cssi/SciSciGPT-SciSciNet huggingface dataset:
Diagnosis and Management of Congenital Sensorineural Hearing Loss

Hearing loss is the most common sensory disorder in the USA. The diagnosis of congenital hearing loss starts with newborn hearing screening, which is best performed with auditory brainstem evoked responses in order to avoid the risk of missing auditory neuropathy spectrum disorder. A careful history and physical exam can occasionally help reveal the etiology for congenital hearing loss. Imaging studies, either CT temporal bones or MRI of the internal auditory canals without gadolinium, and genetic testing, in particular for connexin 26, connexin 30, and Pendred syndrome, are the most useful diagnostic tests. Management of congenital hearing loss involves early fitting of amplification. Early cochlear implantation, preferably before 2 years of age, should be strongly considered for children with bilateral severe hearing loss.
SCHOLARLY COMMUNICATION: Digital archiving

Avec l'arrivee des documents electroniques, la question se pose de definir qui, des bibliothecaires ou des editeurs, sera responsable de leur archivage. Apres avoir evoque le travail de reflexion effectue dans le domaine de l'archivage electronique par les organisations internationales, l'auteur determine les criteres minimum auxquels devra repondre un depot d'archives electroniques.
Introduction to the Volume

This chapter addresses the role that social context plays in the application of problem behavior theory to various problems across societies and settings as diverse as the slums of Nairobi; the middle schools of Beijing, China; and the inner city neighborhoods of Chicago and Denver. It provides an exposition about the multiple environments or contexts in which an adolescent is simultaneously embedded, some distal from experience, like the physical and geographic environment, and some more proximal to experience, such as the family, school, and neighborhood. It argues that the environment or context that is most proximal to experience and, hence, to behavior is the perceived environment. The perceived environment is the environment of meaning for the adolescent and is, therefore, the environment that, in interaction with the person, is most determinative of behavior and development. Reliance on a perceived environment concept brings up the issue of subjectivity in social inquiry, and the chapter argues that both quantitative and qualitative research approaches engage subjectivity and have in common a hermeneutic or interpretive methodological stance. The latter issue is one of several concerns in the philosophy of science that undergirds problem behavior theory and that is noted in the chapter.
A Large Eddy Simulation Model for the Stratus-Topped Boundary Layer

Because of the important impact of the stratus cloud regime on global climate, I have incorporated radiation and condensation processes into my large-eddy-simulation model to simulate the stratus-topped boundary layer. Such simulation helps to understand the turbulent structure within this type of planetary boundary layer (PBL), and. can be used to test the statistical turbulence models which are used as PBL parameterizations in climate models.
Bilayer Nanomesh Structures for Transparent Recording and Stimulating Microelectrodes

Nanomeshed forms of metal have emerged as a promising biocompatible electrode material for future soft bioelectronics. However, metal/electrolyte interfaces are intrinsically capacitive, severely limiting their electrochemical performance, especially for scaled electrodes, which are essential for high-resolution brain mapping. Here, an innovative bilayer nanomesh approach is demonstrated to address this limitation while preserving the nanomesh advantage. Electroplating low-impedance coatings on a gold nanomesh template achieves an impedance < 30 kΩ at 1 kHz and a charge injection limit of 1 mC cm−2 for 80 × 80 µm2 microelectrodes, a 4.3× and 12.8× improvement over uncoated electrodes, respectively, while maintaining a transparency of ≈70% at 550 nm. Systematic characterization of transmittance, impedance, charge injection limits, cyclic charge injection, and light-induced artifacts reveal an encouraging performance of the bilayer nanomesh microelectrodes. The bilayer nanomesh approach presented here is expected to enable next-generation large-scale transparent bioelectronics with broad utility in biology.
Text Messaging May Engage and Benefit Adults with Type 2 Diabetes Regardless of Health Literacy Status.

Background Technology-delivered interventions have the potential to improve diabetes self-care and glycemic control among adults with type 2 diabetes (T2D). However, patients who do not engage with interventions may not reap benefits, and there is little evidence on how engagement with mobile health interventions varies by health literacy status. Objective This study explored how patients with limited health literacy engaged with and experienced Rapid Education/Encouragement and Communications for Health (REACH), a text messaging intervention designed to support the self-care adherence of disadvantaged patients with T2D. We recruited adults with T2D from federally qualified health centers and used mixed methods to examine (1) associations between users' health literacy status and their prior mobile phone use and their engagement with REACH and (2) similarities and differences in users' self-reported benefits by health literacy status. Methods Participants (N = 55) completed a survey, including measures of health literacy and prior mobile phone use. For 2 weeks, participants experienced REACH, which included daily text messages promoting self-care and asking about medication adherence, and weekly text messages providing medication adherence feedback. After 2 weeks, participants completed a semi-structured telephone interview about their experiences. Key Results Participants with limited health literacy were less likely to have used cell phones to access the Internet (48% vs. 90%, p = .001) or email (36% vs. 87%, p < .001), but equally as likely to have used text messaging and to respond to REACH text messages (p = .12 and p = .40, respectively) compared to participants with adequate health literacy. Participants responded to 93% of text messages on average and reported benefits of the intervention, including reminders and accountability, convenience and accessibility, and information and motivation. Participants with limited health literacy described a unique benefit of receiving social support from the intervention. Conclusions Text messaging interventions may engage and benefit patients with T2D, regardless of health literacy status. Text messaging may have the potential to reduce T2D health disparities related to limited health literacy.
Wisdom without tears: Statecraft and the uses of history

