cssi/SciSciGPT-SciSciNet huggingface dataset:
Modern radiation treatment planning and delivery--from Röntgen to real time.

The field of radiation oncology has advanced exponentially since the discovery of X-rays just over 100 years ago. With the advent of three-dimensional treatment planning, the therapeutic index was improved by more accurate shielding of normal tissues which allowed dose escalation and more accurate shielding of normal tissues. Now even greater advances are under way with intensity-modulated radiotherapy, image-guided radiation therapy, delineation and control of organ motion, and real-time imaging. The use of particle therapies such as protons has the potential to achieve even more accurate conformal dose distributions. Clinical studies investigating these modalities appear likely to increase the efficacy of radiation in the years to come.
Meiotic state of bovine oocytes is regulated by interactions between cAMP, cumulus, and granulosa.

Bovine oocytes are arrested at the prophase of first meiotic cell cycle. Meiosis resumes in oocytes of pre-ovulatory follicles upon LH surge. However, oocytes from secondary follicles spontaneously resume meiosis in the absence of hormones if removed from the follicle and cultured in vitro. The nature of meiotic arrestor in bovine follicles is poorly understood. In this study we investigated the role of cell–cell interactions between granulosa and cumulus cells and the oocyte in mediating maintenance of meiotic arrest by cAMP. We sorted oocytes as granulosa–cumulus oocyte complexes (GCOC) if surrounded with cumulus cells attached to a large granulosa investment or cumulus oocytes complexes (COC) if surrounded with cumulus cells only and investigated the role cAMP in maintenance of meiotic arrest in these oocytes under various conditions. In hormone- and serum-free medium both GCOC and COC enclosed oocytes resumed meiosis. When [cAMP]i was elevated with addition of invasive adenylate cyclase (iAC) GCOC enclosed oocytes were maintained in the prophase with intact germinal vesicle (GV) while COC enclosed oocytes underwent GV breakdown (GVBD). iAC elevated [cAMP]i in both types of oocytes to the same level. If oocytes were liberated from the cumulus and granulosa cells, they re-initiated meiosis in serum and hormone free medium, but remained in the GV stage if iAC was added to the medium. Untreated GCOC and COC enclosed oocytes extruded first polar body at the same frequency in hormone-supplemented media. GCOC and COC enclosed oocytes but not denuded oocytes (DO) cultured without somatic cells acquired developmental competence if cultured in hormone-containing medium. It is concluded that maintenance of meiotic arrest is regulated by the interplay of [cAMP]i, and cumulus and granulosa cells. Mol. Reprod. Dev. 65: 336–343, 2003. © 2003 Wiley-Liss, Inc.
Serotonin Transporter Promoter Polymorphism Genotype Is Associated With Behavioral Disinhibition and Negative Affect in Children of Alcoholics

Background: Serotonergic (5-HT) dysfunction has been implicated in the etiology of both behavioral disinhibition (BD) and negative affect (NA). This work extends our previous finding of relationships between whole blood 5-HT and both BD and NA in pubescent, but not prepubescent, children of alcoholics and continues examination of a hypothesized role of 5-HT dysfunction in alcoholism risk. The long and short (L and S) variants of the 5-HT transporter gene-linked polymorphic region (5-HTTLPR) are responsible for differing transcriptional efficiencies in 5-HT uptake. Although associations have been found between the SS 5-HTTLPR genotype and severe alcoholism and neuroticism, recent reports describe relationships between the LL genotype and both low level of response to alcohol and alcoholism diagnosis and a predominance of the LL genotype in early-onset alcoholics. Methods: This report is from an ongoing prospective study of the development of risk for alcoholism and other problematic outcomes in a sample of families classified by father’s alcoholism subtype. This study examines relationships between 5-HTTLPR genotype and both child BD (Child Behavior Checklist Aggressive Behavior) and NA (Child Behavior Checklist Anxious/Depressed) in offspring from 47 families. Results: Results showed significantly higher levels of BD and NA in the 16 children with the LL genotype than the 46 SS or SL children. Conclusions: Behaviors of undercontrol, which occur at increased rates in children of alcoholics, may be genetically influenced through the regulation of the 5-HT transporter. Due to the small sample size and the
Experiencing Interpersonal Violence Perspectives of Sexually Active, Substance-Using Women Living in Shelters and Low-Income Housing

As part of a larger study, the authors investigated experiences of recent violence among sexually active, substance-using women. Structured interviews were conducted with 172 women living in shelters and low-income housing, 41 of whom also completed an in-depth interview on their worst violent episode. Structured interviews indicated that rape and self-blame were more common among sheltered women. In-depth interviews suggested that sheltered women were vulnerable to instrumental aggression from a range of perpetrators, whereas housed women tended to experience hostile partner aggression. Intoxication during the violent episodes was more common among sheltered women. Implications for violence prevention and treatment services are discussed.
Radiation Evaluation of Ferroelectric Random Access Memory Embedded in 180nm CMOS Technology

