cssi/SciSciGPT-SciSciNet huggingface dataset:
Forward-Looking Problems

This chapter considers forward looking problems, including trustworthy tools, formal verification of hardware designs, configuration management, languages, physical attacks, design theft, and securing the entire manufacturing supply chain.
Risky Business: Pathways to Progress in Biologically Informed Studies of Psychopathology

In the target article, Vaidyanathan, Vrieze and Iacono reflect on the lack of advancement in our etiologic understanding of psychopathology. They persuasively argue that theory-guided integrative research, due to its targeted testing of putative mechanisms, should be prioritized. Through a comprehensive narrative, and drawing elegantly on a vast body of endophenotype research, these authors suggest that “risky tests” of causal theories (i.e., a test that narrows the number of causal interpretations available) offer the most potential to inform our understanding of psychopathology. In addition, the authors point out that statistics and technology, when haphazardly applied, can have perilous consequences. They advocate, instead for risky study designs that are guided by a strong theoretical basis, are free of diagnostic boundaries and fueled by knowledge from multiple research domains. We could not agree more with their proposal.
CLIPPERS With Chronic Small Vessel Damage: More Overlap With Small Vessel Vasculitis?

In 2010, Pittock et al (1) published a seminal report on an entity they entitled “Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS).” After this, other reports of the entity quickly appeared (2–22) (Table). A recently presented abstract reviews several more unpublished non-English language cases (19). Despite this, most reports have emphasized neuroimaging or clinical features and neuropathologists may not be familiar with the syndrome. View this table: TABLE Detailed Review of Neuropathologic Features of CLIPPERS As discussed in commentaries by Kira (23), and Keegan and Pittock (24), the essential feature of the disease is seen on magnetic resonance imaging (MRI) scans. These show punctate and curvilinear gadolinium enhancement that “peppers” the pons; the enhancement is almost always symmetric (with only 1 of 8 asymmetric in the original series [1] and 1 asymmetric in a recent case report [17]). Signal abnormalities often extend into contiguous cerebellum, brainstem, or even thalami and cerebral cortex, as emphasized by others after the original report (3, 4, 10). Simon et al (10) even suggested a nomenclature modification from “pontine” to “pontocerebellar” to reflect the more widespread features. Clinically, patients present with fluctuating brainstem symptoms and show response to steroids, although it has become increasingly clear that relapses are frequent (8) and immunosuppressive therapy often needs to be prolonged; nonsteroidal drugs such as cyclophosphamide, azathioprine, or rituximab have been required (18, 19). Stereotypic neuroimaging features were felt from the initial report to obviate the need for brain biopsy (1), leading to fewer histologic than clinical/ neuroimaging descriptions of the syndrome (Table). Nevertheless, neuropathologic features of CLIPPERS, even when biopsied from nonpontine sites (Table), have been fairly uniform. Most cases have shown perivascular and parenchymal lymphocytic collections associated with macrophages, microglia, and occasionally plasma cells or neutrophils; true tight granulomas and demyelination …
Influence of Plasma Chemistry on the Properties of Amorphous (Si,Ge) Alloy Devices

We report on the growth and properties of a-(Si,Ge):H films and p-i-n solar cell devices prepared using a remote, low pressure ECR plasma deposition technique. The films and devices were prepared using either He or H2 as the diluent gas. The plasma conditions were controlled so as to induce significant ion bombardment during growth. We find that there is a dramatic influence of plasma chemistry on the growth and properties of a-(Si,Ge):H films and devices. In particular, with hydrogen as the diluent gas, changing the pressure in the reactor dramatically changes both the Germanium incorporation in the film, and the electronic properties. Lower pressures lead to less Ge being incorporated, and higher mobility-lifetime product for holes for a given Tauc gap, as well as better p-i-n devices. In contrast, changing the pressure when He is the diluent gas does not produce such large changes. We speculate that the changes in device and film properties are due to the influence of ion bombardment on growth chemistry, and that both efficient energy and momentum transfer to the growing surface are necessary to achieve the best devices. The differences between He and hydrogen may simply be due to the fact that He plasma is much more energetic than a comparable hydrogen plasma, and there is more efficient momentum transfer when He is used as compared to when hydrogen is used. We have also produced very good single junction a-(Si,Ge) devices using the ECR technique.
Investigation of farmers' cognition about new rural cooperative medical system of Zhengzhou

Aim:To analyze the farmers' cognition towards the new rural cooperative medical system(NRCMS) of Zhengzhou.Methods:Gongyi, zhongmu, Xinzheng were selected from the counties of NRCMS by random stratified sampling to investigate the proportion of people taking part in NRCMS, the cognition assessment of NRCMS and comprehension of the proportion of reimbursement.Results:The average proportion of the person taking part in NRCMS of the three counties was 92.1%, and the highest was Gongyi, the lowest was Xinzheng.There were significant differences in the satisfaction(P0.001) and the farmer' cognition towards the proportion of reimbursement in decided medical institutions of NRCMS(P0.001) among the thre counties.The farmers of Gongyi who took part in NRCMS earlier had well known of the proportion of reimbursement. Whether knowing the NRCMS was good for the farmers, benefiting from the NRCMS after taking part in NRCMS and the proportion of reimbursement in hospitals of country were main factors affecting the farmers to go on taking part in NRCMS.Conclusion:It's neccesary for the government to develop the farmer' cognition and enthusiasm about NRCMS and to further improve the cooperrative medical system and programs.
Vaginal hysterectomy. An analysis of indications and complications among 1,000 operations.

