cssi/SciSciGPT-SciSciNet huggingface dataset:
Economic evaluation of cell salvage in pediatric surgery.

Background Red blood cells are a scarce resource with demand outstripping supply. Use of intraoperative red cell salvage (CS) – the process of collecting shed blood during surgery and reinfusing it to patients – is often used as an effective blood conservation strategy. However, little is known about the economic impact of CS during pediatric surgery. Methods A decision tree model was used to estimate the transfusion-related costs per patient (2010 USD) from a healthcare system perspective of four transfusion strategies among children undergoing elective orthopedic or cardiac surgery: (i) CS followed by allogeneic transfusion, (ii) CS followed by autologous transfusion, (iii) allogeneic transfusion alone, and (iv) autologous transfusion alone. Results Cell salvage and allogeneic transfusion was the least expensive strategy (USD 883.3) followed by CS and autologous blood transfusion (USD 1,269.7), allogeneic transfusion alone (USD 1,443.0), and autologous transfusion alone (USD 1,824.7). Savings associated with CS use persisted in separate analyses of orthopedic and cardiac surgery, as well as in one-way and probabilistic sensitivity analyses. Conclusions Use of CS, particularly along with allogeneic blood transfusion, appears cost-saving and cost-effective in pediatric surgery.
Oncogenic osteomalacia from pterygopalatine fossa mass.

Introduction: Oncogenic osteomalacia, or tumour-induced osteomalacia, is an uncommon cause of osteomalacia. It has been reported to occur in patients with hypophosphataemia due to excess renal phosphate excretion secondary to mesenchymal tumours. Occurrence of this pathological process in the head and neck is extremely rare. Methods: Case report and literature review. Results: We present a case of a 73-year-old woman with tumour-induced osteomalacia. She was initially followed by the endocrinologists for osteomalacia and pathological fractures. An indium-111 pentetreotide scan showed activity in the left pterygopalatine fossa. A mass was endoscopically resected, and the histopathological appearance was consistent with a haemangiopericytoma. Following surgery, the patient's hypophosphataemia and vitamin D deficiency corrected and her symptoms resolved. Conclusions: Oncogenic osteomalacia, or tumour-induced osteomalacia, is a rare entity in the head and neck. Current research is elucidating the mechanism by which phosphaturic wasting occurs. In most patients, symptoms resolve once the offending tumour is removed.
Application of cholesky-like matrix decomposition methods to the evaluation of atomic orbital integrals and integral derivatives

When viewed as a square two-indexed matrix, the array of atomic orbital-based, two-electron integrals (ij|kl) is a positive semidefinite array. Beebe and Linderberg showed, in 1977, that actual or near linear dependencies often exist within the types of atomic orbital basis sets employed in conventional quantum chemical calculations. In fact, large (i.e., higher quality) bases were shown to be substantially more redundant than smaller or more spatially separated bases. In situations where there exists significant basis near redundancy, the rank (r) of the (ij|kl) ≡ Vl,J matrix of integrals will be significantly smaller than the matrix dimension M. When this occurs, it proves computationally tractable to decompose the M-dimensional matrix V into components L (V = LLT) which contain all of the information needed to form the full V matrix. The Cholesky algorithm allow such a decomposition to be carried out and forms the basis of the work described here. The method is found to be highly successful in reducing the number of integrals and integral derivatives that must actually be calculated. In particular, results on the C2 molecule indicate that the algorithm can be superior to traditional methods of integral derivative generation if the orbital basis is large enough to contain appreciable near redundancy. In contrast, results on benzene with a more spatially delocalized basis show that conventional methods are preferred whenever substantial basis (near) redundancy is not present.
Deep-submicrometer channel design in silicon-on-insulator (SOI) MOSFET's

Short-channel effects in deep-submicrometer SOI MOSFET's are explored over a wide range of device parameters using two-dimensional numerical simulations. To obtain reduced short-channel effects in SOI over bulk technologies, the silicon film thickness most be considerably smaller than the bulk junction depth because of an additional charge-sharing phenomenon through the SOI buried oxide. The optimal design space, considering nominal and short-channel threshold voltage, shows ample design options for both fully and partially depleted devices, however, manufacturing considerations in the 0.1 /spl mu/m regime may favor partially depleted devices. >
Temperature Measurements of Shocked Water Using a Fluorescence Probe

Shock experiments on condensed phase materials primarily yield shock and particle velocity data from which pressure, specific volume and internal energy are inferred using conservation relations1. Determination of a complete equation of state requires, in addition, thermal information. Unfortunately, there does not at this time exist a reliable and general method for measuring the temperature rise of a shock loaded liquid or solid. Limited success has been achieved experimentally using infrared detection for studies of transparent media in the temperature range 200 to 1500 C2. Visible pyrometry, utilized in many laboratories, is best suited for use at higher temperatures. Thermocouple3 or thermistor4 measurements, although more general, are beset with difficulties stemming from required miniaturization for fast response. Another interesting attempt has been the use of Raman spectroscopy5 but this too is very restrictive in its application.
Headache Post-Traumatic Brain Injury