The world is mired in history again, as historical modes of competition return and historical grievances fuel the policies of multiple revisionist actors. If the end of history has ended, then it follows that the time is ripe for an engagement with history’s wisdom. We argue that the making of American statecraft—the deliberate, coordinated use of national power to achieve important objectives—can be significantly enhanced by a better understanding of the past. This essay, which draws on the extensive literature on history and statecraft, U.S. foreign policy, and the author’s own research and experiences, offers a defense of the use of history to improve statecraft, as well as a typology of ten distinct ways in which an understanding of history can improve government policy.
Association Behavior in Steroidal Systems — NMR Spectroscopic and Vapor Pressure Osmometric Studies of Bile Acid Derivatives

Nmr and vapor pressure osmometric (VPO) studies indicate that bile acid esters self-associate and form small aggregates in organic solvents. Intermolecular hydrogen bonding between hydroxyl groups on the steroid nucleus and possibly the carboxylate on the side chain is proposed to play a vital role in the formation of aggregates. The concentration dependence of the chemical shift of the hydroxyl protons confirms the existence of H-bonds in these systems. The decrease in 13C relaxation times of methyl cholate in CDCl3 with increasing concentration is consistent with the self-association in this system. Analysis of the VPO data for methyl cholate in chloroform indicates that the model of self-association is best described by a Type III indefinite sequential type of self-association rather than a monomer-n-mer one.
Development of New Scintillating Materials for the SSC

Development of organic scintillators for the SSC is concentrated in the two areas of scintillating optical fibers and resistance to radiation damage. While good progress has been made in adapting small-scale fiber making methods to the conventional plastic scintillator technology, much work remains in optimizing light output and transmission in small fibers and in mass production techniques. New solvent and fluor systems are being investigated for liquid fiber optics, and novel polymers are being tried for greater rad-hardness. The greatest challenge is the radiation damage issue. Systematic research is building a base for postulating damage mechanisms and how scintillators should be utilized in high intensity radiation fields.
Nocturnal penile tumescent evaluation of erectile function in insulin-dependent diabetic men

This study compared nocturnal penile erections in four age-matched groups of young subjects: diabetic patients with and without erectile problems, psychogenically impotent men and healthy control subjects. All men were assessed under similar conditions during three nights, each for a total of 156 study nights. Diabetic impotent men exhibited a significantly decreased number of erectile episodes (p<0.05) and episodes of maximum tumescence per night (p<0.01). They also spent significantly less time in tumescence (p<0.005) and in simultaneous rapid eye movement sleep and tumescence (p<0.005). Diabetic men without sexual problems, psychogenically impotent men, and normal control subjects did not differ. Diabetic men in both groups spent less sleep time in rapid eye movement sleep and had longer latencies to onset of rapid eye movement. The decreased time in erection noted in impotent diabetic patients was no longer significant when adjusted for differences in duration of rapid eye movement sleep. In comparison to healthy control subjects and psychogenically impotent men, non-impotent diabetic men did show significantly diminished circumferential increases during erections, similar in degree to impotent diabetic patients (p<0.05).
Capability Traps Impeding Homeless Services: A Community-Based System Dynamics Evaluation

Continuums of Care (CoCs) are the primary coordinating bodies for homeless services in the United States. However, the complexities involved in delivering homeless services across interagency netwo...
Ultrafast probes at the interfaces of solar energy conversion materials

Ultrafast carrier dynamics at interfaces plays a major role in governing solar energy conversion efficiency in solar conversion systems, especially in solar cells and photoelectrochemical devices. In this perspective, we discuss recent advances in ultrafast spectroscopic probes to understand the dynamics at such interfaces. Transient reflectance (TR) enables monitoring of the surface carriers that are within ∼10 nm of the surface or interface of interest. Crucial parameters such as surface recombination velocity and carrier diffusion can be determined. When a strong surface or interfacial field is present the reflectance spectrum will exhibit Franz–Kelydesh oscillations. Monitoring the transient formation or decay of such oscillations informs about the interfacial field and is referred to as transient photoreflectance (TPR). Such fields are helpful in designing systems in order to move carriers away from surfaces where photocorrosion can occur and towards catalytic surfaces. Finally, we discuss transient infrared attenuated total reflection (TATR) to probe the ultrafast reaction intermediates in a photo-driven chemical reaction.
Identifying Opportunities to Promote Physical Activity in a Diverse Low-Income Population: A Mixed-Method Study at a Boys & Girls Club Site.