Abstract One thousand vaginal hysterectomies with and without associated procedures have been analyzed as to the indications and complications. The primary indications in order of decreasing incidence are tabulated. Pelvic relaxation and functional uterine bleeding each account for 40 per cent of such indications, for a total of 80 per cent. Other less common indications are sterilization, uterine myomas, uterine retroversion, dysmenorrhea, recurrent postmenopausal bleeding, adenocarcinoma and atypical hyperplasia of the endometrium, recurrent pyometra, and carcinoma in situ of the cervix. Operative complications include excessive vaginal bleeding in 86 cases, bladder injury in 11 with 2 resulting fistulas, ureteral injuries in 2 cases with one resulting fistula, and an unforseen need for laparotomy in 6. The common postoperative complications include a significant fever in 395 patients and urinary tract infection in 308 patients. Less frequent complications include: 29 cases of excessive vaginal bleeding, 20 cases of severe urinary retention, 13 cases of pelvic cellulitis, 7 cases of pelvic hematoma, 3 cases of pelvic abscess, and 7 cases of superficial thrombophlebitis. Two sudden deaths occurred, one from pulmonary embolism and one of unknown cause.
The effect of acute physical and mental stress on soluble cellular adhesion molecule concentration.

Abstract Aims This study investigated the impact of acute physical and mental stress on serum concentrations of vascular cell adhesion molecule (VCAM)-1 and CX3CL1/fractalkine. Materials and methods Male volunteers (n = 20; 21.3 ± 0.55 years of age) completed a graded treadmill test to exhaustion and a 20-minute mental stress task (Stroop Color-Word Test, mental arithmetic) on separate, non-consecutive days. Heart rate (HR) was measured at baseline and throughout exercise and mental stress. Blood was collected at baseline (PRE), immediately following (POST) and 30 min after (POST30) exercise and mental stress. Soluble VCAM-1 and fractalkine were quantified in participant serum via enzyme-linked immunosorbent assays. Key findings Both treadmill exercise and the mental stress task significantly increased participant HR; although, exercise resulted in a substantially greater increase in participant HR compared to mental stress (197.82 ± 11.99 vs. 38.67 ± 3.10% [p Significance In conclusion, maximal aerobic exercise results in a significant elevation of the soluble adhesion molecules VCAM-1 and fractalkine in the serum of adult males that does not occur following laboratory-induced mental stress. The findings of the current investigation may suggest a novel protective role for acute aerobic exercise in vascular health via exercise-induced CAM proteolysis.
Configuration of Flagellar Microtubule Subunits

Microtubule protofilaments and their subunits isolated from sperm flagellar doublet tubules of the sea urchin Strongylocentrotus purpuratus were examined by analytical biochemistry and high-resolution negative staining electron microscopy. All microtubule (tubulin) fractions show 2 polypeptide bands (α and β tubulins) in an approximate 1:1 ratio on urea-polyacrylamide gel electrophoresis. Heat (37 °C)-solubilized microtubules yield a protein fraction containing the tubulin dimer of molecular weight 115000 Daltons. The dimeric tubulin subunit, as seen in the electron microscope, has an overall size of about 3.5 x 8 nm and appears to have the configuration of a figure 8 because of stain penetration into the centre of each of its 2 halves (figure os). Isolated protofilaments (3.5 ± 0.3 nm thick) can each be resolved into 2 subfilaments (1.7 ± 0.2 nm thick). The 2 subfilaments have periodic lateral associations resulting in the basic 4-nm subunit repeat (figure o) along the protofilament. Examination of collapsed and solubilizing protofilaments shows the figure 8 (dimeric) subunits separating at random along the protofilaments. We conclude that the tubulin dimer must be composed of either elongated or bilobed monomers which result in the figure 8 configuration and hence the 2-stranded appearance of the protofilaments.
Acalculous cholecystitis after aortic reconstruction

