cssi/SciSciGPT-SciSciNet huggingface dataset:
Influenza treatment with oseltamivir outside of labeled recommendations.

Purpose Published evidence regarding the use of the antiinfluenza agent oseltamivir outside of the standard dosing recommendations is reviewed. Summary Oseltamivir is a neuraminidase inhibitor indicated for the treatment of uncomplicated influenza in patients two weeks of age or older who have been symptomatic for no more than two days; the recommended dosage is 75 mg twice daily by mouth for five days. A literature search identified six studies evaluating the effects of administering oseltamivir 48 hours or more after the onset of influenza symptoms, administering the drug at double the standard dose, or continuing therapy for more than five days. Two randomized controlled trials found that double-dose oseltamivir therapy conferred no significant survival benefit. The results of one retrospective study of intensive care unit (ICU) patients infected with the influenza H1N1 strain suggested improved survival among those who received oseltamivir no later than five days after symptom onset. Conclusion Oseltamivir may increase survival when used within five days of symptom onset in influenza H1N1–infected patients who require ICU admission. There appears to be no benefit in starting treatment more than 48 hours after symptom onset in hospitalized general medicine patients or outpatients infected with either H1N1 or other influenza strains or in doubling the dose of oseltamivir in hospitalized patients or outpatients. There are scant data supporting the use of oseltamivir for longer than five days in any patient population, with the possible exception of critically ill H1N1-infected ICU patients, who may benefit from extended treatment in some cases.
Improving Interdisciplinary Communication With Standardized Cyber Security Terminology: A Literature Review

The growing demand for computer security, and the cyberization trend, are hallmarks of the 21st century. The rise in cyber-crime, digital currency, and e-governance has been well met by a corresponding recent jump in investment in new technology for securing computers around the globe. Business and government sectors have begun to focus effort on comprehensive cyber security solutions. With this effort has emerged a need for greater collaboration between research and industry fields. Despite much effort, there is still too little cross-disciplinary collaboration in the realm of computer security. This paper reviews the new trends, contributions, and identifiable limitations in cyber security research. We argue that these limitations are due largely to the lack of interdisciplinary cooperation required to address a problem that is clearly multifaceted. We then identify a need for further refinement of standard cyber security terminology to facilitate interdisciplinary cooperation, and propose guidelines for the global Internet multistakeholder community to consider when crafting such standards. We also assess the viability of some specific jargon, including whether cyber should be a separate word when used as a descriptor (e.g. cyber-crime or cybercrime), and conclude with recommendations for terminology use when writing papers on cyber security or the new broader field of all things relating to cyberspace, which has recently been dubbed Cybermatics, a term we also examine and propose alternatives to. By furthering the effort to standardize cyber security terminology, this paper lays groundwork for cross-disciplinary collaboration, interaction between technical and nontechnical stakeholders, and drafting of universal Internet governance laws.
Study on the Technology of Mechanical Crush-up of Rice Stalks for Direct Returning to Farmland in Cold Region

For the problem of the enlarging of rice planting area and the severe deficit of paddy field in Heilongjiang province,the suitable amount and period for rice stalks for direct returning to farmland were studied,fertilizer application methods and the improving degree of soil physical and chemical properties and saving fertilizer effect were determined,and concrete measures of mechanical returning was studied,the technology system of mechanical straw returned field and enrich fertility in cold region was formed.The results as follows:rice stalks returning for 3 years soil organic matter content increased 0.2%,the yield increased 10%,saving fertilizer 10%～20%,the effect of enriching fertility、increasing yield、saving fertilizer was very remarkable.To spread actively the technology of mechanical straw returned field and enrich fertility was an important method for improving fine ecological environment and making economy and the society to develop sustainably.The market prospect of this technology was very broad.
Health-related Quality of Life Issues in Women with Polycystic Ovary Syndrome

Objective:To assess the effect of PCOS on HRQL and psychosocial well-being.Methods:87 women with PCOS and 50 controls were evaluated with standardized questionnaires including 36-item short-form health survey,symptom checklist revised,and life satisfaction questionnaire.Sexual satisfaction was assessed using a 100-mm visual analog scale(VAS).Results:①Patients showed greater psychological disturbances on the dimensions of obsessive-compulsive,interpersonal sensitivity,depression,anxiety,aggression,and psychosis.②Patients reported significantly lower HRQL on the scales of physical role function body pain vitality social function,emotional role function and mental health general health,physical function.③ Patients reported significantly lower satisfaction. ④ Patients were significantly less satisfied with their sex life.Conclusions:Women with PCOS reported greater psychological disturbances compared with controls,they were significantly less satisfied with their lives.PCOS have great impact on HRQL.
Use of Diacetyl To Reduce the Load of Vibrio vulnificus in the Eastern Oyster, Crassostrea virginica