Prevalence and consequences of obesity and sedentary lifestyle are well-documented public health concerns for youth in the United State of America (USA) that disproportionally affect children from low income and minority families. This mixed-method study focused on estimating levels of physical activity and sedentary behavior and prevalence of overweight and obesity among the child members served in one Boys & Girls Club in the Midwest USA. We aimed to better understand opportunities for improving children’s engagement in physical activity through focus groups with members, staff, and parents/caregivers of members. Social cognitive learning theory, the ecological model of health behavior, and community based participatory research principles provided the study framework. Members completed assessments of physical activity, sedentary activity, height, and weight. Focus groups with members, staff, and parents/caregivers identified barriers, facilitators, and opportunities for promoting physical activity. Nearly 50% of members were overweight or obese. Most (87%) participants reported at least 60 min physical activity every day across the 3-day recall. Fewer than half (41%) reported 2 h or less of sedentary screen time every day across the 3 day recall. Focus group themes identified opportunities for addressing needs associated with health disparities in physical activity and pediatric obesity. Findings suggest stakeholder interest in physical activity promotion through afterschool programs. We discuss study implications regarding needs specific to individuals from diverse, low-income households that may not be adequately addressed with existing empirically-supported treatments and opportunities to address health disparities in physical activity and pediatric obesity through afterschool programs.
What Do Think Tanks Think? Proximity to Power and Foreign Policy Preferences

We argue that experts are more hawkish the closer they are to power, both figuratively and literally, and show this through the first study to use survey methods to inquire into the foreign policy preferences of think tank analysts and fellows (think tank employees, or TTEs) relative to professors who are experts in international relations. We find that TTEs are 0.47 standard deviations more hawkish than professors as calculated based on a standard survey measuring militant internationalism (MI). Controlling for self-described ideology mitigates this effect although it remains statistically significant. Among professors, those who have worked for the federal government are higher on MI, as are TTEs located closer to Capitol Hill. Differing levels of regional expertise generally cannot explain these differences, except perhaps in the case of Iran.
Vertebral growth and band-pair deposition in sexually mature little skates Leucoraja erinacea: is adult band-pair deposition annual?

Mature male and female little skates Leucoraja erinacea were injected with oxytetracycline and maintained in captivity for 13 months to assess centrum growth and the frequency of band-pair deposition. Sixty per cent of the individuals analysed did not deposit a full band pair over the 13 month period. Thus, a majority of captive skates did not exhibit annual band-pair deposition. Previous research confirms annual band-pair deposition in all juvenile and most adult L. erinacea, therefore sexual maturation may lead to decreased frequency of band-pair formation. Age underestimation of larger, older elasmobranchs is being identified in an increasing number of elasmobranch species including L. erinacea as demonstrated in this study. The effect of age underestimation from band-pair counts on studies that use age-based characteristics needs to be addressed.
Geoethics training in the Earth and environmental sciences

Ethical dilemmas are regularly encountered by Earth and environmental scientists. Explicit training is required to allow the community to recognize such dilemmas, and to prevent and mitigate ethical issues as they arise.
Abstract IA20: Chromatin state and scRNA-seq analysis defines a common differentiation trajectory towards T-cell exhaustion

We will describe a unified chromatin state and single cell expression analysis underlying T-cell differentiation to “exhaustion.” Numerous studies in chronic viral infection and tumor models have shown that most T cells progress to a terminally dysfunctional (“exhausted”) state from which they cannot be rescued by current immunotherapies. We performed a systematic analysis of over 280 ATAC-seq and RNA-seq experiments from eight published studies of CD8 T cell dysfunction, using a statistical batch correction to define a common differentiation trajectory to terminal exhaustion in all settings of chronic antigen exposure and to identify transcription factors involved in this progression. We further performed scRNA-seq analysis of CD8 T cells at multiple time points during acute and chronic viral infection and in adoptive cell transfer studies to elucidate this trajectory at single-cell resolution. Citation Format: Christina Leslie. Chromatin state and scRNA-seq analysis defines a common differentiation trajectory towards T-cell exhaustion [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2019 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2020;8(3 Suppl):Abstract nr IA20.
The LGBT Equality Gap and Federalism