Researchers at University of Washington, Seattle, and Children's Hospital of Philadelphia, PA conducted a prospective cohort study of the prevalence of headache 3 and 12 months after traumatic brain injury (TBI) in children ages 5 to 17 years.
The Problem and Possibilities of Professionalism

During the past 50 years, the legal profession in the United States has experienced unprecedented growth in numbers, prosperity and influence. The number of lawyers has increased almost fivefold; lawyers are well-compensated in the main, with many being handsomely paid; and the influence of lawyers and the law is felt throughout the public and private institutions of American life. At the same time, members of the legal profession express strong feelings of frustration and dissatisfaction with their work, their colleagues, the lives they lead and the profession itself. Members of the public express somewhat different, but no less serious reservations aout the legal profession, its members, and its values. A recurring theme among both groups is the apparent decline of "professionalism" within the legal profession.The word "professionalism" is ubiquitous, but the concept is more often invoked than explained. The aim of this paper is to pay closer attention to what we mean when we talk about "professionalism," and , thus to clarify what is at stake in the conversations we have. The paper will begin with a short description of the legal profession in the United States. The second part will describe the nature of the ongoing debate about "professionalism." The third part will consider the various ways in which we typically use the word "professional." and the fourth part will seek to develop a deeper understanding of the problem through the perspective of the sociology of the professions. The final section will suggest the need for a more robust and public-spirited concept of "professionalism."
Synthesis of cis-[Cr(diimine)2(1-methylimidazole)2]3+ Complexes and an Investigation of Their Interaction with Mononucleotides and Polynucleotides

A protocol is presented for the synthesis of chromium(III) complexes of the type cis-[Cr(diimine)2(1-methylimidazole)2](3+). These compounds exhibit large excited-state oxidizing powers and strong luminescence in solution. Emission is quenched by added guanine, yielding rate constants that track the driving force for guanine oxidation. The cis-[Cr(TMP)(DPPZ)(1-MeImid)2](3+) species binds strongly to duplex DNA with a preference for AT base sites in the minor groove and may serve as a precursor for photoactivated DNA covalent adduct formation.
Biomimetic Signal Conditioning and Light Adaptation for Compound Vision Sensors

Previous research efforts in mimicking the compound eye of Musca domestica, the common house fly, in hardware have primarily been focused on optical designs to achieve the fast, analog, parallel processing, and motion hyperacuity properties of the biological system. While these optical platforms have shown promising results, nearly all proposed advantages of utilizing a fly-inspired sensor have been discovered through the use of software simulation with very little or no effort being made to validate these simulations using the actual fly-inspired optics. The work presented in this paper advances the frontier of compound vision research by mimicking the core processing systems of the fly's intermediate neural layer structure (the lamina) in hardware. The hardware designs were kept as biomimetic as possible, and the unique motion hyperacuity characteristic of Musca's visual system was preserved in each circuit design. It will be shown that an effective light adaptation system can be designed that is both analog and parallel by directly mimicking the fly's visual system. The proof-of-concept designs presented in this paper are an important first step in turning the novel compound optical designs of the past decade into useful sensors that can function in dynamic real-world environments.
PO-0434 An Evaluation Of Consultation With Parents Of Babies With Severely Abnormal Cerebral Function Monitoring (cfm)traces Receiving Therapeutic Hypothermia At 24 Hours Of Age

Background Cooling may not be appropriate and further treatment is likely to be futile in babies who appear moribund or have persisting extremely severe encephalopathy and severely abnormal aEEG changes (CFM) beyond 12–24 h of age. (www.npeu.ox.ac.uk/tobyregister/Register-Clinicans-Handbook) Aims To assess whether severely abnormal CFM changes in babies receiving therapeutic hypothermia were clearly documented and to ascertain whether treatment-limiting decisions were discussed with parents at 24 h of age. Methods A retrospective review of case notes of babies who received therapeutic hypothermia at a tertiary NICU between October2007-December2013. Results 89 patients were included in our final analysis. 31/89(35%) patients had abnormal CFM changes at 24 h. Of these 16/31(52%) had severely abnormal CFM changes. Withdrawal of care was discussed with parents in 10/16(62.5%) of babies with severe CFM changes at 24 h of age. Of these 10 cases with severely abnormal CFM, 1 baby had care withdrawn due to multiorgan failure before 24 h. In 8 /16 (50%) cases, care was subsequently withdrawn after 24 h. In 6/16(37.5%) of cases with severely abnormal CFM cooling was continued. However, 1 of these 6 cases later had a Do Not Resuscitate (DNR) placed on day 5. Conclusions Severely abnormal CFM findings between 12–24 h of age must always be discussed with parents and where appropriate parents must be counselled regarding the likely futile nature of continuing intensive care.
Chaos Theory: Marketing & Management Implications

