cssi/SciSciGPT-SciSciNet huggingface dataset:
Effects of milking unit design on upper extremity muscle activity during attachment among U.S. large-herd parlor workers.

Abstract Background Large-herd dairy parlor workers experience a high prevalence of musculoskeletal symptoms in the upper extremity. The purpose of this study was to evaluate the effect of milking unit design on upper extremity muscle activity during milking unit attachment. Methods Upper extremity muscle activity was recorded among U.S. large-herd parlor workers (n=11) using surface electromyography. Participants performed several milking unit attachment cycles with each of six milking unit designs. Muscle activity levels were then compared between unit designs. Results Mean muscle activity levels (in %MVE) across milking units ranged from 6.8 to 8.2 for the upper trapezius, 8.2 to 10.3 for the anterior deltoid, 13.8 to 17.2 for the forearm flexors, and 9.9 to 12.4 for the forearm extensors. Pairwise comparisons between milking units did not reveal statistically significant differences in muscle activity levels across milking unit designs. However, a general pattern of higher muscle activity was observed with specific milking units. Milking unit weight, milk tube spread, and teat cup shape may explain differences in muscle activity levels. Conclusions Milking unit design may influence muscle activity levels among parlor workers. Small reductions in muscle activity associated with milking unit design have the potential to delay the onset of fatigue or development of musculoskeletal health outcomes among parlor workers.
CD Review: Tour de Force

Review of Tour de Force, the third album from C Force, an ensemble comprised of flutist Christine Gangelhoff, euphoniumist Christian Justilien, and pianist Christy Lee. With repertoire spanning over two centuries, the trio embarks on a musical tour to Guadaloupe, Jamaica, and Haiti on Disc One, and then Trinidad and Tobago, Curacao, the U.S. Virgin Islands and the Bahamas on Disc Two. Just as the eclectic album artwork by John Cox might suggest, Tour de Force provides listeners with a sense of the rich tapestry of musical connections shared in art music across the Caribbean. This two-disc set (released March 2016) was recorded at the Performing Arts Center of The College of The Bahamas and produced by Terry Manning of Lucky Seven Records.
Managing Depression among Diverse Older Adults in Primary Care: The BRIGHTEN Program

ABSTRACTObjectives: A variety of specific cultural adaptations have been proposed for older adult and minority mental health interventions. The objective of this study was to determine whether the BRIGHTEN Program, an individually tailored, interdisciplinary “virtual” team intervention, would equally meet the needs of a highly diverse sample of older adults with depression.Methods: Older adults who screened positive for depression were recruited from primary and specialty care settings to participate in the BRIGHTEN program. A secondary data analysis of 131 older adults (37.4% African-American, 29.0% Hispanic, 29.8% Non-Hispanic White) was conducted to explore the effects of demographic variables (race/ethnicity, income and education) on treatment outcome.Results: Compared to baseline, participants demonstrated significant improvements on the SF-12 Mental Health Composite and depression (GDS-15) scores at 6-month follow-up. There were no differences on outcome measures based on race/ethnicity, income or e...
Critical Limb Ischemia

Critical limb ischemia (CLI) represents the most severe manifestation of peripheral arterial disease and is defined as the presence of chronic ischemic rest pain, ischemic ulcers, or gangrene attributable to objectively proven arterial occlusive disease. Primary treatment goals include relief of ischemic rest pain, healing of ischemic ulcers, limb salvage, and improvement in quality of life.
The effect of routine training on the self-efficacy of informal caregivers of colorectal cancer patients

Little is known about the degree to which caregiver training as part of routine clinical care influences caregiver self-efficacy. The objective of this study was to examine the relationship between training during routine clinical cancer care and self-efficacy among caregivers of colorectal cancer patients. Caregivers completed a self-administered questionnaire about their experiences with training for specific patient problems and about their task-specific and general caregiving self-efficacy. Associations between training and self-efficacy were examined for each problem using multivariate logistic regression adjusted for caregiver age, race, care burden, education, perception of patient’s health, and patient stage of disease. Four hundred seventeen caregivers completed the survey (70% response rate), of whom 374 (90%) were female and 284 (68%) were the patient’s spouse/partner. Overall, 77 (38%) reported inadequate training for pain, 80 (38%) for bowel, 121 (48%) for fatigue, 65 (26%) for medication administration, and 101 (40%) for other symptoms. The odds of having low self-efficacy were significantly higher among those with perceptions of inadequate training across the following cancer-related problems: pain 10.10 (3.36, 30.39), bowel 5.04 (1.98, 12.82), fatigue 8.45 (3.22, 22.15), managing medications 9.00 (3.30, 24.51), and other 3.87 (1.68, 8.93). Caregivers commonly report inadequate training in routine colorectal cancer care. Significant and consistent associations between training adequacy and self-efficacy were found. This study supports the value of training caregivers in common cancer symptoms. Further work on how and when to provide caregiver training to best impact self-efficacy is needed.
Subangstrom Measurements of Enzyme Function Using a Biological Nanopore, SPRNT.