Vibrio vulnificus is a highly virulent human pathogen that occurs naturally among the microflora of oysters. This organism has two portals of entry into humans, one of which is ingestion. Oysters containing V. vulnificus consumed in a raw or undercooked state often serve as a vehicle for the transmission of this organism. Previous studies conducted in our laboratory have examined various generally recognized as safe compounds and have determined that diacetyl, a component of butter, is among the most effective of these compounds in reducing loads of V. vulnificus in oysters. The purpose of this study was to further examine the role of diacetyl, along with that of depuration, in reducing loads of V. vulnificus. Shellstock oysters were treated with various concentrations of diacetyl, and we found that many of the oysters ceased pumping when diacetyl was added. The data obtained in this study indicated that treatment with diacetyl is ineffective; however, any reduction in V. vulnificus numbers may be masked when groups of oysters, some of which may not have taken up diacetyl, are sampled. We then investigated the efficacy of diacetyl in lowering levels of V. vulnificus in shucked oysters. Diacetyl was found to significantly reduce the load of V. vulnificus in shucked oysters containing natural populations. Overall, it appears that treatment with diacetyl is ineffective for shellstock oysters, although it has potential for use in reducing loads of V. vulnificus in shucked oysters.
Management of Low Back Pain: Current Assessment and Formulation of a Blueprint for the Health Care Delivery System of the Future

This article outlines the authors' recommendations for future health care delivery to patients with low back pain and presents one potential blueprint for a modified delivery system. A group of multidisciplinary physicians and support staff that functions as a unified team with common goals is best positioned to overcome the challenges of providing quality care in a managed care environment. The burden on those who manage patients with spine disorders is to define and prove that high quality medical care results in genuine cost savings and better value for the health care customer.
Worsening anatomic outcomes following aflibercept for neovascular age-related macular degeneration in eyes previously well controlled with ranibizumab

Purpose Antivascular endothelial growth factor injection is the mainstay of treating neovascular age-related macular degeneration (AMD). Previous studies have shown that switching treatment from ranibizumab to aflibercept led to an improvement in eyes with recalcitrant activity. Herein, we identify a unique subset of patients whose eyes with neovascular AMD were previously well controlled with ranibizumab injections were then worsened after being switched to aflibercept.
Updating and augmenting weather data for pavement mechanistic-empirical design using ASOS/AWOS database in Michigan

AbstractClimatic files are an important input in the recently released pavement design software Pavement ME Design (PMED). Currently there are 24 climatic files embedded in the PMED for various locations within the state of Michigan, USA. However, the distribution of existing weather stations is not geographically uniform, with noticeable gap regions among these stations. The existing climatic files have only 5 to 9 years of hourly data and have not been updated since 2006. This study aims to add new weather stations to fill the gap regions and to update existing climatic files to the end of the year 2014 using historical climatic data from the Automated Surface/Weather Observation System (ASOS/AWOS). To achieve this goal, the climatic files from other locations in ASOS/AWOS were edited to meet the requirements of the PMED. The new climatic data were compared with existing data in detail to verify the data source consistency. A quantity and quality check was conducted for the new climatic files. Procedure...
A new leakage energy commutation technique for single stage high frequency link inverters

This paper presents a commutation technique to overcome the effects of transformer leakage inductance in a single stage high frequency ac-link transformer isolated inverter. The presence of leakage inductance causes large voltage spikes across the transformer due to the switched nature of link current that is encountered in direct high frequency ac link to low frequency ac conversion. This paper proposes a partial resonant technique where a capacitor is connected across the link only during the instants when the current in the link needs to change its polarity. This results in a resonant current transition which eliminates the problem of abrupt current transition through an inductor. The proposed technique results in the recovery of the leakage energy to a large extent and also results in soft switching during majority of the switching transitions resulting in enhanced efficiency. The proposed scheme is implemented in the SIMULINK software environment and results are presented.
Achieving hover equilibrium in free flight with a flexible flapping wing

