cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract P3-02-02: Influence of Body Mass Index on Presence of Disseminated Tumor Cells in Clinical Stage I-III Breast Cancer Patients

Background: Disseminated tumor cells (DTCs) are found in approximately one third of clinical stage I-III breast cancer (BC) patients, and published reports show that presence of DTCs is an independent predictor of outcome. While higher body mass index (BMI) is associated with increased risk of breast cancer recurrence and lower survival rates in BC patients, women with lower BMIs may have lower bone density and higher bone turnover. We hypothesized that increases in bone turnover may result in the release of bone growth and “homing” factors that facilitate BC metastasis to bone and provide a “pre-metastatic niche” for BC cells. The purpose of this study was to determine if a correlation existed between DTCs and BMI in early stage BC patients. Methods: We obtained informed consent and collected bone marrow samples from 262 clinical stage I-III BC patients who were participants in an IRB-approved clinical study from 2/2005- 2/2010. All marrow samples were collected at the time of surgery for the primary tumor. DTCs were assessed using anti-pancytokeratin (CK) antibody cocktail (AE1/AE3, CAM5.2, MNF116, CK8 and 18) following cytospin. The presence of one or more CK positive cells meeting morphologic criteria for malignancy was considered a positive result for DTC. Patients with a BMI of (18.5 — 24.9) kg/m 2 were considered “normal weight”, those with a BMI of (25 - 29.9) kg/m 2 “overweight” and a BMI greater than 30 kg/m 2 was used to designate them as “obese”. Information on clinicopathological factors including BMI (measured on initial presentation) was obtained from a prospective database. Statistical analyses used Chi-square and non-parametric tests for trend. Results: Median follow-up was 19 months and mean age was 53 (25-80) years. Eighty-four patients (32%) were normal weight, 85 (32%) were overweight and 91 (35%) were obese. Seventy-eight (30%) patients had DTCs present at the time of assessment. Obese patients were significantly less likely to show presence of DTCs as compared to those who had a BMI 2 (20/78; 26% vs. 71/184; 39%) {O.R. = 0.55, 95% C.I. = 0.29- 0.96, P = 0.03}. DTCs were also less likely to be found in patients with BMI ≥25 kg/m 2 as compared to those with BMI 2 (40/78; 51% vs. 136/184; 74%); {O.R. = 0.42, 95% C.I. = 0.04- 1.02, P = 0.03}. No statistically significant correlation was observed between primary tumor characteristics (ER, PR, HER2, lymph node status, tumor grade) and presence of DTCs. Finally, a non-parametric analysis demonstrated a trend in occurrence of DTCs across the ordered levels of patients’ BMI values (P= 0.013). Conclusions: DTCs were much more common in patients with lower BMI. Further studies are needed to determine if patients with low BMI have unique microenvironmental factors within the bone that predisposes them to tumor cell dissemination. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-02-02.
Accessory factors in lactic fermentation.

SummaryThe formation of lactic acid by washed cells of Streptococcus lactis is increased by the presence of ascorbic acid or nicotinic acid. The two compounds act differently. Ascorbic acid stimulates mostly (perhaps exclusively) injured or exhausted cells while nicotinic acid affects normal and injured cells equally. The combined action of the two acids is usually, but not always additive, and approximates the effect of peptone. When both nicotinic and ascorbic acid are present, other compounds like cysteine or adenine may increase the rate of fermentation while these compounds alone have no such effect.
New species of Empididae of the genera Empis, Hilara, and Hormopeza from Georgia, with a synopsis of the North American species of Hormopeza

Three new species of Empididae (Diptera) Empis snoddyi , Hilara dixi , and Hormopeza fumicola , are described from material collected in Georgia by Edward L. Snoddy, who will report on their biology in another paper. In addition, morphological data concerning Hormopeza senator Melander and other Nearctic species of Hormopeza are presented. Keys to the American species of Hormopeza and to parts of the genera Empis and Hilara also are given.
The Fecal Flora of Typhoid Fever and Its Reaction to Various Diets

Altho the typhoid bacillus itself has been the subject of many investigations and much is known in regard to its biology and its pathogenesis, little exact information has been acquired in reference to the intestinal bacterial conditions which may be associated with an invasion by this bacillus. To be sure, typhoid fever is no longer to be regarded as essentially an intestinal disease, yet bacterial conditions in the intestines may be conceived to be such, in certain cases, as to add the weight of the toxic products of putrefaction to the human organism already oppressed by the typhoidal virus; in other patients, the fecal flora may be of a type which permits the most favorable digestion and absorption of the food administered. As is well known, Coleman,1 for a number of years, has been placing his typhoid patients on a high calory diet in order to reduce to a minimum the severe loss of nitrogen and weight which usually occurs in such cases when kept on a low calory diet. In connection with these cases in addition to careful clinical histories, a very accurate record is kept of the amounts of carbohydrate, fat, and protein consumed daily by each patient. The conditions are, accordingly, such as to present a most favorable opportunity to study the dietetic response of the typhoidal intestinal flora, and through the courtesy and cooperation of Dr. Warren Coleman the material for this study has been available. As far as I am aware, this investigation is the first in which an attempt has been made to correlate conditions and changes in the fecal flora of human subjects with exact data in regard to the constitution of the diet utilized. It seems not unlikely that information of this character may give a clue to the most favorable dietaries for various infections, especially those involving the digestive tract. As Herter2 has well suggested in connection with a general discussion of intestinal
Structuring Uncertainty and Conflicting Objectives for Life or Death Decisions Following an Urban Biological Catastrophe