Abstract Nanopores are emerging as new single-molecule tools in the study of enzymes. Based on the progress in nanopore sequencing of DNA, a tool called Single-molecule Picometer Resolution Nanopore Tweezers (SPRNT) was developed to measure the movement of enzymes along DNA in real time. In this new method, an enzyme is loaded onto a DNA (or RNA) molecule. A single-stranded DNA end of this complex is drawn into a nanopore by an electrostatic potential that is applied across the pore. The single-stranded DNA passes through the pore's constriction until the enzyme comes into contact with the pore. Further progression of the DNA through the pore is then controlled by the enzyme. An ion current that flows through the pore's constriction is modulated by the DNA in the constriction. Analysis of ion current changes reveals the advance of the DNA with high spatiotemporal precision, thereby providing a real-time record of the enzyme's activity. Using an engineered version of the protein nanopore MspA, SPRNT has spatial resolution as small as 40 pm at millisecond timescales, while simultaneously providing the DNA's sequence within the enzyme. In this chapter, SPRNT is introduced and its extraordinary potential is exemplified using the helicase Hel308. Two distinct substates are observed for each one-nucleotide advance; one of these about half-nucleotide long steps is ATP dependent and the other is ATP independent. The spatiotemporal resolution of this low-cost single-molecule technique lifts the study of enzymes to a new level of precision, enabling exploration of hitherto unobservable enzyme dynamics in real time.
Improving the low Mach number steady state convergence of the cascaded lattice Boltzmann method by preconditioning

Abstract Cascaded lattice Boltzmann method (LBM) involves the use of central moments in a multiple relaxation time formulation in prescribing the collision step. When the goal is to simulate low Mach number stationary flows, the greater the disparity between the magnitude of fluid speed and the sound speed, the higher is the numerical stiffness, which results in relatively large number of time steps for convergence of the LBM. One way to improve the steady state convergence of the scheme is to precondition the cascaded LBM, which reduces the disparities between the characteristic speeds or equivalently those between the eigenvalues of the system. In this paper we present a new preconditioned, two-dimensional cascaded LBM, where a preconditioning parameter is introduced into the equilibrium moments as well as the forcing terms. Particular focus is given to preconditioning differently the moments due to forcing at first and second orders so as to avoid any spurious effects in the emergent macroscopic equations. A Chapman–Enskog analysis performed on this approach shows consistency to the preconditioned Navier–Stokes equations. This modified central moment based scheme is then validated for accuracy by comparison against prior analytical or numerical results for certain benchmark problems, including those involving spatially variable body forces. Finally, significant steady state convergence acceleration of the preconditioned cascaded LBM is demonstrated for a set of characteristic parameters.
Trends in Dementia Incidence in a Birth Cohort Analysis of the Einstein Aging Study.

Importance Trends in dementia incidence rates have important implications for planning and prevention. To better understand incidence trends over time requires separation of age and cohort effects, and few prior studies have used this approach. Objectives To examine trends in dementia incidence and concomitant trends in cardiovascular comorbidities among individuals aged 70 years or older who were enrolled in the Einstein Aging Study between 1993 and 2015. Design, Setting, and Participants In this birth cohort analysis of all-cause dementia incidence in persons enrolled in the Einstein Aging Study from October 20, 1993, through November 17, 2015, a systematically recruited, population-based sample of 1348 participants from Bronx County, New York, who were 70 years or older without dementia at enrollment and at least one annual follow-up was studied. Poisson regression was used to model dementia incidence as a function of age, sex, educational level, race, and birth cohort, with profile likelihood used to identify the timing of significant increases or decreases in incidence. Exposures Birth year and age. Main Outcomes and Measures Incident dementia defined by consensus case conference based on annual, standardized neuropsychological and neurologic examination findings, using criteria from the DSM-IV . Results Among 1348 individuals (mean [SD] baseline age, 78.5 [5.4] years; 830 [61.6%] female; 915 [67.9%] non-Hispanic white), 150 incident dementia cases developed during 5932 person-years (mean [SD] follow-up, 4.4 [3.4] years). Dementia incidence decreased in successive birth cohorts. Incidence per 100 person-years was 5.09 in birth cohorts before 1920, 3.11 in the 1920 through 1924 birth cohorts, 1.73 in the 1925 through 1929 birth cohorts, and 0.23 in cohorts born after 1929. Change point analyses identified a significant decrease in dementia incidence among those born after July 1929 (95% CI, June 1929 to January 1930). The relative rate for birth cohorts before July 1929 vs after was 0.13 (95% CI, 0.04-0.41). Prevalence of stroke and myocardial infarction decreased across successive birth cohorts, whereas diabetes prevalence increased. Adjustment for these cardiovascular comorbidities did not explain the decreased dementia incidence rates for more recent birth cohorts. Conclusions and Relevance Analyses confirm decreasing dementia incidence in this population-based sample. Whether decreasing incidence will contribute to reduced burden of dementia given the aging of the population is not known.
Frequency sensitivity in Northern saw-whet owls (Aegolius acadicus)