Abstract Recent discoveries in the fields of flapping wing aerodynamics and fluid–structure interaction have demonstrated that flexible wings can generate more lift than rigid wings. However, the implications of wing flexibility on the flight dynamics of flapping wing flyers is still an open research question. The main difficulty is that the free flight of flapping flyers with flexible wings is a result of the dynamic balance between unsteady aerodynamics, fluid–structure interaction, and flight dynamics. This study presents a fully coupled three-way flight simulator that solves the two-dimensional Navier–Stokes equations, tightly coupled to the Euler–Bernoulli beam equations of the wing and the nonlinear multi-body equations of motion for the dynamics at the fruit fly scale. A novel trim algorithm is used to determine the hover equilibrium in the longitudinal plane. The control inputs, i.e. the flapping amplitude, stroke plane angle, and flapping offset angle as well as the initial conditions are determined that effectively eliminate average body accelerations to less than 3% of gravitational acceleration. The resulting hover equilibrium control parameters flapping amplitude, stroke plane angle and the total power required agree well with the biological observation of fruit flies. Body oscillations in hovering free flight affect the flexible response of the wing compared to prescribed body motion without oscillation. The affected wing motion reduces the lift coefficient by up to 8.7% for the stiffest wing, necessitating slightly different control inputs to achieve trim. Finally, the power required to achieve hover equilibrium is 32%–94% lower for flexible wings than for rigid wings that are actively rotated to match the same passive pitch schedule.
Effect of non-native versus native invaders on macrophyte richness: are carp and bullheads ecological proxies?

While it is accepted that invasive species are non-native organisms that become abundant and cause ecological damage in areas where they are introduced, the problem of ‘native invaders,’ native species that become excessively abundant due to anthropogenic impacts, is frequently encountered by ecologists. Often, native and non-native invaders occur in sympatry. Understanding relative severity of their impacts and niches they occupy is needed to inform management actions. Here, we quantify relative impact of native (black bullhead) and non-native (common carp) benthic fish on macrophytes species richness in over 200 lakes in North America. The impact of each species was addressed while accounting for the effects of water clarity, depth, lake area, watershed size, shoreline irregularity, land use by humans, abundance of planktivorous fishes, and ecoregion. Using model selection, we show that both species had negative impact on macrophytes richness, but the impact of carp was approximately two times as strong when adjusted for catch rates. We also conducted a principal component analysis followed by permutation procedures, which showed that carp and bullheads often occurred together in shallow, turbid lakes in watershed dominated by human use. Our findings have implications for lake-restoration efforts via carp or bullhead management.
Rat 22-kHz Ultrasonic Vocalizations as a Measure of Emotional Set Point During Social Interactions

Abstract Rat 22-kHz ultrasonic vocalizations (USVs) are exhibited in response to a wide variety of stimuli. Recently, we have shown that, depending on the internal state of the animal, a given stimulus can either trigger aversive 22-kHz USVs or hedonic 50-kHz USVs. Notably, preexposure to reward/stress shifts this response of rats; we can selectively breed in a robust fashion for these differential responses. In addition, a change from hedonic 50-kHz to aversive 22-kHz USVs is typical during prolonged social interactions, which reflects a shift from initiation to approach, avoidance, and termination of behaviors; a similar pattern is seen with nonsocial stimuli. We now propose that 22-kHz USVs should not only be thought of as induced primarily by aversive stimuli but also by other stimuli as the transition from approach to avoidance for a wide variety of hedonic and aversive stimuli as well as a means to influence the refractory period for these motivated behaviors. A new model for motivated behavior is proposed in which changing the threshold for eliciting 50-kHz USVs as well as subsequent 22-kHz USVs and returning to baseline can account for the rhythm of changes in motivated behavior. Therefore, understanding the plasticity mechanisms in the neuronal circuits that underlie production of both 50-kHz USVs and 22-kHz USVs will elucidate processing of emotional behavior and decision making as well as lead to the development of potential therapeutics for psychiatric disorders.
Redefining Digital Audience: Models and Actions.

This paper presents a new theoretical model for audience participation in the context of HCI. Such a model is necessary because, while a great amount of new interactive solutions are unveiled each year, the assumptions in regards to users’ roles remain largely unchanged since the dawn of the computer era. This paper questions these roles and articulates a number of principles that interactive environments must employ to bring about new audiences – active communities based on the principles of non-idiomatic improvisation. This theoretical exercise is supplemented by a brief description of the Emonic Environment, our system for creation, modification, exchange, and performance of audiovisual media in an improvisational fashion. The paper concludes with a description of system’s ongoing expansion into the domain of mobile multi-user collaboration.
Clinical Research Informatics: Challenges, Opportunities and Definition for an Emerging Domain

Objectives: Clinical Research Informatics, an emerging sub-domain of Biomedical Informatics, is currently not well defined. A formal description of CRI including major challenges and opportunities is needed to direct progress in the field. Design: Given the early stage of CRI knowledge and activity, we engaged in a series of qualitative studies with key stakeholders and opinion leaders to determine the range of challenges and opportunities facing CRI. These phases employed complimentary methods to triangulate upon our findings. Measurements: Study phases included: 1) a group interview with key stakeholders, 2) an email follow-up survey with a larger group of self-identified CRI professionals, and 3) validation of our results via electronic peer-debriefing and member-checking with a group of CRI-related opinion leaders. Data were collected, transcribed, and organized for formal, independent content analyses by experienced qualitative investigators, followed by an iterative process to identify emergent categorizations and thematic descriptions of the data. Results: We identified a range of challenges and opportunities facing the CRI domain. These included 13 distinct themes spanning academic, practical, and organizational aspects of CRI. These findings also informed the development of a formal definition of CRI and supported further representations that illustrate areas of emphasis critical to advancing the domain. Conclusions: CRI has emerged as a distinct discipline that faces multiple challenges and opportunities. The findings presented summarize those challenges and opportunities and provide a framework that should help inform next steps to advance this important new discipline.
ADMINISTRATIVE DUE PROCESS—WOUNDED WARRIORS AND DUE PROCESS: THE CUSHMAN V. SHINSEKI ANALOGY