On the basis of an extensive review of the literature, the authors present chaos models and principles that explain how products, firms, and industries coevolve in a worldwide market web of connectedness. The concepts and models developed are explained in terms of current marketing and management issues. The focus is on innovation as an autocatalytic process that generates multiple market niches. Critical factors to firm success include diversity, redundancy, independency of operational units and the timely deployment of multiple marketing strategies. The authors hope that the models, metaphors, applications and cases presented will stimulate further examination of marketing issues within a framework of the theoretic principles of chaos theory.
Alignment of Tellurium Nanowires by Agitation-assisted Assembly

We investigated the ordered assembly of Te nanowires under the assistance of agitation and prepared several nanowires arrays through in situ chemical reaction of the assembled Te nanowires. The Te nanowires with long aspect ratio were synthesized through hydrothermal method and then were aligned on the substrate of quartz by agitation-assisted assembly. The influences of the sides of the substrate,solvent,stirring rate and concentration on the morphology of the assembled nanowires were studied. Using the orientated Te nanowires as templates,the arrays of Pt,Pd and Ag2Te nanowires were fabricated by in situ chemical conversion. Due to the distinct properties of the above nanowires,the prepared arrays would be of great potential in the fields of sensor and photoelectronic device. This study indicates the capability of the agitation-assisted assembly in the fabrication of nanowires array,offering a new approach to obtain two-dimension ordered structure.
Disorders of the Adrenal Medulla and Multiple Endocrine Adenomatoses

This article reviews the structure and development of the adrenal medulla, and the principal pathways of synthesis and metabolism of the catecholamines. The clinical manifestations and current treahnent regimens for pheochromocytoma, neuroblastoma, and multiple endocrine adenomatoses are also discussed.
Sexual dimorphism of human vallate papillae: an in vivo study of normative morphology

The perimeters of vallate papillae (VP) house approximately half of the taste buds on the human tongue. However, little information exists regarding perimeter measurements of VP. Likewise, great diversity exists among reports of the number of VP and diameter of VP, in general. The research presents an analysis of the perimeters, counts, and diameters of VP in vivo. Endoscopic examination was performed on 79 individuals (40 females, 39 males) between 18 and 26 years of age. A total of 583 VP were counted, 565 of which were able to be measured. Data revealed a statistically significant difference between male and female VP count (t(75.6) = 4.5; p = 0.00003). Females had, on average, 2.22 more VP than males. Males were found to have larger mean VP diameter per person and mean VP perimeter per person than females (t(58.9) = –2.4; p = 0.021 and t(59.3) = –2.4; p = 0.019, respectively). The report demonstrates that VP are sexually dimorphic at the gross anatomical level.
Percutaneous Nephrolithotomy in the Spinal Cord Injury Population

AbstractWe evaluated 23 male spinal cord injury patients who underwent percutaneous nephrolithotomy for the success rate of stone removal and the incidence of operative complications. There were 18 quadriplegic and 5 paraplegic patients, and 5 had bilateral procedures. Of the kidneys 7 had staghorn calculi, 8 had pelvic and caliceal combinations, 6 had large multiple caliceal stones, 4 had large (more than 2.5cm.) pelvic stones and 3 had pelvic stones less than 2.5cm. Placement of a nephrostomy tube and stone extraction were performed as a single procedure with the use of general anesthesia in all but 4 patients.Our results showed that 19 of 21 compliant patients (90.4 per cent) were free of stone, with an average of 2.04 procedures per patient. A total of 47 procedures was performed, with an average operative time of 1 hour 45 minutes. Major complications were associated with 4 of the 47 procedures (8.5 per cent), and consisted of a respiratory arrest, 2 perirenal abscesses and a hydrothorax. Minor compl...
SU-G-BRA-04: Simulation of Errors in Maximal Intensity Projection (MIP)-Based Lung Tumor Internal Target Volumes (ITV) Using Real-Time 2D MRI and Deformable Image Registration Based Lung Tumor Tracking

Purpose: To evaluate the effect of inter- and intra-fractional tumor motion on the error in four-dimensional computed tomography (4DCT) maximal intensity projection (MIP)–based lung tumor internal target volumes (ITV), using deformable image registration of real-time 2D-sagital cine-mode MRI acquired during lung SBRT treatments. Methods: Five lung tumor patients underwent free breathing SBRT treatment on the ViewRay, with dose prescribed to PTV (4DCT MIP-based ITV+3–6mm margin). Sagittal slice cine-MR images (3.5×3.5mm pixels) were acquired through the center of the tumor at 4 frames per second throughout the treatments (3–4 fractions of 21–32 minutes duration). Tumor GTVs were contoured on the first frame of the cine and tracked throughout the treatment using off-line optical-flow based deformable registration implemented on a GPU cluster. Pseudo-4DCT MIP-based ITVs were generated from MIPs of the deformed GTV contours limited to short segments of image data. All possible pseudo-4DCT MIP-based ITV volumes were generated with 1s resolution and compared to the ITV volume of the entire treatment course. Varying pseudo-4DCT durations from 10-50s were analyzed. Results: Tumors were covered in their entirety by PTV in the patients analysed here. However, pseudo-4DCT based ITV volumes were observed that were as small as 29% of the entire treatment-ITV, depending on breathing irregularity and the duration of pseudo-4DCT. With an increase in duration of pseudo-4DCT from 10–50s the minimum volume acquired from 95% of all pseudo-4DCTs increased from 62%–81% of the treatment ITV. Conclusion: A 4DCT MIP-based ITV offers a ‘snap-shot’ of breathing motion for the brief period of time the tumor is imaged on a specific day. Real time MRI over prolonged periods of time and over multiple treatment fractions shows that the accuracy of this snap-shot varies according to inter- and intra-fractional tumor motion. Further work is required to investigate the dosimetric effect of these results.
“Double Voting” in Mail Surveys the Potential and the Reality