BACKGROUND Acute acalculous cholecystitis is rare in patients undergoing aortic surgery; but, this condition is associated with a high mortality rate. With their comorbid medical problems, patients undergoing aortic reconstruction may have a higher mortality associated with acute acalculous cholecystitis. STUDY DESIGN By retrospectively reviewing patient charts, we studied the prevalence, demographics, details of antecedant aortic procedures, hospital course, and outcome of patients with acute acalculous cholecystitis after aortic surgery. RESULTS In the past 10 years, 7 of the 996 patients who underwent aortic reconstruction at our institution developed postoperative acute acalculous cholecystitis. These patients were all nondiabetic men with a mean age of 66 +/- 4 years (range, 50 to 76 years). Previous aortic operations included four infrarenal aneurysmorrhaphies (three elective, one urgent for a ruptured aneurysm), two aortofemoral bypasses for occlusive disease, and a removal of an infected aortic prosthesis. Six patients had prolonged intraoperative hypotension and increased blood transfusion requirements. All patients had postoperative multiorgan dysfunction. The patients developed fever, leukocytosis, elevated liver function test levels, and other signs and symptoms of acute acalculous cholecystitis a mean of 32 days (range, 9 to 90 days) after operation. Preoperative diagnosis was made in five patients based on clinical examination, laboratory test results, and adjunctive noninvasive test results. Two patients required laparotomy to make the diagnosis of acute acalculous cholecystitis. Five patients underwent cholecystectomy, and two had placement of cholecystostomy tubes. Gangrene or perforation was evident in most. Overall mortality was 71 percent. CONCLUSIONS Acute acalculous cholecystitis is the most common postoperative biliary complication after aortic surgery. The diagnosis should be entertained in patients with signs of abdominal sepsis after aortic surgery, especially those with a complicated postoperative course. Even if acute acalculous cholecystitis is diagnosed before exploration, mortality remains high.
Complications of Advanced Liver Disease

This chapter discusses a number of conditions closely related to acute and chronic diseases of the liver, each of which can and often does adversely affect the outcome of these diseases. It discusses hepatic encephalopathy, the hepatorenal syndrome, the syndrome of fulminant hepatic failure, portal hypertension, and ascites. The first three of these complications occur both in acute and chronic hepatic injury while the final two are almost solely confined to patients with either cirrhosis of the liver or advanced hepatic space-occupy inglesions, usually neoplasms. A degree of uncertainty exists in the understanding of each of these complications. However, considerable information is available attesting again to the importance of normal hepatic function in bodily homeostasis.
Effects of release procedures on the primary stress response and post-release survival and growth of hatchery-reared spotted seatrout Cynoscion nebulosus.

To help explain the apparent poor post-release success of hatchery-reared (HR) spotted seatrout Cynoscion nebulosus, this study examined the effects of handling, transport and release procedures on the stress response of two age classes [48 and 80 day post-hatch (dph)] of HR C. nebulosus, as measured by cortisol concentrations and the post-release survival and growth of 48 and 80 dph HR C. nebulosus. As a proxy for stress, tissue cortisol was measured at various times during the handling, tagging (80 dph), transport, acclimation and release process. To consider the implications of the pre-release stressors, growth and survival were monitored in separate field experiments for each age class of acclimated post-transport C. nebulosus using control C. nebulosus that only experienced anaesthesia, transport, acclimation and a net release v. experimental C. nebulosus that underwent the entire routine procedure, including anaesthesia, tagging, transport, acclimation and gravity release through a pipe. For 48 dph C. nebulosus, mean cortisol varied significantly throughout handling and transport, increasing more than six-fold from controls before decreasing in mean concentration just prior to release. For 80 dph C. nebulosus, cortisol varied throughout handling, tagging and transport, first increasing more than three-fold compared with control C. nebulosus, before decreasing and rising slightly just prior to release. For 48 dph C. nebulosus within field enclosures, survival was high and similar for control and experimental groups; experimental C. nebulosus, however, were shorter, lighter and lower in condition than control C. nebulosus. For 80 dph C. nebulosus within field enclosures, fewer experimental C. nebulosus survived and those that did survive were of lower condition than C. nebulosus from the control group. Small untagged C. nebulosus may survive the release procedure better than larger C. nebulosus carrying a coded-wire tag. These findings document some ways in which pre-release practices may translate into detrimental effects on post-release success of HR C. nebulosus.
School’s Out: Lessons from a Forest Kindergarten: Lisa Molomot & Rona Richter. Linden Tree Films, 2013.

The documentary film, School’s Out: Lessons from a Forest Kindergarten, depicts Swiss kindergarteners, aged four to seven, in a Forest Kindergarten. Throughout the school year, regardless of the we...
Psychosocial factors associated with the uptake of contralateral prophylactic mastectomy among BRCA1/2 mutation noncarriers with newly diagnosed breast cancer

Women who are newly diagnosed with breast cancer may consider contralateral prophylactic mastectomy (CPM) to reduce their future risk of cancer in their unaffected breast. Pre-surgical BRCA1/2 genetic testing can provide valuable risk information to guide this choice. However, little is understood about why BRCA1/2 mutation noncarriers, who are generally not at substantially elevated risk of contralateral disease, select CPM. We examined the uptake of CPM among breast cancer patients identified as BRCA1/2 mutation noncarriers (n = 92) as part of a larger prospective study of the impact of pre-surgical BRCA1/2 testing. Data obtained from self-report questionnaires and patient medical records were used to examine associations between theoretically relevant background and psychosocial factors and BRCA1/2 mutation noncarriers’ decisions to undergo CPM. Among BRCA1/2 mutation noncarriers, 25% (n = 23) elected to undergo CPM. Psychosocial factors including a self-reported physician recommendation for CPM, greater perceived contralateral breast cancer risk, and greater perceived benefits of CPM were all significantly associated with the uptake of CPM. A sizeable minority of BRCA1/2 mutation noncarriers choose to undergo CPM after learning their mutation status through pre-surgical genetic testing. BRCA1/2 mutation noncarriers’ cognitive perceptions and social influences appear to be important in shaping their decisions regarding CPM. This work highlights the importance of several psychosocial factors in influencing patients’ surgical decisions. Future research is needed that examines the formation of BRCA1/2 mutation noncarriers’ beliefs regarding their disease and available treatment options, and that characterizes the physician-patient communication that occurs in this complex decision-making context.
Prospects for Chemicals and Fuels Production by Fermentation