Radiation and Temperature Characterization results of a 2T-2C ferroelectric random access memory (FRAM) are presented. This includes Total Ionizing Dose (TID), Single Event Effects (SEE) and Temperature evaluation at 215 oC.
Do global food systems have an Achilles heel? The potential for regional food systems to support resilience in regional disasters

Today’s domestic US food production is the result of an industry optimized for competitive, high yielding, and high-growth production for a globalized market. Yet, industry growth may weaken food system resilience to abrupt disruptions by reducing the diversity of food supply sources. In this paper, we first explore shifts in food consumption toward reliance upon complex and long-distance food distribution, food imports, and out-of-home eating. Second, we discuss how large-scale, rapid-onset hazards may affect food access for both food secure and insecure households. We then consider whether and how regional food production might support regional food resilience. To illustrate these issues, we examine the case of western Washington, a region not only rich in agricultural production but also threatened by a Cascadia Subduction Zone earthquake and tsunami. Such an event is expected to disrupt transportation and energy systems on which the dominant food distribution system relies. Whether a regional food supply—for the purposes of this paper, defined as food production in one or adjacent watersheds—can support a broader goal of community food resilience during large-scale disruption is a key theme of our paper. The discussion that ensues is not meant to offer simplistic, localist solutions as the one answer to disaster food provision, but neither should regional food sources be dismissed in food planning processes. Our exploration of regional farm production, small in scale and flexible, suggests regional production can help support food security prior to the arrival of emergency relief and retail restocking. Yet in order to do so, we need to have in place a robust and regionally appropriate food resilience strategy. This strategy should address caloric need, storage, and distribution, and, in so doing, rebalance our dependence on food supplied through imports and complex, domestic supply chains. Clearly, diversity of food sourcing can add redundancy and flexibility, allowing more nimble food system adaptation in the face of disruption.
Windsor's Push Toward Universal Interstate Recognition of Same-Sex Marriages

In June 2013, the United States Supreme Court issued its landmark decision in United States v. Windsor. The ruling overturned Section 3 of the federal Defense of Marriage Act and paved the way for federal recognition of same sex marriages. But the impact of the ruling quickly extended beyond its particular holding. Less than one month later, a federal district court judge decided the matter of Obergefell v. Kasich. The Obergefell ruling effectively compels the state of Ohio, which has constitutional and statutory bans on same sex marriages, to recognize the marriage of two Ohio men who recently married in Maryland, where same sex marriages are legal. Relying on the Windsor ruling, the district court judge reasoned that equal protection of the laws requires such a result.This note will explore how the Windsor ruling is changing the legal framework regarding interstate recognition of same sex marriages. Using the district court's decision in Obergefell as a model, this note will examine how the equal protection analysis applied by the Supreme Court in Windsor encourages states to reconsider policies that prohibit recognition of same sex marriages entered into in states or countries where such marriages are legal. The note will explore how the Windsor and Obergefell rulings, by applying the constitutional principle of equal protection of the laws to the same sex marriage issue, lead ultimately to the conclusion that states must recognize valid same sex marriages from foreign jurisdictions, even if they choose not to allow same sex marriages to be entered into on their own soil.
Development and thermal properties of carbon nanotube-polymer composites

Abstract The favorable conductive properties of carbon nanotubes (CNTs) offer opportunities for constructing CNT-based nanocomposites with improved thermal conduction for a range of potential applications. Such lightweight composite materials are expected to have thermal properties that depend on their CNT volume fraction and operating temperature. The lack of available CNT processing methods that are compatible with multi-laminated composite structures is one of the largest challenges facing the construction of CNT-based nanocomposites. The aim of the work is to develop enhanced thermal properties in carbon nanotube-polymer composites that can replace traditional aerospace metallic materials to reduce the weight in space structures. Dispersing the carbon nanotube onto prepreg composite structure, increases the thermal storage, increases the thermal transport and supports scientific instrumentation. The investigated composites were processed and characterized using Raman spectroscopy, thermogravimetric analysis, thermal diffusivity and differential scanning calorimetry. Through varying the concentration of single-walled carbon nanotubes (SWCNTs) up to 30 wt% to the IM7 prepreg composite, its heat capacity increased as much as 30% greater than the tested temperature range and its through-thickness thermal diffusivity increased by 30% compared to the virgin composite material. The addition of randomly oriented SWCNTs yielded an increase in the in-plane thermal conductivity ranging from 120 to 150 percent greater than the temperature range of 120–470 K and 30% in the through thickness. This may be due to interfacial resistance between the SWCNTs, the 8552 epoxy and the IM7 composite. The developed methods provide the opportunity for enhancing the thermal properties of a composite through the use of CNTs as additives. These improvements would be particularly beneficial applications such as solar arrays, fairings and thermal radiators.
Femtosecond 2D fourier transform study of electronic reorientation in silicon naphthalocyanine