Northern saw-whet owls (Aegolius acadicus) are known for their unique asymmetrical ear structure and ability to localize prey acoustically, yet few attempts have been made to explore the auditory capabilities of this species. In this study, we evoked auditory brainstem responses (ABRs) with tonebursts to assess three main hypotheses regarding the evolution of auditory sensitivity: sender-receiver matching, ecological constraints, and phylogenetic/morphological constraints. We found that ABR amplitude increased with increasing stimulus level, which is consistent with results in other avian species. ABR amplitudes, latencies, and thresholds indicate that the hearing range of Northern saw-whet owls extends from 0.7 to 8.6 kHz, with an extended frequency range of best sensitivity between 1.6 and 7.1 kHz. Sensitivity fell off rapidly above and below these frequencies. The average audiogram was structurally similar to those found in other species of owls, suggesting that phylogeny or morphology may be constraining the frequency range of auditory sensitivity. However, ABR thresholds were 10–25 dB lower than those of Eastern screech-owls (Megascops asio), with thresholds below 0 dB SPL in some individuals. The lowest thresholds were at frequencies not found in the vocalizations of Northern saw-whet owls, suggesting ecological constraints rather than conspecific vocalizations are driving absolute sensitivity.
Inflammatory monocytes orchestrate innate antifungal immunity in the lung (MPF7P.701)

Aspergillus fumigatus is a mold fungal pathogen and the most common cause of invasive aspergillosis (IA), a serious infection that develops in patients with compromised immune function. Although a variety of immune cells can help confer protection against IA, the mechanisms that govern immune cell cooperation culminating in the eradication of conidia and IA prevention are unclear. Using selective cell depletion strategies our recent studies have shown that, in addition to neutrophils, CCR2 + inflammatory monocytes (CCR2 + Mo) and their derivative monocyte-derived dendritic cells (Mo-DCs) are required for the prevention of IA. In preliminary studies, we find that IA development in neutrophil-depleted animals is associated with diminished Mo-DC differentiation and lower conidiacidal activity in these cells. We hypothesize that neutrophil and CCR2 + Mo functions are interdependent, continuously cross-regulating each other’s antifungal activities. We are currently investigating the mechanisms of CCR2 + Mo and neutrophil cross-regulation, and characterizing their overall contributions to anti-fungal immunity.
Thermal Stabilization of Enzymes with Molecular Brushes

Herein, we report a conjugation strategy, where we utilize a poly(ethylene oxide) cylindrical molecular brush architecture to design a self-assembled structure for thermal stabilization of enzymes. We demonstrate that the proposed architecture of the moderately stiff polymer ligand results in a significant improvement of biocatalytic activity and thermal stability of lysozyme and trypsin that retain their activity, even upon heating to 100 °C and above. The molecular brush is bound via epoxy functional groups to the amino groups of the lysine on the surface of the enzyme globule, promoting the formation of stiff and crowded cages around the enzymes and preventing the water molecules access to the enzyme and enzymes agglomeration. The molecular dynamic simulations show that the high concentration of poly(ethylene oxide) in the vicinity of the enzyme is critical for their stability. Monitoring of lysozyme–molecular brush conjugates for 6 and 12 months in lyophilized form and in solution, respectively, has s...
Continuous intrathecal morphine infusion for pain management in a patient with burn injury

Abstract Introduction Known risk factors for delirium include admission to an intensive care setting and administration of intravenous infusions for pain and sedation. Patients diagnosed with delirium are more likely to have a prolonged ICU length of stay, increased ventilator days, and higher rates of long-term cognitive dysfunction. There is currently no effective treatment for delirium. Methods This case report details the placement of an intrathecal catheter and infusion of intrathecal preservative-free morphine for the treatment of pain following burn injury. Results During intrathecal infusion of morphine, the patient reported adequate pain control without systemic opioid administration. After intravenous infusions of ketamine, propofol, and dexmedetomidine were discontinued, the patient was awake and responsive. Following removal of the intrathecal morphine infusion, the patient’s opioid requirement remained lower than that needed prior to catheter placement, despite repeated surgical interventions. Discussion Intrathecal opioid administration is a new direction in the treatment of acute pain in the intensive care setting and represents a way to reduce the risk of delirium by limiting exposure to systemic opioids and sedatives. There are no prior reports of intrathecal infusions in this population to directly compare, and therefore, any data on complications or infectious risk must be extrapolated from patients with different disease processes but similar interventions.
Characterization of laser-generated aluminum plasma using ion time-of-flight and optical emission spectroscopy

Laser plasma generated by ablation of an Al target in vacuum is characterized by ion time-of-flight combined with optical emission spectroscopy. A Q-switched Nd:YAG laser (wavelength λ = 1064 nm, pulse width τ ∼ 7 ns, and fluence F ≤ 38 J/cm2) is used to ablate the Al target. Ion yield and energy distribution of each charge state are measured. Ions are accelerated according to their charge state by the double-layer potential developed at the plasma-vacuum interface. The ion energy distribution follows a shifted Coulomb-Boltzmann distribution. Optical emission spectroscopy of the Al plasma gives significantly lower plasma temperature than the ion temperature obtained from the ion time-of-flight, due to the difference in the temporal and spatial regions of the plasma plume probed by the two methods. Applying an external electric field in the plasma expansion region in a direction parallel to the plume expansion increases the line emission intensity. However, the plasma temperature and density, as measured b...
Re-Creating Space in Cristina Cerezales Laforet’s El pozo del cielo (2013)