The chemical industry or, more specifically, the organic chemical industry is characterized as a large volume converter of inexpensive feedstocks into both commodity and specialty chemical products. The chemical process industry, in 1981, produced over 175 billion pounds of organic chemicals which are primarily accounted for by the top 29 organics listed in Table 1 [1]. In addition, 22 inorganic chemicals accounted for 373 billion pounds of production. Total chemical sales for 1981 was $114 billion [1]. The primary feedstocks for the chemical industry are currently derived from petroleum and natural gas resources. It is interesting to consider the “typical” chemical process from a manufacturing cost point of view: 60–75% of the manufacturing costs are feedstock cost and 10–20% is capital-related. From Figure 1, which relates selling price to production volume, the price range for commodity chemicals is 10–50c/lb. The capital investment for construction of a new chemical plant is approximately $0.25–0.30 per annual pound of product produced. The expected capital spending in the chemical industry for 1982 is $14.7 billion [2], Over the period 1971 to 1981, the annual growth in organic chemicals production has proceeded at 4.5%.
Copper-oxide spinel absorber coatings for high-temperature concentrated solar power systems

Abstract Concentrated Solar Power (CSP), a promising renewable energy technology, involves methods to concentrate the sun's energy onto receiver systems that generate steam, activate turbines, and consequently generate electrical power. To ensure CSP technologies remain cost-competitive, absorber coatings on CSP receiver systems require performance enhancements for increasing solar-thermal energy conversion efficiency. In this work, black metal-oxide nanoparticles comprising copper-cobalt oxides ( Cu x Co 3 − x O 4 ) and copper-manganese oxides ( Cu x Mn 3 − x O 4 ) are synthesized for solar absorptive potential by hydrothermal syntheses – selected for low-cost, energy-efficient fabrication capable for bulk manufacturability. The material is deposited onto high-temperature, durable Inconel substrates by a flexible spray-coating method, and characterization is performed by Scanning Electron Microscopy (SEM), Energy-Dispersive X-Ray Spectroscopy (EDS), and X-Ray Powder Diffraction (XRD) analyses, as well as measurements to gauge thermal performance. High temperature stability of a model solar receiver surface using these synthesized materials are assessed by comparing spectral reflectance and a figure-of-merit efficiency metric before and after high temperature exposure beyond 1000 h. To extend spectrally-selective absorbance capability, the coating surfaces are geometrically-textured using sacrificial polymer beads that are jointly implemented in the spray-coating process. This study ultimately showcases materials produced with high figure-of-merit conversion efficiency, demonstrating solar absorber coatings capable of interfacing with next-generation CSP receiver systems.
Positive Paradigm Shifts in Health Care

The American health delivery system is undergoing enormous change. Some of the changes threaten the spiritual underpinnings of the hospital movement and discount theological insights into the nature of healing. This article identifies and advocates six health care paradigms that are grounded in the Judeo-Christian ethic.
Cancer vaccines: Dream, reality, or nightmare?

Over the past 30 years, a multidisciplinary approach com-bining surgery, chemotherapy, and radiation has led to a dramatic improvement in survival for patients affected by malignant diseases. Cellular therapies, such as stem cell transplantation, have also made a significant contribution. Nonetheless, many patients are still resistant to standard therapies, which also have high and often unacceptable acute and chronic organ toxicity, with an increased risk for secondary malignancies. Therefore new strategies are needed to improve overall survival and decrease treatment-asso-ciated morbidity. Immunotherapy represents one of the most appealing of these approaches, and active immunization in particular has proved to be amongst the most important of these new cellular strategies because of its ability to stimulate the immune system to actively recognize and kill the malignant cells. Identification of antigens expressed on tumor cells (Table 1), together with a better understanding of the molecular and cellular mechanisms involved in the immune response against cancer, have given investigators tools to manipulate the immune system to induce an efficient immune response in the tumor-bearing host [1-5]. The present review describes the approaches used in cancer vaccination that are intended not only to optimize antitu-mor immunity, but also to overcome tumor immune escape. Examples of how these approaches are being applied clinically are also given.
Assessors’ Language Awareness in the Evaluation of Academic Writing