This paper presents the results of two studies investigating the incidence of “double voting” by respondents in multi‐wave mail surveys. Two separate surveys with a total sample in excess of 1300 were conducted. In both cases these were genuine studies, but dealt with innocuous topics. The results appear to indicate that the tendency for respondents to register their opinions more than once is limited. This, however, may not be the case in surveys involving topics of a somewhat controversial nature.
Referral for genetic counseling in survivors of triple negative breast cancer (TNBC): An ongoing objective.

1095Background: Inherited mutations in the BRCA gene are responsible for 5-10% of breast cancers. These mutations, predominantly BRCA 1, predispose to TNBC. Around 20% of women with TNBC are BRCA m...
An Examination of Factors That Impact the Retention of Online Students at a For-Profit University.

Online learning has continued to grow in recent years. However, retaining students in online courses and programs has posed a challenge. Whether the university is public, private, offers both face-to-face and online programs, or is 100% online, retaining students in online programs can be an issue. This study reflects the widespread desire at a large online for-profit university to improve student retention rates. The goal of the research was to provide further insight into why students may decide to drop out of online programs. Participants consisted of former undergraduate students at the university in the College of Education who dropped out without providing a specific reason for doing so. The study used a non-experimental mixed methods approach collecting data from university databases, an online survey, interviews, and classroom walk-throughs. Data analysis employed techniques such as frequency calculations, a MANOVA, and qualitative content analysis. Results from the MANOVA revealed statistically significant results when examining student GPA and last course grade. Furthermore, data collected from the online survey, interviews, and classroom walk-throughs revealed common reasons for why students may drop out of online programs.
Nuclear Crisis Management and Deterrence: America, Russia, and the Shadow of Cyber War

Among the changing characteristics of nuclear deterrence in the 21st century, compared to the first nuclear age that preceded it, is the relationship between nuclear weapons and cyber war. It might...
Neurostimulant use is associated with improved survival in comatose patients after cardiac arrest regardless of electroencephalographic substrate.

Abstract Aim Identify EEG patterns that predict or preclude favorable response in comatose post-arrest patients receiving neurostimulants. Methods We examined a retrospective cohort of consecutive electroencephalography (EEG)-monitored comatose post-arrest patients. We classified the last day of EEG recording before neurostimulant administration based on continuity (continuous/discontinuous), reactivity (yes/no) and malignant patterns (periodic discharges, suppression burst, myoclonic status epilepticus or seizures; yes/no). In subjects who did not receive neurostimulants, we examined the last 24 h of available recording. For our primary analysis, we used logistic regression to identify EEG predictors of favorable response to treatment (awakening). Results In 585 subjects, mean (SD) age was 57 (17) years and 227 (39%) were female. Forty-seven patients (8%) received a neurostimulant. Neurostimulant administration independently predicted improved survival to hospital discharge in the overall cohort (adjusted odds ratio (aOR) 4.00, 95% CI 1.68–9.52) although functionally favorable survival did not differ. No EEG characteristic predicted favorable response to neurostimulants. In each subgroup of unfavorable EEG characteristics, neurostimulants were associated with increased survival to hospital discharge (discontinuous background: 44% vs 7%, P = 0.004; non-reactive background: 56% vs 6%, P Conclusion EEG patterns described as ominous after cardiac arrest did not preclude survival or awakening after neurostimulant administration. These data are limited by their observational nature and potential for selection bias, but suggest that EEG patterns alone should not affect consideration of neurostimulant use.
Rapidly developing heart failure from capecitabine cardiotoxicity: a case study.

