cssi/SciSciGPT-SciSciNet huggingface dataset:
Twin-screw extruder development for the ITER pellet injection system

The ITER pellet injection system is comprised of devices to form and accelerate pellets, and will be connected to inner wall guide tubes for fueling, and outer wall guide tubes for ELM pacing. An extruder will provide a stream of solid hydrogen isotopes to a secondary section, where pellets are cut and accelerated with a gas gun into the plasma. The ITER pellet injection system is required to provide a plasma fueling rate of 120 Pa-m3/s (900 mbar-L/s) and durations of up to 3000 s. The fueling pellets will be injected at a rate up to 10 Hz and pellets used to trigger ELMs will be injected at higher rates up to 20 Hz.
Effects of Limbic Lesions on Chlorpromazine-Pentobarbital Interaction

Small lesions within the limbic system of the rat produced no consistent behavioral defects or altered responses to chlorpromazine and/or pentobarbital measured by a new behavioral scoring method.
Throughput modeling for multi-rate IEEE 802.11 vehicle-to-infrastructure networks with asymmetric traffic

This paper proposes an analytical throughput model for IEEE 802.11-based vehicle-to-infrastructure networks with asymmetric traffic. Previous models assume all nodes use ad-hoc mode with uniform traffic without mobility. This model is developed using the fixed-point analysis, which assumes asymmetric traffic loads for AP and clients, and both types of traffic are nonsaturated. The mobility effect is also considered, which is modeled as a throughput scaling factor taking account of velocity and communication range. Numerical evaluation compared with Bianchi's model, verifies the proposed model and quantifies the difference caused by asymmetric traffic, and the throughput with mobile nodes is evaluated with the increase in velocity.
Novel antiplatelet therapies for treatment of patients with ischemic heart disease: inhibitors of the platelet glycoprotein IIb/IIIa integrin receptor.

Abstract Blood platelets play essential roles in normal coagulation and in coronary atherosclerotic disease and its complications. Various antiplatelet therapies, including aspirin, ticlopidine, and dipyridamole, have been developed for use in patients with known coronary artery artery disease to prevent ischemic complications. More recently a more complete anti-aggregation effect has been accomplished by the use of monoclonal antibodies and specific peptide and nonpeptide compounds that bind to the platelet GP IIbIIIa surface receptor. This receptor becomes activated by platelet stimulation and binds fibrinogen molecules between platelets in the aggregation process. These new antiplatelet drugs are now being evaluated in clinical trials in patients undergoing balloon coronary angioplasty, in whom fewer ischemic events occur when the receptor blocker is used intravenously than with standard therapy, and in patients with stable and unstable angina. Excessive bleeding is an important problem with these agents, and efforts must be made to eliminate this side effect.
Transcript Abundance Responses of Resistance Pathways of Arabidopsis thaliana to Deoxynivalenol

Mycotoxin deoxynivalenol (DON), produced by Gibberella zeae (Schwein.) Petch (teleomorph of Fusarium graminearum Schwabe) was known to be both a virulence factor in the pathogenesis of Triticum aestivum L. (wheat) and an inhibitor of Arabidopsis thaliana L. seed germination. Fusarium graminearum causes both Gibberella ear rot in maize (Zea mays L.) and Fusarium head blight (FHB) in wheat and barley. Arabidopsis thaliana was also a host for the related root rot pathogen F. virguliforme Aoki. A. thaliana seedling growth was reduced by the pathogen in a proportional response to increasing spore concentrations. Here, the changes in transcript abundances corresponding to 10,560 A. thaliana expressed sequence tags (ESTs) was compared with changes in 192 known plant defense and biotic/abiotic stress related genes in soybean roots after infestation with F. virguliforme. A parallel comparison with a set of resistance pathways involved in response to the DON toxicity in A. thaliana was performed. A. thaliana data was obtained from the AFGC depository. The variations of transcript abundances in Arabidopsis and soybean treated with pathogen suggest that both plants respond to the pathogen mainly by common, possibly global responses with some specific secondary metabolic pathways involved in defense. In contrast, DON toxin appeared to impact central metabolisms in Arabidopsis plants with significant alterations ranging from the protein metabolism to redox production. Several new putative resistance pathways involved in responding to both pathogen and DON infestation in soybean and A. thaliana were identified.
Francisella tularensis Catalase Restricts Immune Function by Impairing TRPM2 Channel Activity