To date, Language Awareness and the evaluation of academic writing have focused primarily on learners and how their awareness of language can help them achieve better results in their writing for the academy. Only secondarily have researchers asked how assessors’ awareness of language might affect evaluations of academic writing. Since ‘language awareness’ has been thought to raise’ sensitivity to and conscious awareness’ of language in action (van Lier, 1991, p. 532; citing Donmall, 1985), and since it has been seen as ‘a means to bridge the consciousness gap within the individual’ (James & Garrett, 1991, p. 5), one can consider research on writing assessors’ evaluation practices as an attempt to gauge assessors’ sensitivity and consciousness to language and its variation. To that end, the research in this area can be seen as attempts to answer the following questions: What factors influence writing assessors? How and why do these factors influence them? Are they aware of language and language variation? Are they aware of language’s effects on their judgements?
Feedback enhances greening during disaster recovery: A model of social and ecological processes in neighborhood scale investment

Abstract In disaster recovery situations, including the post-Katrina recovery in New Orleans, greening behavior (i.e., the planting of trees, flowers and other plants) is thought to play an important role in social, ecological and economic recovery. In this paper, we use agent-based modeling to investigate and understand the roles of green attachment (which encompasses place attachment and biophilia), engagement in local ecological investment (i.e., greening), and social feedback (where individuals who observe greening become more likely to engage in it). We model this social-ecological feedback process, basing our parameters and assumptions on real-world data and grounding our model in the Treme neighborhood of New Orleans. We find that social-ecological feedback enhances greening overall and leads to larger spatially continuous regions with high rates of greening. We also find that social-ecological feedback leads to tipping points in neighborhood greening, with approximately 30% of households needing to engage in greening for it to reach asymptotically high levels. In addition, when green attachment is high, this leads to more widespread greening behavior. We conclude that social-ecological feedback processes such as those modeled here may play important roles in neighborhood recovery after disasters such as Hurricane Katrina.
Benchmarking Performance for Migrating a Relational Application to a Parallel Implementation

Many organizations rely on relational database platforms for OLAP-style querying (aggregation and filtering) for small to medium size applications. We investigate the impact of scaling up the data sizes for such queries. We intend to illustrate what kind of performance results an organization could expect should they migrate current applications to big data environments. This paper benchmarks the performance of Hive [20], a parallel data warehouse platform that is a part of the Hadoop software stack. We set up a 4-node Hadoop cluster using Hortonworks HDP 1.3.2 [10]. We use the data generator provided by the TPC-DS benchmark [3] to generate data of different scales. We use a representative query provided in the TPC-DS query set and run the SQL and Hive Query Language (HiveQL) versions of the same query on a relational database installation (MySQL) and on the Hive cluster. We measure the speedup for query execution for all dataset sizes resulting from the scale up. Hive loads the large datasets faster than MySQL, while it is marginally slower than MySQL when loading the smaller datasets.
The Effect of Gastrocnemius Tightness on the Pathogenesis of Juvenile Hallux Valgus: A Preliminary Study

Hallux valgus is the most common foot disorder associated with gastrocnemius tightness, and there is a particularly strong association with juvenile hallux valgus. This article describes an oblique windlass mechanism that can be a causative or a contributory factor in the pathogenesis of juvenile hallux valgus. This article presents a study of 108 patients who underwent a proximal gastrocnemius release and hallux valgus correction using a scarf osteotomy. We believe that assessment of gastrocnemius tightness in juvenile hallux valgus is important and that gastrocnemius lengthening should be routinely considered as part of the operative strategy.
Celestial chaos: The new logics of theory-testing in orbital dynamics

Abstract I explore how the nature, scope, and limits of the knowledge obtained in orbital dynamics has changed in recent years. Innovations in the design of spacecraft trajectories, as well as in astronomy, have led to new logics of theory-testing—that is, new research methodologies—in orbital dynamics. These methodologies—which combine resonance overlap theories, numerical experiments, and the implementation of space missions—were developed in response to the discovery of chaotic dynamical systems in our solar system. In the past few decades, they have replaced the methodology that dominated orbital research in the centuries following Newton's Principia. As a result, the kind of knowledge achieved by orbital research has changed: we can know how orbiting bodies in chaotic systems behave, but only over sufficiently short time scales; and we can reliably measure those temporal limitations, using Lyapunov time.
The Architecture Of Safety: An Emerging Priority For Improving Patient Safety

There is a lack of awareness regarding the pervasive influence of the built environment on caregiving activities, and how its design could reduce risks for patients and providers. This article pres...
An Algorithm for Bounding the Probability of r-core Formation in k-uniform Random Hypergraphs.

We present an algorithm for bounding the probability of r-core formation in k-uniform hypergraphs. Understanding the probability of core formation is useful in numerous applications including bounds on the failure rate of Invertible Bloom Lookup Tables (IBLTs) and the probability that a boolean formula is satisfiable.
Cross-border antibiotic resistance patterns in trauma patients.