LGBT people in the United States live with an Equality Gap that seems to grow wider with each legislative session. The majority of states do not have non-discrimination protections in place for LGBT people. In the absence of blanket federal non-discrimination protections, a same-sex couple can be denied service by bakers, catering halls, and photographers while trying to exercise their constitutionally protected right to marry. A transgender person can be denied access to a public bathroom that matches their gender identity. A federally funded adoption agency can refuse to work with LGBT persons who wish to adopt. In addition, many states have enacted explicitly anti-LGBT measures and prohibitions that exacerbate the Equality Gap and further underscore regional disparities. Even states with non-discrimination protections for LGBT people have considered expanding religious exemptions in a way that could greatly undercut the effectiveness and scope of existing non-discrimination protections. As a result of this mismatch of laws, the lived experience of LGBT people varies wildly depending on where they reside. For example, LGBT people living in New York enjoy many more protections and suffer none of the disabilities that are imposed on LGBT people living in Mississippi. The regional disparities are so extreme that some countries have issued travel advisories for their citizens visiting certain parts of the United States. This article examines the role federalism has played in the trajectory of LGBT rights and the creation of the Equality Gap. The first section of this article explores federalism as an institutional choice that strikes a balance between state and national power. The second section reviews the instrumental use of federalism by LGBT advocates to advance the legal strategy that ultimately led to nationwide marriage equality. It also provides an overview of corresponding and complementary visions of federalism expressed in both Windsor and Obergefell. The last section reviews the current Equality Gap and the most recent anti-LGBT initiatives that are being considered on the state and local levels in light of Bostock v. Clayton County, the 2020 US Supreme County case that extended Title VII non-discrimination protections to sexual orientation and gender identity. A brief conclusion closes with the observation that federalism has proven to be a pragmatic, but also imperfect, institutional choice for LGBT rights advocates because state level civil rights protections are, by their nature, partial, not portable, and especially vulnerable to majoritarian bias. This observation has particular salience for both our understanding of federalism and the future of LGBT advocacy.
Harmonic instability in a quantum cascade laser with Fabry-Perot cavity

A new state of instability called harmonic instability, which is characterized by the appearance of side modes separated by multiple of free spectral range from each other, was discovered in quantum cascade lasers (QCLs) a few years ago. However, a detailed analysis using a model beyond the two-level density-matrix (DM) equations as well as incorporating phenomena such as the detuning of the primary-mode frequency from the line-center frequency and the frequency dependence of the background refractive index, resulting in group velocity dispersion (GVD), has not been performed yet. In this paper, we present a comprehensive analysis of harmonic instability in a QCL with a Fabry–Perot (FP) cavity. Starting from three-level DM equations, which include the resonant tunneling phenomenon and scattering rates between all three states, and then by using Maxwell's equation, we derive a closed-form expression for the gain of the side modes, from which quantities pertinent to instability can be determined. We also take the aforementioned phenomena into account in our theory. By using our theory, we show the way of determining primary-mode detuning from the line center. Furthermore, we study the effects of GVD on instability in detail, showing that the output from an FP QCL demonstrates the characteristic of a frequency-modulated wave up to a certain value of dispersion. Above this value, because of the significant deviation of the side-mode amplitude ratio from unity, the output shows neither frequency-modulated-like nor amplitude-modulated-like behavior.
What’s the Risk: Differentiating Risk Ratios, Odds Ratios, and Hazard Ratios?

Risk ratios, odds ratios, and hazard ratios are three common, but often misused, statistical measures in clinical research. In this paper, the authors dissect what each of these terms define, and provide examples from the medical literature to illustrate each of these statistical measures. Finally, the correct and incorrect methods to use these measures are summarized.
Ocular Versus Oral Propranolol for Prevention and/or Treatment of Oxygen-Induced Retinopathy in a Rat Model.

Purpose: Propranolol, a nonselective B1/B2 adrenoceptor antagonist, promotes the regression of infantile hemangiomas likely through suppression of vascular endothelial growth factor (VEGF), which p...
Low-bias quenching due to spontaneous orientation polarization and its impact on OLED efficiency

Much effort has been directed at understanding organic light-emitting device (OLED) efficiency and the role of bimolecular quenching in efficiency roll-off. Quenching is less widely discussed at low-bias, where populations are reduced. Here, we describe lock-in-based photoluminescence measurements on working phosphorescent OLEDs to demonstrate that this assumption is not generally valid, and that significant exciton-polaron quenching is present even prior to turn-on. Exciton-polaron quenching arises with holes accumulated due to spontaneous orientation polarization in the electron transport layer. This low-bias quenching is found to strongly determine maximum achievable efficiency, suggesting a need to refine materials selection and device design rules.
Toward Using Twitter Data to Monitor Covid-19 Vaccine Safety in Pregnancy