A large-scale biological terrorist attack would likely result in mass casualties and have major economic consequences for the affected area, and potentially for the nation as a whole. The extent to which an impacted area recovers from such losses depends in large part on the decision making of local residents. In this study we utilize scenario simulation, a methodology that uses video simulation of a news report to immerse respondents in the details and consequences of a biological terrorist attack. Specifically, we explore the decision-making of local residents to a large-scale terrorist attack using weaponized anthrax in the Seattle, Washington area. The scenario was based on one of the U.S. Department of Homeland Security’s National Planning Scenarios. This study focuses on structuring a decision model around the objectives and motivations that shape local residents’ decisions to act during recovery from an anthrax attack. The relevant uncertainties and objectives that drive residents’ decisions during response and recovery from the anthrax attack were developed using group scenario simulations with various stakeholders in Seattle. In the beginning stages of the crisis concerns about health predominate. Later concerns about financial security emerge. Throughout it appears that residents weigh their concerns for safety with the collective costs of leaving the Seattle area. The decision model produces several key insights that are critical to the development and implementation of recovery policies. A causal loop diagram is also presented that depicts the dynamic nature of this decision process.
Generalized solutions of semistate equations

A generalized solution of a system of semistate equations is defined via the system of associated integral equations. Two theorems on the existence and uniqueness of a generalized solution are given.
SU-F-T-125: Radial Dose Distributions From Carbon Ions of Therapeutic Energies Calculated with Geant4-DNA

Purpose: Radial dose distribution D(r) is the dose as a function of lateral distance from the path of a heavy charged particle. Its main application is in modelling of biological effects of heavy ions, including applications to hadron therapy. It is the main physical parameter of a broad group of radiobiological models known as the amorphous track models. Our purpose was to calculate D(r) with Monte Carlo for carbon ions of therapeutic energies, find a simple formula for D(r) and fit it to the Monte Carlo data. Methods: All calculations were performed with Geant4-DNA code, for carbon ion energies from 10 to 400 MeV/u (ranges in water: ∼ 0.4 mm to 27 cm). The spatial resolution of dose distribution in the lateral direction was 1 nm. Electron tracking cut off energy was 11 eV (ionization threshold). The maximum lateral distance considered was 10 µm. Over this distance, D(r) decreases with distance by eight orders of magnitude. Results: All calculated radial dose distributions had a similar shape dominated by the well-known inverse square dependence on the distance. Deviations from the inverse square law were observed close to the beam path (r 1 µm). At small and large distances D(r) decreased, respectively, slower and faster than the inverse square of distance. A formula for D(r) consistent with this behavior was found and fitted to the Monte Carlo data. The accuracy of the fit was better than 10% for all distances considered. Conclusion: We have generated a set of radial dose distributions for carbon ions that covers the entire range of therapeutic energies, for distances from the ion path of up to 10 µm. The latter distance is sufficient for most applications because dose beyond 10 µm is extremely low.
Short wavelength sources for microlithography

Summary form only given. The evolution of microlithography tools to generate smaller features on microchips has involved using shorter ultraviolet wavelength sources and larger numerical aperture transmissive optics for imaging the complex mask patterns onto the wafers. During this evolution, the imaging source went from the mercury g-line at 436 nm to the i-line at 365 nm and then to the 248 nm KrF laser. At the 248 nm wavelength a laser source was necessary because the imaging optics required a very narrow linewidth at high power levels in order to obtain diffraction-limited imaging over a large imaging field. Presently, manufacturing tools are beginning to use the 193 nm wavelength of the ArF excimer laser. Operating at this wavelength places even more stringent requirements on the illuminating linewidth than at 248 nm. Looking ahead, it is expected that an EUV stepper operating at a wavelength of 13.5 nm will become available that could eventually print features as small as 30 nm. Fortunately there is a very strong group of emission lines from transitions in tenth ionized xenon that radiate in the region of 13.5 nm. These emission lines can be produced with significant flux from either a laser-produced plasma or a plasma discharge source. At this short wavelength, there are no transmissive optical materials available to provide imaging from the mask to the wafer. Hence reflective optics must be used for the imaging process. The scaling of radiative transition probabilities at shorter wavelengths in atoms and ions allows for a very significantly increased power emitted from an incoherent plasma source when compared to a similar source in the UV region. Hence, laser sources are not required in this wavelength region to achieve the necessary flux needed for the high wafer throughputs of a microlithographic manufacturing system.
Commentary: Public Health System Perspective on Implementation of Evidence-Based Fall-Prevention Strategies for Older Adults

