord involvement. The pediatric prehospital literature would benefit from the development of a clinical decision tool to guide prehospital personnel as to when a cervical collar is indicated. Moreover, appropriate size equipment should be available when caring for host national civilians.
Cuprous chloride promoted coupling reaction of diethoxyphosphinyldifluoromethylcadmium reagent with aryl iodides: A practical and convenient preparation of α,α-difluoro benzylic phosphonates

Abstract The cross coupling reaction of diethoxyphosphinyldifluoromethylcadmium reagent with aryl iodides was promoted by CuCl under mild conditions to give α,α-difluoro benzylic phosphonates in good yields. A variety of functional groups, including halides, phosphonate, nitro, ketone, carboxylic acid and ester in aryl iodides, could be tolerated. This methodology has been successfully applied to prepare α,α-difluoro Fostedil 9 .
Boron-10 Prompt Gamma Analysis Using a Diffracted Neutron Beam

A prompt gamma neutron activation analysis (PGNAA) facility has been built at the 5 MW MITR-II Research Reactor to support our ongoing boron neutron capture therapy (NCT) program. This facility is used to determine the concentration of B-10 in NCT relevant samples such as blood and urine. The B-10 concentration is needed to determine the radiation doses that tumor and healthy brain receive during neutron irradiation of a patient (1). Assaying for B-10 by PGNAA has several advantages over conventional chemical methods. It is rapid, accurate, nondestructive (allowing for re-analysis), inexpensive, sensitive (ppm level), generally independent of the chemical or physical matrix of the B-10, and does not require chemical manipulations of the sample.
Release of trivalent chromium from serum transferrin is sufficiently rapid to be physiologically relevant.

Abstract Transferrin, the major iron transport protein in the blood, apparently also transports trivalent chromium in vivo via endocytosis. Recent in vitro studies have, however, suggested that the release of chromic ions from serum transferrin is too slow to be biologically relevant. Consequently, the release of chromium(III) from human serum transferrin has been examined under conditions mimicking an endosome during endocytosis. At pH 4.5 and 5.5, the release of Cr(III) from transferrin occurs rapidly from the weak binding site. While appreciably slower, the release of Cr(III) from the tighter site in the presence of biological chelating agents is potentially sufficiently fast to be physiologically relevant. When Cr(III)-loaded transferrin is added to soluble transferrin receptor, the interaction with the receptor results in Cr(III) in both the weak and tight binding sites giving rise to an EPR signal similar to that of the weak binding site; concurrently, the loss of Cr(III) from both binding sites becomes rapid at acidic pH, more rapid than from either site in the absence of the receptor. Loss of Cr(III) from the transferrin-transferrin receptor complex, thus, is easily sufficiently rapid for transferrin to serve as the physiological transporter of Cr(III) from the bloodstream to the tissues. However, detailed studies of conformational changes of transferrin associated with the binding and release of chromium along with investigations of how and at what rate Cr(III) is transported from the endosome will be required before this question of whether transferrin transport Cr(III) in vivo can be definitively resolved.
Electron cloud development in the Proton Storage Ring and in the Spallation Neutron Source

Author(s): Pivi, M.T.F.; Furman, M.A. | Abstract: We have applied our simulation code "POSINST" to evaluate the contribution to the growth rate of the electron-cloud instability in proton storage rings. Recent simulation results for the main features of the electron cloud in the storage ring of the Spallation Neutron Source (SNS) at Oak Ridge, and updated results for the Proton Storage Ring (PSR) at Los Alamos are presented in this paper. A key ingredient in our model is a detailed description of the secondary emitted-electron energy spectrum. A refined model for the secondary emission process including the so-called true secondary, rediffused and backscattered electrons has recently been included in the electron-cloud code.
“I Can Spin Some Bullshit If You Want”: Narrating (and Bridging?) The Civil-Military Divide in Phil Klay’s Redeployment