Background: Coronavirus Disease 2019 (Covid-19) during pregnancy is associated with an increased risk of maternal death, intensive care unit (ICU) admission, and preterm birth; however, many people who are pregnant refuse to receive Covid-19 vaccination because of a lack of safety data. Objective: The objective of this preliminary study was to assess whether we could identify (1) users who have reported on Twitter that they received Covid-19 vaccination during pregnancy or the periconception period, and (2) reports of their pregnancy outcomes. Methods: We searched for reports of Covid-19 vaccination in a large collection of tweets posted by users who have announced their pregnancy on Twitter. To help determine if users were vaccinated during pregnancy, we drew upon a natural language processing (NLP) tool that estimates the timeframe of the prenatal period. For users who posted tweets with a timestamp indicating they were vaccinated during pregnancy, we drew upon additional NLP tools to help identify tweets that report their pregnancy outcomes. Results: Upon manually verifying the content of tweets detected automatically, we identified 150 users who reported on Twitter that they received at least one dose of Covid-19 vaccination during pregnancy or the periconception period. Among the 60 completed pregnancies, we manually verified at least one reported outcome for 45 (75%) of them. Conclusions: Given the limited availability of data on Covid-19 vaccine safety in pregnancy, Twitter can be a complementary resource for potentially increasing the acceptance of Covid-19 vaccination in pregnant populations. Directions for future work include developing machine learning algorithms to detect a larger number of users for observational studies.
Intracellular calcium homeostasis in galactosamine-intoxicated rat liver cells. Active sequestration of calcium by microsomes and mitochondria.

Abstract Active transport of Ca 2+ by isolated microsomes and mitochondria from galactosamine-intoxicated rat liver cells was studied. The aim was to determine the respective role of each organelle in the disturbed intracellular Ca 2+ homeostasis induced by this hepatotoxin. Calcium uptake by isolated microsomes is ATP dependent and oxalate augmented with a V of 1.45 nmol of Ca 2+ /mg of microsomal protein/mm at 25 °C and an apparent K m for free Ca 2+ of 2.4 μ m . Concentrations of total Ca 2+ higher than 40 μ m are inhibitory. Two hours after administration of galactosamine (200 or 400 mg/kg), at a time when the total cell Ca 2+ content has increased, microsomes isolated from the treated animals exhibited no impairment in calcium transport. The microsomal preparations from the galactosamine-treated animals also had the same content of cytochrome P -450 and the same specific activity of glucose 6-phosphatase as those from the control animals. Calcium uptake by isolated liver mitochondria is also ATP dependent but virtually completely inhibited by 5 m m sodium azide. The V is higher than that of the microsomes, 20.5 nmol of Ca 2+ /mg of protein/min at 25 °C, but the apparent K m for free Ca 2+ is similar, 5.7 μ m There was no alteration in the Ca 2+ uptake activity of mitochondria isolated from galactosamine-treated animals. These results imply that the initial disturbance in intracellular Ca 2+ homeostasis induced by galactosamine is entirely a consequence of the previously described plasma membrane injury. The potential significance of the observed kinetic properties of microsomes and mitochondria with regard to their respective roles in intracellular Ca 2+ homeostasis is discussed.
Statutory Interpretation in the EU: the Augustinian Approach

EU legislation is written in all of the EU’s official languages. Each version is authoritative, and no version is privileged as ‘the original’, at least not as an official matter. The practice derives from the very first Regulation of the Council of the European Economic Community in 1958, which declared Dutch, French, German and Italian as the official languages.1 As countries enter the EU, the Regulation has been amended many times to expand the number of official languages to match the official languages of the member states. Moreover, as accession treaties are signed, the treaties themselves contain provisions that show respect for the linguistic diversity of the EU. For example, the 1997 Treaty of Amsterdam says: This Treaty, drawn up in a single original in the Danish, Dutch, English, French, German, Greek, Irish, Italian, Portuguese and Spanish languages, the texts in each of these languages being equally authentic, shall be deposited in the archives of the government of the Italian Republic, which will transmit a certified copy to each of the governments of the other signatory States.
Digital Inclusion, Learning, and Access at the Public Library

New York City is not an easy place to live. Brooklynites who are just learning about the Internet in 2013—20 years after the development of the World Wide Web—likely have more challenges than simply needing someone to show them how to open up the computer's browser. Brooklyn Public Library has been engaged in a digital inclusion project that brings together issues of ability, access, and learning styles. By giving our patrons skills and confidence to navigate technology both online and off, we are laying the groundwork for them to have a voice in the city.
Enhancing performance of Hadoop and MapReduce for scientific data using NoSQL database

Scientific data sets usually have similar jobs that are frequently applied to them by different users. In addition, many of these data sets are unstructured and complex, and required fast and simple processing. In order to increase the performance of the existing Hadoop and MapReduce algorithm, it is necessary to develop an algorithm based on the type of data sets and requirements of the jobs. Genomic and biological data is an example of unstructured data because it only has a huge sequence of unreadable and non-relational letters. In this paper, we present an overview of a developed MapReduce algorithm and its simulation using HBase as a NoSQL database.
Angiectatic Nasal Polyps That Clinically Simulate a Malignant Process