1 Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 2 South College, School of Physical Therapy, Knoxville, TN, USA, 3 Department of Health Promotion and Behavior, The University of Georgia College of Public Health, Athens, GA, USA, 4 Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
The Importance of the Literary Title and its Implications for Translation Theory

This essay seeks to give a detailed examination of the notion of the title and its implications for the translation of titles into foreign languages. Thereby, the term “title” shall be analysed exclusively in the context of fictional works within different genres. I will begin with a theoretical analysis of the effects that an original title has on the text that it precedes, which will be based on Gerard Genette’s chapter on titles in his influential treatise Seuils (Paratexts. Thresholds of Interpretation). In addition, Genette’s thoughts on titles shall be complemented by and contrasted to those of David Lodge and Umberto Eco as they incorporate the positions of both the literary critics and the author of fiction. Ultimately, this essay aims to discuss the findings on the notion of the title with the help of translation theory, especially from Umberto Eco.
Tricholides A and B and Unnarmicin D: New Hybrid PKS-NRPS Macrocycles Isolated from an Environmental Collection of Trichodesmium thiebautii

Bioassay-guided isolation of the lipophilic extract of Trichodesmium thiebautii bloom material led to the purification and structure characterization of two new hybrid polyketide-non-ribosomal peptide (PKS-NRPS) macrocyclic compounds, tricholides A and B (1 and 2). A third macrocyclic compound, unnarmicin D (3), was identified as a new depsipeptide in the unnarmicin family, given its structural similarity to the existing compounds in this group. The planar structures of 1-3 were determined using 1D and 2D NMR spectra and complementary spectroscopic and spectrometric procedures. The absolute configurations of the amino acid components of 1-3 were determined via acid hydrolysis, derivitization with Marfey's reagent and HPLC-UV comparison to authentic amino acid standards. The absolute configuration of the 3-hydroxydodecanoic acid moiety in 3 was determined using a modified Mosher's esterification procedure on a linear derivative of tricharmicin (4) and additionally by a comparison of 13C NMR shifts of 3 to known depsipeptides with β-hydroxy acid subunits. Tricholide B (2) showed moderate cytotoxicity to Neuro-2A murine neuroblastoma cells (EC50: 14.5 ± 6.2 μM).
Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences

In this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers' self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers' self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers' self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.
Effect of channel-width and chirality on graphene field-effect transistor based real-time biomolecule sensing

Graphene field-effect transistors (GFET) hold promise in biomolecule sensing due to the outstanding properties of graphene materials. Charges in biomolecules are transduced into a change in the GFET current, which allows real-time monitoring of the biomolecule concentrations. Here we theoretically evaluate the performance of GFET based real-time biomolecule sensing, aiming to better understand the width-scaling limit in GFET based biosensors. In particular, we study the effect of the channel-width and the chirality on FET sensitivity by taking the percentage change of the FET current per unit charge density as the sensing signal. Firstly, GFETs made of graphene nanoribbons (GNR) and graphene sheets (GS) show comparable sensing signals to each other when gated at 1011 – 1012 cm-2 carrier densities. Sensing signals in GNRs are enhanced when gated near the sub-band thresholds, and increase their values in wider GNRs due to the change in device conductance and quantum capacitance. Secondly, the GNR chirality is found to fine tune the sensing signals. Armchair GNRs with smaller energy bandgaps appear to have an enhanced sensing signal close to 1011 cm-2 carrier densities. These results may help understand the scaling limit in GFET based biosensors along the width direction, and shed light on forming all-electrical bio-arrays.
The Development of Coherence in Narratives by Understanding Intentional Action

Publisher Summary This chapter discusses how one might construct a coherent interpretation by application of local inferences from the knowledge of intentional action. A causal network model for discourse analysis outlined and used to describe how one constructs representations of stories that differ greatly in structure and meaning of content. The constructive process, based upon the analytical model, shows to find support in developmental data of children who judge the importance of or who answer questions on story statements that they read or hear. The analysis and data indicate that story understanding and its development proceed in a parallel manner, from simple to complex integration of the content by causal inferences that result from the application of common but developing knowledge about intentional action.
Thermal Control of Electronic Equipment and Devices