In Phil Klay’s fiction, the telling of one’s tale is fraught with personal peril. Exposing one’s actions to the scrutiny and possible condemnation of others is a difficult task requiring the embracing of one’s own vulnerability. This trepidation, combined with a strong suspicion that one will be misunderstood, creates conditions where miscommunication is more likely to occur than not. This tenuous dynamic explains the ambivalent stance towards narrative adopted by Klay’s veteran-narrators in Redeployment – perhaps best reflected in their repeated use of the word “bullshit” (over a dozen times) in a variety of instances throughout the collection. Examining three stories from the collection – “Bodies,” “War Stories,” and “Psychological Operations” – I consider the extent to which Klay’s invocation of “bullshit” announces that one carries no illusions about the truth-bearing quality of one’s narrative and that one is subsequently seeking a different kind of contract with the listener. In Klay’s stories, then, bullshit acts as both a defense mechanism and an instigation. Urging the reader to truly listen, Klay seeks to open new avenues for civil-military connection and an acceptance of mutual responsibility.
Early-Life Adversities and Recalcitrant Smoking in Midlife: An Examination of Gender and Life-Course Pathways

BACKGROUND Little is known about life-course factors that explain why some individuals continue smoking despite having smoking-related diseases. PURPOSE We examined (a) the extent to which early-life adversities are associated with the risk of recalcitrant smoking, (b) psychosocial factors that mediate the association, and (c) gender differences in the associations. METHODS Data were from 4,932 respondents (53% women) who participated in the first and follow-up waves of the Midlife Development in the U.S. National Survey. Early-life adversities include low socioeconomic status (SES), abuse, and family instability. Potential mediators include education, financial strain, purpose in life, mood disorder, family problems/support, and marital status. We used sequential logistic regression models to estimate the effect of early-life adversities on the risk of each of the three stages on the path to recalcitrant smoking (ever-smoking, smoking-related illness, and recalcitrant smoking). RESULTS For women, low SES (odds ratio [OR] = 1.29; 1.06-1.55) and family instability (OR = 1.73; 1.14-2.62) are associated with an elevated risk of recalcitrant smoking. Education significantly reduces the effect of childhood SES, yet the effect of family instability remains significant even after accounting for life-course mediators. For men, the effect of low SES on recalcitrant smoking is robust (OR = 1.48; 1.10-2.00) even after controlling for potential mediators. There are noteworthy life-course factors that independently affect recalcitrant smoking: for both genders, not living with a partner; for women, education; and for men, family problems. CONCLUSIONS The findings can help shape intervention programs that address the underlying factors of recalcitrant smoking.
Self-Efficacy and Sexual Purity among SDA Emerging Adults: A Bivariate Analysis*

The purpose of this study was to examine the ability of SDA emerging adults (N = 558) to remain sexually abstinent prior to marriage in spite of pressures to engage in such act. The researchers exp...
PUTATIVE SYNAPTIC TRANSMITTERS INVOLVED IN THE CONTROL OF GONADOTROPIN AND GROWTH HORMONE RELEASE

Publisher Summary This chapter discusses the putative synaptic transmitters involved in the control of gonadotropin and growth hormone release. Hypothalamic control over gonadotropin secretion is mediated by the decapeptide, LH-releasing hormone (LHRH), which appears to be released in pulsatile bursts to control LH secretion. The decapeptide can also stimulate FSH secretion under certain conditions that has led some to postulate that this is the hypothalamic factor controlling FSH secretion as well. On the basis of lesion and stimulation studies, it appears that there is a selective control of FSH secretion by the dorsal anterior hypothalamic area that may be mediated by a distinct FSH releasing factor. It is likely that FSH secretion is also inhibited by inhibin, which arises from the testes in the male and the ovary in the female. Growth hormone secretion is under dual control by growth hormone-releasing factor, which has yet to be characterized, and probably arises from neurons with cell bodies in the ventromedial nucleus and by a growth hormone-inhibiting factor, now usually called somatostatin, which is a tetradecapeptide.
CT evaluation of unrepaired/incidental congenital cardiovascular diseases in adults

Congenital heart disease (CHD) affects approximately one million people in the USA with the number increasing by 5% each year. Patients are usually both diagnosed and treated in infancy, however many of them may have subclinical CHD that remains undiagnosed until late adulthood. Patients with complex CHD tend to be symptomatic and are diagnosed at a younger age than those with a single defect. CHDs can be divided into three categories, including cardiac, great vessels and coronary artery anomalies. Recent advances in computed tomography (CT) technology with faster acquisition time and improved spatial resolution allow for detailed evaluation of cardiac morphology and function. The concomitant increased utilization of CT has simultaneously led to more sensitive detection and more thorough diagnosis of CHD. Recognition of and understanding the imaging attributes specific to each anomaly is important for radiologists in order to make a correct and definite diagnosis. This article reviews the spectrum of CHDs, which persist into adulthood that may be encountered by radiologists on CT.
Effect of Hf/Zr Ratio on Shape Memory Properties of High Temperature Ni50.3Ti29.7(Hf,Zr)20 Alloys