Abstract Background Antibiotic resistance is a growing problem worldwide, with differences in regional resistance patterns driven by variance in antibiotic stewardship. Hospitals along the United States-Mexico border increasingly identify resistance, raising concern for transfer of drug-resistant organisms across the border. Methods This retrospective review evaluated trauma admissions between March 2011 and August 2015. Patients were included if cultures were obtained during the first 3 days of hospitalization to limit analysis of hospital-acquired bacteria. A matched Mexico and US cohort subanalysis was later compared to eliminate bias in time from injury to culture. Results Among 115 Mexico and 1,149 US patients, Mexico patients were younger (mean 44.3 vs 60.4 years), had a higher median injury severity score (21 vs 10), and longer hospital durations of stay (mean 11.6 vs 5.5 days). These differences resolved in the matched analysis. Infections were more common in Mexico than US patients in the matched cohort, and resistant infections including resistant gram-negative infections were more common in Mexico patients in both the matched and overall cohorts. The only resistant organism identified in matched US patients was methicillin-resistant Staphylococcus aureus. Extended-spectrum β-lactamase Klebsiella was found only in patients from Mexico. Additional risk factors for resistance in the matched cohorts included injury in Mexico, ≥2 days from injury to admission, and tracheostomy placement in Mexico. Conclusion Antibiotic resistance is more common in patients initially treated in Mexico healthcare facilities than those treated exclusively in the United States and may require alternative empiric treatment. Global initiatives to improve antibiotic stewardship will be critical to limit the continued rise in drug-resistant infections.
Semi-analytical prediction of critical oil rate in naturally fractured reservoirs with water coning

Abstract Naturally fractured reservoirs (NFRs) with bottom water are generally produced above their critical oil rate (maximum possible oil production rate without water breakthrough) that is difficult to determine as it varies between wells, depending on the well's location in the fracture network. In principle, wells can either be completed in matrix or fractures. Present formulas of critical-rate in NFR are oversimplified ignoring the network heterogeneity and anisotropy ratio of fractures, and they also do not consider the difference between on-fracture/off-fracture well completion placements. Presented is development of a new semi-analytical formula that considers these effects– with emphasis given to well placement assessment. The critical rate model is derived from mechanistic principles and then improved with statistical calibration. The mechanistic approach (Chaperon (1986)) considers vertical equilibrium of viscous and gravity forces for a hemispherical flow to a point-source well in a dual porosity/dual permeability model of naturally fractured reservoirs. The model considers the water cone instability, and anisotropy ratio of NFR only for a short-perforated completion interval. The model is tested for wide variety of NFRs for short completions. The model is then statistically calibrated to including the effect of long penetration ratio, using a designed matrix of simulated experiments covering wide ranges of NFR properties. This statistical approach allows the model to consider any change in flow regime from semi-spherical to non-radial distorted flow. The comparison of Chaperon's analytical model and NFR simulations shows that the model is good for NFRs for penetration ratio smaller than 0.35. For penetration ratio greater than 0.35, a new semi-analytical model of critical-rate for NFR is developed by statistically calibrating the Chaperon's analytical model. The new model considers the parameters ignored in the previous models of NFR. Finally, a new mechanistic derivation of critical rate for wells completed in matrix block of NFR is determined by analytically including the effect of well's distance to fracture in a critical rate formula for NFR. The model matches well with the simulated data when compared with it. The model shows that the wells accidently completed off-fractures may display higher values of critical rates and the difference relates to their distance to the nearest fractures. It is also shown that the off-fracture well's formula reduces to the on-fracture well's formula when the distance is reduced to zero.
Catheter-Directed Pharmacologic Thrombolysis for Acute Submassive and Massive Pulmonary Emboli in Children and Adolescents-An Exploratory Report.

Objectives The objective of this study is to report a single-center experience of the safety and efficacy of pulmonary artery catheter-directed thrombolysis for both massive and submassive pulmonary emboli in the pediatric and adolescent population. Design A 22-month retrospective review of the electronic medical record and picture archiving and communication system was performed of patients less than 21 years old, presenting with massive or submassive pulmonary emboli treated with pulmonary artery catheter-directed thrombolysis at a single, tertiary care pediatric hospital. Multiple variables were analyzed including indications, technical success, clinical efficacy, and complications. Setting A single, tertiary care pediatric hospital. Patients Nine patients (mean 13.9 yr; range 6-19 yr) with massive and/or submassive pulmonary emboli who underwent pulmonary artery catheter-directed thrombolysis met inclusion criteria. Interventions Catheter-directed thrombolysis. Measurements and main results Pulmonary emboli was diagnosed by CT angiography in all cases. Catheter-directed thrombolysis alone was clinically successful (defined as improved cardiopulmonary function following catheter-directed thrombolysis) in seven patients (78%) with two patients not improving following catheter-directed thrombolysis. There were no immediate bleeding complications from catheter-directed thrombolysis therapy. All patients were maintained on anticoagulation treatment following catheter-directed thrombolysis. Catheter-directed thrombolysis was technically successful (defined as successful placement of pulmonary artery infusion catheters with full or partial resolution of thrombus) in all cases. Follow-up pulmonary angiography at the cessation of catheter-directed thrombolysis revealed complete thrombus resolution in four patients (44%) and partial resolution in five patients (55%). Mean pulmonary artery pressures decreased in all patients (mean precatheter-directed thrombolysis pulmonary artery pressure = 37 ± 11 mm Hg; mean postcatheter-directed thrombolysis pulmonary artery pressure = 28 ± 10 mm Hg; p = 0.0164). Conclusions Pulmonary artery catheter-directed thrombolysis is a technically feasible therapeutic option for children and adolescents with submassive and massive pulmonary emboli.
Diffusion Bonding of AgC–Cu Bi-layered Electrical Contacts