Publisher Summary Thermal control of electronic components has one principal objective, to maintain relatively constant component temperature equal to or below the manufacturer's maximum specified service temperature, typically between 85 and 100°C. It is noted that even a single component operating 10°C beyond this temperature can reduce the reliability of certain systems by as much as 50%. Therefore, it is important for the new thermal control schemes to be capable of eliminating hot spots within the electronic devices, removing heat from these devices and dissipating this heat to the surrounding environment. Several strategies have developed over the years for controlling and removing the heat generated in multichip modules, which include advanced air-cooling schemes, direct cooling, and miniature thermosyphons or free-falling liquid films. The chapter summarizes analytical, numerical, and experimental work in literature, in order to facilitate the improvement of existing schemes and provide a basis for the development of new ones. The chapter focuses on investigations performed over the past decade and includes information on the thermal control of semiconductor devices, modules, and total systems.
Parent-adolescent communication and its relationship to adolescent depression and suicide proneness

Suicide is the second leading cause of death among adolescents in the United States, and the rates in this age group are increasing. A possible factor related to adolescent suicide may be inadequate or insufficient parent-adolescent communication. The purpose of this study was to investigate the communication level between selected adolescents and their parents, and to determine its relationship to the parents' perceptions of their adolescent's depression and proneness to suicide. The Parent-Adolescent Communication Inventory (PACI) was used to measure communication, and the Suicide-Depression Inventory (SDI) was used to measure depression and suicide proneness. Upon statistical analysis of the instrument scores, simple correlation coefficients expressed significant relationships between mother's and adolescent's scores, but not between father's and adolescent's scores. However, when controlling for other independent variables, neither the father's nor the mother's scores were significantly related to the adolescent's SDI score. The adolescent's PACI score was the only independent variable that produced a significant semi-partial correlation coefficient. A multiple regression procedure isolated only one of the independent variables which entered and stayed in the predictor model at the .05 level--the adolescent's PACI score (p = .001). Language: en
The Role of Concept Inventories in Course Assessment

Development of effective instructional materials, particularly those intended to address strongly held alternative conceptions about the natural world, is difficult. Research suggests that the most effective instruction stems from initial consideration of instructional goals and careful alignment of practice with those goals. Understanding whether or not instruction is effective itself requires development of assessment instruments that are written in direct correspondence to pre-articulated goals. Concept inventories (CIs), multiple-choice tests targeting specific content, are becoming increasingly popular mechanisms for assessing student learning, particularly in the USA. CIs have become popular because they target student alternative conceptions authentically and are relatively easy to implement even to very large lecture courses. The wide array of CIs available both in the USA and internationally reflects the importance that faculty place on addressing student conceptions. CIs can be used as both instructional tools and as research instruments; where used for research, scholars must be careful to evaluate the validity and reliability of the CI being used. In this chapter, we provide evidence of the value of CIs for use in both course and programmatic assessment. In addition, we illustrate the importance of community discourse in ensuring that CIs are appropriate for research.
Dietary Management of Elevated Blood Lipids

High levels of plasma cholesterol, in particular LDL-cholesterol, are associated with premature atherosclerosis and heart disease. Therefore, it is important to know how drug therapy and dietary management can be used to lower blood cholesterol levels. The effect of dietary management, particularly of dietary lipids, will be considered first, since for most people this approach to treatment of of hyperlipidemia is tried before drug therapy.
Prevalence of Posttraumatic Stress Disorder Symptoms Among Young Athletes After Anterior Cruciate Ligament Rupture

Background:The risk of depression and the fear of reinjury were documented in recent investigations of patients after anterior cruciate ligament (ACL) ruptures. The extent of psychological trauma a...
Massive transfusion protocols and the use of tranexamic acid

Purpose of reviewWe review recent articles pertaining to the use of tranexamic acid (TXA) in populations at risk for massive transfusion. Although there are no recent studies that specifically examine the use of TXA in massive transfusion protocols (MTPs), there are a few studies with subgroups of m
The Matchmaking Activity: An Experiential Learning Exercise on Influencer Marketing for the Digital Marketing Classroom.

Influencer marketing is an emerging technological disruptor for marketing across a wide range of industries. This tactic allows companies to promote products in a more organic, trust-affirming mann...
Landowner Functional Types to Characterize Response to Forest Insects

Forest insects and pathogens (FIPs) play an important role in the complex interactions between woodland owners and the ecosystems they manage. Understanding the specifics of woodland owner decision-making with regard to trees impacted by FIPs can facilitate projections of future forest conditions and insect spread. Our first objective is to: (i) characterize agent functional types (AFTs) of New England family forest owners (FFOs) using a set of contingent behavior questions contained in a mail survey of FFOs concerning response to FIPs. We establish AFTs as a form of dimension reduction, effectively assigning individual FFOs to particular decision-making classes, each with distinct probabilities of behavior with respect to the harvest of impacted trees. Our second objective is to: (ii) model AFT membership to predict the distribution of AFTs across the landscape. Predictors are chosen from a set of survey, geographic, and demographic features. Accomplishing (i) establishes three functional classes of landowners: ‘cutters’ (46% of respondents; highly likely to cut timber impacted by FIPs), ‘responsive’ cutters (42% of respondents; sensitive to pest severity), and ‘non-cutters’ (12% of respondents; highly unlikely to cut). Fulfilling (ii) provides a high-resolution probability surface of AFTs across the landscape, delivering key input for simulation models of forest and land cover change in New England. Predictors in our best model of AFT membership include parcel size (hectares of forest), region, and town-level forested fraction.
Subcutaneous Nodules on the Chest, with Cough and Weight Loss.