Abstract A series of Ni50.3Ti29.7(Hf,Zr)20 (Zr=0 to 20 at %) high-temperature shape memory alloys were investigated to determine the effect of varying Hf/Zr ratio on shape memory properties. Uniaxial constant-force thermal cycling (UCFTC) tests and electron microscopy were used to determine the effect of composition on microstructure, transformation temperatures, and functional material properties. In general, substitution of Zr for Hf resulted in a slight decrease in transformation temperatures, a negligible change in transformation strain, and an improvement in dimensional stability. Thus, the entire range of NiTiHfZr alloys resulted in acceptable actuation properties across the compositions studied with the additional ability to adjust composition for cost and mass savings.
Mediational Effect of Prior Preparation on Performance Differences of Students Underrepresented in Physics.

Instructional interventions are necessary in introductory college physics so that differences in preparation do not generate differences in outcomes for women, underrepresented ethnic or racial minorities, and first-generation college students.
Condition Based Monitoring for a Hydraulic Actuator

In some environments where prognostics and health management would be beneficial, for example on board U.S. naval vessels, installation location and accessibility to power system must be considered. In this study, we investigate condition based maintenance and fault diagnosis for hydraulic actuators in power constrained environments. The experimental setup for collecting data is outlined, and a data set replicating multiple types of faults is collected. Several types of machine learning classifiers, including random forest and classification trees, are tested on the data set. Prediction accuracy as well as training and testing times are compared, which are used as a surrogate for power consumption in this study. We find that the random forest algorithm provides the lowest error rate of the tested classifiers but has some of the highest training and testing times. Classification trees, on the other hand, provide a better tradeoff between accuracy and computation time.
COVID-19 Vaccine Breakthrough Infections Reported to CDC - United States, January 1-April 30, 2021

COVID-19 vaccines are a critical tool for controlling the ongoing global pandemic. The Food and Drug Administration (FDA) has issued Emergency Use Authorizations for three COVID-19 vaccines for use in the United States.* In large, randomized-controlled trials, each vaccine was found to be safe and efficacious in preventing symptomatic, laboratory-confirmed COVID-19 (1-3). Despite the high level of vaccine efficacy, a small percentage of fully vaccinated persons (i.e. received all recommended doses of an FDA-authorized COVID-19 vaccine) will develop symptomatic or asymptomatic infections with SARS-CoV-2, the virus that causes COVID-19 (2-8).
Experimental investigation into the basic application of force and position control for human-machine team lifting operations in manufacturing:

In manual material handling operations associated with manufacturing, often a two-person team lifts a container. The labor intensive task of lifting a container could be improved by replacing the t...
Immunosuppression and Outcomes in Acute Myeloid Leukemia

Abstract Acute myeloid leukemia (AML) patients rarely have long first remissions (> 5 years) after standard-of-care chemotherapy, unless classified as favorable risk at presentation. Identification of the mechanisms responsible for long vs. more typical, short remissions may help to define prognostic determinants for chemotherapy responses. Using exome sequencing, RNA-sequencing and functional immunologic studies, we characterized 28 Normal Karyotype (NK)-AML patients with >5 year first remissions after chemotherapy (Long First Remissions, LFR) and compared them to a well-matched group of 31 NK-AML patients who relapsed within 2 years (Standard First Remissions, SFR). Our combined analyses indicated that genetic risk profiling at presentation (as defined by ELN 2017 Criteria) was not sufficient to explain the outcomes of many SFR cases. Single cell RNA-sequencing studies of 15 AML samples showed that SFR AML cells differentially expressed many genes associated with immune suppression. The bone marrow of SFR cases had significantly fewer CD4+ Th1 cells; these T-cells expressed an exhaustion signature and were resistant to activation by T-cell receptor stimulation in the presence of autologous AML cells. T-cell activation could be restored by removing the AML cells, or blocking the inhibitory MHC Class II receptor, LAG3. Most LFR cases did not display these features, suggesting that their AML cells were not as immunosuppressive. These findings were confirmed and extended in an independent set of 50 AML cases representing all ELN 2017 risk groups. AML cell-mediated suppression of CD4+ T-cell activation at presentation is strongly associated with unfavorable outcomes in AML patients treated with standard chemotherapy.