Cristina Cerezales Laforet’s 2013 novel El pozo del cielo, set in contemporary Madrid, intimates that by engaging the arts and literature we participate in a process that remedies divisions in life and creates space for re-defined gender roles. Cerezales’ narrative supports Henri Lefebvre’s theory that the arts serve the urban and neutralize alienation in modern society by illustrating how fiction can open the mind to new possibilities. Her novel demonstrates a creative way to alter men’s and women’s places in urban society when opposites—sky and well, male and female, house and urban space—attain a new balance. Cerezales illuminates the power of the pen by transposing the space her characters occupy, with the male inside and the female outside.
Exploring opioid use disorder, its impact, and treatment among individuals experiencing homelessness as part of a family.

Abstract Background Opioid Use Disorder (OUD) causes significant morbidity and mortality among people experiencing homelessness. We aimed to explore the unique way in which OUD impacts individuals experiencing homelessness as part of a family. Methods We conducted semi-structured interviews with adults experiencing OUD staying in Boston-area family shelters along with dependent children. We used Borkan’s Immersion-Crystallization method to uncover themes from interview transcripts. Results We conducted 14 interviews. Eleven participants identified as female and three as male. Mean age was 35 (range 24–51) and median number of children was 2.5 (range 1-5). Emergent themes fell in three categories: 1) Initiation of OUD: Many patients were introduced to opioids through physician prescriptions, with recreational use coming first for some. Parents and partners also contributed to opioid use. 2) Impact of OUD: Overdose, homelessness, and unemployment were common impacts of OUD. Many patients described co-morbid chronic pain and mental illness. Psychosocial trauma, prominently due to loss of child custody, was common. 3) Treatment for OUD: Childcare, transportation to treatment at distant sites, and requirements that interfered with life responsibilities were barriers to treatment that shelter-based opioid treatment (SBOT) allowed patients to overcome. Family unity was universally seen as motivation for treatment. Conclusions According to a sample of adults experiencing OUD in the context of family homelessness, an ideal OUD treatment program would overcome logistical barriers, provide comprehensive treatment for comorbidities, support employment and housing needs, and focus care on the family. Future work should explore the generalizability and financial feasibility of this model.
Thermodynamic modeling of the La-Te system aided by first-principles calculations

Abstract A complete thermodynamic description of the La-Te binary system is developed by means of CALculation of PHAse Diagram (CALPHAD) method in combination with available experimental data in the literature and the present first-principles calculations based on density functional theory. The intermetallic phases with homogeneity ranges, La3-xTe4 and LaTe2-x, are modeled using a two-sublattice (La,Va)3(Te)4 model and a three-sublattice (La)1(Te)1(Te,Va)1 model based on their structure features, respectively. The intermetallic phases, LaTe and LaTe3, are treated as stoichiometric compounds. The thermodynamic properties of the intermetallic compounds and their corresponding end members at finite temperatures are predicted using first-principles quasi-harmonic approach. The associate solution model is used to describe the short-range ordering behavior of the liquid phase. The calculated phase diagram agrees well with the available phase equilibrium data in the literature.
The eighth edition American Joint Committee on Cancer (AJCC) melanoma staging system: implications for melanoma treatment and care.

Introduction: The eighth edition of the American Joint Committee on Cancer (AJCC) melanoma staging system was implemented in the United States on 1 January 2018.Areas covered: This article provides...
The speed of sound in mixtures of the major sea salts. A test of Young's rule for adiabatic PVT properties

The relative sound speed of mixtures of aqueous solutions of NaCl−MgSO4 and MgCl2−Na2SO4 at I=0.1 and 0.5m have been determined at 5, 15, and 25°C and pressures to 1000 bars. The resulting sound speeds, adiabatic and apparent molal compressibilities have been compared to results estimated from binary solutions using an additivity principle — Young's rule. The estimated sound speeds agree with the measured values for the NaCl−MgSO4 system to ±0.15 m-sec−1 and for the Na2SO4−MgCL2 system to ±0.20 m-sec−1. The deviations increase with increasing ionic strength (±0.08 m-sec−1 at I=0.1 and ±0.25 m-sec−1 at I=0.5 m).
Medical Issues in the Care of Child and Adolescent Inpatients