Military service members and veterans receive various benefits arising from their military service. The Department of Veterans Affairs acts as the trustee for distribution of these benefits upon veterans’ transition to civilian society. Among these benefits is disability compensation for medical conditions incurred or aggravated by the veteran in the course of their military service. This compensation makes the veteran whole for each condition that can be traced back to the veteran’s service. In many cases, this compensation is the veteran’s sole source of subsistence when they return to civilian life. Until 2009, these benefits were not considered property interests under the Due Process Clause. But the Court of Appeals for the Federal Circuit changed that in Cushman v. Shinseki, which stands for a rather simple proposition: veterans’ benefits are constitutionally protected property interests. The author takes the proposition presented in Cushman and seeks to expand it to another scheme that provides disability benefits to service members still in the military. The Department of Defense may separate with severance pay or medically retire a member who suffers from a medical condition which renders him or her unfit for further military duty. The military disability benefits available to members under this scheme lack any judicially recognized constitutional protection—despite many shared characteristics with disability compensation provided to veterans. The unspoken doctrine of judicial non-interference with national defense and military matters—the military deference doctrine— has stymied opinions like Cushman from appearing in the military disability benefits context. The author argues this doctrine does not apply where the military is acting as an administrator of benefits instead of providing for the national defense. Classifying military disability benefits as property interests does not imply national security issues. Rather, it recognizes that the government cannot arbitrarily deprive service members of disability benefits. The end sought by the Cushman analogy is as simple as the proposition the case stands for: disabled service members ought to be guaranteed a fundamentally fair adjudication—no matter the circumstances.
Florida East Coast Railway and the Structure of Administrative Law

A typical Administrative Law course presents the Supreme Court's decision in United States v. Florida East Coast Railway Co.1 as establishing the rule that statutory text quite close to the magic words, "on the record after opportunity for an agency hearing,"2 is needed to trigger the Administrative Procedure Act's (APA) formal hearing requirements for a rulemaking.3 Florida East Coast Railway is a prime example of an underrated case because, even though the case is well known,4 its renown is
Biophysics of the DNA Molecule: A New Trend

Briefly discussed are experiments with single molecules, representing a novel trend in the biophysical study of DNA. The techniques of optical and magnetic tweezers whereby external force can be applied to individual DNA molecules were used to assess the structural transitions of the DNA double helix under such conditions. Discussed are the latest data on the dependence of the rate of complementary chain synthesis by DNA polymerase on the stretching of the template.
Generalization of Deep Learning for Cyber-Physical System Security: A Survey

Cyber-Physical Systems (CPSs)have become ubiquitous in recent years and has become the core of modern critical infrastructure and industrial applications. Therefore, ensuring security is a prime concern. Due to the success of Deep Learning (DL)in a multitude of domains, development of DL based CPS security applications have received increased interest in the past few years. Developing generalized models is critical since the models have to perform well under threats that they havent trained on. However, despite the broad body of work on using DL for ensuring the security of CPSs, to our best knowledge very little work exists where the focus is on the generalization capabilities of these DL applications. In this paper, we intend to provide a concise survey of the regularization methods for DL algorithms used in security-related applications in CPSs and thus could be used to improve the generalization capability of DL based cyber-physical system based security applications. Further, we provide a brief insight into the current challenges and future directions as well.
Envelope Tracking Linearizability of Power Amplifier

Envelope tracking (ET) linearizability of a power amplifier (PA) is studied in this paper. ET linearization can be explained as the cancellation between two intermodulation distortion (IMD) components [1], [2]. The phase difference θ 0 between the two IMD components is identified as the criterion of ET linearizability. The IMD improvement by incorporating ET module with PA can be analytically calculated in terms of $\theta_{0}$ Excellent agreement between the prediction and measurement is achieved. Determination of $\theta_{0}$ using three-tone measurement is proposed and demonstrated. ET linearizability is an inherent feature of a standalone PA itself, and can be quantitatively predicted before incorporating an ET module.
The Evolving Architecture of Smart Cities