Abstract Background.—Approximately 5% of inflammatory or allergic sinonasal polyps develop extensive vascular proliferation and ectasia with deposition of pseudoamyloid. These so-called angiectatic nasal polyps (ANPs) can grow rapidly and exhibit an aggressive clinical behavior that could simulate malignancy preoperatively. Objective.—To systematically address the differential histologic diagnosis of ANPs. Methods.—We evaluated by light microscopy, immunohistochemistry, and electron microscopy biopsy and resection specimens from 2 large ANPs (8 and 10 cm in diameter) that presented in 2 adult men with life-threatening epistaxis and facial deformity, respectively. Results.—The tumors were firm, lobulated, and covered by smooth, partially ulcerated mucosa. Histologically, clusters of dilated, thin-walled blood vessels embedded in pools of Congo red–negative eosinophilic material, associated with patchy necrosis and atypical stromal spindle cells, were seen. Electron microscopy and immunohistochemistry (CD34...
Fatal cardiac tamponade following cytoreductive surgery for serous carcinoma of the ovary

•Pericardial effusion may be present early in the disease process in patients with ovarian cancer.•Even a small pericardial effusion may become clinically apparent in the setting of concomitant pleural effusion(s).•Cardiac tamponade should be considered in the differential diagnosis of postoperative hemodynamic instability to facilitate timely intervention.
Vascular access complications during outpatient parenteral antimicrobial therapy at home: a retrospective cohort study

Objectives The need for indwelling vascular access for outpatient parenteral antimicrobial therapy (OPAT) places patients at risk of vascular access complications. The purpose of this study was to describe vascular access complications during OPAT at home, and identify factors associated with their occurrence. Methods All OPAT courses carried out at home for patients at Cleveland Clinic in 2013 were identified from the institution's OPAT registry. The first OPAT course per patient was included. Vascular access complications that occurred during the treatment course were abstracted from the electronic medical record. Only complications that triggered a clinical intervention were included. Results The 1461 included OPAT courses encompassed 33,579 OPAT days of treatment. One-hundred-and-forty-four vascular access complications occurred in 131 OPAT courses (9% of OPAT courses, 4.29 complications per 1000 OPAT days). The most common complication was occlusion (53% of all complications). Hickman catheters [incidence rate ratio (IRR) 0.20, 95% CI 0.03-0.63] and indwelling ports (IRR 0.25, 95% CI 0.04-0.78) were associated with lower complication rates than peripherally inserted central catheters, as was increasing age (IRR 0.99, 95% CI 0.98-1.00). Log OPAT duration (IRR 1.60, 95% CI 1.28-2.03), female sex (IRR 1.62, 95% CI 1.16-2.28) and injection drug use (IRR 3.32, 1.16-7.46) were associated with increased risk of vascular access complications. Conclusions Nine percent of OPAT courses at home have at least one vascular access complication requiring clinical intervention. Longer OPAT duration, younger age, female sex and injection drug use are associated with increased risk of vascular access complications.
No time to waste--the ethical challenges created by CRISPR: CRISPR/Cas, being an efficient, simple, and cheap technology to edit the genome of any organism, raises many ethical and regulatory issues beyond the use to manipulate human germ line cells.

The term “CRISPR” has gained a lot of attention recently as a result of a debate among scientists about the possibility of genetically modifying the human germ line and the ethical implications of doing so. However, CRISPR is not just a method to edit the genomes of embryonic cells, as the public discussion might have implied; it is a powerful, efficient, and reliable tool for editing genes in any organism, and it has garnered significant attention and use among biologists for a variety of purposes. Thus, in addition to the discussion about human germ line editing, CRISPR raises or revives many other ethical issues, not all of which concern only humans, but also other species and the environment. > … CRISPR raises or revives many other ethical issues, not all of which concern only humans, but also other species and the environment CRISPRs are short DNA sequences with unique spacer sequences that, along with CRISPR‐associated (Cas) proteins, constitute an adaptive immune system in many bacteria and archaea against invading bacteriophages [1]. By using short RNA molecules as a template, Cas makes highly sequence‐specific cuts in DNA molecules that can be exploited to insert genes or to precisely modify the nucleotide sequence at the cut site. CRISPRs were first identified in the 1980s, but it is only during the past few years that scientists realized their potential to edit the genomes of any organism, from microorganisms to plants to human cells and, most controversially, human embryos. The CRISPR/Cas system is not a breakthrough technology in the sense that it enables genome editing; biologists have been using transcription activator‐like effector nucleases (TALENs) and zinc finger nucleases (ZFNs) to edit genomes for some time. However, those technologies are expensive, technically challenging, and time‐consuming, as they require protein engineering to target specific DNA …
Association between emergency department resources and diagnosis of intimate partner violence.