It surprises very few mental health workers that emotional and behavioral disorders in children and adolescents are often underdiagnosed and undertreated or inappropriately treated in traditional medical and pediatric settings, where the focus of patient, family, and physician is generally on physical symptoms or complaints (Costello, Edelbrock, Costello, Dulcan, Burns, & Brent, 1988). Conversely, in the mental health setting, where the focus is generally on “psychological” suffering, the presence of a predisposing, precipitating, or coexisting medical illness may be overlooked or undervalued, or it may be treated with a great deal of uneasiness. The mind-body problem that has plagued Western medicine and philosophy does not appear likely to go away any time soon. Although some have derided the “false boundary between mind and brain” (Detre, 1987, p. 621), our real limitations in examining, identifying, and studying the somatic underpinnings of psychological states are all too evident from a practical perspective. In our day-to-day dealings with patients, we are confronted with a “practical dualism” (McHugh & Slavney, 1983; Schiffer, Klein, & Sider, 1988). In order to ensure adequate care, we must view our patients as both subjective agents (who experience and do things) and objective organisms (who are diagnosed, studied, and “have” things, like diseases) (Schiffer et al., 1988). Nevertheless, an integrated understanding of our patients is desirable, and in many instances, the relationship between the “psychological” and the “organic,” the subjective and the objective, can be sorted out, at least in part. In some instances, there appears to be evidence that a biological lesion or vulnerability may require a subsequent Stressor in order to become manifest (Kruesi, 1990). In addition, although our impressions about the direction of causality (i. e., whether psychological distress precedes physical illness or vice versa) are often of clinical relevance, and words like psychosomatic or somatopsychic slip easily off the tongue, it is difficult to imagine a truly “nonpsychosomatic” disorder (Lask & Fosson, 1989).
Description of Bread Textural Deterioration by Stress-Strain Curves, Recoverable Work, and Thermal Transitions

Standard white (SWB) and intermediate moisture (MRE) breads are characterized here in terms of stress-strain curves analysis and thermal transitions. Observation of changes in these parameters can be useful for studying the mechanisms of bread staling in relation to textural deterioration. Glass transition temperature was found to increase in SWB but not in MRE breads. Relationships with moisture loss and amylopectins crystallization are discussed.
Boundary Organizations and Objects Supporting Stakeholders for Decision Making on Sustainable Water Management in Phoenix, Arizona USA

Integrating divergent knowledge systems among scientists and other stakeholders with diverse values and interests presents a major obstacle for collaboration to inform sustainability in social-ecological systems. This integration has been hampered by, among other issues, unrealistic expectations about the ability of science to inform policy decisions, differences in scientific and political understandings of uncertainty, difficulty achieving scientific consensus on complex topics, different time scales for scientific and political processes, and social and cultural differences between scientists and policy makers. Boundary organizations theory presents one promising approach for overcoming these barriers and enhancing the linkages between science and decision making. Boundary organizations provide institutional structure, space, bilateral knowledge translators, and incentives for the creation of boundary objects such as maps, models, and decision support systems. Boundary organizations and objects can help to structure the relationships between multiple stakeholders. This chapter examines the design and functions of the Decision Center for a Desert City (DCDC) at Arizona State University and the use of the WaterSim and the Decision Theater as examples of effective use of boundary organization principles. We discuss these concepts in the context of water resources management in the Phoenix metropolitan area in arid southwestern United States.
Utilization of Imidacloprid to Control Thrips in Peanut in North Carolina

ABSTRACT Tobacco thrips (Frankliniella fusca Hinds) is an important pest in peanut (Arachis hypogaea L.) in North Carolina and injury from this insect can lower yield. Research was conducted from 2...
An mHealth approach to extend a brief intervention for adolescent alcohol use and suicidal behavior: Qualitative analyses of adolescent and parent feedback.

Mobile health (mHealth) tools that supplement inpatient psychiatric care can maintain and enhance intervention effects following hospitalization. Adolescents hospitalized following a suicidal event...
Bacterial Aspartyl-tRNA Synthetase Has Glutamyl-tRNA Synthetase Activity

The aminoacyl-tRNA synthetases (aaRSs) are well established as the translators of the genetic code, because their products, the aminoacyl-tRNAs, read codons to translate messenger RNAs into proteins. Consequently, deleterious errors by the aaRSs can be transferred into the proteome via misacylated tRNAs. Nevertheless, many microorganisms use an indirect pathway to produce Asn-tRNAAsn via Asp-tRNAAsn. This intermediate is produced by a non-discriminating aspartyl-tRNA synthetase (ND-AspRS) that has retained its ability to also generate Asp-tRNAAsp. Here we report the discovery that ND-AspRS and its discriminating counterpart, AspRS, are also capable of specifically producing Glu-tRNAGlu, without producing misacylated tRNAs like Glu-tRNAAsn, Glu-tRNAAsp, or Asp-tRNAGlu, thus maintaining the fidelity of the genetic code. Consequently, bacterial AspRSs have glutamyl-tRNA synthetase-like activity that does not contaminate the proteome via amino acid misincorporation.
Neosporin® Ophthalmic (Burroughs Wellcome)

Neosporin ophthalamic ointment contains three antibiotics. Polymyxin B is an antibacterial agent whose action is restricted to gramnegative bacteria. Neomycin has antibacterial activity in vitro against a wide range of gram-negative and gram-positive organisms. Bacitracin is an antibiotic whose actions in vitro works against a variety of gram-positive and a few gram-negative organisms.
Laparoscopy in the Pediatric Population

Although once limited to the adult population, laparoscopic applications to urologic surgery are now being successfully applied to children of all ages. The current role of laparoscopy in children requiring pyeloplasty, orchidopexy, renal ablative procedures, ureteral reimplantation, lower urinary tract reconstruction, and varicocelectomy are reviewed. Newer applications of robotic assistance are also discussed with emphasis on published results. Future research will continue to define the safest and most efficacious applications of laparoscopy in pediatric urology.
Moving the Practice of Respiratory Therapy Forward.