26 fs excitation of a doubly degenerate transition in a molecule with square symmetry yielded a ~200 fs pump-probe anisotropy decay from 0.40(1) to 0.11(1). 2D spectra probe this rapid reorientation of the electronic wavefunction.
Stress-dependent ultrasonic scattering in polycrystalline materials

Stress-dependent elastic moduli of polycrystalline materials are used in a statistically based model for the scattering of ultrasonic waves from randomly oriented grains that are members of a stressed polycrystal. The stress is assumed to be homogeneous and can be either residual or generated from external loads. The stress-dependent elastic properties are incorporated into the definition of the differential scattering cross-section, which defines how strongly an incident wave is scattered into various directions. Nine stress-dependent differential scattering cross-sections or scattering coefficients are defined to include all possibilities of incident and scattered waves, which can be either longitudinal or (two) transverse wave types. The evaluation of the scattering coefficients considers polycrystalline aluminum that is uniaxially stressed. An analysis of the influence of incident wave propagation direction, scattering direction, frequency, and grain size on the stress-dependency of the scattering coefficients follows. Scattering coefficients for aluminum indicate that ultrasonic scattering is much more sensitive to a uniaxial stress than ultrasonic phase velocities. By developing the stress-dependent scattering properties of polycrystals, the influence of acoustoelasticity on the amplitudes of waves propagating in stressed polycrystalline materials can be better understood. This work supports the ongoing development of a technique for monitoring and measuring stresses in metallic materials.
Experimental and Computational Evaluation of Out-of-Autoclave Adhesively Bonded Repairs on Carbon/Epoxy Fuselage Skin

The manufacturing and mechanical testing of the pultruded rod stitched efficient unitized structure (PRSEUS) Multi-Bay Box (MBB) test article is a major milestone for the National Aeronautics and Space Administration (NASA) Environmentally Responsible Aviation Project. The MBB test article contains eleven large out-of-autoclave cured carbon/epoxy stiffened panels built using the PRSEUS concept. During the manufacture of the first PRSEUS MBB panel, a series of grooves were unintentionally cured into the outer mold line of the skin of the stiffened panel. A series of repair concepts were considered with the goal of evaluating whether the panel would successfully carry the full design capability loads. The repair concept involves filling the grooves with a paste adhesive, sanding the cured adhesive flush, and secondarily bonding a pre-cured external doubler onto the skin with a film adhesive. Researchers at The Boeing Company and NASA Langley Research Center carried out series of experimental and computational evaluations of the MBB panel repair concept. The experimentally evaluated specimens had two different skin thicknesses for the doubler and two film adhesive materials. The specimens were loaded to failure in tension and four-point bending tests. For each specimen and loading configurations considered, interlaminar delamination in the repaired skin was the primary failure mechanism. Finite element analyses were performed to model the tension and four-point bending repair specimens to gain a greater understanding of the failure processes involved.
Dihydroergotamine-induced vasospastic angina in a patient taking a calcium channel blocker.

Objective To report a probable case of vasospastic angina after administration of dihydroergotamine mesylate in a patient without coronary artery disease. Case summary A 49-year-old woman with relapsing/remitting multiple sclerosis was admitted for severe headache and pain crisis. She received a single dose of intravenous dihydroergotamine and, within 30 minutes, experienced chest pain, nausea, and vomiting. No changes on electrocardiogram were noted, but cardiac enzyme levels were elevated. Brief episodes of chest pain persisted for several days and resolved spontaneously before the woman's discharge. She had several cardiac risk factors, including cigarette smoking, hypertension, and a family history of coronary artery disease, but cardiac catheterization on hospital day 5 revealed no underlying coronary artery disease. Discussion Although cardiovascular adverse reactions have been reported with ergotamine tartrate, dihydroergotamine has rarely been linked with such reactions, including coronary vasospasm and myocardial infarction. Prescribing information for dihydroergotamine cautions against its use in patients with coronary artery disease or risk factors for underlying coronary artery disease without a cardiac workup before initiation of therapy. This patient had several cardiac risk factors, but cardiac catheterization revealed no underlying coronary artery disease. Concomitant verapamil therapy for hypertension did not prevent the vasospastic effects of dihydroergotamine. The Naranjo probability scale revealed a probable adverse reaction of vasospastic angina associated with dihydroergotamine. Conclusions Health-care professionals should be aware of the possibility for vasospastic angina in patients receiving dihydroergotamine who have no underlying coronary artery disease. Prescribing information should be closely followed.
Experimental Research on the Mechanical Equpiment Status Monitoring and Diagnosis

Scientific proof was provided for the modern management of a dockyard through experimental research on the trend analysis of the pivotal equipment in the dockyard, which can guarantee the operation reliability and safety.
Open Retromuscular Ventral Hernia Repair