As an innate defense mechanism, macrophages produce reactive oxygen species that weaken pathogens and serve as secondary messengers involved in immune function. The Gram-negative bacterium Francisella tularensis utilizes its antioxidant armature to limit the host immune response, but the mechanism behind this suppression is not defined. Here we establish that F. tularensis limits Ca2+ entry in macrophages, thereby limiting actin reorganization and IL-6 production in a redox-dependent fashion. Wild type (live vaccine strain) or catalase-deficient F. tularensis (ΔkatG) show distinct profiles in their H2O2 scavenging rates, 1 and 0.015 pm/s, respectively. Murine alveolar macrophages infected with ΔkatG display abnormally high basal intracellular Ca2+ concentration that did not increase further in response to H2O2. Additionally, ΔkatG-infected macrophages displayed limited Ca2+ influx in response to ionomycin, as a result of ionophore H2O2 sensitivity. Exogenously added H2O2 or H2O2 generated by ΔkatG likely oxidizes ionomycin and alters its ability to transport Ca2+. Basal increases in cytosolic Ca2+ and insensitivity to H2O2-mediated Ca2+ entry in ΔkatG-infected cells are reversed by the Ca2+ channel inhibitors 2-aminoethyl diphenylborinate and SKF-96365. 2-Aminoethyl diphenylborinate but not SKF-96365 abrogated ΔkatG-dependent increases in macrophage actin remodeling and IL-6 secretion, suggesting a role for H2O2-mediated Ca2+ entry through the transient receptor potential melastatin 2 (TRPM2) channel in macrophages. Indeed, increases in basal Ca2+, actin polymerization, and IL-6 production are reversed in TRPM2-null macrophages infected with ΔkatG. Together, our findings provide compelling evidence that F. tularensis catalase restricts reactive oxygen species to temper macrophage TRPM2-mediated Ca2+ signaling and limit host immune function.
Chest Physiotherapy for Chronic Obstructive Pulmonary Disease

Chest physiotherapy is designed to increase the capacities and activities of the patient with chronic obstructive pulmonary disease. This program of bronchial hygiene, breathing exercises, and phys...
The Cultural Basis of European Security: Analysis and Implication for Ukraine

Many of the challenges facing European security and prosperity stem from the fact that the unique historical and cultural models of the Anglo-Saxon world have become the mainstream paradigms by which other nations measure their own success. As other cultural traditions deemed inferior to the “mainstream” strive for recognition, it can produce deep social tensions. Many advocates of modernization recognize this, but nevertheless see it as the price that backwards nations must pay to join the global economic and political mainstream, and thereby achieve security. Others, however, are not so sure. One alternative school of thought, known as the Copenhagen School, takes a radically different approach to security that focuses on issues of cultural identity.
Distance Dependence of Exciton Dissociation at a Phthalocyanine–C60 Interface

Exciton dissociation at donor–acceptor (DA) interfaces is critical for the operation of organic photovoltaic (OPV) devices, yet a detailed physical understanding of this process is lacking. This work examines an important aspect of this process, namely the dependence of the exciton dissociation rate on distance from the DA interface. Time-resolved two-photon photoemission (TR-2PPE) measurements were performed on bilayer H2Pc\C60 heterojunctions fabricated using organic molecular beam epitaxy (MBE) with varying H2Pc thickness. In the measurements, the dynamics of the H2Pc S1 exciton population created with a 1.55 eV pump pulse were monitored via photoemission with a delayed UV probe pulse. The depth sensitivity of TR-2PPE, due to the short electron attenuation length, provides the means to follow excited state dynamics as a function of H2Pc thickness. Analysis of the S1 population decay as a function of H2Pc thickness revealed that the electron transfer rate for the first H2Pc layer, adjacent to C60, is kC...
Dynamic reactive power compensator control considering source-grid coordination for wind farm

The affect of constant reactive power control for the inductive branch of dynamic reactive power compensator on the reactive voltage sensitivity of regional grid is analyzed,which shows that it may easily lead to the substantial voltage fluctuation after disturbance,and the necessity for applying the constant voltage auxiliary control in the dynamic reactive power compensator of wind farm is pointed out. A strategy of main / auxiliary coordinated control is proposed from the source-grid coordination for the dynamic reactive power compensator,which,when the operating condition of system changes,realizes the flexible switchover between the constant reactive power control in inductive branch and the constant voltage control at low-voltage side to avoid the substantial voltage fluctuation after disturbance and reduce the risk of wind turbine high-voltage trip-off accident. A model of grid-connected wind power system is built with PSS / E to simulate the process of wind turbine high-voltage trip-off accident,which verifies the effect of the proposed control strategy in avoiding the wind turbine high-voltage trip-off accident after disturbance.
Accelerating multi-user large vocabulary continuous speech recognition on heterogeneous CPU-GPU platforms

In our previous work, we developed a GPU-accelerated speech recognition engine optimized for faster than real time speech recognition on a heterogeneous CPU-GPU architecture. In this work, we focused on developing a scalable server-client architecture specifically optimized to simultaneously decode multiple users in real-time. In order to efficiently support real-time speech recognition for multiple users, a "producer/consumer" design pattern was applied to decouple speech processes that run at different rates in order to handle multiple processes at the same time. Furthermore, we divided the speech recognition process into multiple consumers in order to maximize hardware utilization. As a result, our platform architecture was able to process more than 45 real-time audio streams with an average latency of less than 0.3 seconds using one-million-word vocabulary language models.
The AMA Clinical Quality Improvement Forum on Addressing Patient Safety