Due to the immiscibility of graphite in copper and silver, the conventional press and sinter method for fabrication of bi-layered silver graphite-copper electrical contacts are a challenging process. During sintering of silver graphite-copper compacts, silver diffuses into copper leaving a trace of graphite at the interface. This creates a poor interface between the mating surfaces, thereby decreasing the shear strength of the joint. In this work, interlayers with different compositions were used to promote diffusion bonding at various sintering conditions. The results show that vacuum diffusion bonding using an interlayer of Ag–Cu, with eutectic composition, is an effective method for fabricating the AgC–Cu bilayer electrical contacts.
Nephron Progenitor Maintenance Is Controlled through Fibroblast Growth Factors and Sprouty1 Interaction.

Background Nephron progenitor cells (NPCs) give rise to all segments of functional nephrons and are of great interest due to their potential as a source for novel treatment strategies for kidney disease. Fibroblast growth factor (FGF) signaling plays pivotal roles in generating and maintaining NPCs during kidney development, but little is known about the molecule(s) regulating FGF signaling during nephron development. Sprouty 1 (SPRY1) is an antagonist of receptor tyrosine kinases. Although SPRY1 antagonizes Ret-GDNF signaling, which modulates renal branching, its role in NPCs is not known. Methods Spry1, Fgf9, and Fgf20 compound mutant animals were used to evaluate kidney phenotypes in mice to understand whether SPRY1 modulates FGF signaling in NPCs and whether FGF8 functions with FGF9 and FGF20 in maintaining NPCs. Results Loss of one copy of Spry1 counters effects of the loss of Fgf9 and Fgf20, rescuing bilateral renal agenesis premature NPC differentiation, NPC proliferation, and cell death defects. In the absence of SPRY1, FGF9, and FGF20, another FGF ligand, FGF8, promotes nephrogenesis. Deleting both Fgf8 and Fgf20 results in kidney agenesis, defects in NPC proliferation, and cell death. Deleting one copy of Fgf8 reversed the effect of deleting one copy of Spry1, which rescued the renal agenesis due to loss of Fgf9 and Fgf20. Conclusions SPRY1 expressed in NPCs modulates the activity of FGF signaling and regulates NPC stemness. These findings indicate the importance of the balance between positive and negative signals during NPC maintenance.
Added value of small bowel transit scintigraphy for assessment of patients with symptoms of gastroparesis

428 Introduction: Patients with symptoms of gastroparesis often undergo assessment of gastric emptying(GE). Upper gastrointestinal(UGI) dyspeptic symptoms however are not well correlated with GE results. These patients may have small bowel(SB) motility abnormalities. The aims of this study were: 1)To determine the prevalence of delayed SB transit(SBT) in patients undergoing GE scintigraphy for symptoms of gastroparesis and 2)To determine what symptoms are associated with delayed SBT and to compare them to the symptoms seen with patients with delayed GE. Methods: From 12/22/2015 to 11/20/2019, 402 patients with symptoms of gastroparesis underwent a combined GE and SBT scintigraphy examination (GE/SBT) utilizing the current SNMMI practice guideline for GE/SBT(J Nucl Med.2013;54:2004-2013). Patients ingested a standardized mixed solid plus liquid meal consisting of liquid egg white labeled with 500 uCi Tc-99m sulfur colloid and two pieces of white-bread toast and jam. The liquid portion of the meal consisted of 125 uCi In-111 DTPA in 6 oz of water. Images of the abdomen were acquired in anterior and posterior projections for 6 hours to record solid(S) and liquid(L) GE and to measure SBT. From these images, decay-corrected geometric mean values of retained gastric activity for solids and liquids and the percent of total In-111 activity administered that had transited into the terminal ileum and/or cecum/colon at 6 hours were determined. Patient Assessment of Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM) was completed by patients to assess symptoms over the prior 2 weeks using a 0(none) to 5 (very severe) scale. Results: Excluded patients(n= 39) included those with prior GI surgery(n=30), marked delay in LGE(> 20% L gastric retention at 6 hrs)(n=4), and patient intolerance and/or incomplete imaging(n=5). Of the 363 patients with evaluable studies, 174 (47.9%) had delayed S GE (>60% gastric retention at 2 hours and/or >10% at 4 hours), 141(38.8%) had delayed L GE(> 50% retention at 1 hr), and 70(19.3%) had delayed SBT ( Conclusions: In this series of patients using GE/SBT scintigraphy to assess patients with UGI dyspeptic symptoms, overall delayed SBT occurred in 19% of patients. Isolated delay in L GE was only rarely associated with delayed SBT. Delayed SBT was more commonly associated with delayed S GE with(7.7%)or without delayed L GE(4.9%). SBT scintigraphy detected small bowel dysmotility as a potential cause of symptoms in 6.6% of patients with normal S GE. Delayed SBT was associated with increased severity of bloating, stomach visibly larger, and constipation, but decreased symptoms of nausea, vomiting. Using a top ranked symptoms based approach, these results suggest that nausea is more associated with delayed GE whereas bloating is more associated with delayed SBT. Based on these findings we conclude that SBT scintigraphy can augment GE studies and may help explain some of the symptoms associated with UGI dyspepsia and suspected gastroparesis.
Crowd-out 10 years later : Have recent public insurance expansions crowded out private health insurance?