This paper will present research being conducted in developing housing models that leverage data collection for use in Population Health strategies. A multifamily prototype unit that demonstrates best practices in creating livable communities within Smart Cities is being developed. Utilizing prefabricated construction methodologies to bring these models to scale is being investigated.Gigabit networks allow Smart Cites to collect and analyze vast amounts of data. Sensors embedded in the built environment are able to collect human vital signs, physical activity, environmental conditions, and pharmaceutical regiments.Population Health strategies utilize the collection and analysis of such data to deliver health care more affordably, effectively, and sometimes before we know we need it. This predictive ability will allow Smart Cities to evolve into Responsive Cities. Some of the more advanced technologies presented here include: motion sensors/fall detection, gait-analysis, automated LED smart-spectrum lighting, smart mirrors, smart toilets, sleep sensors, and automated medicine dispensers.
Are individual characteristics and behaviors necessary-but-not-sufficient conditions for academic success?: A demonstration of Dul's (2016) necessary condition analysis

Abstract Claiming that high levels of an independent variable represent a necessary-but-not-sufficient condition for an outcome suggests that the outcome is only possible – but not guaranteed – with high levels of that variable. Necessary condition analysis (NCA) allows researchers to determine if an observed relation between an independent variable and a dependent variable is consistent with such a necessary-but-not-sufficient relation. Using both archival and primary data, we apply Dul's (2016) necessary condition analysis techniques to common correlates of academic success in college. We find data patterns that are consistent with necessary-but-not-sufficient conditions for academic success for a variety of variables including class attendance, grit-perseverance, growth mindset, prior achievement, and admissions test scores. Our findings imply that some individual characteristics and behaviors may constrain the level of grades possible in college and that researchers may benefit from considering necessity models of academic performance. We discuss further applications of necessary condition analysis in educational research as a supplement to traditional data analysis.
Design and Characterization of Uniform Field Eddy Current Probes

Current practice in the design of eddy current probes calls for an optimum balance between detection sensitivity and false rejection of test pieces. Naturally, designers have emphasized improving the sensitivity and signal-to-noise ratio of eddy current probes to achieve these goals. As progress has been made in mathematical modeling of eddy current flaw signals, it has become possible to consider designing probes for specific functions and workpieces. It is now recognized that probes of different design might be required for detection and inversion. The study described here is one of the first instances in which an eddy current probe was designed specifically for inversion. This has involved balancing an entirely different set of constraints than those that must be optimized for a probe intended for detecting flaws.
Using Microprobe to enhance Die Level Static Fault Isolation in Complex IC

Modern SoC design incorporates power management circuits to minimize standby leakages of digital logic circuitry. This isolates the logic blocks from being directly powered by the IC’s pad level power supply and ground. As a result, die level static fault isolation became ineffective even for gross defects that are shorting the power lines in the logic blocks due to gated supply. From the foundry standpoint, fault isolation on such devices are even more challenging without the product knowhow, device specific hardware and test program to properly condition the power management circuits. An alternative method is to bypass the power control circuits through microprobing on the top metal traces to directly supply power to the logic blocks. However, the key challenge to this method is the means to identify these power gated devices and verify the relevant power traces to microprobe, sometimes even in situations without layout information. In this paper, 3 different approaches have been illustrated using 3 case studies to overcome this challenge and achieve static fault isolation success on power gated devices.
The Neuropathology of MIRAGE Syndrome

MIRAGE syndrome is a multisystem disorder characterized by myelodysplasia, infections, restriction of growth, adrenal hypoplasia, genital phenotypes, and enteropathy. Mutations in the sterile alpha motif domain containing 9 (SAMD9) gene which encodes a protein involved in growth factor signal transduction are thought to cause MIRAGE syndrome. SAMD9 mutations lead to an antiproliferative effect resulting in a multisystem growth restriction disorder. Though rare, a few patients with SAMD9 mutations were reported to have hydrocephalus and/or cerebellar hypoplasia on imaging. The neuropathologic features of MIRAGE syndrome have not been previously described. Here, we describe the postmortem neuropathologic examinations of 2 patients with a clinical diagnosis of MIRAGE syndrome and confirmed SAMD9 mutations. Common features included microcephaly, hydrocephalus, white matter abnormalities, and perivascular calcifications. One of the 2 cases showed marked cerebellar hypoplasia with loss of Purkinje and granule neurons as well as multifocal polymicrogyria and severe white matter volume loss; similar findings were not observed in the second patient. These cases demonstrate the variation in neuropathologic findings in patients with MIRAGE syndrome. Interestingly, the findings are similar to those reported in ataxia-pancytopenia syndrome caused by mutations in SAMD9L, a paralogue of SAMD9.
Ten Best Practices for Improving Emergency Medicine Provider-Nurse Communication.