Article-at-a-Glance Background More than 200 health care policy makers and researchers, clinicians, quality professionals, and other representatives of health care organizations, government, and academia attended the Division of American Medical Association Clinical Quality Improvement's conference, "Addressing Patient Safety," April 28, 2000, in Chicago—the first national conference to respond to the recent Institute of Medicine (IOM) report, To Err Is Human: Building a Safer Health System. Addressing patient safety–Public and private perspectives John M. Eisenberg, MD, stated that research on errors is needed to describe the scope and nature of the problem, understand the barriers to and benefits of improvement, and develop and test strategies for improvement. Kenneth W. Kizer, MD, MPH, stated that the National Quality Forum will develop a compendium of best practices and will develop core measures for serious adverse events, and health care organizations and government health programs should act now to make a clear organizational commitment to patient safety, create a nonpunitive health care culture of safety, and implement known safe medication practices. Alan R. Nelson, MD, stated that the IOM report places its emphasis on continuous quality improvement and technology that can be used to mitigate the risks in a complex health system. Hospital and accreditation agency activities on patient safety issues Donald M. Nielsen, MD, discussed the American Hospital Association's (AHA's) Medication Safety Initiative, which promised to provide its members with successful practices, tools, and resources and to track progress of implementation of the recommended successful practices. Dennis S. O'Leary, MD, stated that when a hospital reports a sentinel event, the hospital is expected to implement improvements to reduce risk and monitor their effectiveness. The National Committee for Quality Assurance is considering changes to its accreditation standards to further address patient safety.
Ammonia loss from rat proximal tubule in vivo: effects of luminal pH and flow rate

The roles of luminal pH and flow rate in determining ammonia loss from proximal tubules perfused with solutions containing 10 mM NH4Cl were examined using in vivo microperfusion. Perfusate bicarbonate concentration was varied between 5, 25, and 40 mM in tubules perfused at 50 nl/min. As expected, ammonia loss from the 25 or 40 mM bicarbonate-containing perfusates was greater than from that containing 5 mM bicarbonate. Furthermore, there was a correlation between ammonia loss and the log mean luminal bicarbonate concentration (r = 0.39, P less than 0.01). From the collected fluid ammonia and bicarbonate concentrations, the transtubular gradients for NH+4 and NH3 were estimated, allowing a calculation of the apparent permeability coefficients for NH3 (PNH3) and NH+4 (PNH+4). The calculated PNH3 of 2.2 +/- 0.5 X 10(-2) cm/s was similar to previous estimates in the rabbit; the calculated PNH+4 of 5.5 +/- 0.8 X 10(-4) cm/s was approximately 10 times that previously found in the rabbit proximal straight tubule ...
Conduct of Stroke-Related Clinical Trials

Friedman and colleagues 1 define a clinical trial as “a prospective study comparing the effect and value of intervention(s) against a control in human subjects.” Drawing from the general literature on the conduct of clinical trials, 1 2 3 this chapter addresses the design, data management, analytical, ethical, and regulatory issues relevant to stroke prevention and therapeutic trials.
p38 (Mapk14/11) occupies a regulatory node governing entry into primitive endoderm differentiation during preimplantation mouse embryo development

During mouse preimplantation embryo development, the classically described second cell-fate decision involves the specification and segregation, in blastocyst inner cell mass (ICM), of primitive endoderm (PrE) from pluripotent epiblast (EPI). The active role of fibroblast growth factor (Fgf) signalling during PrE differentiation, particularly in the context of Erk1/2 pathway activation, is well described. However, we report that p38 family mitogen-activated protein kinases (namely p38α/Mapk14 and p38β/Mapk11; referred to as p38-Mapk14/11) also participate in PrE formation. Specifically, functional p38-Mapk14/11 are required, during early-blastocyst maturation, to assist uncommitted ICM cells, expressing both EPI and earlier PrE markers, to fully commit to PrE differentiation. Moreover, functional activation of p38-Mapk14/11 is, as reported for Erk1/2, under the control of Fgf-receptor signalling, plus active Tak1 kinase (involved in non-canonical bone morphogenetic protein (Bmp)-receptor-mediated PrE differentiation). However, we demonstrate that the critical window of p38-Mapk14/11 activation precedes the E3.75 timepoint (defined by the initiation of the classical ‘salt and pepper’ expression pattern of mutually exclusive EPI and PrE markers), whereas appropriate lineage maturation is still achievable when Erk1/2 activity (via Mek1/2 inhibition) is limited to a period after E3.75. We propose that active p38-Mapk14/11 act as enablers, and Erk1/2 as drivers, of PrE differentiation during ICM lineage specification and segregation.
Anthropogenic Sources Stimulate Resonance of a Natural Rock Bridge