OBJECTIVE: There is little information about which intimate partner violence (IPV) policies and services assist in the identification of IPV in the emergency department (ED). The objective of this study was to examine the association between a variety of resources and documented IPV diagnoses. METHODS: Using billing data assembled from 21 Oregon EDs from 2001 to 2005, we identified patients who were assigned a discharge diagnosis of IPV. We then surveyed ED directors and nurse managers to gain information about IPV-related policies and services offered by participating hospitals. We combined billing data, survey results, and hospital-level variables. Multivariate analysis assessed the likelihood of receiving a diagnosis of IPV depending on the policies and services available. RESULTS: In 754 597 adult female ED visits, IPV was diagnosed 1929 times. Mandatory IPV screening and victim advocates were the most commonly available IPV resources. The diagnosis of IPV was independently associated with the use of a standardized intervention checklist (odds ratio: 1.71; 95% confidence interval: 1.04-2.82). Public displays regarding IPV were negatively associated with IPV diagnosis (odds ratio 0.56; 95% confidence interval: 0.35-0.88). CONCLUSION: IPV remains a rare documented diagnosis. Most common hospital-level resources did not demonstrate an association with IPV diagnoses; however, a standardized intervention checklist may play a role in clinician's likelihood of diagnosing IPV. Language: en
Neuromuscular Prehabilitation to Prevent Osteoarthritis After a Traumatic Joint Injury

Abstract Post-traumatic osteoarthritis (PTOA) is a process resulting from direct forces applied to a joint that cause injury and degenerative changes. An estimated 12% of all symptomatic osteoarthritis (OA) of the hip, knee, and ankle can be attributed to a post-traumatic cause. Neuromuscular prehabilitation is the process of improving neuromuscular function to prevent development of PTOA after an initial traumatic joint injury. Prehabilitation strategies include restoration of normative movement patterns that have been altered as the result of traumatic injury, along with neuromuscular exercises and gait retraining to prevent the development of OA after an injury occurs. A review of the current literature shows that no studies have been performed to evaluate methods of neuromuscular prehabilitation to prevent PTOA after a joint injury. Instead, current research has focused on management strategies after knee injuries, the value of exercise in the management of OA, and neuromuscular exercises after total knee arthroplasty. Recent work in gait retraining that alters knee joint loading holds promise for preventing the development of PTOA after joint trauma. Future research should evaluate methods of neuromuscular prehabilitation strategies in relationship to the outcome of PTOA after joint injury.
A solution for a dugdale crack subjected to a linearly varying tensile loading

Abstract The Dugdale crack model has been extended to include the effects of a linearly varying tensile loading. Under this type of loading the plastic zone lengths and the crack opening displacements at each end of a central crack are different. Expressions for these quantities in terms of the crack length, the parameters characterizing the loading, and the yield stress of the material are deduced by removing the singularities at the ends of the crack in accord with Dugdale's postulate. It is found that the plastic zone lengths are much more sensitive to a nonuniform loading of this kind than are the crack opening displacements.
Approximate heating analysis for the windward-symmetry plane of Shuttle-like bodies at large angle of attack

An engineering method has been developed for computing the windward-symmetry plane convective heat-transfer rates on Shuttle-like vehicles at large angles of attack. The engineering code includes an approximate inviscid flowfield technique, laminar and turbulent heating-rate expressions, an approximation to account for the variable-entropy effects on the surface heating and the concept of an equivalent axisymmetric body to model the windward-ray flowfields of Shuttle-like vehicles at angles of attack from 25 to 45 degrees. The engineering method is validated by comparing computed heating results with corresponding experimental data measured on Shuttle and advanced transportation models over a wide range of flow conditions and angles of attack from 25 to 40 degrees and also with results of existing prediction techniques. The comparisons are in good agreement.
What Place for Hunter-Gatherers in Millennium Three?

What Place for Hunter-Gatherers in Millennium Three? Thomas N. Headland and Doris E. Blood, eds. Dallas: SIL International, 2002. 105 pp.
Health effects of cell-phone research outcomes and sources of funding [Telecommunications Health & Safety]

A recent systematic review of the outcome of experimental studies reported in scientific journals and the sources of funding for the reported research suggests that the evaluation of results from existing and future studies of health effects of microwave radiation from wireless communication should take sponsorship into account.
Expressions of Aggression Aggression-Inhibiting Effects of Anonymity to Authority and Threatened Retaliation

Social learning theory suggests that factors that increase the risk of social reprisal and reprobation should inhibit unprovoked physical attacks. A factorial experiment employing 56 males and 56 females investigated the effects of anonymity to authority figures and potential retaliation from a victim upon aggression displayed by small groups (n = 4) of coacting aggressors. The results disclosed that anticipated negative consequences in the form of counteraggression from the victim combined with surveillance by an authority inhibited the expression of aggression among both males and females. These findings were interpreted in terms of social learning theory, which emphasizes the role of expected negative consequences of behavior violating norms of social propriety.
Performance and the celebration of a subaltern counterpublic