Abstract Background The current state of scientific knowledge regarding communication between emergency medicine (EM) providers indicates that communication is critical to safe and effective patient care. Objectives In this study, we identified communication needs of EM nurses and physicians; in particular, what information should be conveyed, when, how, and to whom. Methods Five semi-structured focus groups and one interview were conducted with nine nurses, eight attending physicians, and four residents. Questions addressed how EM personnel use and share information about patients and clinical work, what information tends to be exchanged, and what additional information would be helpful to share. Sessions were audio recorded. Transcripts were generated and analyzed using a concept mapping approach (a visual qualitative analysis technique to represent and convey synthesized knowledge). Results Eleven concept maps were produced summarizing: information physicians needed from nurses and vice versa; methods of communication that could be utilized; barriers or obstacles to effective communication; strategies to enhance or ensure effective communication; and environmental or situational factors that impact communication. Conclusions Our main finding of this research is that communication ensures shared awareness of patient health status, the care plan, status of plan steps and orders, and, especially, any critical changes or “surprises” regarding the health of a patient. Additionally, the research identified shared information needs; communication methods, strategies and barriers; and factors affecting successful communication, and has implications for both system and training design. Key implications for emergency nursing practice from this research are distilled in 10 ‘best practice’ strategies for improving EM nurse–physician communication.
Chapter 21 – Progress—Purpose?

Early evolutionary thinkers accepted as a given that evolution had a direction, and that therefore some plan or goal was inherent in the evolutionary process. Darwin effectively removed such thinking by establishing that evolution was “only” a process that adapted organisms to be well suited to survive and reproduce within their respective environments. While some evolutionists craft their own definition of progress such that evolution does meet their definition, there really is no scientific definition—only subjective definitions of the term “progress”. Since progress implies that something is getting better, it really cannot be a scientific concept. Science describes what is, not what should be in terms of “better”. Since nature is filled with imperfection at all levels, and extinction is the certain end for the great majority of species, progress seems most definitely not to be a trend or goal of the evolutionary process. Evolution is rather affected significantly by opportunity and contingency, not by any plan or trend involving “progress”.
P727 County-level factors associated with reported congenital syphilis—united states, 2012–2015

Background Although preventable through timely screening and treatment, congenital syphilis (CS) cases are rising in the United States. Individual CS risk factors are well-described, but county factors are not. We developed a predictive model that could identify county risk factors and use these to predict counties at highest risk for future CS. Methods We included all 3,142 US counties. To identify county risk factors, we defined the outcome as a county having ≥1 CS case during 2012–2015. Case counts were taken from the National Notifiable Disease Surveillance system; county data were from a 2015 county health rankings analytic file. We used a stepwise logistic regression model to identify adjusted associations between CS and county factors. Retained predictor variables were each assigned a score based on the strength of their association with the outcome. Risk scores were calculated by summing predictor scores for each county. Counties with risk scores ≥24 were defined as high-risk for having ≥1 CS case. We cross validated the model using coefficients from the final 2012–2015 model to predict high-risk counties for 2016–2017 and compared predicted and actual counties by calculating the area-under-the-curve (AUC) value. Results Our model identified 721 counties as high-risk for CS (sensitivity: 80.1%; specificity: 83.7%). County predictors included: 2015 Medicaid expansion status, presence of a metropolitan area, population size, income inequality, syphilis among women and men who have sex with men, violent crime rate, and the population proportions that were black, Hispanic, and uninsured. The final model based on 2012–2015 CS data was predictive of 2016–2017 CS counties (AUC: 88.1%). Conclusion Given the damaging yet preventable nature of CS, enhancing prevention is a priority. The ability to predict counties at highest risk for CS based on county factors may help target CS resources where they are needed most. Disclosure No significant relationships.
Flexural Performance of Direct Resin Composite Restorative Materials Past Expiration Date.

Objective This study' s purpose was to examine the flexural properties of five direct restorative resin composites stored up to 30 months after the expiration date. Materials and Methods Ambient-stored materials had pre-expiration date baseline flexure strength values as per ISO 4049 (n = 20). All materials were used per manufacturer guidelines, photopolymerized on both sides using a LED-based visible light curing unit, and stored in 0.2M phosphate buffered saline. At 24 hours, specimens were stressed to failure in three-point bend at a 0.5 mm/min cross head speed. Additional samples were made at 3, 6, 9, 12, 15, 18, 24, and 30 months past expiration date. Young’s modulus (flexural) was ascertained using the linear slope of the stress-stain curve. Statistical Analysis The mean data was found to contain a non-normal distribution and irregular variance which was compared using Kruskal–Wallis with Dunn’s posthoc testing. Also, Pearson’s correlation analysis was used to identify possible similar degradation behavior between products within both flexure strength and modulus determinations. A 95% level of confidence (α = 0.05) was used. Results Materials maintained similar to baseline flexure strength and modulus for up to 15 months past expiration date with two materials being similar at 30 months. However, clinicians were still advised to follow expiration dates, as resin composite degradation mechanisms are complex and vital constituents might degrade that are not overtly identified by clinical handling characteristics. No dental shelf life standards exist and manufacturers are requested to provide protocol information used in determining shelf life expiration.
Improving Point-of-Care Ultrasound Documentation and Billing Accuracy in a Pediatric Emergency Department.