The natural modes of vibration of bedrock landforms, as well as the sources and effects of stimulated resonance remain poorly understood. Here we show that seismic energy created by an induced earthquake and an artificial reservoir has spectral content coincident with the natural modes of vibration of a prominent rock bridge. We measured the resonant frequencies of Rainbow Bridge, Utah using data from two broadband seismometers placed on the span, and identified eight distinct vibrational modes between 1 and 6 Hz. A distant, induced earthquake produced local ground motion rich in 1 Hz energy, stimulating a 20 dB increase in measured power at the bridge's fundamental mode. Moreover, we establish that wave action on Lake Powell, an artificial reservoir, generates microseismic energy with peak power ~1 Hz, also exciting resonance of Rainbow Bridge. These anthropogenic sources represent relatively new energy input for the bridge with unknown consequences for structural fatigue.
Intergenerational Space Edited by Robert M. Vanderbeck and Nancy Worth

This edited collection of 22 chapters, including an introduction by the editors, resulted from the conference Intergenerational Geographies: Spaces, Identities, Relationships, Encounters, held May ...
SPAN: integrating problem-solving tactics

This paper describes SPAN, a system designed to integrate a variety of problem solving tactics in a coherent package. The paper discusses some of the tactics that had been used in previous systems to overcome the combinatorial explosion that is inherent in any planning problem. It then continues with a description of SPAN architecture. Two case studies are presented. The first, from the blocks world, is already implemented, and the second, from the domain of bridge playing, is in the coding stage. SPANS limitations are discussed and directions for further research are considered.
Perceptions of suspect statements: a comparison of exposed lies and confessions

Confrontational interrogation techniques seek to produce a confession, while investigative interviews focus on information gathering and/or catching suspects in lies. Confessions obtained during in...
Survey of collaborative drug therapy management in U.S. hospitals.

Purpose Results of a survey assessing the extent and scope of collaborative drug therapy management (CDTM) in U.S. hospitals are presented. Methods A survey questionnaire was mailed to a national random sample of hospital pharmacies. Pharmacy directors provided data on CDTM activities; their views on support for CDTM, the financial and strategic impact of CDTM, and the effect of state regulations on CDTM practice were assessed using summative Likert-type scales. Logistic regression was performed to assess associations of respondent demographics and hospital characteristics with CDTM use. Results The usable response rate was 30.2%. Pharmacists were reported to be engaged in CDTM in 66% of respondents’ hospitals, a significantly (p Conclusion From 2003 to 2013, the prevalence of CDTM use in surveyed U.S. hospitals increased significantly, from about 50% to 66%. The 3 most common specific CDTM activities in 2003—ordering test results, adjusting drug strength, and changing frequency of administration—were still the most common in 2013 but were allowed at higher percentages of hospitals.
Impact of an antifungal stewardship intervention on optimization of candidemia management

Background:Candidemia represents a leading cause of healthcare-associated bloodstream infections with significant morbidity and mortality. Previous studies have demonstrated that comprehensive care bundles improve candidemia management but are time-consuming.Objective:To determine the impact of a one-time targeted candidemia intervention on time to initiation of adequate therapy compared to standard of care.Methods:This Institutional Review Board (IRB)-approved, quasi-experiment evaluated a targeted candidemia intervention involving a single phone call to the primary team providing recommendations for care. Daily follow-up was provided by the infectious diseases (ID) consult service. Two time periods were evaluated: pre-intervention (01 August 2012 to 31 July 2014) and post-intervention (01 October 2014 to 30 September 2016). The primary endpoint was time to adequate antifungal therapy (TTx) in the business hours (6 a.m. to 6 p.m. Monday through Friday) population (BHP). Secondary endpoints were TTx in th...
Lithium Metal Anodes: A Recipe for Protection

Effective stabilization of lithium metal anode is the key to the development of next-generation high-energy rechargeable batteries. In this issue of Joule, Linda Nazar and colleagues demonstrated a rationally designed electrolyte additive that can form a robust, single-ion-conducting protective layer on lithium metal surface while the battery operates, promoting uniform lithium deposition with high cycling efficiency.
Asymptotic Normality, Strong Mixing and Spectral Density Estimates

Asymptotic normality is proven for spectral density estimates assuming strong mixing and a limited number of moment conditions for the process analyzed. The result holds for a large class of processes that are not linear and does not require the existence of all moments.
Direct-to-Consumer Advertising and Insurers’ Spending Control Mechanisms for Prescription Drugs

Numerous studies have examined the effects of direct-to-consumer advertising (DTC) on patient and physician behaviors; however, none has focused on the relationship between DTC and insurance benefit design. In this study, we explored the impact of DTC advertising on the cost control behaviors of private firms supplying insurance in the Medicare Part D program. We used data from the IMS National Prescription Drug Promotions database and formulary information from Medicare Part D prescription drug plans from the Centers for Medicare and Medicaid Services (CMS) to study the relationship between DTC spending and formulary tier placement, using an instrumental variables estimator to control for the endogeneity of DTC spending. Our results suggest that direct-to-consumer advertising puts pressure on insurers for more favorable formulary placement. Television direct-to-consumer advertising and other measures of manufacturer market power had a significant and negative effect on the likelihood of a branded drug being classified as nonpreferred in formularies. Similarly, we found that when insurers had more market power, branded drugs were more likely to be placed in a nonpreferred formulary tier. We hypothesize that consumers play an important mediating role in the relationship between DTC advertising and insurance coverage for drugs.
Interdisciplinary systems and simulation studies for an innovative undergraduate program