Large ventral and incisional hernias are challenging procedures often associated with significant morbidity and high risks of recurrence. While there are a variety of options available for the repair of these hernias, this chapter will focus on the open retromuscular technique for Ventral Hernia repairs.
Experimental reduction of miR-92a mimics arterial aging

MicroRNAs (miRs) are small non-coding RNAs that are important regulators of aging and cardiovascular diseases. MiR-92a is important in developmental vascular growth and tumorigenesis and two of its putative targets, tumor necrosis factor alpha receptor 1 (TNFR1) and collagen type 1, play a role in age-related arterial dysfunction. We hypothesized that reduced miR-92a expression contributes to age-related arterial dysfunction characterized by endothelial dysfunction and increased large artery stiffness. MiR-92a is reduced 39% (RT-PCR, p<0.05) in arteries of older adults compared to young adults. Similarly, there was a 40% reduction in miR-92a in aortas of old (29months, n=13) compared to young (6months, n=11) B6D2F1 mice, an established model of vascular aging. To determine if reduced miR-92a contributes to arterial dysfunction; miR-92a was inhibited in vivo in young mice using antagomirs (I.P., 4wks). Antagomir treatment was associated with a concomitant 48% increase in TNFR1 (Western blot, p<0.05), 19% increase in type 1 collagen (immunohistochemistry, p<0.01), and a reduction in endothelial dependent dilation (max dilation: 93±1 vs. 73±5%, p<0.01) in response to acetylcholine (ACh, 10(-9) to 10(-4)M). Treatment with the nitric oxide (NO) synthase inhibitor, L-NAME (10(-4)M), revealed that impaired ACh dilation after antagomir treatment resulted from reduced NO bioavailability. Inhibition of miR-92a also increased arterial stiffness (pulse wave velocity, 309±13 vs. 484±52cm/s, p<0.05). Together, these results suggest that experimental reductions in arterial miR-92a partially mimic the arterial aging phenotype and we speculate that modulating miR-92a may provide a therapeutic strategy to improve age-related arterial dysfunction.
Review of Experimental Compounds Demonstrating Anti-Toxoplasma Activity

Toxoplasma gondii is a ubiquitous apicomplexan parasite capable of infecting humans and other animals. Current treatment options for T. gondii infection are limited and most have drawbacks, including high toxicity and low tolerability. Additionally, no FDA-approved treatments are available for pregnant women, a high-risk population due to transplacental infection. Therefore, the development of novel treatment options is needed. To aid this effort, this review highlights experimental compounds that, at a minimum, demonstrate inhibition of in vitro growth of T. gondii When available, host cell toxicity and in vivo data are also discussed. The purpose of this review is to facilitate additional development of anti-Toxoplasma compounds and potentially to extend our knowledge of the parasite.
In the Pursuit of Absence: Reimagining Early Loss within the Psychotherapy Relationship

In this paper I examine absence—absence as an internal relationship, absence as an enactment, absences characteristic of psychotherapy, absence as a theory, and absence as something people do to each other, including patients, therapists, families, and societies. To illustrate these ideas, I discuss my work with Gemma. When absence enters our relationship in a very present way, the powerful emotions that absence eludes come alive for us. Forced to confront my own absences, I begin doing a better job of holding her in mind, which ultimately helps her to hold me in mind and make better use of me.
253. Expanded Packaging Capacity of AAV by Lumenal Charge Alteration

Adeno-associated virus (AAV) is widely believed to be the safest viral vector for gene therapy. Moreover, the array of AAV serotypes available allows transduction of different tissues in vivo. However, one major limitation of AAV is the relatively small DNA packaging size (4,700 nt). Existing serotypes have been over-packaged with limited success and varying reproducibility. The consensus appears to be that AAV can be over packaged by ~10%, but with a concomitant reduction in both viral titers and in vivo transduction.We have taken a novel approach to increase the packaging limitations of AAV by focusing on the lumen of AAV where vector DNA interacts with the capsid. We have created a series of AAV capsid variants that alter the capsid lumenal charge using AAV-DJ as the scaffold. The variants add positively charged lysine and arginine residues at lumenally exposed sites within the capsid that, we believe, may allow for interaction and condensation of vector DNA increasing the packaging capacity and/or stabilizing the capsid in an over-packaged state. We present in vitro characterization of the library of capsid variants and demonstrate that variants with intermediate charge (+4 to +7 over wildtype) can be produced at high titer when over-packaged up to 6.2 kb. In addition, these variants can transduce HEK293 cells with a 5.6 kb length vector better than wildtype. Finally, these variants can completely encapsidate at least a 5.4 kb vector by alkaline Southern blot. To validate that these new vectors are functional, we establish that a subset of these vectors are still able to transduce mouse liver in vivo. We are currently establishing the relative transduction efficiencies using standard length and expanded genome sizes in order to establish the maximal DNA length that can be functionally packaged by these new vectors. We believe our capsid alteration strategy can be extrapolated to other serotypes with distinct tissue tropism and applied in vivo to treat hemophilia A and other monogenic disorders suitable to replacement therapy.
Introduction: The Ethical Turn in African Literature