A 60-year-old smoker presented with cough and hemoptysis. She had also developed several subcutaneous masses on her chest wall and left and right abdominal wall over the past several months.
What Is Adequate Understanding

As Beskow and Weinfurt (2019) emphasize, their striking and very valuable data underline the importance of resolving a neglected question in research ethics—namely, whether understanding the standa...
Economics of the disintegration of the Greenland ice sheet.

Concerns about the impact on large-scale earth systems have taken center stage in the scientific and economic analysis of climate change. The present study analyzes the economic impact of a potential disintegration of the Greenland ice sheet (GIS). The study introduces an approach that combines long-run economic growth models, climate models, and reduced-form GIS models. The study demonstrates that social cost–benefit analysis and damage-limiting strategies can be usefully extended to illuminate issues with major long-term consequences, as well as concerns such as potential tipping points, irreversibility, and hysteresis. A key finding is that, under a wide range of assumptions, the risk of GIS disintegration makes a small contribution to the optimal stringency of current policy or to the overall social cost of climate change. It finds that the cost of GIS disintegration adds less than 5% to the social cost of carbon (SCC) under alternative discount rates and estimates of the GIS dynamics.
The impact of Ki-67 in the context of multidisciplinary care in primary inflammatory breast cancer

Background: Research on the prognostic or predictive value of Ki-67 among patients with inflammatory breast cancer (IBC) is limited. Methods: Using the comprehensive database of the Morgan Welch Inflammatory Breast Cancer Research Program at MD Anderson Cancer Center, we identified a cohort of breast cancer patients who were diagnosed with IBC between 1992 and 2012. Distributions of survival outcomes were estimated by the Kaplan-Meier method and compared by log-rank tests and Cox models. Results: Among a total of 257 patients with stage III IBC, the mean percentage of tumor cells that stained positive for Ki-67 was 48%, (range, 4% to 100%). Using a cutoff of 20% as being Ki-67 positive, this characteristic tended to be associated with worse overall survival (p=0.07) in the univariate analysis. After controlling for hormone receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status and having received trimodality treatment, the association between Ki-67 status and overall survival remained marginally significant (p=0.07). The effects of trimodality treatment on overall survival were statistically significantly different between patients with Ki-67-positive tumors (hazard ratio=0.26, 95% confidence interval [CI]=0.15-0.44, p<0.01) and those with Ki-67-negative tumors (hazard ratio =2.04, 95% CI=0.45-9.29, p=0.36) after adjusting for other tumor characteristics (p=0.01). Conclusion: IBC patients with Ki-67-positive tumors tended to have worse overall survival, but were more likely to benefit from trimodality treatment, with better overall survival and distant metastasis-free survival. Patients with Ki-67-negative tumors had similar survival distributions, regardless of whether they received trimodality treatment.
Use of a Novel Articulating Laparoscopic Needle Driver for Partial nephrectomy: An Initial Experience.

Abstract Objectives To demonstrate the clinical feasibility of an articulated laparoscopic needle driver to assist in the performance of laparoscopic PN (LPN). Previous studies have demonstrated under-utilization of minimally invasive techniques for patients undergoing partial nephrectomy (PN). Methods Consecutive patients with renal masses amenable to PN underwent LPN with an articulating laparoscopic needle driver. A consecutive cohort of patients who previously underwent robot assisted laparoscopic partial nephrectomy (RALPN) was selected as a comparison cohort. Preoperative, perioperative and postoperative variables were retrospectively collected. Results A total of 20 patients underwent PN with 10 patients assigned to each of the LPN and RALPN cohorts. Median R.E.N.A.L. nephrometry scores assigned to the LPN and RALPN cohorts were 7 and 6 respectively (p = 0.31). Median warm ischemia time for patients in the LPN and RALPN groups was 25.5 and 18.5 minutes respectively (p = 0.36). Median estimated blood loss for LPN and RALPN was 200 and 50 mL (p = 0.03). Median operative time for LPN and RALPN was 203 and 194 minutes respectively (p = 0.76). Median Length of stay after LPN and RALPN was similar (3.0 versus 2.5 nights, p = 0.26). Following LPN, three patients required blood transfusion as compared to two patients in the RALPN cohort (p = 0.61). Conclusions Our initial results demonstrated the clinical safety and feasibility of a new surgical device for performing LPN. Patients who underwent LPN with a novel articulating needle driver demonstrated equivalent results to RALPN across several key outcomes.
Physician Self-assessment of Shared Decision-making in Simulated Intensive Care Unit Family Meetings.