To improve student critical and systems thinking abilities, we propose a simulation-based approach to teach and to conduct interdisciplinary systems studies as a part of an innovative undergraduate program. In this paper, we propose a sequence of simulation courses, discuss their goals and structure. To demonstrate the improved problem-solving ability of our students we briefly describe their systems simulation research projects in several areas. Some of our undergraduate student simulation projects were nationally recognized at the Student Research Contests at ACM-affiliated conferences.
Phenotypic Modulation of the Stromal Reticular Network in Normal and Neoplastic Lymph Nodes: Tissue Transglutaminase Reveals Coordinate Regulation of Multiple Cell Types

The lymph node paracortex is composed of a network of fibroblastic reticular cells (FRC) and reticular fibers linking sinuses to blood vessels. Using immunostaining for the inducible enzyme/adhesion molecule tissue transglutaminase (TG), we demonstrate coordinate regulation of multiple stromal cell types of this reticular network including FRC, endothelial cells and sinus lining cells. Tissue transglutaminase is expressed at low levels in the paracortex around primary follicles but is markedly up-regulated in stromal cells around hyperplastic germinal centers and then down-regulated around regressing follicles. In cultured FRC, TG is induced 5- to 20-fold and becomes colocalized with matrix proteins by treatment with interleukin-4, but not by other cytokines that are commonly increased in lymph upon immune activation. Coordinate TG up-regulation is observed surrounding nodules of follicular lymphoma (14 of 15 cases) and in the FRC and endothelium of classical Hodgkin's disease, two tumor types that also showed an activated paracortical phenotype. Small lymphocytic lymphoma showed minimal TG staining, with other lymphoma types showing patterns suggesting differential TG regulation. Using TG as a stromal marker, we have identified differential modulation of the phenotype of the lymph node reticular network that parallels change in the B-cell compartment.
The Diffusion Process in Nb3Sn-Cu Superconducting Wire Made by the External Tin Method

The external Sn process for producing Nb3Sn-Cu superconducting wire generally employs a solid state diffusion process for the Sn diffusion step. The latter process is reviewed and shown to have limitations at larger wire sizes due to both long time requirements and a blister formation problem. New experimental data are presented on wire geometries and compared to previous results on sheet geometries. It is concluded that the blister formation problem results from nucleation of rows of voids at the e/α interface during stage I of the process. The void and blister formation problem is found to be more severe with a wire versus a sheet geometry, which is consistent with the idea that phase transformation induced tensile stresses play a key role in nucleation of the void rows. Methods for minimizing the blister problem, and implications for the Sn core process are discussed.
Fabrication and characterization of free-standing, flexible and translucent BaTiO3-P(VDF-CTFE) nanocomposite films

Abstract Free-standing and translucent nanocomposite films with good flexibility were fabricated using a spin-coating process. BaTiO3 nanoparticles with an average size of about 50 nm and P(VDF-CTFE) 91/9 mol.% copolymer were used as ceramic fillers and polymer matrix, respectively. Dense and uniform microstructure was obtained due to the good compatibility and homogeneous distribution of BaTiO3 nanoparticles in P(VDF-CTFE) matrix. It was experimentally found that the dielectric constant increased but the breakdown strength decreased with increasing volume fraction of BaTiO3. A dielectric constant of about 53 was obtained in the nanocomposite film with 40 vol.% of BaTiO3, which was about 4.4 times higher than that of the pure P(VDF-CTFE) film. A discharged energy-storage density of 4.9 J/cm3 was obtained in the nanocomposite film with 35 vol.% of BaTiO3 under 2000 kV/cm, which was about 2 times higher than that of the pure P(VDF-CTFE) film under the same electric field.
Growth behavior of γ'/γ'' coprecipitates in Ni-Base superalloys

Abstract Precipitation of the γ ' ' phase on { 100 } facets of preceding γ ' precipitates is found to prevent the latter from overaging upon slow cooling from solution treatment in Ni-base superalloys based on the composition of alloy 718. By computer simulation using a multi-phase-field model, we find that the growth of a coprecipitate involves several concurrent and closely coupled processes, including thickening and lengthening of γ ' ' shells, growth of the γ ' core along the " open=" 001 γ ' , " open=" 011 γ ' and " open=" 111 γ ' directions, hard impingement between γ ' and γ ' ' precipitates, and soft impingement among γ ' ' precipitates of different variants. These processes at different stages of growth are analyzed systematically as a function of coprecipitate size and configuration, and the results show that the growth kinetics of the γ ' core in a coprecipitate is controlled by the interplay among: (1) partial removal of supersaturated γ matrix surrounding the γ ' core by coprecipitation of γ ' ' shells, (2) cooperative growth of γ ' and γ ' ' in the coprecipitates and (3) atomic mobility of γ ' -formers in the γ ' ' phase. To maximize the effect of coprecipitation on preventing γ ' from overaging upon slow cooling, the alloy composition and heat treatment schedule should be optimized to minimize the size of γ ' cores at which coprecipitation of γ ' ' shells occurs and to reduce diffusion of γ ' -formers through γ ' ' .
Taking the Lead: Changing the Experience of Family ICU Syndrome by Changing the Organization of Care