Eze offers a profound introduction to the recent emphasis on the ethical in African literary and cultural discourses. Contemporary African women writers are no longer interested in writing back to the Empire; they write back to their bodies. In narrating stories of women incapacitated by the ideologies of tradition and patriarchy, the writers demand that women be treated as ends, not as means to men’s ends. Eze proposes feminist empathy as a theoretical tool for understanding the writers’ works. Feminist empathy is the ability to feel oneself into the experience of a woman in unwarranted suffering, that is, suffering that resulted due to no fault of her own. Eze argues that these writings enact ways of being human; they script human rights.
Vasculitides, Vasculopathies, and Neutrophilic Infiltrates

Alterations in dermal blood vessels occur as primary cutaneous disorders and more frequently as a manifestation of a systemic process. Inflammation of vessel walls can occur within capillaries, post-capillary venules or cutaneous arteries and at all levels of the dermis and subcutis. The inflammatory infiltrate can be neutrophil-mediated, or less commonly lymphocytic or granulomatous. Another spectrum of vasculopathic disease involves widespread vascular occlusion in the absence of an inflammatory infiltrate. Diffuse neutrophilic infiltrates may occur in the dermis unrelated to blood vessels.
Refundable Deposits as Enforcement Mechanisms in Cooperative Agreements: Experimental Evidence with Uncertainty and Non-deterrent Sanctions

Refundable Deposits as Enforcement Mechanisms in Cooperative Agreements: Experimental Evidence with Uncertainty and Non-deterrent Sanctions
An evaluation of the pharmacotherapy for interstitial cystitis.

Introduction: Interstitial cystitis (IC) and bladder pain syndrome (BPS) are chronic conditions that can be debilitating for patients. There is no consensus as to their etiology, and there are many...
An information security ethics education model

This paper proposes a model for teaching information assurance ethics. The model is composed of four dimensions: the moral development dimension; the ethical dimension; the security dimension; and the solutions dimension. The ethical dimension explores the ethical ramifications of a topic from a variety of perspectives. The security dimension includes ways in which an information assurance topic manifests to information assurance professionals. The solutions dimension focuses on remedies that individuals, groups of individuals and society have created to address security problems and associated ethical dilemmas. The moral development dimension describes the stages and transitions that humans experience as they develop morally, as they develop their own personal beliefs and behaviors about right and wrong.
Unified Positivism Philosophy for the Revolution to Unity

Psychology has had a major aim of making its purview of study into a science. The natural sciences were to be the model, with logical positivism (until recently) describing that model. But the natural sciences solved the central problem of disunity faced by all sciences before there was a logical positivism to describe what was involved. This model thus provided no understanding of how a science acquires unity and no analysis of the special characteristics that psychology and the other behavioral sciences possess as modern disunified sciences.
Psychosocial Evaluation and Management of Weight Loss Surgery Patients

There has been an alarming increase in obesity rates in the USA, other industrialized countries, and even in developing countries in the last few decades. Obesity-related diseases including hypertension, hyperlipidemia, and cardiovascular disease have also been on the rise with their associated costs. Weight loss surgery (WLS) is one of the few effective and durable treatment options for obesity, reducing morbidity and mortality associated with obesity as well as complications. As a part of their preparation for WLS, patients are required to have a psychosocial evaluation, but there is significant variability in the structure of this evaluation and in the credentialing and training of the clinicians performing this evaluation. Presurgical psychological evaluation could guide the patient and the WLS program to achieve the desired goal of weight loss, thus improving the patient’s medical and psychological well-being. This chapter summarizes the current WLS procedures and trends in their utilization and describes domains of the pre-WLS psychological evaluation and post-WLS psychopharmacology to optimize psychiatric care of WLS patients.
Clinician Perspectives on the Benefits of Practice Facilitation for Small Primary Care Practices

PURPOSE Small independent primary care practices (SIPs) often lack the resources to implement system changes. HealthyHearts NYC, funded through the EvidenceNOW initiative of the Agency for Healthcare Research and Quality, studied the effectiveness of practice facilitation to improve cardiovascular disease– related care in 257 SIPs. We sought to understand SIP clinicians’ perspectives on the benefits of practice facilitation. METHODS We conducted in-depth interviews with 19 SIP clinicians enrolled in HealthyHearts NYC. Interviews were transcribed and coded using deductive and inductive approaches. To understand whether the perceived benefits of practice facilitation differ based on the availability of internal staff for quality improvement (QI), we compared themes pertaining to benefits between practices with 3 or fewer office staff vs more than 3 office staff. RESULTS Clinicians perceived 2 main benefits of practice facilitation. First, facilitators served as a connection to the external health care environment for SIPs, often through teaching and information sharing. Second, facilitators provided electronic health record (EHR)/data expertise, often by teaching functionality and completing technical assistance and tasks. SIPs with more than 3 office staff felt that facilitators provided benefits primarily through teaching, whereas SIPs with 3 or fewer staff felt that facilitators also provided hands-on support. At the intersections of these benefits, there emerged 3 central practice facilitation benefits: (1) creating awareness of quality gaps, (2) connecting practices to information, resources, and strategies, and (3) optimizing the EHR for QI goals. CONCLUSIONS SIP clinicians perceived practice facilitation to be an important resource for connecting their practice to the external health care environment and resources, and helping their practice build QI capacity through teaching, hands-on support, and EHR-driven solutions.
Impact of a Standardized Clinical Pathway for Suspected and Confirmed Ileocolic Intussusception.