Ten years ago, Cutler and Gruber [Cutler, D., Gruber, J., 1996. Does public health insurance crowdout private insurance? Quarterly Journal of Economics 111, 391-430] suggested that crowd-out might be quite large, but much subsequent research has questioned this conclusion. Our results using improved data and methods clearly show that crowd-out is still significant in the 1996-2002 period. This finding emerges most strongly when we consider family level measures of public insurance eligibility. We also find that recent anti-crowd-out provisions in public expansions may have had the opposite effect, lowering take-up by the uninsured faster than they lower crowd-out of private insurance.
Evolutionary divergence of potential drought adaptations between two subspecies of an annual plant: Are trait combinations facilitated, independent, or constrained?

PREMISE Whether drought-adaptation mechanisms tend to evolve together, evolve independently, or evolve constrained by genetic architecture is incompletely resolved, particularly for water-relations traits besides gas exchange. We addressed this issue in two subspecies of Clarkia xantiana (Onagraceae), California winter annuals that separated approximately 65,000 years ago and are adapted, partly by differences in flowering time, to native ranges differing in precipitation. METHODS In these subspecies and in recombinant inbred lines (RILs) from a cross between them, we scored traits related to drought adaptation (timing of seed germination and of flowering, succulence, pressure-volume curve variables) in common environments. RESULTS The subspecies native to more arid environments (parviflora) exhibited slower seed germination in saturated conditions, earlier flowering, and greater succulence, likely indicating superior drought avoidance, drought escape, and dehydration resistance via water storage. The other subspecies (xantiana) had lower osmotic potential at full turgor and lower water potential at turgor loss, implying superior dehydration tolerance. Genetic correlations among RILs suggest facilitated evolution of some trait combinations and independence of others. Where genetic correlations exist, subspecies differences fell along them, with the exception of differences in succulence and turgor loss point. In that case, subspecies difference overcame genetic correlations, possibly reflecting strong selection and/or antagonistic genetic correlations with other traits. CONCLUSIONS Clarkia xantiana subspecies' differ in multiple mechanisms of drought adaptation. Genetic architecture generally does not seem to have constrained the evolution of these mechanisms, and it may have facilitated the evolution of some of trait combinations.
Communication and Teamwork During Telemedicine-Enabled Stroke Care in an Ambulance:

ObjectiveThe purpose of this study is to understand the communication among care teams during telemedicine-enabled stroke consults in an ambulance.BackgroundTelemedicine can have a significant impa...
Homology spheres

An analysis of the homotopy type of spaces with the same homology as the sphere Sn (n>1) is given. All such spaces are constructed by means of algebraic “invariants” and a certain homology decomposition tower.
Enhancing instruction in mathematics and science in secondary schools: an innovative approach using remote sensing

As the age of educational reform begins the new millennium, years of educational reform in mathematics and science have not yielded anticipated results. The performance of students in the United States, compared to students in industrialized nations, demonstrates that American students are not acquiring the math and science knowledge and skills necessary to compete in a global economy. The Partnership Award, a collaborative initiative between Mississippi Valley State University and NASA, provides a unique solution to a multi-faceted problem. Pre-service and in-service teachers, working in rural Empowerment Zones and Enterprise Communities (EZ/EC), are provided with opportunities to acquire specialized training in math and science instruction with hands-on activities included in the Global Learning and Observations to Benefit the Environment (GLOBE) Program. The resources of NASA, especially remote sensing, are utilized to enhance curriculum and to increase student performance on standardized tests.
Cultural Estimation of Yeasts on Seaweeds

Five per cent suspensions of freshly harvested seaweeds were used as an inoculum to develop a selective medium for epiphytic yeasts. Conditions for satisfactory yeast growth and visualization as red colonies on membrane filters were obtained by supplementing a basal glucose-Trypticase-yeast extract-agar at pH 7.0 with 100 mg each of chloramphenicol and 2,3,5-triphenyl tetrazolium chloride per liter. Maximal counts were obtained by triturating the algae in prechilled (4 C) seawater with a blender for 2 to 5 min. Inhibitory phenolic materials released from phaeophytes during this process were removed with a modified Cholodny filtration. A preliminary survey indicated that yeasts were epiphytic on all nine species of seaweeds and that maximal populations occurred on the chlorophytes and rhodophytes especially during the periods of warmer water.