Objective The performance and interpretation of point-of-care ultrasound (POCUS) should be documented appropriately in the electronic medical record (EMR) with correct billing codes assigned. We aimed to improve complete POCUS documentation from 62% to 80% and improve correct POCUS billing codes to 95% or higher through the implementation of a quality improvement initiative. Methods We collected POCUS documentation and billing data from the EMR. Interventions included: (1) staff education and feedback, (2) standardization of documentation and billing, and (3) changes to the EMR to support standardization. We used P charts to analyze our outcome measures between January 2017 and June 2018. Results Six hundred medical records of billed POCUS examinations were included. Complete POCUS documentation rate rose from 62% to 91%, and correct CPT code selection for billing increased from 92% to 95% after our interventions. Conclusions The creation of a standardized documentation template incorporated into the EMR improved complete documentation compliance.
Long-term soil fungal community recovery after fire is impacted by climate change

Abstract Though much is known about fungal importance to forest health, there is very little information about factors that impact soil fungal community recovery time after a fire. Soil samples were taken from burn sites within one ecotype of temperate coniferous forest in Utah over a 20-year chronosequence. Sites were selected from available historic burns and were similar in plant community structure, elevation, slope, and aspect. Fungal DNA from these samples was compared to soil from paired unburned sites nearby to measure community similarity and estimate soil fungal recovery rates. Differences between paired burned and unburned sites remained fairly stable over a decadal time scale overall, but fungal community structure was found to recover more quickly in areas with a higher average annual temperatures. A significant positive correlation in community recovery was seen in areas with a difference of as little as two degrees celsius per year. The only other environmental variable that significantly interacted with time since burn was annual mean precipitation. As global temperatures increase, alpine fires are increasing as well, but these results suggest that fungal community recovery time will be shortened under new climate scenarios.
Synthetic Training Data Generation for ML-based Small-Signal Stability Assessment

This article presents a simulation-based massive data generation procedure with applications in training machine learning (ML) solutions to automatically assess the small-signal stability condition of a power system subjected to contingencies. This method of scenario generation for employs a Monte Carlo two-stage sampling procedure to set up a contingency condition while considering the likelihood of a given combination of line outages. The generated data is pre-processed and then used to train several ML models (logistic and softmax regression, support vector machines, k-nearest Neighbors, Naive Bayes and decision trees), and a deep learning neural network. The performance of the ML algorithms shows the potential to be deployed in efficient real-time solutions to assist power system operators.
Drums of War, Drums of Development. The Formation of a Pacific Ruling Class and Industrial Transformation in East and Southeast Asia, 1945–1980: Jim Glassman (Leiden: Brill, 2018)

This is a magnificent book. It is also daunting, coming in at a mammoth 715 pages, with two challenging theoretical chapters. For determined readers, though, the size and theoretical engagement are...
Fast computation of dissipative quantum systems with ensemble rank truncation

This work details a deterministic ensemble method for evolving open quantum systems and compare it with stochastic techniques.
Community Outreach – Education

Sports medicine and primary care providers have many roles and responsibilities. These may include educating the public on preventative health issues and taking care of athletes both on and off the field. Additionally, providers strive to contribute to the communities they serve through community outreach. Providers have multiple ways in which they can engage their community and impact their patient’s health, including contributing to more formal training in residency, understanding the community in which they work, incorporating their community in their practice, engaging in community education, and advocating actively for their patients. By engaging and educating their patients in the community in which they live, medical caregivers can get closer to achieving the aim for a healthier population.
Allometric Growth Response of Exercised Rainbow Trout to Cyanide Poisoning