Introduction Clinical pathways for specific diagnoses may improve patient outcomes, decrease resource utilization, and diminish costs. This study examines the impact of a clinical pathway for emergency department (ED) care of suspected and confirmed pediatric ileocolic intussusception. Methods Our multidisciplinary team designed an intussusception clinical pathway and implemented it in a tertiary children's hospital ED in October 2016. Process measures included the proportion of patients who underwent abdominal radiography, had laboratory studies, received antibiotics, or required admission following reduction of intussusception. The primary outcome measure was the cost per encounter. Balancing measures included unplanned ED visits within 72 hours of discharge. Data analyzed compared 24 months before and 21 months following pathway implementation. Results After pathway implementation, the use of abdominal radiography in patients with suspected intussusception decreased from 50% to 12%. In patients with confirmed intussusception, laboratory studies decreased from 58% to 25%, antibiotic use decreased from 100% to 2%, and hospital admissions decreased from 100% to 12%. The average cost per encounter for confirmed intussusception decreased from $6,724 to $2,975. There was a small increase in unplanned returns to the ED within 72 hours but no increase in readmissions after pathway implementation. Conclusion Implementation of a standardized ED pathway for the management of suspected and confirmed pediatric ileocolic intussusception is associated with a reduction in abdominal radiographs, improved antibiotic stewardship, reduction in laboratory studies, fewer inpatient admissions, and decreased cost, with no compromise in patient safety.
Binding of the synaptic vesicle radiotracer [11C]UCB-J is unchanged during functional brain activation using a visual stimulation task.

The positron emission tomography radioligand [11C]UCB-J binds to synaptic vesicle glycoprotein 2 A (SV2A), a regulator of vesicle release. Increased neuronal firing could potentially affect tracer ...
A theoretical model of contraceptive decision‐making and behaviour in diabetes: A qualitative application of the Health Belief Model

Aim People with diabetes have contraceptive needs that have been inadequately addressed. The aim of this qualitative study was to develop a theoretical model that reflects contraceptive decision-making and behaviour in the setting of diabetes mellitus. Methods We conducted semi-structured, qualitative interviews of 17 women with type 1 or type 2 diabetes from Michigan, USA. Participants were recruited from a diabetes registry and local clinics. We adapted domains from the Health Belief Model (HBM) and applied reproductive justice principles to inform the qualitative data collection and analysis. Using an iterative coding template, we advanced from descriptive to theoretical codes, compared codes across characteristics of interest (e.g. diabetes type), and synthesized the theoretical codes and their relationships in an explanatory model. Results The final model included the following constructs and themes: perceived barriers and benefits to contraceptive use (effects on blood sugar, risk of diabetes-related complications, improved quality of life); perceived seriousness of pregnancy (harm to self, harm to foetus or baby); perceived susceptibility to pregnancy risks (diabetes is a 'high risk' state); external cues to action (one-size-fits-all/anxiety-provoking counselling vs. personalized/trust-based counselling); internal cues to action (self-perceived 'sickness'); self-efficacy (reproductive self-efficacy, contraceptive self-efficacy); and modifying factors (perceptions of biased counselling based upon one's age, race or severity of disease). Conclusions This novel adaptation of the HBM highlights the need for condition-specific and person-centred contraceptive counselling for those with diabetes.
Low Dose Ketamine Infusion for Comorbid Posttraumatic Stress Disorder and Chronic Pain: A Randomized Double-Blind Clinical Trial.

ObjectiveTo date, treatment options (i.e. psychotherapy, antidepressant medications) for patients with posttraumatic stress disorder (PTSD), are relatively few, and considering their limited effica...
Lithium-based polyanion oxide cathodes

Polyanion oxide cathodes offer better thermal stability and safety than transition-metal oxide cathodes, and their cell voltages are also higher than those of the oxide analogues with the same redox couple. Lithium iron phosphate is the first commercialized polyanion cathode for lithium-ion batteries.
Advances in the treatment of gastric cancer: 2020-2021.