Capecitabine is a pyrimidine analogue used as an anti‐neoplastic agent. It is a fluoropyrimidine‐based oral prodrug of 5‐fluorouracil (5‐FU). It exerts its effect by selectively activating a three step enzymatic pathway. The last step is catalysed by the enzyme thymidine phosphorylase 1. As compared to normal tissues, this enzyme has higher activity in neoplasms than in normal tissues. Hence, 5‐FU tends to accumulate in tumour cells. Capecitabine is currently approved for treatment of metastatic breast cancer and is included in the WHO list of essential medicines. Though 5‐FU has been associated with cardiotoxicity, there have only been a handful of reports linking capecitabine to cardiac dysfunction. Generally speaking, capecitabine is known as a relatively safe drug. However, the most common reversible side effects are hand–foot syndrome (17%), gastrointestinal upset (17%), and nausea (15%) 1. Though 5‐FU has been associated with cardiotoxic effects, capecitabine‐induced myocardial toxicity is rare and has not been much reported. Its incidence is on the rise due to a burgeoning geriatric population and more widespread use of capecitabine 2. In this case report, we describe a male with metastatic breast cancer and no pre‐existing heart disease, who was being treated with capecitabine. Before initiation of chemotherapy, his cardiac function was normal with an ejection fraction of 70%. However, over the next 12 months, he developed progressive exertional dyspnoea. Repeat Transthoracic Echocardiography (TTE) revealed an ejection fraction of 10%.
Resting-state thalamic dysconnectivity in schizophrenia and relationships with symptoms.

BACKGROUND Schizophrenia (SZ) is a severe neuropsychiatric disorder associated with disrupted connectivity within the thalamic-cortico-cerebellar network. Resting-state functional connectivity studies have reported thalamic hypoconnectivity with the cerebellum and prefrontal cortex as well as thalamic hyperconnectivity with sensory cortical regions in SZ patients compared with healthy comparison participants (HCs). However, fundamental questions remain regarding the clinical significance of these connectivity abnormalities. METHOD Resting state seed-based functional connectivity was used to investigate thalamus to whole brain connectivity using multi-site data including 183 SZ patients and 178 matched HCs. Statistical significance was based on a voxel-level FWE-corrected height threshold of p < 0.001. The relationships between positive and negative symptoms of SZ and regions of the brain demonstrating group differences in thalamic connectivity were examined. RESULTS HC and SZ participants both demonstrated widespread positive connectivity between the thalamus and cortical regions. Compared with HCs, SZ patients had reduced thalamic connectivity with bilateral cerebellum and anterior cingulate cortex. In contrast, SZ patients had greater thalamic connectivity with multiple sensory-motor regions, including bilateral pre- and post-central gyrus, middle/inferior occipital gyrus, and middle/superior temporal gyrus. Thalamus to middle temporal gyrus connectivity was positively correlated with hallucinations and delusions, while thalamus to cerebellar connectivity was negatively correlated with delusions and bizarre behavior. CONCLUSIONS Thalamic hyperconnectivity with sensory regions and hypoconnectivity with cerebellar regions in combination with their relationship to clinical features of SZ suggest that thalamic dysconnectivity may be a core neurobiological feature of SZ that underpins positive symptoms.
Recommendations For Field-scale Induced Polarization (ip) Data Acquisition and Interpretation

Field-scale induced polarization (IP) data remain underutilized due to the challenges of data acquisition and interpretation of the resulting observations for near surface environmental applications. We use measurements at a test site and the principle of IP reciprocity to demonstrate that the primary factor controlling the quality of IP data acquired using standard resistivity/IP imaging systems is the signal to noise ratio (SNR), i.e., the recorded signal strength. This factor favors the use of nested arrays, where one or two of the potential electrodes fall between the current electrode pair, that guarantee a high primary voltage (Vp) versus Dipole-Dipole type arrays where voltage differences rapidly decay away from the current injection pair. Comparison of data acquired using stainless steel, Cu-CuSO4 porous pot and graphite electrodes demonstrates that electrode material is a significant second order factor but only for measurements where the SNR is relatively low (for the instrument used in this study when Vp < 30 mV). We also propose a simple framework for interpretation of environmental IP datasets whereby the acquisition of IP data is used to remove the inherent ambiguity in the interpretation of standalone resistivity data such that the subsurface distribution of the surface conductivity and electrolytic conductivity contributions to the total conductivity can be resolved. We demonstrate this approach on a field site within a first order catchment where a high surface area formation likely limits vertical transport and promotes interflow. Sharp contrasts in electrical structure between the two slopes of the catchment are observed.
Necessary Basics: Elements, Isotopes, Ions, Chemical Reactions, Energy Metabolism, and Bacterial Structures

This chapter describes how a traditional discussion of atomic structure and its relationship to organic chemistry is relevant to dentistry. Although the fundamental chemistry and biochemistry described here are common knowledge, the discussion centers on the associations with teeth and dental disease (Sects. 1 and 2). In addition, the difference between respiration and fermentation and the different types of fermentations involved in dental caries and periodontal disease are discussed (Sect. 3). The chapter concludes with a discussion of the difference between the outer cell surface of gram-positive and gram-negative bacteria that is important in causing these diseases (Sect. 4).
Learning While Black: A Culturally Informed Model of the Impostor Phenomenon for Black Graduate Students:

This study presents a culturally informed model of the impostor phenomenon construct for Black graduate students who attend predominantly White universities. The impostor phenomenon is an internal ...
The Abacus: Instruction by Teachers of Students with Visual Impairments.