Open and patient-tailored guidelines have been recommended as the preferred family visitation model in critical care settings, but many intensive care units continue to restrict visitation. One of the major developments in modern management theory and research has been its continued focus on better understanding how to introduce and manage organizational change. Leading and managing a change effort within an ICU is not easy and not well suited to the simplistic and over-reductionist models that tend to dominate the popular business literature. Further, while the practice of medicine may be viewed as a business, a fundamental error is made if the differences between providing care and treatment for a person in medical need are ever truly confused or conflated with the purpose, processes, and ethics of producing good or service in a purely economic marketplace. A current example where this confusion is present is in the widespread use of the Plan-Do-Study-Act model of continuous quality improvement (CQI) to change the way in which healthcare services are produced. While useful in some situations, the CQI model was developed foundationally to standardize the structure and processes for producing automobiles and other industrial products – not provide medical care to those in need and suffering. An alternative to overly-simplistic and industrial models of change is presented through the exposition of four key elements of a person-focused approach to ICU care that treats patients as real people, respects and engages with the diversity of families, and releases physicians and other caregivers from the constraints of existing medical bureaucracies.
Lecanora markjohnstonii (Lecanoraceae, lichenized Ascomycetes), a new sorediate crustose lichen from the southeastern United States

Lecanora markjohnstonii is described as new to science from the southeastern United States, with a primary center of distribution in the southern Appalachian Mountain region. This sterile, sorediate crust is saxicolous on both sandstone and granite and occurs commonly in mixed hardwood-conifer forests with rock outcrops. It is characterized by a gray-green, rimose-areolate thallus, erumpent, raised soralia, and the production of atranorin together with 2-0-methylperlatolic acid. Molecular phylogenetic analyses of newly generated rDNA assemblies from a broad sampling of lineages within the Lecanoromycetes and Arthoniomycetes inferred placement of the unknown crust in the Lecanoraceae, specifically within Lecanora. Analysis of the mtSSU gene region then inferred placement in the Lecanora subfusca group. Finally, a fully assembled and annotated mitochondrial genome was compared to other lichenized fungal mitogenomes, including the publicly available Lecanora strobilina mitogenome, and showed that the gene region atp9 was missing as in other members of the Lecanorales.
In-Situ Intrinsic Interface Strength Measurement at Elevated Temperatures and its Relationship to Interfacial Structure

A previously developed laser spallation technique has been modified to measure the tensile strength of thin film interfaces in-situ at temperatures up to 1100°C. Tensile strengths of Nb/A-plane sapphire, FeCrAl/A-plane sapphire and FeCrAlY/A-plane sapphire were measured up to 950°C. The measured strengths at high temperatures were substantially lower compared with their corresponding strengths at ambient temperature. For example, at 850°C, the interface tensile strength for the Nb/sapphire (151 ± 17 MPa), FeCrAl/sapphire (62 ± 8 MPa) and FeCrAlY/sapphire (82 ± 11 MPa) interface systems were lower by factors of approximately, 3, 5, and 8, respectively, over their corresponding ambient values. These results underscore the importance of using such in-situ measured values under operating conditions as the failure criterion in any life prediction or reliability models of such coated systems where local interface temperature excursions are expected. The results on alloy film interfaces also demonstrate that the presence of Y increases the strength of FeCrAl/Al2O3 interfaces.
A Prospective Examination of Men’s Condom Use Resistance: Event-Level Associations with Sexual Aggression, Alcohol Consumption, and Trait Anger

Burgeoning research suggests that men engage in a variety of coercive and non-coercive tactics to avoid condom use (condom use resistance; CUR), suggesting a risk nexus regarding sexual risk and se...
The Economics of Memory: How Copyright Decides Which Books Do (and Don’t) Become Classics

Legal scholars usually analyze copyright as an incentive and sometime obstacle to creation. This encourages us to see publishers as middlemen who siphon off rents that would be better spent on authors. By comparison, recent social science research emphasizes that word-of-mouth markets are highly imperfect. This means that many deserving titles will never find readers unless some publisher takes the trouble to market them. But this second view is deeply subversive. After all, the need for publishers – and reward – does not end when a book is published. At least in principle, copyright should last forever. The trouble with this argument is that it assumes what ought to be proven. How much effort do publishers really invest in finding forgotten titles? And does vigorous marketing attract more readers than high copyright prices deter? This article looks for answers in the history of 20th Century print publishers and today’s Print-on-Demand and eBook markets. We argue that, far from promoting dissemination, copyright frequently operates to suppress works that would otherwise erode the price of new titles. This pathology has gotten dramatically worse in the Age of eBooks. Meanwhile, public domain publishers are facing their own crisis. Mid-20th Century books had large up-front costs. This deterred copyists. By comparison, digital technologies make it easy for copyists to enter the market. This has suppressed profits to the point where many public domain publishers spend little or nothing on forgotten titles.The article concludes by reviewing possible reforms. Partial solutions include clarifying antitrust law so that firms have more freedom to implement price discrimination; modifying copyright so that consumers can re-sell used eBooks; letting on-line markets limit the number of publishers allowed to post redundant public domain titles on their sites; and strengthening non-commercial institutions for finding, curating, and delivering quality titles to readers.
Inconsistency of findings due to low power: A structural MRI study of bilingualism.