Purpose of review To review studies from 2020 to 2021 in esophagogastric cancer. Recent findings After up front D2 gastrectomy for lymph node-positive gastric cancer, 6 months of adjuvant chemotherapy with S-1 and oxaliplatin achieved superior disease-free survival (DFS) compared with 1 year of S-1. The addition of adjuvant radiotherapy, however, added no benefit. After chemoradiotherapy and surgery in esophageal and gastroesophageal junction cancer, in patients with residual disease found at surgery, 1 year of adjuvant nivolumab substantially improved DFS compared with observation alone, leading to regulatory approval for adjuvant nivolumab. In metastatic esophagogastric cancer, the addition of either pembrolizumab or nivolumab to first-line chemotherapy improved response, disease free, and overall survival with the greatest survival benefit dependent on programmed death receptor ligand, programmed death receptor ligand -1 status, leading to regulatory approval for these agents. A preliminary report of a phase 3 trial adding pembrolizumab to first-line chemotherapy with trastuzumab in HER2-positive gastric cancer reported a significant improvement in response, leading to regulatory approval for pembrolizumab. The fibroblast growth factor receptor appears to be a promising new target in gastroesophageal cancer based on phase 2 data for bemarituzumab. Summary Optimal adjuvant chemotherapy after D2 resection of node-positive gastric cancer is 6 months of a fluorinated pyrimidine and oxaliplatin, with no benefit for adjuvant radiotherapy. Adjuvant nivolumab after resection of esophageal cancer after chemoradiotherapy improves DFS and is a new care standard. Pembrolizumab added to first-line chemotherapy in both HER2-positive and negative esophagogastric cancer improves outcome and is a new standard of care. Nivolumab added to first-line chemotherapy in HER2-negative gastric cancer improves treatment outcome and is a new care standard.
Adolescent and Parent Perceptions of Telehealth Visits: A Mixed-Methods Study

Abstract Purpose Telehealth presents unique benefits and challenges for adolescents and their parents. This study aimed to explore adolescent and parent perceptions of privacy, confidentiality, and therapeutic alliance during telehealth video visits. Methods This was a cross-sectional convergent parallel mixed-methods study. English-speaking parents and 13- to 17-year-old adolescents who completed a video visit at eight academic-affiliated pediatric primary care practices in the Southeastern U.S. were recruited between September 2020 and January 2021. Online surveys were administered and analyzed using descriptive and bivariable analysis. Subsequent semi-structured qualitative interviews were conducted and analyzed using thematic analysis. Results Forty-eight adolescents and 104 parents completed surveys. Fourteen adolescents and 20 parents were interviewed. Mean ages of adolescents and parents were 15 and 46 years, respectively, and most participants identified as female, non-Hispanic, and white. Seventy-seven percent of adolescents reported very private telehealth visits. Most privacy concerns were related to the location of the visit in the patient's home or family members overhearing. Adolescents reported that alone time with their provider increased comfort in discussing sensitive issues, although only 31% of adolescents reported having time alone with their provider during their telehealth visit. Neither adolescents nor parents reported concerns about confidentiality. Interviews suggested that adolescent autonomy and independence in accessing health care may explain the positive relationship observed between therapeutic alliance and privacy. Conclusions Adolescents and parents describe telehealth as convenient, useful, private, and confidential. Providers should strive to maximize privacy and the therapeutic alliance during video visits, including encouraging alone time and supporting adolescent autonomy and independence.
Spatiotemporal Expression and Functional Analysis of miRNA-22 in the Developing Secondary Palate.

Objective Normal development of the embryonic orofacial region requires precise spatiotemporal coordination between numerous genes. MicroRNAs represent small, single-stranded, non-coding molecules that regulate gene expression. This study examines the role of microRNA-22 (miR-22) in murine orofacial ontogeny. Methods Spatiotemporal and differential expression of miR-22 (mmu-miR-22-3p) within the developing secondary palate was determined by in situ hybridization and quantitative real-time PCR, respectively. Bioinformatic approaches were used to predict potential mRNA targets of miR-22 and analyze their association with cellular functions indispensable for normal orofacial ontogeny. An in vitro palate organ culture system was used to assess the role of miR-22 in secondary palate development. Results There was a progressive increase in miR-22 expression from GD12.5 to GD14.5 in palatal processes. On GD12.5 and GD13.5, miR-22 was expressed in the future oral, nasal, and medial edge epithelia. On GD14.5, miR-22 expression was observed in the residual midline epithelial seam (MES), the nasal epithelium and the mesenchyme, but not in the oral epithelium. Inhibition of miR-22 activity in palate organ cultures resulted in failure of MES removal. Bioinformatic analyses revealed potential mRNA targets of miR-22 that may play significant roles in regulating apoptosis, migration, and/or convergence/extrusion, developmental processes that modulate MES removal during palatogenesis. Conclusions Results from the current study suggest a key role for miR-22 in the removal of the MES during palatogenesis and that miR-22 may represent a potential contributor to the etiology of cleft palate.
Cell components in the immune response. II. Cell attachment separation of immune cells.