Importance Professional guidelines have identified key communication skills for shared decision-making for critically ill patients, but it is unclear how intensivists interpret and implement them. Objective To compare the self-evaluations of intensivists reviewing transcripts of their own simulated intensive care unit family meetings with the evaluations of trained expert colleagues. Design, Setting, and Participants A posttrial web-based survey of intensivists was conducted between January and March 2019. Intensivists reviewed transcripts of simulated intensive care unit family meetings in which they participated in a previous trial from October 2016 to November 2017. In the follow-up survey, participants identified if and how they performed key elements of shared decision-making for an intensive care unit patient at high risk of death. Transcript texts that intensivists self-identified as examples of key communication skills recommended by their professional society’s policy on shared decision-making were categorized. Main Outcomes and Measures Comparison of the evaluations of 2 blinded nonparticipant intensivist colleagues with the self-reported responses of the intensivists. Results Of 116 eligible intensivists, 76 (66%) completed the follow-up survey (mean [SD] respondent age was 43.1 [8.1] years; 72% were male). Sixty-one of 76 intensivists reported conveying prognosis; however, blinded colleagues who reviewed the deidentified transcripts were less likely to report that prognosis had been conveyed than intensivists reviewing their own transcripts (42 of 61; odds ratio, 0.10; 95% CI, 0.01-0.44;P Conclusions and Relevance In this study, guidelines for shared decision-making and end of life care were interpreted by intensivists in disparate ways. In the absence of training or personalized feedback, self-assessment of communication skills may not be interpreted consistently.
56-OR: Degree of ß-Cell Function (ßCF) Impairment and Glycemic Alterations in Obese Youth (OY) Spanning from Normal Glucose Tolerance (NGT) to Impaired Glucose Tolerance (IGT) to Type 2 Diabetes (T2D): Does Race Matter?

In OY it is not clear what degree of βCF impairment translates to increases in OGTT glucose area under the curve (G-AUC) commensurate with transition from NGT to IGT to T2D, and whether there are racial differences. Given the high rates of T2D in Black (BY) vs. White youth (WY), we hypothesized that βCF decline in BY is more detrimental and results in larger increases in G-AUC than in WY. Here we report the quantitative relationship between differences in clamp disposition index (DI=insulin sensitivity [IS] by a 3-hr hyperinsulinemic (80 mu/m2/min)-euglycemic clamp x 1st-phase insulin by a 2-hr hyperglycemic (225 mg/dL) clamp) and OGTT G-AUC in 152 OY. Two-way ANOVA (race x glycemic status) showed that in BY vs. WY larger decrements in DI from NGT to IGT and from NGT to T2D (all p Disclosure J. Kim: None. H.M. Tfayli: None. F. Bacha: Research Support; Self; AstraZeneca, Takeda Development Center Americas, Inc. N. Gebara: None. S.A. Arslanian: Research Support; Self; National Institutes of Health. Other Relationship; Self; AstraZeneca, Eli Lilly and Company, Novo Nordisk Inc. Funding Eunice Kennedy Shriver National Institute of Child Health and Human Development (K24-HD01357, R01HD27503); National Center for Advancing Translational Sciences (UL1TR000005); National Center for Research Resources (UL1RR024153)
Ethnography and Public Scholarship: Ethical Obligations, Tensions, and Opportunities:

The article introduces the special issue, “Ethnography and Public Scholarship: Ethical Obligations, Tensions, and Opportunities.” The editors begin with a discussion of Alice Goffman’s On the Run. ...
Bankruptcy as Consumer Protection: The Case of Student Loans

Over 300,000 student loan borrowers have applied to the Department of Education for administrative relief from federal student loans on the ground that they were deceived or otherwise victimized by their schools. The Department adopted relatively borrower-friendly rules for this process in 2016. But under the new administration, the Department changed course and adopted new rules that make it “nearly impossible” for student borrowers to prevail. After a presidential veto of a resolution that would have stopped the new rules, they went into effect on July 1, 2020. With victimized students effectively deprived of administrative relief, bankruptcy provides at least a partial solution. Many such borrowers will be candidates for bankruptcy: The median loan default rate at for-profit colleges sued or investigated for wrongdoing against students is estimated at 31 percent. To get bankruptcy relief, a debtor must show that repayment would cause “undue hardship.” Courts currently do not consider school wrongdoing in assessing undue hardship; this article argues that they should. When repayment will entail some hardship and the borrower’s decision to incur the student loan was induced by the school’s deceptive representations or unfair, abusive, or unconscionable practices, bankruptcy courts should provide relief. They should discharge at least the amount of the loan corresponding to the difference between the cost of the schooling and any value the loan holder can prove the education actually had. Considering school misconduct is consistent with the policies underlying non-discharge-ability of student loan debt because victimized students are not abusing the system when they seek relief and because collection from them is unlikely to be cost-effective. Moreover, discharge advances the goals of the student loan program. It might be objected that the federal government is not itself a wrongdoer in school-misconduct cases, so it should not bear losses arising from bankruptcy discharge of federal student loans. But the FTC’s Holder Rule has provided since 1976 that consumer lenders are responsible for sellers’ misconduct in analogous situations. The assumptions underlying the Holder Rule are met in student-loan cases. As between the two innocent parties, government and student, the government is both better able to absorb school-misconduct losses. The government is also better situated to prevent such losses due to its extensive supervisory powers over schools.
Physical Aggression Is Associated With More Effective Postdecisional Processing of Social Threat