IntroductionThis article, based on a study of 196 teachers of students with visual impairments, reports on the experiences with and opinions related to their decisions about instructing their stude...
The mechanism of integration preference to heterochromatin of yeast retrotransposon Ty5

vii CHAPTER I. GENERAL INTRODUCTION 1 Transposable elements 1 Integrase and integration 3 Ty elements and targeted integration 6 Heterochromatin and silencing 9
Sapega, Ellen W. Consensus and Debate in Salazar's Portugal: Visual and Literary Negotiations of the National Text, 1933-1948. The Pennsylvania State UP, 2008.

At once tightly focused and wide-ranging, Ellen Sapega’s study offers a fascinating perspective on the politics of cultural production during the arguably most consequential decade and a half of the Portuguese Estado Novo regime.
Prevalence of Chronic Constipation and Chronic Diarrhea in Diabetic Individuals in the United States

Diabetic individuals commonly report disordered bowel habits. This study aims to report the prevalence and associated factors of chronic diarrhea (CD) and chronic constipation (CC) in diabetics using a nationally representative sample of US adults. Analyses were performed using data from subjects in the 2009–2010 National Health and Nutrition Examination Survey (NHANES) dataset who completed the Bowel Health Questionnaire. The NHANES dataset provides medical comorbidities, demographics, and dietary habits of a nationally representative group of adult survey participants in the United States. CC and CD were defined by Bristol Stool Form Scale (BSFS) Types 1 & 2 and BSFS Types 6 & 7 as the “usual or most common stool type,” respectively, and frequent laxative users were also defined as having CC. Co-variables for all subjects included demographic and lifestyle factors, and co-variables evaluated only in diabetics included treatment and severity markers for diabetes. We identified 661 diabetic subjects and 4488 non-diabetic subjects. Diabetic subjects (25.8%) reported disordered bowel habits. In unadjusted analysis, CD was more prevalent in diabetics than in non-diabetics (11.2% vs. 6.0%; p < 0.0001); however, the prevalence of CC was not significantly different between groups (14.6% vs. 11.2%; p = 0.126). When adjusting for covariates (e.g., BMI, gender, age, race/ethnicity, education level, etc.), diabetes itself remained associated with CD. Diabetic individuals with CD more frequently used drugs to lower blood sugar, and diabetic subjects with CC more frequently had poor kidney function. CD is significantly more prevalent in diabetics than in non-diabetics, whereas CC is not, and the association between CD and diabetes remains significant when adjusting for covariates. Use of medications that lower blood sugar is associated with CD in diabetic individuals, whereas poor kidney function is associated with CC in diabetics.
Development of clay based novel hybrid bio-ink for 3D bio-printing process

Abstract 3D bio-printing is a revolutionary technology to reproduce a 3D functional living tissue scaffold in-vitro through controlled layer-by-layer deposition of biomaterials along with precisely positioning the live cells. Natural hydrogels are commonly considered as the scaffold material due to their bio-compatibility. However, the mechanical integrity of hydrogel material especially in 3D scaffold architecture is an issue. In this research, a novel hybrid bio-ink is developed that composed of alginate, carboxymethyl cellulose and montmorillonite clay. Several systematic quantitative characterization tests are conducted on the newly developed material to validate its printability shape fidelity and cell viability. The outcome from rheological and swelling test, filament collapse and fusion test are used to optimize the material composition to ensure printability and shape fidelity in extrusion based bio-printing process. Multiple 3D scaffolds structure with complex shape and varying pattern are fabricated with the proposed bio-ink to demonstrate its printability and shape fidelity. Furthermore, 84% live cell after 7 days of bio-printing shows its cell viability. This hybrid hydrogel can be a potential biomaterial in 3D bio-printing process and the outlined characterization techniques open an avenue directing reproducible printability and shape fidelity.
Paravalvular leak repair after balloon-expandable transcatheter mitral valve implantation in mitral annular calcification: Early experience and lessons learned.

BACKGROUND Treatment of hemodynamically significant mitral annular calcification (MAC) using transcatheter approaches is in the early learning phase. The occurrence of paravalvular leak (PVL) following transcatheter mitral valve in MAC is common. AIMS To report the initial experience and techniques of percutaneous PVL closure after transcatheter valve in MAC. METHODS This series includes five consecutive patients who underwent percutaneous PVL closure following transcatheter balloon expandable SAPIEN S3 valve in MAC. RESULTS Mean patient age was 73.6 ± 5.4 years (4 [80%] female), with average Society of Thoracic Surgeons score of 8.1 ± 2.8%. Three patients had a single PVL defect while two patients had two defects; all were located at the commissural sites. Closure was performed primarily for heart failure in four patients and hemolytic anemia in one patient. Transfemoral transseptal antegrade approach and Amplatz Vascular Plug (AVP)-II occluders were utilized in all patients. Procedure success was achieved in three patients. One patient developed significant occluder related leaflet impingement and subsequent severe prosthetic mitral regurgitation requiring a second transcatheter mitral valve in valve implantation. The procedure was aborted in one patient due to difficulty crossing PVL defect after balloon post-dilatation of SAPIEN prosthesis with 10 mL of additional volume. There was no in hospital or 30 day mortality or the need for emergent surgery. CONCLUSION Early experience with percutaneous PVL closure of SAPIEN valve in MAC demonstrated feasibility of this approach. Careful procedure planning and monitoring for SAPIEN prosthesis leaflet impingement and frame instability is of utmost importance to increase the chances of procedural success.
A mixed upwind/central WENO scheme for incompressible two-phase flows