By documenting the creation of a production based on the history of the Women's Center of Carbondale, Illinois, this essay explores difficulties in celebrating, through means of performance, an organization that exists because women are beaten and raped every day. First, we examine how the members of the Women's Center community make sense of their relationship to the dominant culture by forming a parallel or subaltern counterpublic through the formulation of a counterdiscourse. Second, we examine our scripting and staging decisions as the products of our simultaneous immersion in the multiple cultures of the dominant public sphere, the academy, and the Women's Center.
828. Promoter Strength Versus Transactivation Potential: Creating a Safer Integrating Vector

The ability of retroviral and lentiviral vectors to permanently integrate into the host genome makes them attractive tools for gene therapy applications which require long-term expression. However, the benefits of permanent integration are counterbalanced by two areas of weakness: 1) the difficulty in obtaining high-level transgene expression which persists over time and 2) the potential for insertional mutagenesis and transactivation of host genes. The recent development of leukemia-like disease in SCID-X1 clinical trial patients, as well as the development of tumors in several animal models receiving retroviral gene therapy, demonstrates the problems associated with strong vector promoters. In order to create a safer integrating vector, it would be beneficial to identify promoters which drive high levels of transcription of the linked transgene but which are also less likely to transactivate. Thus, we have designed an assay system which allows both the measurement of promoter strength and the quantitation of transactivation potential. Commonly-used human and viral promoters, including retroviral LTRs, were ranked according to promoter strength by measurement of the mean fluorescence intensity (MFI) of GFP expression following transient transfection with promoter-GFP reporter constructs. In addition, transactivation potential was assayed by measuring the ability of the promoters to increase GFP MFI above baseline levels when the test promoter was placed downstream of a GFP reporter driven by a minimal promoter. All MFI data were collected from transfected cell populations which exhibited a constant MFI over a range of plasmid DNA concentrations (typically giving 5-15% GFP positive cells), indicating that the average copy number was less than one GFP construct per cell. Using these assays, we are able to identify promoters which are both high in transcriptional strength and low in transactivation potential and, thus, are better suited for use in retroviral and lentiviral vectors.
Toward the ideal professional master's degree program

Abstract This report summarizes the building blocks, process and working documents used by volunteer members of the integrative team assigned to develop a model curriculum for a professional master's degree program in public relations/communications management during the July, 1998 Summer Conference sponsored by the National Communication Association. Using a variety of previous studies, the extensive academic and professional experience of the team members, exercises in nominal group technique and creative brainstorming, the team put forth its recommendations for the “ideal” graduate program.
Issues and Challenges in Building a Framework for Reactive Agent Systems

New tools and techniques are emerging to handle the complexities that might arise with the development of software systems. Reactive agent models are one such area that is emerging as a powerful paradigm in software engineering. This paper describes issues, trends, and approaches that exhibit the innovative characteristic of the reactive agent model and the design aspects of such a system. Engineering flexible agent systems has always been a challenging task. Development of such systems highlights the importance of formal specification methods. Descartes, an executable specification language, was taken into study with these complicated systems because of the importance of providing a satisfactory approach to software development. This approach enhances software development by providing a means of reduction of the gap between analysis and design. The paper concludes with proposed extensions to specification languages to support agent-based software engineering.
The Fat Redistribution Syndrome in Patients Infected with HIV: Measurements of Body Shape Abnormalities

Abstract Objective To describe the body shape changes in the syndrome of fat redistribution or lipodystrophy seen in patients infected with HIV. Design An objective description of patients with HIV with fat redistribution syndrome. Body height, weight, shape, and composition were measured by anthropometrics and bioelectrical impedance analysis by a single observer. Clinical data were collected by chart review. Subjects/setting Thirty-nine patients with HIV receiving primary HIV care at a university hospital-affiliated infectious disease clinic who presented with complaints of body shape changes or who were referred by their primary care providers for body shape changes. Analysis Descriptive statistics were performed. Results Four of the 39 patients (10%) had not used protease inhibitor therapy. HIV status (by clinical presentation, CD4 and VL) varied widely. Laboratory abnormalities were moderate. Percent body fat differed widely when measured by bioelectrical impedance analysis and anthropometry (23% vs 13%). The mean body mass index was 25.6kg/m 2 for men and 25.8kg/m 2 for women. The mean waist/hip ratio was above normal, at 1.02. The mean mid-arm circumference and triceps skinfolds were below national standards for both men (30.4cm and 8.1mm, respectively) and women (26.7cm and 7.5mm, respectively). Nine patients (23%) had an increased dorso-cervical pad. Seventeen patients returned for follow-up measurements at 3 months; no significant differences were found between baseline and follow-up measurements. Conclusions The waist/hip ratio, mid-arm and mid-thigh circumference, and triceps skinfolds were useful measures to define and follow the fat redistribution syndrome in patients with HIV. These body composition changes were not transitory in this short follow-up period. J Am Diet Assoc. 2001:101:1175-1180 .