Physically aggressive individuals are more likely to decide that others are threatening. Yet no research has examined how physically aggressive individuals’ social decisions unfold in real time. Se...
Generalized approach for radiotherapy treatment planning by optimizing projected health outcome: preliminary results for prostate radiotherapy patients.

Research in cancer care increasingly focuses on survivorship issues, e.g., managing disease- and treatment-related morbidity and mortality occurring during and after treatment. This necessitates innovative approaches that consider treatment side effects in addition to tumor cure. Current treatment-planning methods rely on constrained iterative optimization of dose distributions as a surrogate for health outcomes. The goal of this study was to develop a generally applicable method to directly optimize projected health outcomes. We developed an outcome-based objective function to guide selection of the number, angle, and relative fluence weight of photon and proton radiotherapy beams in a sample of ten prostate-cancer patients by optimizing the projected health outcome. We tested whether outcome-optimized radiotherapy (OORT) improved the projected longitudinal outcome compared to dose-optimized radiotherapy (DORT) first for a statistically significant majority of patients, then for each individual patient. We assessed whether the results were influenced by the selection of treatment modality, late-risk model, or host factors. The results of this study revealed that OORT was superior to DORT. Namely, OORT maintained or improved the projected health outcome of photon- and proton-therapy treatment plans for all ten patients compared to DORT. Furthermore, the results were qualitatively similar across three treatment modalities, six late-risk models, and 10 patients. The major finding of this work was that it is feasible to directly optimize the longitudinal (i.e., long- and short-term) health outcomes associated with the total (i.e., therapeutic and stray) absorbed dose in all of the tissues (i.e. healthy and diseased) in individual patients. This approach enables consideration of arbitrary treatment factors, host factors, health endpoints, and times of relevance to cancer survivorship. It also provides a simpler, more direct approach to realizing the full beneficial potential of cancer radiotherapy.
Sanctions in Political Science

A sanction is an action by one actor (A) intended to affect the behavior of another actor (B) by enhancing or reducing the values available to B. Influence attempts by A using actual or threatened punishments of B are instances of negative sanctions. Influence attempts by A using actual or promised rewards to B are instances of positive sanctions. Until the mid-twentieth century, sanctions were viewed primarily as mechanisms for enforcing societal norms, including those embedded in laws. Although this normative view of sanctions continues in legal theory, ethics, political theory, and sociology, a broader usage has emerged in political science during the latter part of the twentieth century. This broader usage depicts sanctions as potentially relevant to any type of influence attempt. This usage is typically found in discussions of influence and power. The subfield of political science that has devoted the most attention to sanctions in recent years is international relations and foreign policy. Most of this research has focused on the use of economic sanctions as foreign policy tools. Here, as elsewhere in political science, more attention has been devoted to the negative sanctions than to the positive ones.
Fast vision-guided mobile robot navigation using neural networks

Based on observations of human navigational behaviors, the authors have designed a vision-guided mobile robot navigation system that uses both a knowledge base system for high level supervisory control, and a collection of neural networks that mimic human reactive navigational behaviors such as 'go down the hallway' or 'follow the junction to the left'. They present the neural network component of the vision-guided mobile robot navigation system called NEURO-NAV and deal with how visual information is processed and how neural networks are used to perform primitive navigational tasks. Experimental results of neural classification and vision-guided navigation are included. >
STS: Adding Value To Research and Practice.

This article introduces the Kumar and Chubin-edited collection, Science, Technology, and Society: A Sourcebook on Research and Practice (Kluwer Academic/Plenum Publishing, New York). STS, a hybrid area of scholarship focuses on science-technology-society interactions, draws on the intellectual resources of scientists, educators, engineers, social scientists, and philosophers inside and outside academe. A dozen chapters examine STS trends, curriculum, teaching, learning, mentoring, advocacy, public policy, and issues for further research.
Spectral calibration of the EO-1 Advanced Land Imager