Abstract In this paper, an accurate and efficient numerical scheme is developed to solve the Navier-Stokes equations for two-phase flow systems with the nonlinear inertial term in conservation form. The major difficulty of discretizing the nonlinear inertial term in conservation form in two-phase flows is rooted in the discontinuous nature of momentum across interfaces. To overcome this difficulty, we developed the mixed Upwind/Central WENO scheme so that no grid deformation or mapping, or explicit interface reconstruction is necessary. Our mixed Upwind/Central WENO scheme also removes the dependence on the interface tracking/capturing method so it is compatible with any popular interface tracking/capturing methods. To decouple the overall equations of the two-phase system, an efficient semi-implicit projection scheme is constructed, which shares the efficiency of pressure stabilization method while enforces divergence-free condition to machine precision, to benefit interface advection, reduction consistency as well as large density ratio. The accuracy and reduction consistency of this projection scheme are validated by numerical experiments. Several benchmark cases are performed to show the capability of the overall scheme handling realistic two-phase problems with multiple physical effects, complex interface evolution and/or large density ratio of the order of ( ρ water / ρ air ). Both quantitative and qualitative comparisons have been made and very good agreements with analytical solutions, published numerical and/or experimental results are achieved.
Light, sound, nanobubbles: New approach to contrast-enhanced ultrasound and photoacoustic imaging

To overcome the most significant deficiencies of conventional and contrast-enhanced ultrasound imaging—low contrast and large size of microbubbles, we introduced new class of contrast agents—nanometer scale particles that are capable of escaping vascular compartments, penetrating into tissue, and then, once they reach the target site, generating sufficient ultrasound and photoacoustic contrast upon user-controlled optical activation. These multimodal contrast agents—phase-change perfluorocarbon nanodroplets and plasmonic nanoparticles covered by azide compounds—are stable at physiological temperatures, biocompatible, and monodisperse in size. Given the unique properties of the particles, our approach to image these particles is drastically different and is based on ultrasound read-out of the optically induced temporal changes. Specifically, time-varying ultrasound signals exhibited by the nanoparticles versus the static background are used to reconstruct a high contrast, background-free image of the contrast agent. Furthermore, these particles allow for multiplexed molecular imaging by permitting user-controlled triggering of distinct color-coded populations of contrast agents via tuning of the incident laser irradiation to match peak optical absorption of the particles. Finally, nanoparticles may also contain therapeutic cargo and thus can be used for controlled drug delivery and release. This presentation, via examples, will discuss diagnostic imaging and image-guided therapy using the gas-generating nanoparticles.
Privacy, Anonymity, and Perceived Risk in Open Collaboration: A Study of Service Providers

Anonymity can enable both healthy online interactions like support-seeking and toxic behaviors like hate speech. How do online service providers balance these threats and opportunities? This two-part qualitative study examines the challenges perceived by open collaboration service providers in allowing anonymous contributions to their projects. We interviewed eleven people familiar with organizational decisions related to privacy and security at five open collaboration projects and followed up with an analysis of public discussions about anonymous contribution to Wikipedia. We contrast our findings with prior work on threats perceived by project volunteers and explore misalignment between policies aiming to serve contributors and the privacy practices of contributors themselves.
Bulimia and Dissociation: A Developmental Perspective

Counselors and researchers are increasingly recognizing that persons diagnosed with bulimia nervosa typically manifest high levels of the defense of dissociation. Treatments for bulimia nervosa may be unsuccessful due to insufficient acknowledgment of the role that dissociation can play in mediating the disorder. Failing to acknowledge client dissociation constricts the potential for an efficacious therapeutic relationship because certain aspects of the client's self-experience are prevented from emerging in counseling. The authors explore core concepts in the development of self-formation that illuminate the origins and function of dissociation in bulimia. The exploration suggests developmental explanations, implications for alternate and effective treatment, and possibilities for future research.
Fitness costs and benefits vary for two facultative Burkholderia symbionts of the social amoeba, Dictyostelium discoideum.