In this issue of Respiratory Care, Chatburn et al,[1][1] from the Cleveland Clinic, describe their experience with a respiratory therapy consult service at the main campus hospital compared with 2 off–main campus hospitals without a respiratory therapy consult service. These investigators found
Brain Acetylcholine and Disorders of Memory

There is neurochemical and pharmacological evidence linking changes in brain cholinergic function with aging and changes in memory function. This data has clear implications for the treatment of senile dementia and age related cognitive deficits. This paper reviews this data and discusses its implications.
Male Preconception Marijuana Use and Spontaneous Abortion: A Prospective Cohort Study.

BACKGROUND Male marijuana use has increased steadily over the last decade, but its effect on risk of spontaneous abortion to our knowledge has not been studied. METHODS We analyzed data from Pregnancy Study Online, a North American prospective cohort study of pregnancy planners (2013-2019). During the preconception period, male and female participants completed baseline questionnaires on demographics, medical history, and behavioral factors, including marijuana use. Female participants identified pregnancy losses on bimonthly follow-up questionnaires and questionnaires completed in early and late pregnancy. We categorized frequency of male marijuana use in the 2 months before baseline as none, <1 time/week, or ≥1 time/week. We estimated the association between preconception male marijuana use and spontaneous abortion, adjusting for male and female confounders. RESULTS Among 1535 couples who conceived during follow-up, 9% of men reported preconceptional marijuana use <1 time/week and 8% ≥1 time/week. Nineteen percent of pregnancies ended in spontaneous abortion. Compared with no use, adjusted hazard ratios (HRs) for male marijuana use were 1.1 (95% confidence interval [CI] = 0.64, 1.7) for <1 time/week and 2.0 (95% CI = 1.2, 3.1) for ≥1 time/week. The association for ≥1 time/week persisted after restricting to couples where the female partner did not use marijuana (HR = 2.0, 95% CI = 1.1, 3.3), and was stronger for losses at <8 weeks' gestation (HR = 2.5, 95% CI = 1.4, 4.3) and among males aged ≥35 years (HR = 4.1, 95% CI = 1.54, 11). CONCLUSIONS Couples with male partners who used marijuana ≥1 time/week during preconception had greater risk of spontaneous abortion than couples with males who did not use marijuana.
Sleep disturbance is associated with less emotional reactivity in individuals with heightened repetitive negative thinking

Recently, there has been increasing recognition that individuals with heightened repetitive negative thinking and anxiety often experience disruptions in their sleep and circadian rhythms. However, the mechanisms of this relation require further study. The primary aim of this study is to identify whether emotional reactivity is related to sleep in individuals with repetitive negative thinking. Fifty-two individuals selected for high levels of transdiagnostic repetitive negative thinking and varying amounts of sleep disruption were included in the study sample. Participants passively viewed emotionally-valenced (positive and negative) and neutral images. Some of these images had been previously-seen by participants and others were novel. Participants’ pupil diameter was measured as they viewed the images and they also rated their subjective reaction to these images. Poorer sleep quality was significantly associated with less pupil dilation in response to all novel stimuli (i.e., collapsing across emotion). Shorter habitual sleep duration and longer sleep onset latency were associated with lower subjective unpleasantness when viewing all study stimuli (i.e., collapsing across novelty and emotion). These findings were consistent with the possibility that sleep disturbance may be related to repetitive negative thinking through differences in emotional reactivity. Sleep disturbance has been associated with blunted responses to emotional stimuli in other samples. Future studies examining mechanisms and moderators of increased and blunted emotional response related to sleep disturbance are needed.
An Atypical Presentation of Hemophagocytic Lymphohistiocytosis (HLH) Secondary to Occult Hodgkin Lymphoma.

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening syndrome of immune system dysregulation characterized by the phagocytosis of various cells by histiocytes in the bone marrow. HLH can present in one of the two ways: primary HLH, which is caused by mutations in genes essential to T and NK-cell function, and secondary HLH, typically caused by Epstein–Barr virus (EBV) infection or malignancy. Because of the rapid progression and high mortality of this disease, prompt diagnosis is essential to good outcomes. Here, we report the 2-month clinical course of a patient who presented with altered mental status and recurrent fever of unknown origin. Initially, he did not meet diagnostic criteria for HLH and had a negative bone marrow biopsy; however, he eventually progressed to full-blown HLH secondary to occult Hodgkin lymphoma. This case is unusual for the slow and smoldering course of the patient’s disease and highlights the importance of aggressively searching for potential malignancies to ensure the initiation of definitive therapy as soon as possible.
Multicavity linear transformer driver facility for Z -pinch and high-power microwave research