The spectral response of the Earth Observing 1 Advanced Land Imager (ALI) has been characterized at Lincoln Laboratory as a fully assembled instrument in a thermal vacuum chamber at operational temperatures. The focal pane for this instrument is partially populated over a 3 degree cross-track segment with 9 multispectral bands having a 30-meter ground sample distance (GSD) and a single panchromatic band having a 10- meter GSD. These bands were selected to mimic the six Landsat-7 VNIR/SWIR bands with three additional bands covering 0.433-0.453, 0.845-0.890, 1.20-1.30 micrometers . The instrument system level response was characterized spectrally form 400-900 nm in 2 nm increments and from 900- 2500 nm in 4 nm increments using a collimated monochromatic beam. Spectral artifacts introduced by the monochromatic and the collimator were accounted for using spectrally calibrated silicon and lead-sulfide detector which sampled the beam at each measurement interval. In this paper we describe the techniques employed during spectral calibration, present the measured in band and out of band spectral response for all VNIR bands, and compare the results to those obtained at the component level.
Myths About Controlling Pain

Myths and misinformation about pain and its management often lead to poor therapy for patients in pain. Nine common myths about pain and its management are described and refuted.
Symbolic modeling in building energy simulation

Abstract We show how symbolic modeling is used in the Simulation Problem Analysis and Research Kernel (SPARK) for solving complex problems in building energy simulation. After a brief overview of SPARK, we describe its symbolic interface, which reads equations that are entered in symbolic form and automatically generates a program that solves the equations. The application of this method to solving the partial differential equations for two-dimensional heat flow is illustrated.
Machined surface error analysis for 5-axis machining

The complexity of a tool's simultaneous movement in five axes increases the difficulty of evaluating surface error in 5-axis machining. This paper presents an error analysis method for 5-axis machining which applies differential geometry techniques to evaluate the cusp height between adjacent cutter locations. Effective cutting shapes of adjacent cutting positions are derived. The technique of finding cusp height is also proposed. A method of finding the direct and indirect intersection positions is presented to evaluate the surface error. The error analysis method proposed in this paper can be used to improve the efficiency of 5-axis machining and to generate appropriate cutter path distribution. Analytical results and examples of practical applications are also presented.
Chiral Loops and Ghost States in the Quenched Scalar Propagator

The scalar, isovector meson propagator is analyzed in quenched QCD, using the MQA pole-shifting ansatz to study the chiral limit. In addition to the expected short-range exponential falloff characteristic of a heavy scalar meson, the propagator also exhibits a longer-range, negative metric contribution which becomes pronounced for smaller quark masses. We show that this is a quenched chiral loop effect associated with the anomalous structure of the eta' propagator in quenched QCD. Both the time dependence and the quark mass dependence of this effect are well-described by a chiral loop diagram corresponding to an eta'-pi intermediate state, which is light and effectively of negative norm in the quenched approximation. The relevant parameters of the effective Lagrangian describing the scalar sector of the quenched theory are determined.
Notes to a paper by C. N. Friedman

Abstract The proof of one of the main results of C. N. Friedman, Perturbations of the Schroedinger equation by potentials with small support ( J. Functional Analysis 10 (1972), 346–360) is modified basing it on a more general existence theorem. A proof of this existence theorem is provided.
Separation and purification of lactic acid : fundamental studies on the reverse osmosis down-stream process

Abstract The physico-chemical properties and effects of lactic acid and lactates in the reverse osmosis process were investigated using a polyamide composite membrane. The membrane was found to swell at pH 2.2, yet has no detectable solute-membrane affinity. The decrease in flux and increase in the solute reduction factor of lactic acid (0.66 m 3 .m −2 .d −1 ; 5.8), ammonium lactate (0.30 m 3 .m −2 .d −2 .d −1 ; 18.3) and sodium lactate (0.18 m 3 .m −2 .d −1 ; > 80) were found to be related to the concentration of ions dissociated into solution as affected by the pH of the feed. The effects of operating parameters such as pressure, feed concentration and stirring speed were also discussed. Optimum operating conditions were found to be 7 MPa and 900 rpm.
Adsorptive preconcentration for voltammetric measurements of trace levels of zirconium.

Abstract This paper describes an electrochemical stripping procedure for ultratrace measurements of zirconium, in which preconcentration is achieved by the adsorption of a zirconium—Solochrome Violet RS complex onto a hanging mercury drop electrode. Cyclic voltammetry was used to characterize the interfacial and redox behaviour. For a 10-min preconcentration time, the detection limit found was 2.3 × 10 −10 M . Optimal experimental conditions were found to be use of a stirred acetate buffer (pH 4.6) solution with Solochrome Violet RS concentration 1.5 × 10 −6 M , a preconcentration potential of −0.3 V and linear scan mode. A 60-fold enhancement of the response is obtained following 5-min preconcentration. With preconcentration for 60 sec, calibration plots for zirconium are linear for the 1.1 × 10 −8 −1.1 × 10 −7 M range. The relative standard deviation at 5.5 × 10 −8 M is 1.7%. Possible interferences by surface-active organic materials and other trace metals have been investigated. Zirconium added to a sea-water sample at the 10 ng/ml level was readily determined.