Hosts and their associated microbes can enter into different relationships, which can range from mutualism, where both partners benefit, to exploitation, where one partner benefits at the expense of the other. Many host-microbe relationships have been presumed to be mutualistic, but frequently only benefits to the host, and not the microbial symbiont, have been considered. Here, we address this issue by looking at the effect of host association on the fitness of two facultative members of the Dictyostelium discoideum microbiome (Burkholderia agricolaris and Burkholderia hayleyella). Using two indicators of bacterial fitness, growth rate and abundance, we determined the effect of D. discoideum on Burkholderia fitness. In liquid culture, we found that D. discoideum amoebas lowered the growth rate of both Burkholderia species. In soil microcosms, we tracked the abundance of Burkholderia grown with and without D. discoideum over a month and found that B. hayleyella had larger populations when associating with D. discoideum while B. agricolaris was not significantly affected. Overall, we find that both B. agricolaris and B. hayleyella pay a cost to associate with D. discoideum, but B. hayleyella can also benefit under some conditions. Understanding how fitness varies in facultative symbionts will help us understand the persistence of host-symbiont relationships. Open research badges This article has earned an Open Data Badge for making publicly available the digitally-shareable data necessary to reproduce the reported results. The data is available at https://openscholarship.wustl.edu/data/15/.
Homelessness Among Patients in a Southeastern Safety Net Emergency Department.

Objectives Emergency departments (EDs) are important providers for homeless individuals, providing vital health care and meeting the subsistence needs of many homeless patients (eg, food, water, shelter). Studies that have examined the proportion of patients in the ED setting who experience homelessness have been conducted primarily in the northeastern United States. We hypothesized that findings from prior studies, conducted primarily in the Northeast, would not generalize to other regions of the United States. We conducted a direct patient survey to describe the proportion and demographics of ED patients who have experienced homelessness within the past 12 months in an urban safety net hospital in Atlanta, Georgia. Methods A cross-sectional survey of a convenience sample of patients presenting to the ED from September to December 2016. A team of trained research assistants administered a structured survey instrument to patients who were 18 years old, English speakers, not incarcerated, and able to provide informed consent. Questions were based on the US Department of Health and Human Services definition of homelessness. Results A total of 923 ED patients (55.1% male; median age 44 years) completed the survey. Of the ED patients surveyed, 51.5% reported some measure of homelessness in the past 12 months: lived with others but did not pay rent (n = 279, 30.2%), skipped mortgage or rent payment (n = 111, 12%), experienced eviction (n = 74, 8%), lived in a hotel or motel (n = 196, 21.2%), lived in a place not meant for human habitation (n = 76, 8.2%), slept in a shelter (n = 131, 14.2%), and slept on the street (n = 115, 12.5%). Men (odds ratio [OR] 1.56, 95% confidence interval [CI] 1.17-2.09), patients who completed some school (OR 2.85, 95% CI 1.72-4.71), and patients who completed high school (OR 2.32, 95% CI 1.53-3.52) were more likely to have experienced homelessness in the 12 months preceding their ED visit. Conclusions The rate of patients experiencing homelessness at our hospital is substantially greater than those reported in prior surveys of ED patients. More research is needed on homelessness and its implications for ED patients.
An Atypical Presentation of Prion Disease with Alien Limb, Apraxia, and Intact Cognition (P2.1-035)

Objective: To report an atypical presentation of Creutzfeldt-Jakob disease with preserved cognition, alien limb phenomenon, and apraxia. Background: Creutzfeldt-Jakob disease (CJD) is a neurodegenerative condition caused by the accumulation of misfolded prion protein that is rapidly progressive, invariably fatal, and typically characterized by acute neurocognitive decline and myoclonus. In this case, a 66-year-old previously healthy woman with a past medical history of essential tremor and recent tick bite presented with involuntary left hand movements and was found to have left hand apraxia and alien limb phenomenon. Design/Methods: N/A Results: The patient’s initial neurologic examination was normal other than observed left arm apraxia and mildly brisk reflexes in that arm. She described the left arm as “not doing what I want.” MRI brain scan and serum labs were normal. The patient was eventually admitted to the hospital for progressive symptoms of difficulty ambulating, double vision, left hemibody paresthesias and increased tone, and involuntary rapid left arm movements consistent with myoclonus. Other than mild sleep disturbance, her orientation and cognition remained intact. CSF studies revealed elevated tau, low GAD 65 Ab, and positive 14-3-3. EEG showed intermittent slowing. Repeat MRI brain showed evidence of right cortical ribboning. She underwent an empiric trial of steroids and IVIG without improvement. CSF RT-Quic returned positive for CJD. The patient was discharged to another facility for second opinion however her neurocognitive status rapidly declined. She was ultimately transitioned to comfort measures and passed away within weeks. Conclusions: Sporadic CJD is idiopathic and accounts for ~85% of prion disease. Although it classically presents with progressive dementia and myoclonus, atypical presentations can occur and may delay diagnosis. This case was remarkable for a cortical apraxia far out of proportion to cognitive issues. Urgent and thorough investigation should be considered to prevent diagnostic delay and focus care on symptomatic management and patient end-of-life wishes. Disclosure: Dr. Chaudhry has nothing to disclose. Dr. Wodziak has nothing to disclose.