BLUE is a four-cavity linear transformer driver system in the Plasma, Pulsed Power, and Microwave Laboratory at the University of Michigan. Each BLUE cavity can store up to 2 kJ of electrical energy and provide an open-circuit voltage of 200 kV when using the maximum bipolar charge voltage of $\ifmmode\pm\else\textpm\fi{}100\text{ }\text{ }\mathrm{kV}$. The impedance of each cavity is approximately $0.5\text{ }\text{ }\mathrm{\ensuremath{\Omega}}$, and the rise time of the current pulse into a reasonably matched load is $\ensuremath{\sim}100\text{ }\text{ }\mathrm{ns}$. The system will be used to study high-energy-density $Z$-pinch plasmas and high-power radiation sources. The facility has been equipped to handle intense bursts of x rays, nuclear fusion neutrons, and high-power microwaves (HPM). This paper reports on the construction and performance of the first (prototype) BLUE cavity and its auxiliary systems, as well as preliminary experiments using the cavity to drive resistive loads and a magnetically insulated line oscillator (MILO) HPM device. In these initial single cavity, BLUE-driven MILO experiments, 1.19 GHz microwave oscillations were successfully generated.
Growing Executive Power: The Strange Case of the 'Protective Return' Pocket Veto

Recent presidents have carved out a presidential power by asserted constitutional right allegedly adhering to the presidency in the form of the so-called "protective return" pocket veto, by which presidents claim to pocket veto a bill - a circumstance where, by definition, bill return to Congress is not possible - yet proceed to do the impossible by returning the bill to Congress. This obscure yet portentous power grab 1) arose, ironically, from adverse court rulings and a repudiation of the procedure, 2) illustrates the accretion of presidential power by the claiming of constitutional (as opposed to Neustadtian political) powers by presidents, and 3) exemplifies the ability of presidents to autonomously define, consolidate, and expand power over time. This paper excavates and examines the genesis of this obscure power claim and argue that it is incompatible with that which can be gleaned from textual construction, original intent, court rulings, and separation of powers principles.
Carbachol in the presence of guanosine 5'-O-(3-thiotriphosphate) stimulates the breakdown of exogenous phosphatidylinositol 4,5-bisphosphate, phosphatidylinositol 4-phosphate, and phosphatidylinositol by rat brain membranes

Abstract The breakdown of exogenously added [3H]inositol-labeled phosphoinositides by rat brain cortical membranes was stimulated by the muscarinic cholinergic agonist carbachol. The stimulation required the presence of guanine nucleotide. Optimal conditions were similar to those described for guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S) + carbachol stimulation of phosphoinositide breakdown in [3H]inositol-prelabeled brain membranes (Claro, E., Garcia, A., and Picatoste, F. (1989) Biochem J. 261, 29-35). Carbachol stimulated [3H]phosphatidylinositol 4,5-bisphosphate (PIP2) breakdown was inhibited by atropine and guanosine 5'-O-(2-thiobisphosphate). The magnitude of the stimulation of exogenous PIP2 breakdown by carbachol and GTP gamma S (2- to 3-fold) was little affected over a PIP2 concentration range of 0.03-100 microM. Phosphatidylinositol 4-phosphate (PIP) was as good a substrate at all concentrations as PIP2 for carbachol stimulation of phospholipase C activity. There was appreciable phosphomonoesterase degradation of PIP to phosphatidylinositol (PI) over 10 min. There was also some conversion of added PIP to PIP2 in the presence of added ATP. The effect of calcium on PIP breakdown was similar to that on PIP2 breakdown, with an apparent EC50 for Ca2+ stimulation of 0.74 and 0.72 microM, respectively, under basal conditions. The stimulation of PIP2 and PIP breakdown by carbachol in the presence of GTP gamma S was greatest on a percentage basis at the lowest free Ca2+ concentrations. Above 1 microM free Ca2+, the stimulatory effect was lost, whereas 10 microM free Ca2+ gave a maximal stimulation of basal phospholipase C activity. Degradation of added PI was also stimulated by carbachol in the absence of ATP. PI breakdown had an EC50 for Ca2+ stimulation of 1.07 microM. The best stimulation of PI breakdown due to carbachol plus GTP gamma S was seen with 0.3 microM free Ca2+ and 100 microM PI. Maximal activation of PI breakdown was seen at 1 mM deoxycholate as was true for PIP2 and PIP breakdown. There was little effect, even of 30 microM GTP gamma S alone or of carbachol alone, on PI breakdown. Half-maximal activation of the carbachol response required only 0.2 microM GTP gamma S. These results indicate that the phospholipase C enzyme(s) activated by carbachol in the presence of GTP gamma S in rat brain cortical membranes can degrade PIP2, PIP, and PI to inositol phosphates and diacylglycerol.
Franklin and the Pennsylvania Germans

Although the Germans began to arrive in Pennsylvania forty years before Benjamin Franklin left Boston for Philadelphia in 1723, both began to attract attention in that decade. Franklin gained fame as an innovative writer and expert printer, which made him wealthy enough to withdraw from business by the late 1740s.1 The Pennsylvania Germans became obvious because of the non-Britishness of the multitudes of them who were leaving behind the wars of Europe for William Penn's comparatively peaceful "Holy Experiment." By the middle decades of the century, estimates placed their numbers between 60,000 and 100,000, constituting one-third to three-fifths of the colony's nearly 200,000 to 300,000 inhabitants.2 Most of the early arrivals belonged to the pacifistic religious groups. Almost all of the later ones were Lutheran and Reformed, with a few Roman Catholics, who had no qualms about fighting "a just war," though almost all initially supported the peace-loving English Quakers politically.3
Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review

Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine’s effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for.
Correlations between Personality and Leadership Concepts and Skills as Measured by the High School Personality Questionnaire and the Leadership Skills Inventory

The correlations among the subscales on the High School Personality Questionnaire and the Leadership Skills Inventory, estimated for 95 student leaders, were numerous, significant, and positive but of small magnitude. Several significant differences were found between boys and girls.
«Annuloplasty» of the proximal coronary bypass anastomosis

A technique is described to reduce the size of the aortotomy after constructing the proximal coronary bypass anastomosis. It is used to avoid suture line hemorrhage and distortion of the proximal vein graft.
Application of Ceramic Membranes in Advanced Coal-based Power Generation Systems

Abstract The U.S. Department of Energy is researching high-temperature ceramic gas separation membranes. DOE will demonstrate the feasibility of using these membranes to remove the sulfur and nitrogen contaminants found in gas streams of advanced coal-based power generation systems. These contaminants must be removed to protect not only the turbine system components but also the environment. This paper discusses the integration of passive, faciltated, and catalytic membranes, and the expected benefits of applying this membrane technology.
Lesions in the pulvinar in patients with Alzheimer's disease

The pulvinar nucleus of the thalamus has been implicated in visual attention and in the control of eye movements, and may also help mediate attention-dependent tasks in the auditory and somatosensory systems. Consequently, a hypothetical disruption of functions mediated by the pulvinar may help understand common visual and nonvisual symptoms in patients with Alzheimer's disease. To test this hypothesis, the pulvinar nuclei of nine patients with histologically confirmed Alzheimer's disease and twelve young (9-28 years of age) and age-matched controls (without dementia and with non-Alzheimer dementias) were examined using a battery of histopathological methods. All patients with Alzheimer's disease had numerous amyloid plaques and some neuritic plaques throughout the various subdivisions of the pulvinar. Neuropil threads were also present among the senile plaques, and neurofibrillary tangles occurred in clusters throughout the nucleus. Control patients with and without dementia had very few Alzheimer lesions, which should be expected in normal elderly individuals. The lesions in the pulvinar may help understand some of the clinical manifestations of Alzheimer's disease, including deficits in attention and in a host of visual disturbances. Such deficits may be the result of involvement of reciprocal thalamo-cortical and corticothalamo-cortical circuits that appear to be critical for the function of a vast expanse of association cortices interconnected with the pulvinar, which are heavily laden with lesions themselves.
Hope for the Best, Prepare for the Worst: Response of Tall Steel Buildings to the ShakeOut Scenario Earthquake

This work represents an effort to develop one plausible realization of the effects of the scenario event on tall steel moment-frame buildings. We have used the simulated ground motions with three-dimensional nonlinear finite element models of three buildings in the 20-story class to simulate structural responses at 784 analysis sites spaced at approximately 4 km throughout the San Fernando Valley, the San Gabriel Valley, and the Los Angeles Basin. Based on the simulation results and available information on the number and distribution of steel buildings, the recommended damage scenario for the ShakeOut drill was 5% of the estimated 150 steel moment-frame structures in the 10–30 story range collapsing, 10% red-tagged, 15% with damage serious enough to cause loss of life, and 20% with visible damage requiring building closure.
Characterization of phycoerythrin from a Cryptomonas sp.

Two closely similar phycoerythrins were purified from Cryptomonas sp. The two proteins were indistinguishable with respect to native molecular weight, subunit structure, photolability and immunological specificity, and differed only in their isoelectric points (pH 5.74 and 6.35), as determined by isoelectric focussing in polyacrylamide gels. Each protein consisted of two unequal subunits, α (mol. wt. 11,800) and β (mol. wt. 19,000), and each subunit contained covalently bound chromophore. In contrast to the blue-green and red algal phycoerythrins studied thus far, the Cryptomonas sp. phycoerythrins are extremely photolabile; exposure of the purified proteins to relatively short periods of intense illumination with visible light produces a marked decrease in fluorescence and in absorbance at 567 mμ.
Observations of parent-child interactions with hyperactive children: Research and clinical implications

Abstract This paper provides a review and summary of the functional relations and possible reciprocal effects that take place during interactions between Attention-Deficit Hyperactive Disorder (ADHD) children and their parents. Following a general description of an interactional model, direct observation, medication, and parent training research involving ADHD children and their parents is reviewed. Results indicate that the behaviors emitted by ADHD children and their parents are consistent with Patterson's coercion theory. Medication and parent training may be effective because they both interrupt coercive interactions by lowering the base rate of aversive behaviors, consequently reducing the frequency of behaviors that are negatively reinforced by the discontinuation of aversive responses emitted by another person. A final section focuses on research design issues and implications for treatment.