Abstract Research on structural brain differences between monolinguals and bilinguals remains inconsistent, and this has been proposed by some to be due in part to inadequate sample sizes. The aim of the present study is to reveal the expected degrees of uncertainty among neuroimaging findings by analyzing random samples of varying sizes from a larger-than-average sample. Bilinguals ( n = 216) were compared with monolinguals ( n = 146) using grey matter volume measures across region-of-interest tests. Variability among findings were compared with the true full-sample findings, and taken in the context of expected differences within the larger bilingualism neuroimaging literature. Results demonstrate excessive variability across the lowest sample sizes (e.g. samples totaling 20–80 participants), and this is explored through the trends of subsample outcomes and effect sizes across sample sizes. The results of this study illustrate the influences of power on expected variability among sample findings.
Retrospective Analysis of Chronic Hepatitis C Patients with Hepatic Iron Depletion.

Objective The study retrospectively analyzed the effects of hepatic iron depletion on the therapy of chronic hepatitis C patients. Materials A total of 195 patients from Hamad General Hospital were studied retrospectively. Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), and g-glutamyl transferase (GGT) tests were implemented; descriptive analysis and mean testing were performed to analyze the data. Results It has been observed that ferritin increases with HCV, displaying R-value =0.450 and p-value=0.182. Levels of ALT (P-value=0.812) and GGT (P-value=0.723) may increase slightly with the treatment. Chronic hepatitis C patients develop iron deficiency that can be marked by evaluating various iron markers in the body. Conclusion The study identified that iron markers may decrease markedly among HCV patients; yet, researches consider the occurrence as support to management modality to improve response, delivered towards the treatment.
Cingulo-hippocampal effective connectivity positively correlates with drug-cue attentional bias in opioid use disorder.

Abstract Individuals with opioid use disorder (OUD) often relapse when exposed to opioid-related cues. Previous functional magnetic resonance imaging (fMRI) studies have identified neuronal corticolimbic changes related to drug cue reactivity in OUD. However, the corresponding manner in which brain regions interact is still unclear. Effective (directional) connectivity was analyzed using dynamic causal modeling of fMRI data acquired from 27 OUD participants (13 with OUD and 14 with OUD and cocaine use disorder [OUD+CUD]), while performing an opioid-word Stroop task. Participants were shown opioid and neutral words presented in different colors and were instructed to indicate word color but ignore word meaning. The effects of opioid words relative to neutral words on effective connectivity and on behavioral reaction time were defined as modulatory change and attentional bias, respectively. For all the 27 participants, left anterior cingulate cortex (ACC) to right hippocampus effective connectivity exhibited the largest modulatory change, which was positively correlated with attentional bias. The findings for the ACC to hippocampus EC were consistent across OUD and CUD found in a previous study.
Cat-Scratch Disease

Cat-scratch disease (CSD) was first recognized by Parinaud in 1889 in three patients with granulomatous conjunctivitis, preauricular lymphadenopathy, chronic fever, and contact with animals. This constellation of symptoms initially became known as Parinaud oculoglandular syndrome, and subsequent reports noted a history of cat exposure in some patients with this syndrome (Cassady and Culbertson 1953; Henry 1952). Sweeney and Drance (1970) first suggested an association between CSD and neuroretinitis in 1970, a finding later confirmed by Gass (Dreyer et al. 1984; Gass 1977). In 1994, Golnik and associates provided the first serologic evidence of systemic Bartonella infection in patients with neuroretinitis (Golnik et al. 1994). Cat-scratch disease is the most common cause of neuroretinitis with approximately two thirds of patients demonstrating seropositivity for gram-negative bacillus, Bartonella henselae.
Flutter-enhanced mixing in small-scale mixers

Enhancement of mixing via flow-induced flutter of a flexible membrane is explored for small-scale mixers that operate at low Reynolds numbers. Flow induced flutter and mixing in a duct flow is simulated using fully coupled fluid-structure-scalar interaction simulations including two-way coupling between the fluid and structure. The fluid and structural dynamics are analyzed and their impact on the mixing performance is characterized. The sensitivity of the system to the Reynolds number and to the membrane’s size and shape are also examined. It is shown that these flutter mixers create complex vortex structures even at low Reynolds numbers and these vortex structures lead to complex stretching and folding of fluid interfaces resulting in rapid mixing.
A note on perfect correlated equilibria