Abstract Cell suspensions from the spleens of normal mice were separated by differential attachment to glass beads and plastic surfaces. Individual populations or combinations of populations were cultured in the presence of foreign erythrocytes and the number of hemolytic plaque-forming cells were measured at day 4. Marked cooperative effects were demonstrated in the size of the response when nonattached cells were cultured with small numbers of attached cells. It was shown that precursor cells were present predominantly in the nonattached cell population, and the development of a population of antibody-forming cells by day 4 was increased in the presence of attached cells. Similar cooperative effects were demonstrated when attached cells were prepared from cells obtained from the peritoneal cavity. Such cells were inhibitory at higher concentrations.
The New Californians: Comparative Research Findings on the Educational Progress of Immigrant Children

No state has felt the impact of the new immigration more than California, and no institution more than its public schools. A third of the nation's immigrants are concentrated in California; and over a third of California's K-12 public school children speak a language other than English at home. These new Californians are extraordinarily diverse; they hail largely from Asia and Latin America, and include among them at once the most educated and the least educated ethnic groups in the U.S. today. Their children are growing up in a context where economic restructuring, a prolonged recession, and accompanying fiscal woes have exacerbated a deep public discontent particularly aimed at immigrants. Yet for all of the political controversy surrounding the public education of immigrant children - and even though they will become a crucial component of the larger economy and society in the years to come - very little is in fact known about their educational progress and adaptation patterns to date. The import of the course of the adaptation of this new second generation goes far beyond its immediate impacts on school systems, state budgets, and fiscal policies. It will ultimately be the measure by which the long-term national consequences of the present wave of immigration are gauged. This chapter aims to contribute to the development of that knowledge base and to review current research findings about immigrant students in California public schools. It is organized in five parts. First, census data on the size, national origins, and socioeconomic characteristics of the foreign-born population are presented to document the current diversity and its concentration in California. This is followed by a profile of both LEP (Limited English Proficient) and FEP (Fluent English Proficient) language-minority students enrolled statewide in K-12 public schools in California. Next I report results from two new comparative research studies of the educational performance of children of immigrants in San Diego schools (including dropout rates, GPAs, achievement test scores, and educational aspirations), focusing on the largest groups: Mexicans, Filipinos, Vietnamese, Laotians, Cambodians, and East Asian-origin groups. Finally, the findings of four case studies of the adaptation of immigrant high school students in different parts of California are discussed, focusing on Southeast Asians, Punjabi Sikhs from India, Mexicans, and Central Americans.
Forecasting with neural networks

Abstract In the business environment, Least-Squares estimation has long been the principle statistical method for forecasting a variable from available data with the logit regression model emerging as the principle methodology where the dependent variable is binary. Due to rapid hardware and software innovations, neural networks can now improve over the usual logit prediction model and provide a robust and less computationally demanding alternative to nonlinear regression methods. In this research, a back-propagation neural network methodology has been applied to a sample of bankrupt and non-bankrupt firms. Results indicate that this technique more accurately predicts bankruptcy than the logit model. The methodology represents a new paradigm in the investigation of causal relationships in data and offers promising results.
Particle image velocimetry in the crossplane of a supersonic jet in subsonic compressible crossflow

A particle image velocimetry instrument has been constructed for a transonic wind tunnel and applied to study the interaction created by a supersonic axisymmetric jet exhausting from a flat plate into a subsonic compressible crossflow. Data have been acquired in two configurations; one is a two-dimensional measurement on the streamwise plane along the wind tunnel centerline, and the other is a stereoscopic measurement in the crossplane of the interaction. The presence of the induced counter-rotating vortex pair is clearly visible in both data sets. The streamwise-plane data determined the strength and location of the vortices using the vertical velocity component while the crossplane data directly provided a measurement of the vortical motion. A comparison of the vertical velocity component measured using each configuration showed reasonable agreement.
NATURAL VIBRATIONS OF SUSPENSION CABLES

Natural frequencies and modes of vibration for suspension cables are determined using a discretized system composed of a linkage of straight bars connected by frictionless pins with concentrated masses at the connection points. The governing equations are linearized which limits the applicability to small oscillations. The frequencies are determined by a generalized Holzer method coupled with the solution of the associated boundary value problem as a set of initial-value problems. The method is applied to sample numerical problems and the results are compared with the results obtained by alternate approaches. The sensitivity of the results to the nature of the discretization is studied. Also, several parameter studies are conducted to determine how the natural vibrations are altered in response to dimensional variations in the suspension cable. The results of the parameter studies are summarized in a nondimensional form.
Chaos in the black hole S-matrix

Recent work by Shenker, Stanford, and Kitaev has related the black hole horizon geometry to chaotic behavior. We extend this from eternal black holes to black holes that form and then evaporate. This leads to an identity for the change in the black hole S-matrix (over times shorter than the scrambling time) due an addition infalling particle, elaborating an idea of 't Hooft.