The toxicity of cyanide to juvenile rainbow trout held in swimming chambers during 20-day growth experiments at 10°C was found to be size related, the larger trout being more adversely affected than the smaller ones. The results of four experiments on control and cyanide-exposed trout forced to swim against a constant current speed of 12.1 cm/s while being fed restricted rations revealed that cyanide at 0.01 mg/litre hydrogen cyanide (HCN) increased the food maintenance requirement of the large fish, which were growing less rapidly than their respective controls. The smaller fish, however, grew faster than their controls when exposed to cyanide because of a faster accumulation of lipids. The metabolic rate of fish is related to size, and this relation is described by the allometric formula Y = aX b , where Y is the metabolic rate, X the body size, a the Y-intercept, and b the weight exponent and slope. This formula was applied to the present results, and a log-log plot of dry weight gains against initial wet weights provided a linear relationship describing the metabolic rates of the control and poisoned fish. The slope representing the controls was 1.12, indicating a metabolic rate function of the weight of the fish, whereas the slope representing the cyanide-poisoned group was 0.67, thus describing a metabolism proportional to the surface area of the fish. This study brings to light the determining influence of factors modifying the metabolic rate, such as exercise and size, on the response of fish to a toxicant.
Evidence-Based Practice and the Effectiveness of Indigenous Helpers, Mentors, and Self-Help Groups with Children and Adolescent Health and Mental Health Problems

This chapter focuses on self-help groups and offers some hopeful evidence that self-help may provide assistance to a variety of clients experiencing problems with addictions, health, mental health, and other social and emotional problems. A large number of Americans use self-help but questions remain about the validity of findings indicating that self-help may be an effective alternative to professional assistance. Most of these questions relate to research issues that may be difficult to resolve, given the fact that self-help groups do not have the same expectations as professional help to prove effectiveness. Self-help is generally supportive in nature and usually provides an affirming and positive approach to problem-solving. Some concern is raised that self-help groups may not be effective for everyone because they sometimes have an unacceptable religious ideology or encourage people to believe that recovery is a lifelong struggle.
Regulation of experimental allergic encephalomyelitis: Part 5. Role of the recipient in suppressor cell induction*

Suppressor cells that regulate experimental allergic encephalomyelitis (EAE) are present in spleens of Lewis rats that have recovered from the disease, as demonstrated by adoptive transfer of suppression to normal recipients. However, lethally irradiated recipients (850 rad) of spleen cells from recovered donors are not protected against EAE. Indeed, onset of EAE is accelerated in these irradiated recipients. These findings suggest that the host participates in the suppression of EAE.
THE CONTEMPORARY U.S. TORTURE DEBATE IN CHRISTIAN HISTORICAL PERSPECTIVE

The U.S. turn toward torture tested the moral resources of all faiths, but perhaps especially of Christianity, which has the greatest number of adherents in the United States. This moral crucible revealed that American Christian scholars and leaders were generally blind to the resources available in relation to the resources available to address torture in a study of scripture, early Christian experience under empire, Christian abuses of suspected heretics, and the just war theory, all of which are considered here. Uses of just war theory have revealed a fracture in that theory between deontological/virtue orientations and consequentialist reasoning, the latter proving susceptible to exploitation in defense of torture. Just war theory also revealed a lacuna of explicit reasoning about torture through the centuries, in a world where torture has so often been an instrument of state power.
Doing Harder Time? The Experiences of an Ageing Male Prison Population in England and Wales by Natalie Mann

Doing harder time? The experiences of an ageing male prison population in England and Wales by Natalie Mann, provides an invaluable insight into a seldom explored subject. This book, a product of m...
Fragment size difference between multiplex and singleplex PCR products and their practical implications.

By simultaneously amplifying several loci in the same reaction, multiplex PCR has been used in gene mapping and DNA typing with polymorphic short tandem repeat loci. Previous studies have discussed...
Pulsed EPR characterization of HIV-1 protease conformational sampling and inhibitor-induced population shifts

The conformational landscape of HIV-1 protease (PR) can be experimentally characterized by pulsed-EPR double electron-electron resonance (DEER). For this characterization, nitroxide spin labels are attached to an engineered cysteine residue in the flap region of HIV-1 PR. DEER distance measurements from spin-labels contained within each flap of the homodimer provide a detailed description of the conformational sampling of apo-enzyme as well as induced conformational shifts as a function of inhibitor binding. The distance distribution profiles are further interpreted in terms of a conformational ensemble scheme that consists of four unique states termed "curled/tucked", "closed", "semi-open" and "wide-open" conformations. Reported here are the DEER results for a drug-resistant variant clinical isolate sequence, V6, in the presence of FDA approved protease inhibitors (PIs) as well as a non-hydrolyzable substrate mimic, CaP2. Results are interpreted in the context of the current understanding of the relationship between conformational sampling, drug resistance, and kinetic efficiency of HIV-1PR as derived from previous DEER and kinetic data for a series of HIV-1PR constructs that contain drug-pressure selected mutations or natural polymorphisms. Specifically, these collective results support the notion that inhibitor-induced closure of the flaps correlates with inhibitor efficiency and drug resistance. This body of work also suggests DEER as a tool for studying conformational sampling in flexible enzymes as it relates to function.