Abstract This note studies perfect correlated equilibrium introduced by Dhillon and Mertens (1996). We show that the standard revelation principle for perfect correlated equilibrium distributions holds in two-by-two games. We then show that in N -player two-action games, although the revelation principle fails, a canonical correlated device for any perfect correlated equilibrium distribution involves two copies of action sets as the message space.
Relationship of Movement Disorders Society–Unified Parkinson's Disease Rating Scale Nonmotor Symptoms to Cognitive Functioning in Patients with Parkinson's Disease

Background Few studies assess the relationships between nonmotor aspects of experiences of daily living and cognitive functioning in Parkinson's disease (PD). Objective To evaluate the relationships among the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part I items and neuropsychological tests in PD.Methods: We assessed 151 PD patients with the MDS-UPDRS part I and a battery of cognitive tests focused on the following 5 cognitive domains: attention/working memory, executive functioning, recent memory, language, visuoperception. Raw scores for individual cognitive tests were transformed to z scores, and cognitive domain scores were calculated by averaging z scores within each domain. Individual items from the MDS-UPDRS part I were entered in a stepwise linear regression analysis assessing item contribution to cognitive domain scores. Results The MDS-UPDRS part I item scores for hallucinations and psychosis and light headedness on standing predicted attention/working memory domain scores (P = 0.004). These same item scores, along with apathy, depressed mood, and dopamine dysregulation syndrome, predicted executive functioning (P = 0.044). The apathy and dopamine dysregulation syndrome items predicted language (P = 0.006). In addition, the cognitive impairment and sleep items were predictors of recent memory (P = 0.031). None of the items were predictors of visuoperception (P = 0.006). Other part I items were not significantly related to cognitive domain scores. Conclusions Specific nonmotor MDS-UPDRS part I items, particularly mood, behavior, and autonomic-related items, exhibited significant relationships with cognitive domains. The highest number of items were predictive of the executive functioning domain, which is the hallmark cognitive dysfunction in PD.
The asymptotic validity of sequential stopping rules for confidence interval construction using standardized time series

We establish the asymptotic validity of a class of sequential stopping rules when applying standardized time series (STS) to construct fixed-width confidence intervals (CI). The STS CI construction avoids requiring a consistent variance estimator, which is attractive to a class of steady-state simulation problems in which variance estimation is difficult. We quantify the asymptotic distribution of STS at stopping times as the prescribed half-width of the CI approaches zero. This provides us with the appropriate scaling parameter for the CI in the sequential stopping setting.
The Sensitivity of Teacher Value-Added Scores to the Use of Fall or Spring Test Scores:

Papay (2011) noticed that teacher value-added measures (VAMs) from a statistical model using the most common pre/post testing timeframe–current-year spring relative to previous spring (SS)–are esse...
Complex Abdominal Wound Healing After Multivisceral Retransplant: A Case Report on the Importance of Nutrition.

Abstract Background Intestinal transplantation (ITx) is performed as an isolated ITx or as a part of multivisceral transplantation for intestinal failure secondary to short gut syndrome, inflammatory bowel disease, trauma, and sequelae of chronic parenteral nutrition dependence. Wound complications after ITx are very common, and abdominal wound closure cannot be immediately achieved in half of cases. Case presentation A 25-year-old man sustained an abdominal crush injury causing complete loss of his small intestine, requiring an isolated ITx in March 2016. He lost his graft because of early exfoliative rejection in November 2016. Five months after enterectomy and the immunosuppression-free period, he underwent multivisceral retransplantation in April 2017. His post-transplant course was complicated by wound healing problems that improved with treatment of his malnutrition, quantified by increasing albumin, total protein, prealbumin, weight, body mass index, and total psoas muscle area over a period of 19 months after retransplant. Conclusion To our knowledge, this is the first case described of long-term wound follow-up after a multivisceral (re)transplantation, with corresponding nutrition information and images of the wound.
Agroforestry in acid soils of the humid tropics.

Publisher Summary The majority of the soils in the humid tropics are acidic and infertile. Agroforestry systems are the most appropriate forms of sustainable, productive management of soils in the humid tropics because perennial woody vegetation can recycle nutrients, maintain soil organic matter, and protect the soil from surface erosion and runoff. This chapter evaluates three agroforestry systems that are helpful to overcome these constraints to production—namely, alley cropping systems; managed leguminous fallows to accelerate the restoration of soil fertility and reduce the duration of the fallow period; and fruit tree-annual crop sequential cropping systems. These technologies represent a range of agroforestry options, the suitability of which will vary with the relative availabilities of land, labor, and capital. Alley cropping may contribute to the maintenance of soil fertility under annual cropping by improved nutrient cycling, but the system's total labor and possibly capital requirements are likely to be greater than those with shifting cultivation. Hence, the system seems appropriate for situations of limited land availability. In contrast, managed fallows might reduce the duration of the fallow period and improve productivity per unit time by accelerating weed suppression and nutrient accumulation in the fallow biomass. This system requires relatively small quantities of labor and capital, but like most fallow-based systems, it requires moderate to high land availability. Finally, cultivation of fruit trees can help alleviate labor and capital constraints by spreading labor over periods of low demand and by providing additional income through the sale of fruits and other products.